Contraception Flashcards Preview

ESA 4 - Reproductive System > Contraception > Flashcards

Flashcards in Contraception Deck (71):
1

What is the role of oestrogen in the menstrual cycle in the early/middle follicular phase, before ovulation? 

It has a negative effect on the anterior pituitary and hypothalamus, thus producing negative feedback

2

What else has a negative effect on the anterior pituitary during the early/middle follicular phase? 

Inhibin 

3

What is the role of oestrogen at ovulation? 

It has a positive effect on the hypothalamus and anterior pituitary, causing the LH surge

4

What dose is progesterone at in the early/middle follicular phase (before ovulation)?

Moderate/high doses

5

What does progesterone do at moderate/high doses in the early/middle follicular phase? 

Enhances the negative feedback of natural oestrogen, reducing LH and FSH secretion

6

What does progesterone do at moderate/high doses during ovulation? 

Inhibits positive feedback of oestrogen, so no LH surge, so no ovualtion

7

What does progesterone do at lower doses during ovulation? 

Does not inhibit LH surge, so ovulation still likely, but will thicken cervical mucus

8

What are the common methods of contraception? 

  • Natural 
  • Barrier
  • Prevention of ovulation
  • Inhibition of sperm transport
  • Inhibition of implantation
  • Sterilisation 

 

9

What are the natural methods of contraception? 

  • Fertility awareness methods
  • Lactational amenorrohea method

 

10

What happens in fertility awareness methods? 

 Use of fertility indicators to identify fertile and infertile points of the menstrual cycle

11

What are the fertility awareness methods of contraception? 

  • Cervical secretions
  • Basal body temperature
  • Length of menstrual cycle

 

12

What is the lactionional amenorrhoea method of contraception? 

Breastfeeding delays the return of ovulation after childbirth

13

How long is the lactational amenorrhoea method effective for? 

Up to 6 months after giving birth

14

What are the advantages of natural contraception methods? 

  • No hormones
  • No contraindications

 

15

What are the disadvantages of natural contraception methods? 

  • Not as effective
  • Unreliable

 

16

What is barrier contraception? 

A physical barrier that prevents entrance of sperm into cervix

17

Give 2 examples of barrier contraception

  • Male/female condoms
  • Female diaphragm/cap

 

18

What are the advantages of condoms? 

Can help prevent STIs

19

What are the disadvantages of male condoms? 

Sensitivity/allergy to latex

20

What are the disadvantages of female condoms? 

Not as widely available

21

What are female diaphragms/caps also used with? 

Spermicide

22

What are the advantages of female diaphragms/caps? 

Can be inserted anytime, so additional chemical barrier

23

What are the disadvantages of female diaghragms/caps? 

Need to use with spermicide, which can cause local reaction

24

What methods of contraception prevent ovulation? 

  • Combined oral contraceptive pill
  • Progesterone depot
  • Progesterone implant

25

How can progesterone prevent ovulation? 

At moderate/high doses, it inhibits the positive feedback of oestrogen, so no LH surge, so no ovulation 

26

What does the combined oral contraceptive pill (COCP) contain? 

Combination of oestrogen and progesterone

27

When is the COCP taken? 

Either for 21 days, followed by 7 day break, or 28 days with 7 days of 'dummy' pill

28

What is the principal action of the COCP? 

To prevent ovulation

29

What is the secondary action of the COCP? 

  • Reduced endometrial receptivitiy to inhibit implantation 
  • Thickens cervical mucus to inhibit penetration of sperm

 

30

What are the advantages of COCP?

  • Can relieve menstrual disorders
  • Reduces risk of ovarian cysts and cancer

 

31

What are the disadvantages of the COCP? 

  • User dependant 
  • Side effects
  • Increases risk of certain conditions 

 

32

What are the side effects of COCP? 

  • Breakthough bleeding
  • Breast tenderness
  • Mood disturbance

 

33

What does COCP increase the risk of? 

  • Venous thromboembolism 
  • Myocardial infarction

 

34

What is in a prosterone depot? 

Synthetic progesteron

 

35

How is a progesterone depot administered? 

Via subcutaneous/intramuscular injection, which is slowly released into the systemic circulation 

36

How long does a progesteron depot last? 

8-13 weeks

37

What is the principle action of a progesteron depot? 

Prevent ovulation 

38

What are the secondary actions of progesterone depots? 

  • Thickens cervical mucus to inhibit penetration of sperm
  • Reduces endometrial receptivity to inhibit implantation

 

39

What are the advantages of a progesterone depot? 

  • Convenient
  • Can relieve menstrual disorders

 

40

What are the disadvantages of a progesterone depot? 

  • Altered and irregular bleeding is common
  • Delayed return of fertility for up to 1 year after stopping
  • Not quickly reversible
  • Small loss of bone mineral density, and possible increase fracture risk

 

41

What is a progesterone implant? 

A progesterone containing 4cm flexible rod implant that is inserted sub-dermally in upper arm

42

How long does the progesterone implant work for? 

Can work for up to 3 years

43

What is the principle action of the progesterone implant? 

Prevent ovulation

44

What are the secondary actions of the progesterone implant? 

  • Reduce endometrial receptivity to inhibit implantation
  • Thickens cervical mucus to inhibit penetration of sperm

 

45

What are the advantages of the progesterone implant? 

  • Long duration of action
  • Convenient
  • Can relieve menstrual disorders

 

46

What are the disadvantages of the progesterone implant? 

  • Small procedure required to fit and remove the implant
  • Local adverse effects can occur
  • Can cause changes in bleeding pattern

 

47

What methods of contraception inhibit sperm transport? 

  • Progesterone only pill
  • Secondary action of other contraceptives

 

48

What will progesterone do at lower doses?

Does not inhibit the LH surge, so ovulation still likely, but will thicken cervical mucus

49

How does the progesterone only pill compare to other contraceptive methods? 

It has a lower dose of progesterone

50

What does the progesterone only pill do? 

Thickens the cervical mucus, making it impenetrable to sperm

51

What are the advantages of the progesterone only pill? 

Can be used where the COCP is contraindicated

52

What are the disadvantages of the progesterone only pill? 

  • Menstrual problems are common
  • Must be taken at the same time each day

 

53

What is the error for forgotton progesterone only pill? 

Only 3 hours late

54

What contraceptive methods is inhibition of sperm transport a secondary action of? 

  • COCP
  • Progesterone depot
  • Progesterone implant
  • Intrauterine system

 

55

What methods of contraception inhibit implantation?

Intrauterine device

56

What is a intrauterine device? 

A small device made of plastic with added copper that is placed in the uterus

57

What is the principal action of an intrauterine device? 

Copper is toxic to sperm and ovum, which prevents fertilisation 

58

What are the secondary actions of an intrauterine device? 

  • Convenient 
  • Long duration of action
  • Emergency contraception

 

 

59

How long does an intrauterine device last? 

5-10 years

60

When can an intrauterine device be used as emergency contraception? 

Up to 5 days after unprotected intercourse

61

What are the disadvantages of an interuterine device? 

  • Insertion may be unpleasant
  • IUD displacement/expulsion may occur
  • Periods may be heavier, longer, and more painful
  • Risk of uterine perforation is 2/1000 insertions

 

62

What is the male sterilisation procedure called? 

Vasectomy

63

What happens in a vasectomy? 

Vas deferens are interrupted to prevent sperm entering the ejaculate. Done under local anaesthetic 

64

What much be done after a vasectomy? 

Must conform success by post-operative semen analysis to confirm no sperm in the ejaculate

65

When is a post-vasectomy semen analysis done? 

12-16 weeks after surgery

66

What are the advantages of a vasectomy? 

  • Pernament
  • No hormonal side effects

 

67

What are the disadvantages of a vasectomy? 

  • Failure rate 1/2000
  • Should not be done if any doubt about having chidren in the future

 

68

What is the female sterilisation procedure? 

Tubal ligation/clipping

69

What happens in tubal ligation/clipping? 

Fallopian tubes are cut or blocked to stop the ovum travelling down from the ovary to the uterus. Done under local or general anasthetic 

70

What are the advantages of tubal ligation/clipping? 

  • Permanent
  • No hormonal side effects

 

71

What are the disadvantages of tubal ligation/clipping? 

  • Failure rate 2-5/1000
  • Should not be chosen if any doubt about having children in the future