Flashcards in 7.2 Contraception Deck (18):
Give the main methods to contraceptions
- Abstinence, coitus interuption, rhythm
Inhibition of transport along uterine tubes
Inhibition of implantation:
Give 3 methods of natural contraception.
What is the problem with coitus interrupts?
Stop sex before ejaculation
Sperm in pre-ejaculate
What is the rhythm method? Disadvantage?
Have sex only in non-fertile period
Requires regular cycle.
What is a vasectomy?
Prevent sperm from entering ejactulate by dividing cad deferens bilaterally.
Give 3 barrier methods of contraception. Prupose?
Prevent sperm from reaching cervix
Advantages of condoms?
Disadvantages of diaphragm
Protect against STIs
Requires correct fitting
Does not completely occlude passage
Holds sperm in acid environment of vagina, reducing survival time.
How does progesterone act as contraception? Oestrogen?
Thick hostile cervical mucus plug
Prevents sperm from entering uterus
Negative feedback to hypothalamus/pituitary
Decrease frequency of GnRH pulses, inhibiting follicular development.
Oestrogen negatively feeds back on ant pit
Loss of positive feedback - no LH surge - inhibits ovulation
Giv the types of hormonal contraception.
3 monthly injections
Negative feedback to inhibit ovulation
What is sterilisation?
Occlusion of Fallopian tubes:
Clips, rings, ligatino.
Give some IUCDs
Interferes with endometrial enzymes
Interferes with implantation
Describe post-coital contraception
• Combined Oestrogen / Progesterone High Dose
o Or Progesterone only
• Up to 72 hours after intercourse
• May disrupt ovulation
• Blocks implantation
• May also impair luteal function
What is infertility? What can it be due to?
• Failure to conceive within 1 year
• Primary (no previous pregnancy) or secondary (previous pregnancy)
• Due to:
o Coital problems
• Occasionally anovulatory cycles are normal at extremes of reproductive life
Describe polycystic ovarian syndrome.
• Uncertain pathogenesis
• Increased androgen secretion
• Raised LH/FSH ratio
o Lack of pulsatile GnRH release
o Many follicles begin to develop but dominant follicle is not selected to mature.
• Insulin resistance
• Multiple small ovarian cysts
• Anovulation, amenorrhoea/oligomenorrhoea
• LH dependent excess androgen production from both ovaries and adrenals
o Androgens may suppress LH surge
• Abnormal hair growth
o Oily skin/acne
• Abnormal oestrogen secretion put women at risk of endometrial malignancy
o Sustained oestrogen stimulation of endometrium
How can ovulation be induced?
o Reduce negative feedback to hypothalamus/pituitary.
o Increase GnRH/FSH
o FSH administration
• GnRH agonists
o Pulsatile to mimic normal secretion
How is infertility due to tubal occlusion caused, diagnosed and treated?
• Caused by:
o Scarring from infection/endometriosis
• Diagnosed by:
o Laparoscopy and dye
o Tubal surgery
o Assisted conception
How is infertility due to abnormal sperm caused, diagnosed and treated?
• Abnormal production
o Testicular disease
• Obstruction of ducts
• Hypothalamic/pituitary dysfunction