Contraceptions Flashcards
(32 cards)
What is the two type of contraceptions?
One requires ongoing action by the individual.
The other type prevents contraception by default.
What are some examples of ongoing contraception?
Oral contraception, barrier methods, fertility awareness, coitus interruption and oral emergency contraception.
What are some examples of contraception by default?
IUD, progesterone implant, progesterone injections and sterilisation.
Describe the perfect contraception.
The perfect contraception should be 100% reliable and safe. It should be universally usable.
Ideally, it is not related to coitus and visible to women so we know when it is safe.
If there is no ongoing input then you don’t have to worry about it.
It should be completely reversible within 24 hours.
It shouldn’t cause discomfort.
What does COCP contain?
Oestrogen and progesterone
How does COCP work?
a higher than normal levels of oestrogen and progesterone and acts on the hypothalamic/pituitary/ ovarian axis to provide negative feedback. It tricks the body into thinking it is pregnant and prevent ovulation.
Progesterone also act on the fallopian tube to prevent contraction and peristalsis, the cervical mucus to make it thicker and prevent sperm from entering.
what are the names of oestrogen and progestogens that are given in COCPs?
ethinylestradiol is oestrogen.
2nd gen progesterones are norethisterone and levonorgestrel.
3rd gen are desogestrel, gestodene and norgestimate.
which type of progestogens have anti-mineralocorticoid effects?
Latest in use of COCP is called drospirenone.
What are the benefits of using COCP?
It is reliable and safe.
Unrelated to coitus.
Women is in control
Rapidly reversible - it takes 10 days of no drugs to return to fertility.
half your chance of ovarian and endometrial cancer - due to those cells not proliferating.
also helps wth dysmenorrhoea, menorrhagia.
You can take as long as you want without taking a break.
What is the recommended use of COCP?
take it every day for 21 days in a 3 hours window and rest for 7 days for a light bleed.
What are the risks of COCP?
1 in 500 women will get pregnant.
Progesterone increase blood pressure and 2% of women develop hypertension.
Oestrogen increase clotting factors so increase the risk of DVT. If you were to develop a DVT it would occur within 6 months and expose women with underlying problems and risk factors.
What is the advice for forgetting to take COCP?
use a condom as you are no longer safe. Maybe don’t have the break.
What are the contraindications to COCP?
enzyme-inducing drugs such as antiepileptic drugs. enzyme inducing drugs can increase the metabolism of both oestrogen and progesterone.
Broad spectrum antibiotics affect the enterohepatic circulation of oestrogen causing it to be broken down.
What is combined vaginal contraception?
IT is a ring that is inserted into the vagina which releases the combined hormones in COCP. You put the ring in for 21 days and take it out for 7.
What are some progesterone only methods of contraception?
progesterone implant in the skin in your arm last 3 years.
cerazette is a newer version progesterone only pill. It has better control over bleeding, whereas the older version has trouble with spotting and bleeding. It also has a longer window of 12 hours.
Medroxyprogesterone is an injection which lasts 12 weeks in your buttocks.
It is good when you don’t want oestrogen while breastfeeding.
What are the two major types of IUD? And how does it work?
The copper bearing which is used to cause a local inflammatory environment. It kills sperms and prevents implantation. the minimum amount of time is 5 years. The higher amount of copper the longer it lasts.
Marina hormone bearing, it contains progestogens. It runs out after 5 years.
Benefits to IUD?
Immediately effective, non-user dependent, long-term and very reliable.
Merina reduces menses.
Disadvantages to IUDs?
IT can range from discomfort to hurt unbearably when you are putting it in.
With copper bearing the period can become more heavy and painful, due to the transition from COCP to regular flow then heavier flow.
If te thread i=is too long then it rubs against the vaginal wall, if it is too short then it can stab the guy.
4cm vs 2 cm.
Risk to IUD
If the person is pregnant before IUD is put in, chances of miscarriage increase. It is best to take it out in this case.
Overall chances of pregnancy increase, but the risk of ectopic pregnancy increases if the patient were to be impregnated.
If you don’t put it in further enough the cervix push it out if it is put in wrongly or too far it can end up in the abdomen.
Contraindications to IUCD
Pelvic inflammatory disease and infections need to be treated first.
never put it in if there is suspected pregnancy.
investigate unexplained vaginal pregnancy.
an abnormal uterine cavity can be a problem.
can’t use it on women with an endometrium fibroid problem.
Condoms advantage and disadvantage
The best protection against STIs, no serious health risks except latex allergies.
Must be used during all part of intercourse, people need to be taught how to use it.
What are the two types of caps?
Diaphram, which is made up of latex and it fits across the vagina. It needs to be used with spermicide and left in for 6 hours after sex to kill all the sperms.
Suction (cervical) caps, which is made up of plastic. It acts as a vaginal vault. It also needs to be used with spermicide and left for 6 hours.
What are some advantage and disadvantages to diaphragm Caps?
The advantage is the women is in control, it can be prepared in advance. It offers protection against cervical dysplasia. It is perceived as natural (diaphragm).
Disadvantage include, you need to teach how it is used, it can be messy, higher failure rate, higher UTI and higher candidiasis which is a fungal infection.
What are some advantage and disadvantage to suction caps?
It is suitable for women with poor pelvic muscles and no rubber allergies. It is very nonobstructive and the women are in control.
The disadvantage is it needs a suitable and accessible cervix. It has a higher failure rate than the diaphragm cap. It is also difficult to find an experienced teacher.
