14 - Repro - Contraception Flashcards Preview

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Flashcards in 14 - Repro - Contraception Deck (34):
1

Name the 2 methods of natural contraception:

1) Fertility awareness
2) Lactational amenorrhoea

2

What can be used to monitor fertility, as a method of natural contraception?

- Cervical secretion
- Body temperature
- Length of cycle

3

What are the advantages of natural contraception?

- No hormones
- No contraindications

4

What are the disadvantages of natural contraception?

- Not as effective
- Unreliable

5

Name the 6 main types of contraception:

1) Natural
2) Barrier
3) Prevention of ovulation
4) Inhibition of sperm transport
5) Inhibition of implantation
6) Sterilisation

6

List 2 types of barrier contraceptions:

1) Condoms
2) Female diaphragm/cap

7

What are the advantages of barrier contraceptions?

- Can prevent STIs
- No hormones

8

What are the disadvantages of barrier contraceptions?

- Latex allergies (male condoms)
- Female condoms are not widely available
- Female diaphragms/cap require spermicide

9

What hormone is used in contraceptions which prevent ovulation? How does it work?

Progestogen (synthetic progesterone) at moderate/high dose
- Inhibits positive feedback of oestrogen on the hypothalamus
= no LH surge = no ovulation

10

What are the 3 methods of contraception used to prevent ovulation?

1) Combined Oral Contraceptive Pill (COCP)
2) Progesterone Implant
3) Progesterone Depot (injection)

11

What are the disadvantages/side-effects of the Combined Oral Contraceptive Pill?

- User dependent (inconvenient)
- Bleeding
- Breast tenderness
- Mood disturbances
- Headaches
- Hypertension
- Gallstones + cholestatic jaundice
- Increased risk of venous thromboembolism
- Increased risk of myocardial infarction
- Many contraindications

12

What are the disadvantages of the prosterone depot (injection)?

- Bleeding
- Not quickly reversible (return of fertility <1yr)
- Small loss of bone mineral density

13

How long does the progesterone depot (injection) last?

~ 8-13 wks

14

How long does the progesterone implant last?

~ 3yrs

15

What are the disadvantages of the progesterone implant?

- Small procedure required
- May have local adverse effects
- Can affect bleeding

16

Name the main method of contraception which inhibits sperm transport:

Progesterone-only pill (POP)

17

How does the progesterone-only pill work as a method of contraception?

Low-dose progesterone thickens cervical mucous, which becomes impenetrable to sperm

18

What are the disadvantages/side-effects of the progesterone-only pill?

- Breast tenderness
- Mood swings
- Heavy bleeding or spotting
- Abdominal cramps
- User dependent, must be taken at same time everyday (error margin = 3hrs)

19

What are the 2 main methods of contraception which inhibit implantation?

1) IUD (copper coil)
2) IUS (progesterone coil)

20

How does an Intrauterine System work as contraception?

Progestogen:
- Decreases endometrial proliferation
- Thickens cervical mucous

21

How does an Intrauterine Device work as contraception?

Copper:
- Toxic to sperm and ovum
- Inflammatory endometrial reaction = prevents implantation
- Changes cervical mucous

22

What are the disadvantages of using a coil for contraception? (copper + progestogen)

- Unpleasant insertion
- Displacement/expulsion may occur
- Menstrual irregularity + may be longer/heavier/painful
- Uterine perforation

23

What are the methods of sterilisation used as contraception?

- Vasectomy
- Tubal ligation

24

Define primary infertility:

Failure of conception in a couple having regular unprotected sex for 1+ yr, with no previous pregnancy.

25

Define secondary infertility:

Failure of conception in a couple having regular unprotected sex for 1+ yr, with 1+ previous pregnancy.

26

What percentage of couples concieve within 1 yr of havinf regular unprotected sex?

~ 75 - 80%

27

Is infertility more likely due to the female or male?

Female ~ 70%

28

What causes Polycystic Ovary Syndrome (PCOS)?

Lack of pulsatile GnRH secretion
= abnormal oestrogen secretion

29

What is the typical presentation of Polycystic Ovary Syndrome?

- Secondary amenorrhoea
- Hirsutism
- Infertility
- Obesity

30

Why are women with Polycystic Ovary Syndrome at higher risk of endometrial carcinoma?

Abnormal oestrogen secretion
= Abnormal endometrial proliferation

31

Why are women with Polycystic Ovary Syndrome at higher risk of diabetes + CVD?

Commonly have high insulin resistance = obese

32

What investigations may you do on a couple presenting with infertility?

Female:
- LH/FSH/Progesterone check
- Cervical smear
- Pelvic USS

Male:
- Sperm analysis
- LH/FSH/Testosterone check
- USS

33

What are some methods of inducing ovulation?

- Weight loss/gain
- Clomiphene citrate
- Gonadotrophins
- GnRH agonists
- Ovum donation

34

How does clomiphene citrate induce ovulation?

Anti-oestrogen = reduces negative feedback of oestrogen at the hypothalamus
= ^ GnRH = ^ FSH + LH