Contraception Flashcards
(36 cards)
What is the mechanism of action of the combined contraceptive pill
Prevents ovulation:
-ve feedback of oestrogen and progesterone on HP axis- prevents the LH surge
thickens cervical mucus- reduces chances of sperm penetrating womb
thins lining of the womb - reduce chance of egg implantation
How often is the COCP taken
taken every day for 3 weeks out of each month
What are the advantages of the COCP
does not interrupt sex
reduces risk of ovarian. uterine and colorectal cancer
can protect against PID and ovarian cysts
usually makes bleeds lighter, more regular and less painful
What are the disadvantages of the COCP
effectiveness depends on user Side effects- headaches, breast tenderness, mood changes has to be taken routinely increased BP no protection against STIs breakthrough bleeding increased risk of thrombosis
What are the contraindications of the COCP
pregnancy
BMI >35
breastfeeding
smoking or stopped less than a year ago and over 35
Hx of thrombosis, stroke, hypertension, migraine, currently Dx breast cancer
prolonged inactivity
What is the mechanism of action of the implant (Nexplanon)
steady release of progesterone - prevents ovulation, thickens cervical mucus and thins womb lining
How long does the implant last
3 years
What are the advantages of the implant
can be taken out at any point doesnt interrupt sex option for those who cant use oestrogen based contraception safe during breastfeeding not affected by other medication decreased risk of endometrial cancer
What are the disadvantages to the implant
no protection against STIs oligomenorrhoea or amenorrhoea weight gain SE - loss of libido and mood swings needs a procedure to insert - bruising and pain
What are the contraindications to the implant
pregnancy
arterial disease - Hx stroke and heart disease
unexplained bleeding post intercourse or inbetween periods
liver disease
breast cancer
How does the injection (depo-provera) work
Progesterone release
prevents ovulation
thickens cervical mucus
thins womb lining
How long does the injection last for
About 8-13 weeks
What are the advantages of the injection
Lasts 8 or 13 wks at a time Doesn’t interrupt sex Option for those who can’t use oestrogen based contraception Safe whilst breastfeeding Not affected by other meds
What are the disadvantages of the injection
Change to periods No protection against STIs Can be a delay of up to a year before periods return to normal and you can conceive once stopping it Weight gain SE: loss of libido, mood swings etc
What are the contraindications to the injection
Pregnant Want to conceive in next year Unexplained bleeding Liver disease Breast cancer Osteoporosis risk History of CV disease and stroke.
How does the patch work
Releases oestrogen and progesterone through the skin.
prevents ovulation, thickens cervical mucus and thins womb lining
What are the advantages of the patch
easy to use
doesn’t interrupt sex
still works with D&V
reduced risk of ovarian and bowel cancer, fibroids and cysts
What are the disadvantages to the patch
may be visible can cause skin irritation and soreness no protection against STIs breakthrough bleeding needs to be changed weekly
What are the contraindications to the patch
pregnancy breastfeeding a baby <6 weeks old smoking and are 35 and over and have just stopped overweight other medication
How does the intrauterine system (mirena/jaydess) work
small T shaped plastic device inserted into uterus
releases levonorgestrel.
thins womb lining - implantation less likely
can prevent ovulation but women will often still ovulate
What are the advantages of the IUS
works for 3/5 years
one of the most effective forms of contraception
safe to use if breastfeeding
doesnt interrupt sex
good option if unable to take oestrogen
possible to conceive as soon as it’s removed
What are the disadvantages to the IUS
risk of developing small ovarian cysts increased risk of ectopic pregnancies and PID and perforation no protection against STIs spotting in the first few weeks may stop periods altogether
What are the contraindications to the IUS
Untreated STI
Womb or cervix problems
How does the intrauterine copper device (copper coil) work
small t shaped copper device that creates an unfavourable environment in the womb for sperm and causes a localised inflammatory response preventing implantation of eggs
