Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproduction > Contraception > Flashcards

Contraception Flashcards

(85 cards)

Start Studying
1
Q

What is involved in natural family planning?

A 
Basal body temperature
Cervical mucous
Cervical position
“Standard” days
Breast feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is basal body temp taken and what are the characteristics of it?

A

Before rising in morning
Increase in temp of >0.2’C
Sustained for 3 days after at least 6 of lower temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe cervical mucous

A

Thick and sticky post ovulation

At least 3 days after thinner, watery, stretchy mucous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is meant by cervical position?

A

When fertile, cervix is high in vagina, open and soft

When less fertile, cervix is low in vagina, firm and closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are standard days?

A

In a 28 day cycle, days 8-18 are the most fertile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can breast feeding be used as a form of birth control?

A 
3 criteria needed:
Exclusively breast feeding
Less than 6/12 post natal
Amenorrhoeic 
98% effective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 4 UKMEC categories for contraception?

A
  1. No restriction for the use of the contraceptive method
  2. Where the advantages of using the method generally outweigh the theoretical or proven risks
  3. A condition where the theoretical or proven risks generally outweigh the advantages of using the method.
  4. A condition which represents an unacceptable risk if the contraceptive method is used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Pearl index?

A

Represents no. of contraceptive failures per 100 women users/year
No. of accidental pregnancies x 1200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What LARC exists in the UK?

A

Injectable contraceptive: Depo provera/Sayana press

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does Depo provera/Sayana press work?

A

Inhibit ovulation
Given every 13 weeks, will last 14
Other effects on cervical mucus and endometrium
P.I. 0.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What examination should be done prior to contraception prescription?

A

BP/BMI
Smear status
RFs for osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the risk factors for osteoporosis?

A 
Underweight
Anorexia
Prolonged steroid use
XS alcohol intake
Immobility
FHx
Smoking
Low trauma fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What chronic conditions increase the likelihood of osteoporosis?

A 
Hypothyroidism
Coeliac
RA
Hyperparathyroidism
IBD
Chronic renal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When can depo be started?

A

Up to and including day 5 of cycle without need for additional contraception
Beyond day 5, depo can be started but condoms must be used for 7 days, and reasonably certain of not pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is defined as reasonably certain of not currently pregnant?

A

No sex since last period
Consistently using reliable contraception
<7days since last normal period
<4 weeks post partum
Fully breastfeeding, amenorrhoeic and <6m post partum
-ve preg test
>3 wks since UPSI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When can Depo be started post partum and post TOP?

A

Postpartum: Up to day 21 with immediate cover

Post TOP: Up to day 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some side effects of Depo?

A

Weight gain
Delay in return of fertility
Irregular bleeding
Risk of osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe IUD

A 
Non-hormonal
Copper and plastic
Prevents fertilisation- inflammatory response in endometrium
5/10years
P.I. 0.6-0.8%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe IUS

A 
T-shaped
Releases levonorgestrel
Effects on implantation-endometrium rendered unfavourable
Also on mucus and pre-fertilisation
P.I. 0.2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the two types of IUS?

A 
52mg LNG-IUS  (MIRENA®)
52mg levonorgestrel 
20 mcg levonorgestrel daily
Decreasing to 10ug per day a 5 yrs 
13.5mg LNG-IUS (Jaydess®)
14ug per day for first 24 days
Decreasing to 5ug per day at 5 yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What contraindicates IUD/IUS?

A 
Current pelvic infection
Abnormal uterine anatomy
Pregnancy
Sensitivity to any of the constituents
Gestational trophoblastic disease when BHCG levels are abnormal/persistently elevated
Endometrial ca
Cervical ca awaiting treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What examination should be done prior to IUD/IUS?

A

PV to check uterine size/position

BP/pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When can an IUD be fitted?

A

Within first 7 days of period
Anytime provided reasonably certain not pregnant
Up to 5 days after UPSI (for emergency contraception)
Up to 5 days after predicted date ovulation
Either within 48hours or >4 weeks post partum
Immediately post TOP (if products of conception seen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When can an IUS be fitted?

A

Within first 7 days of period
Anytime provided reasonably certain not pregnant
Not used for EC
If fitted within first 7/7, use condoms for 7/7
Either within 48 hrs or >4wks post partum
Immediately post TOP (products of conception seen) up to day 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the side effects and problems associated with IUD?
``` Heavy, prolonged menses Pain, infection PID increased in first 20days Perforation Expulsion Higher post 2nd trim abortion Ectopic risk ```
26
What are the side effects and problems associated with IUS?
``` Lighter, less frequent bleeding Pain, infection PID increased in first 20 days Perforation Expulsion Ectopic risk Failure ```
27
What is the implant?
Single, non biodegradable subdermal rod 3 years licence Contains 68mg ENG, releases 60/70ug/day in weeks 5-6, 25-30ug/day by end of 3 years
28
How does the implant work?
Inhibition of ovulation Also effect on endometrium and cervical mucus P.I. 0-0.1%
29
When can the implant be fitted?
No need for precautions: first 5 days of cycle, up to day 5 post 1st/2nd trim abortion, on or before day 21 post partum Precautions first 7 days: if reasonably certain not pregnancy, quick start after EC, off-licence
30
When can the implant be fitted post CHC/depo and COC, patch or vaginal ring?
CHC/depo-immediately | COC/patch/vaginal ring: week 2-3
31
When switching from another method, when are additional precautions needed in the first 7 days?
Changing from POP or LNG-IUS | Switching from non-hormonal method
32
What are the side effects of the implant?
``` Irregular bleeding Wt gain Acne Nerve/vascular injury Deep insertion ```
33
Are there any general health concerns with the implant?
No known effect on BMD, CV risk, VTE risk, MI risk
34
What are the non-contraceptive features that CHC can benefit/improve?
``` Heavy menstrual bleeding Painful periods Acne Irregular periods Premenstrual symptoms Endometriosis Menstrual migraine (no aura) ```
35
What are the 3 types of CHC, and their drug doses?
COC- 20-35μg EE Combined transdermal patch- 33μg EE Combined vaginal ring- 15μg EE
36
What medications are used in CHC?
Oestrogen (ethinyl estradiol (EE)) | Progestogen (various)
37
What is the mode of action of CHC?
Inhibiting ovulation via action on HPO axis to reduce LH/FSH | Also alters cervical mucus, and renders endometrium unfavourable for implantation
38
What is the efficacy of CHC?
Perfect use: 0.3% | Typical: 9%
39
If a patient using CTP is >=90kg, what may this cause?
Decreased efficacy- use alternative
40
What is the standard regime for COC?
Take daily for 21 days, then stop for 7 (withdrawal bleed occurs) First 7 pills inhibit ovulation, remaining 14 pills maintain anovulation
41
When will follicular activity resume following COC?
After 9 pills have been omitted
42
What is the standard regime for CTP?
One patch applied and worn for 1 week to suppress ovulation Reapplied weekly for further 2 weeks 4th week is patch free (withdrawal bleed), new patch worn thereafter
43
What is the standard regime for CVR?
Ring placed in vagina and left continuously for 21 days | Ring free interval of 7 days for withdrawal bleed, then new ring
44
What are some tailored off licence regimes for CHC?
Tri cycling- 3 packs back to back then 7 days off Shortened hormone free interval, 3 weeks on 4 days off Extended use- continuous until breakthrough bleeding, then stop for 4 or 7 days
45
What factors require consideration for safe prescribing of CHC?
Absorption Metabolism Metabolic effects
46
What factors may affect effectiveness of CHC?
Impaired absorption- GI conditions Increased metabolism-liver enzyme induction Drug Interaction Compliance
47
What should you do when you miss one COC pill?
Over 24 hours and less than 48 hours without pill Take the missed pill as soon as it is remembered Remaining pills are taken at the normal time EC is not required
48
What should you do when you miss two or more COC pills?
More than 48 hrs without pills Take the most recent missed pill Take the remaining pills at the correct time Use condoms or abstain until 7 pills have been taken consecutively
49
To minimise the risk of pregnancy, what can be done if more than 48 hours without pills?
Days 1-7: Consider EC Days 8-14: No extra instructions Days 15-21: Omit pill free interval Low threshold for EC and bicycling packets
50
What happens regarding removal of a CTP?
Can remain off for up to 48 hours before efficacy reduced
51
How long can the patch be worn or the patch free interval be extended by before efficacy is reduced?
7 days + 48 hours | Though if interval, EC may be needed
52
How long can the CVR be left out of vagina before efficacy reduced?
48 hours
53
How long can the CVR be worn for before efficacy reduced?
Up to 4 weeks
54
How long can the ring free interval be extended by without efficacy reduced?
48 hours
55
What are some risks of CHC?
Venous thrombosis Arterial thrombosis Adverse effects on some cancers
56
What are some metabolic effects of CHC?
Alteration in clotting factor levels induced by EE may be thrombogenic eg reduces levels of antithrombin III and protein S In patients with significant arterial wall disease EE may also promote superimposed arterial thrombosis There is increased fibrinolytic activity but reversed in heavy smokers
57
What are some risk factors for VTE with regards to contraception?
``` Obesity Smoking Age Known thrombophilia VTE in first degree relative < 45 yrs Up to 6 weeks postnatal Trekking >4500m for >1wk Long-haul flights Reduced mobility Antiphospholipid syndrome Other ```
58
What can co-cyprindiol be used for?
Acne and hirsutism treatment- not licenced contraception but acts as contraceptive
59
What makes up co-cyprindiol?
Ethinyl-estradiol 35μg/cyproterone acetate
60
What CHCs have the lowest risk of VTE?
CHCs that contain levonorgestrel, norethisterone, or norgestimate
61
What are some circulatory effects from COC?
Systemic HT, therefore must check initially at 3 months then annually Arterial disease- risk of MI- especially smokers, ischaemic stroke
62
CHC use in individuals with migraine with aura further increases the risk of what?
Stroke, therefore contraindicated
63
What UKMEC category is BRACA?
3
64
If you have a personal or family history of breast cancer, what does this mean for contraception?
Personal: CHC contraindicated FHx: UKMEC 1
65
CHC can increase the risk of cervical cancer with what use?
Long term of >5yrs, reduces to baseline 10y after stoppign
66
What cancers have CHCs been shown to provide protection against?
Ovarian and endometrial- benefit may last decades after CHC use
67
Do all CHCs show a beneficial effect on acne?
Yes
68
What conditions/problems can benefit from CHC?
``` Acne Bleeding-withdrawal bleed Functional ovarian cysts Premenstrual syndrome PCOS ```
69
What are some S/Es of CHCs?
Unscheduled bleeding- usually settles by 3 months Mood changes- no evidence for depression Weight gain- no strong evidence
70
What side effects does CTP have compared to COC?
More breast pain Nausea Painful periods compared to COC/CVR
71
What side effects does CVR have compared to COC?
Less bleeding problems Acne Irritability/mood changes
72
When can you start CHC?
Up to and including day 5 of cycle without precautions | Beyond this, anytime off licence provided reasonably certain not pregnant and uses condoms for 7 days
73
What should be used after EC?
``` Levonelle 1500 (progestogen) – abstain/condoms 7 days Ulipristal Acetate (anti-progesterone)- hormonal contraception interferes with action of Ulipristal Acetate- avoid starting contraception for 5 days ```
74
If pregnancy cannot be excluded, how should CHC be started?
Quick start and do PT in 4/5weeks (outwith licence, but guidelines support)
75
What are the types of POP?
Traditional: levonorgestrel, norethisterone Newer: etonorgestrel- longer lasting
76
What is the MOA of POP?
Thickening of cervical mucous Etonorgestrel – suppression of ovulation in up to 97% of cycles Also suppression of ovulation in up to 60% (levonorgestrel) Decreased endometrial receptivity to blastocyst Reduction in cilia activity in fallopian tube
77
What are the risks of POP?
Little effect on metabolism Given in most circumstances Safer than pregnancy, so UKMEC 3 UKMEC 4: Current breast cancer
78
What can POP's interact with?
Liver enzyme inducers-cytochrome P450 | Suitable alternatives needed, effect continues for 28 days after stopping
79
How are traditional POPs taken?
Daily at same time, no break | Within 24-27hours of last dose
80
How are newer POPs taken?
Daily at same time within 24-36hrs of last dose | No break
81
What should you do if you miss 1 dose of POP and have UPSI?
EC plus 2 days extra protection
82
What is the efficacy of POPs?
Perfect 0.3% Typical 9% Etonorgestrel- more effective Age important
83
How is vasectomy carried out?
LA/GA | No-scalpel technique
84
What is the P.I. of vasectomy?
0.1% (0.05 after clearance given)
85
What are some complications of vasectomy?
Failure- early (non compliant) | Post op testicular, scrotal, penile, lower abdo pain-rarely severe or chronic

Reproduction (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions