Contraception Flashcards
(34 cards)
Which types of contraception act in the ovaries?
Combined hormonal contraception
Progesterone-only pill
Injection
Implant
Which types of contraception act in the endometrium?
IUS and IUD
Which types of contraception act in the cervix?
IUS
Progesterone-only pill
CHC
Describe the female menstrual cycle
FSH
Ovarian follicular development
Oestrogen levels rise
Oestrogen
Endometrial proliferation
LH surge
LH
Ovulation
Corpus luteum formation
Oestrogen and progesterone rise
Progesterone
Endometrial thickening
What is the mode of action for the combined hormonal contraception?
- Inhibits LH and FSH which prevents ovulation
- Thickens cervical mucus which is a natural sperm barrier
- Thins endometrium which prevents implantation
What is the failure rate for Combined hormonal therapy?
If used perfectly 0.3 per 100 woman years
If used typically 9 per 100 woman years
What are the different ways CHC can be administered?
Birth control pills
Patch
vaginal ring
What are the advantages and disadvantages of the combined hormonal contraception?
Advantages
- Reduces PMS
- Reduces heavy menstral bleeding
- Reduces painful periods
- Reduces the risk of pelvic inflammatory disease
- Reduces the risk of ovarian and colorectal cancer
- improves acne
What are the disadvantages of combined hormonal therapy?
- High risk of venous thromboembolism
- High risk of stroke
- High risk of cardiovascular;ar disease
- Increased risk of breast cancer- (returns to normal after 10 years)
- causes depression
Temporary side effects:
headache, nausea, breast tenderness,mood changes, breakthrough bleeding.
Conditions which you should not take CHC with?
- cardiovascular disease (atrial fibrillation)
- Stroke
-Hypertension - Liver disease
-BMI>35
-smoker over 35
< 6 weeks postpartum if breastfeeding
<3 weeks postpartum if non-breastfeeding
What is the mode of action for progesterone only contraception?
Thickens cervical mucus- natural sperm barrier
Thins endometrium- prevents implantation
Inhibits ovulation
What is the failure rate for progesterone only contraception?
If used perfectly 0.3 per 100 woman years
If used typically 9 per 100 woman years
What are the different types of progesterone only contraception?
Injection (Depo-Provera)
lasts 3 months
Implant (Nexplanon/Implanon)
lasts 3 years
Intrauterine system (IUS) lasts 5 years
What are the advantages of progesterone only contraception?
- Reduces menstrual bleeding
- Reduces painful periods
- Reduce risk of endometrial cancer
- Can be used when breastfeeding
- Fewer adverse effects compared to CHC
What are the disadvantages of progesterone only contraception?
- Irregular spotting
- Acne
- Headaches, nausea, mood swings, bloating, breast tenderness, weight gain
- Ovarian cysts
- All above usually settle after 6 months
IUS only – expulsion, ectopic pregnancy
Conditions which you should not take progesterone only contraception with?
Unexplained vaginal bleeding
If VTE / stroke / Ischaemic heart disease occurs during use
Breast cancer
Severe liver disease
IUS only – Pelvic inflammatory disease, >48h - <4w postpartum
What is the mode of action for the Intrauterine device/Copper coil?
Copper is spermicidal
Thickens cervical mucus-natural sperm barrier
May act as physical barrier to implantation
What is the failure rate for Intrauterine device/Copper coil?
0.6-0.8 per 100 woman years
What are the advantages of the Intrauterine device/Copper coil?
Long-acting (5-10 years)
No hormones
What are the disadvantages of the Intrauterine device/Copper coil?
Uterine perforation Expulsion Ectopic pregnancy Pelvic inflammatory disease Menorrhagia (IUD only)
Conditions which you should not take Intrauterine device/Copper coil with?
Unexplained vaginal bleeding
PID / untreated STI
Cancers (cervical, endometrial)
List the two types of barrier methods, what is there failure rate?
Male condom
If used perfectly failure rate 2 per 100 woman years
If used typically failure rate 18 per 100 woman years
Diaphragm / cap
If used perfectly, failure rate 6 per 100 woman years
If used typically, failure rate 12 per 100 woman years
What has to be monitored in the natural planning method?
Temperature
Consistency of cervical mucus
Position of cervix
Day of cycle
What is the failure rate for the natural planning method?
If used perfectly failure rate is 0.5 per 100 woman years
If used typically failure rate is 24 per 100 woman years
