S5) Contraception and Infertility Flashcards Preview

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Flashcards in S5) Contraception and Infertility Deck (57)
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1

What is contraception?

Contraception is any method to prevent pregnancy 

2

Describe 3 different means of contraception

- Blocking transport of sperm to avoid fertilisation of oocyte

- Disrupting the HPG axis to interfere with ovulation

- Inhibiting implantation of the conceptus into endometrium 

3

Identify 6 broad methods of contraception

- Natural

- Barrier

- Hormonal Control

- Prevention of implantation

- Sterilisation

- Emergency contraception 

4

Identify 4 forms for natural contraception

- Abstinence 

- Withdrawal method

- Fertility Awareness Methods

- Lactational amenorrhoea method

5

What is abstinence?

Abstinence is the practice of refraining from sex 

6

What are the advantages and disadvantages of abstinence?

- Advantage: 100% reliable 

- Disadvantage: no sex

7

What does fertility awareness involve?

Fertility awareness involves the use of fertility indicators to identify fertile and infertile points of the menstrual cycle

8

Identify 3 different fertility awareness methods 

- Cervical secretions

- Basal body temperatures

- Length of menstrual cycle 

9

Identify the advantages and disadvantages of fertility awareness methods

- Advantages: no hormones/contraindications

- Disadvantages: unreliable, no protection from STI's

10

What does the withdrawal method involve?

The withdrawal method involves withdrawing the penis before ejaculation 

11

Identify the advantages and disadvantages of the withdrawal method

- Advantages: no devices/hormones

- Disadvantages: unreliable, some sperm may be released in the pre-ejaculate, no protection from STI’s 

12

What does the lactational amenorrhea method involve?

- Breastfeeding delays the return of ovulation after childbirth

- Suckling stimulus disrupts release of GnRH

- Affects feedback cycle of HPG axis

13

How long is the lactational amenorrhea method effective for?

Up to 6 months after giving birth 

14

What are the advantages and disadvantages of the lactational amenorrhoea method 

- Advantages: no hormones/contraindications

- Disadvantages: unreliable, no STI prevention 

15

Identify 2 forms of barrier contraception

- Male/Female condoms

- Diaphragm/Caps 

16

What does barrier contraception involve?

- Physical barriers prevent sperm entering the cervix

- Can also used with spermicide (additional chemical barrier)

17

What are the advantages and disadvantages of barrier contraception?

- Advantages: reliable, protection from STIs, widely available (male condom)

- Disadvantages: disrupt romantic nature, reduce sexual pleasure, can expire, allergy/sensitivity to latex/ spermicide 

18

Identify 4 forms of contraception involving hormonal control

- Combined Oestrogen and Progestogen

- Progesterone Depot

- Progesterone Implant

- Low dose progestogen 

19

Identify 2 long-acting reversible contraceptives (LARC)

- Progesterone Depot

- Progesterone Implant 

20

What is progestogen?

Progestogen is a synthetic form of progesterone 

21

What is the role of progesterone in moderate/high doses?

- Progesterone enhances the negative feedback of natural oestrogen – reducing LH and FSH secretion

- No LH surge means no ovulation 

22

What is the role of progesterone in lower doses?

- Progesterone does not inhibit the LH surge

- Ovulation is still likely

- Cervical mucus thickens

23

What is the Combined Oral Contraceptive Pill?

COCP is a pill containing combination of synthetic oestrogen and progestogen 

24

What is the principal action of the COCP?

Principal action: prevents ovulation

 

25

What are the secondary actions of the COCP?

- Reduces endometrial receptivity to inhibit implantation

- Thickens cervical mucus to inhibit penetration of sperm 

26

What are the advantages and disadvantages of COCP?

- Advantages: relieves menstrual disorders, reduces risk of ovarian and endometrial cancer

- Disadvantages: no protection from STI's, interacts with other medications, side effects

27

Identify 4 clinical conditions which are at increased risk when on the COCP

- Breast and cervical cancer

- Venous thromboembolism

- MI

- Stroke

28

What is the principal action of High Dose Progestogen contraception?

Principal action: prevents ovulation

29

What is the secondary action of High Dose Progestogen contraception?

- Thickens cervical mucus to inhibit penetration of sperm

- Prevents endometrial proliferation 

30

What are the advantages and disadvantages of the High Dose Progestogen injection?

- Advantages: reliable, used by women who can't use contraception with oestrogen

- Disadvantages: appointment needed every 12 weeks, side effects, delay in fertility returning, no STI protection