Contraception / Womens Health Flashcards
(40 cards)
What are some forms of contraception?
COCP
POP
Copper coil
Levonorgestrel IUD
Depo injections
How does the combined oral contraceptive pill act as contraception?
Inhibits ovulation
Thickens cervical mucous
Prevents thickening of the endometrial lining
How does the Combined oral contraceptive pill (COCP) prevent ovulation?
High levels of oestrogen and progesterone have a negative feedback affect on the hypothalamic-gonadal-pituitary axis
Oestrogen - prevents release of GnRH and so levels of FSH stay low so less ovarian follicles mature
Progesterone - prevents LH surge preventing ovulation from taking place
What can the combined oral contraceptive pill be used for (COCP)?
Contraception
Menstrual regulation (menorrhagia, dysmenorrhoea)
Acne and hirstism
Endometriosis symptoms
PMS
PCOS
Protection from ovarian, endometrial and colorectal cancer
What scoring system is used to assess whether certain contraceptive measures are safe?
UKMEC criteria
What are some contraindications to the combined oral contraceptive pill?
Migraine with aura
VTE
Breast cancer
How long does it take for the combined oral contraceptive pill to become effective?
7 days
What is some saftey netting advice for the combined oral contraceptive pill?
Chest pain, severe headaches, severe leg pain, eye symptoms seek urgent medical help
Doesnt protect from STIs
What are some common side effects with the COCP?
Nausea and breast tenderness
Spotting
Mood changes
Headaches
How does the progesterone only pill act as contraception?
Inhibits ovulation
Thickens cervical mucus
Slows tubul motility
What are the indications for using the progesterone only pill?
Cannot tolerate or have contraindications to oestrogen (migraine with aura or VTE)
Are breastfeeding
Bridging therapy to long acting methods
What are the contraindications for the progesterone only pill?
Current breast cancer (main one)
Unexplained vaginal bleeding
Severe arterial disease
What are the common side effects for the progesterone only pill?
Irregular bleeding
Amenorrhoea
Breast tenderness
What is the main life threatening complication that can occur with the progesterone only pill and why?
Ectopic pregnancy
Reduced tubular motility in the fallopian tubes
How does the progesterone injection work as contraception (depo)?
Inhibits ovulation (prevents LH surge)
Thickens cervical mucous
Thins endometrial lining
How often is the depo-provers administered?
IM injection every 12 weeks
What are the indications for giving the progesterone injection?
Long acting reversible contraception
When oestrogen contraindicated
Heavy menstrual bleeding
Dysmenorrhoea
Endometriosis
What are the contraindications to the progesterone injection?
Current breast cancer
Unexplained vaginal bleeding
Severe arterial disease
What are some side effects/considerations for the progesterone injection?
Irregular bleeding
Delayed returns to fertility
Increased risk of breast cancer
Weight gain
How does the IUS act as contraception?
Locally releases progesterone (levonorgestrel) into the uterus
This thickens cervical mucous, thins endometrial lining
DOES NOT TYPICAALLY PREVENT ovulation
What are the indications for the IUS?
Contraception long term
FIRST LINE FOR HEAVY MENSTRUAL BLEEDING IS MIRENA
Endometriosis dysmenorrhoea
Endometrial protection in HRT
What are the contraindications to the IUS?
Pregnancy
Fibroids
PID
Breast cancer
Progesterone sensitive cancers
What are some considerations and side effects for the IUS?
No STI protection
Fertility rapidly returns with removal
Bleeding often irregular at first - tends to improve
