Contraception - Combined Hormonal Flashcards Preview

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Flashcards in Contraception - Combined Hormonal Deck (49)
1

What does hormonal contraction use?

The female steroid hormones oestrogen and progesterone

2

Is hormonal contraception effective?

Yes, is very effective way of preventing pregnancy

3

What can hormonal contraception be split into?

- Combined methods
- Progesterone-only

4

What do combined methods of hormonal contraception contain?

Oestrogen and progesterone

5

What is the primary action of combined hormonal contraception?

Inhibits ovulation due to the negative feedback effect of the oestrogen and progesterone on the hypothalamic-pituitary axis. This prevents the surge in LH, thus preventing ovulation

6

What are the additional actions of progesterone in combined hormonal contraception?

- Inhibits proliferation of endometrium, creating unfavourable conditions for implantation
- Increases thickness of cervical mucus, preventing passage of sperm

7

How is a period free of hormones achieved in combined hormonal contraceptives?

The patient takes a pill-free break or takes placebos

8

What does the period free of hormones cause when using combined hormonal contraceptives?

A fall in hormone levels, which leads to degeneration of the endometrium and menstrual bleeding

9

What is the failure rate of combined hormonal contraceptives with perfect use?

0.3%

10

What is the typical failure rate of combined hormonal contraceptives?

9%

11

What is the combined oral contraceptive pill (COCP) commonly called?

The pill

12

What does the COCP contain?

Oestrogen and progesterone

13

How many tablets are there in a packet of the COCP?

Either 21 or 28

14

What is the regime of COCP with a packet containing 21 tablets?

Taken consecutively for 21 days, and then a 7-day break when no pills are taken

15

What is the regime of COCP with a packet containing 28 tablets?

The pills are taken non-stop, and there is no break before starting the next packet

16

What are the types of COCP?

- Monophasic
- Phasic

17

What is meant by monophonic COCP?

Every pill contains the same levels of oestrogen and progesterone

18

What is meant by phasic COCP?

Levels of oestrogen and progesterone in the pills changes throughout the cycle

19

Other than monophonic and phasic, how can the hormone levels vary between different pills?

Can have varying levels of oestrogen

20

What is classified as a 'low oestrogen' COCP?

Contains 20µg of ethinylestradiol

21

What is more common, monophasic or phasic?

Monophasic

22

Give 2 examples of monophasic COCPs?

- Microgynon 30
- Brevinor

23

Is microgynon 30 and brevinor given in 21 or 28 tablet packs?

21

24

What are the types of phasic COCPs?

- Biphasic
- Triphasic
- Quadriphasic

25

What is very important when the patient is taking phasic COCP?

They take them in the correct order

26

Give 2 examples of phasic COCPs

- Qlaria
- Binovum

27

What kind of COCP is Qlaria?

Quadriphasic

28

Is Qlaria given in 21 or 28 tablet packs?

28

29

How many active pills are there in a pack of Qlaria?

26 (2 inactive)

30

What kind of COCP is Binovum?

Biphasic

31

Is Binovum given in 21 or 28 tablet packs?

21

32

What is the contraceptive patch?

A small 5x5cm patch that can be stuck onto the body to prevent pregnancy

33

Where can the contraceptive patch be stuck?

- Upper arm
- Abdomen
- Buttock
- Back

34

What is the brand of contraceptive patch used in the UK called?

Ortho Evra

35

How often should the contraceptive patch be changed?

Every 7 days over a period of 3 weeks (21 days)

36

What should happen after the patient has worn the contraceptive patch for 21 days?

It should be removed for 7 patch-free days

37

What will happen when the contraceptive patch is withdrawn?

The patient will usually experience a withdrawal bleed

38

How sticky is the contraceptive patch?

Extremely lol

39

Can the contraceptive patch be worn whilst bathing or swimming?

Yes

40

What is the brand name for the contraceptive vaginal ring?

NuvaRing

41

What is the contraceptive vaginal ring?

A plastic ring that is inserted into the vagina and provides hormones

42

How long is does the contraceptive vaginal ring sit in the vagina once inserted?

21 days

43

When might women feel discomfort with the contraceptive vaginal ring?

Some women feel uncomfortable inserting or removing the ring

44

What are the advantages of combined hormonal contraception?

- Non-invasive
- More effective than barrier methods if taken correctly
- Sex doesn't need to be interrupted to use contraception
- Menses tend to become regular, lighter, and less painful
- Reduced risk of certain medical conditions
- Normal fertility returns immediately after stopping use

45

What medical conditions does combined hormonal contraception reduce the risk of?

- Cancer of the ovary, uterus, and colon
- Functional ovarian cysts

46

What is an additional clinical use of combined hormonal contraception?

Can allow for timing over menses

47

What are the disadvantages of combined hormonal contraception?

- User dependant
- Some temporary adverse effects may be experienced by some women
- Women may experience breakthrough bleeding and spotting for first few months
- Increased risk of VTE
- Small increase in risk of MI and strokes
- Small increase in risk of breast cancer

48

What temporary adverse effects may be experienced with combined hormonal contraception?

- Headaches
- Breast tenderness
- Mood changes

49

What are the contraindications to combined hormonal contraception?

- BMI over 35
- Breastfeeding
- Smoking over the age of 35
- Hypertension
- History or family history of VTE
- Prolonged immobility due to surgery or disability
- Diabetes mellitus with complications, e.g. retinopathy
- History of migraines with aura
- Breast cancer or primary liver tumours