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Contraception and HRT Flashcards

1
Q

List 3 ways by which contraception prevents pregnancy.

A

1 - Preventing ovulation.

2 - Preventing fertilisation.

3 - Preventing implantation.

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2
Q

Which event marks the beginning of pregnancy?

A

Implantation.

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3
Q

What is the PEARL index?

A

The failure rate of a contraceptive per 100 years of use.

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4
Q

List 4 contraceptives with no potential for user failure.

A

1 - Intrauterine devices such as copper coils.

2 - Intrauterine systems such as levonorgestrel.

3 - Hormone implants.

4 - Sterilisation.

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5
Q

List 3 contraceptives with potential for user failure.

A

1 - Barrier contraceptives.

2 - Hormonal drugs.

3 - Lactational amenorrhoea.

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6
Q

How do levels of oestrogen and progesterone differ between pregnancy and the combined contraceptive pill?

A
  • In pregnancy, oestrogen and progesterone increase until delivery.
  • With the combined pill, oestrogen and progesterone stay at a constant level.
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7
Q

What is the typical failure rate of male condoms?

How does this compare to the failure rate with perfect use?

A
  • Male condoms have a 17% failure rate with typical use.

- Male condoms have a 2% failure rate with perfect use.

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8
Q

What is the typical failure rate of female condoms?

How does this compare to the failure rate with perfect use?

A
  • Female condoms have a 21% failure rate with typical use.

- Female condoms have a 5% failure rate with perfect use.

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9
Q

List 2 barrier methods other than condoms.

How are they used?

A

1 - Diaphragms.

2 - Caps.

  • They are inserted into the cervix and used in combination with spermicides.
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10
Q

What does LARC stand for?

List 4 advantages of LARCs.

A
  • Long-acting reversible contraception.

1 - Effectiveness doesn’t depend on memory or use.

2 - More effective than other forms of contraception.

3 - Cost-effective.

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11
Q

List 4 LARCs.

A

1 - Intrauterine systems.

2 - Intrauterine devices.

3 - Implants.

4 - Progesterone only injection.

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12
Q

What are intrauterine systems?

Describe the mechanism of action of intrauterine systems.

A
  • Intrauterine systems are small, plastic T-shaped devices that are inserted into the uterus.
  • They gradually release levonorgestrel, a progesterone analogue. This causes:

1 - Thinning of the endometrium.

2 - Thickening of the cervical mucus.

3 - Inhibition of ovulation by negative feedback of FSH and LH.

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13
Q

What is the failure rate of intrauterine systems?

A

<1%.

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14
Q

What are intrauterine devices?

Describe the mechanism of action of intrauterine devices.

A
  • Intrauterine devices are small, plastic T-shaped devices with copper on the stem / arms that are inserted into the uterus.
  • They are directly toxic to both the sperm and the egg.
  • If fertilisation occurs, they prevent implantation by inducing a foreign body reaction.
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15
Q

What is the failure rate of intrauterine systems?

A

<1%.

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16
Q

Describe the mechanism of action of implants.

A

They release etonogestrel, a progesterone analogue, to:

1 - Prevent ovulation by negative feedback of FSH and LH.

2 - Thicken cervical mucus.

17
Q

What is the failure rate of implants?

A

<1%.

18
Q

What is the main injectable contraceptive?

Which drug does it contain?

A
  • Depo-provera is the main injectable contraceptive.

- It contains medroxyprogesterone acetate, a progesterone analogue.

19
Q

List 2 injectable contraceptives other than Depo-provera.

A

1 - Sayana Press.

2 - Norethisterone enanthate.

20
Q

List 3 combined hormonal contraceptives.

A

1 - Combined pill.

2 - Patch.

3 - Vaginal ring.

21
Q

List the mechanisms of action by which hormonal contraceptives prevent pregnancy.

A
  • Primary mechanism: prevent ovulation by negative feedback of FSH and LH.
  • Secondary mechanism: thickens cervical mucus and thins endometrium.
22
Q

Which hormones are contained in combined pills?

A

Oestrogen and progesterone.

23
Q

What is a hormone-free gap?

A

The period in which a person taking a combined pill stops taking the medication to allow for withdrawal bleeding.

24
Q

List the drugs contained in combined vaginal rings.

A

1 - An oestrogen analogue.

2 - Etonogestrel, a progesterone analogue.

25
Q

List 3 examples of progesterone only pills.

A

1 - Desogestrel.

2 - Levonorgestrel.

3 - Norethisterone.

*All of these are progesterone analogues.

26
Q

Describe the mechanism of action of progesterone only pills.

A
  • Primary mechanism: prevent ovulation by negative feedback of FSH and LH.
  • Secondary mechanism: thicken cervical mucus and thin endometrium.
27
Q

List 3 main fertility indicators.

A

1 - Body temperature.

2 - Consistency and colour of cervical secretions.

3 - Point in menstrual cycle.

28
Q

List 2 natural family planning methods.

A

1 - Using indicators to determine fertility at a particular point in the menstrual cycle.

2 - Lactational amenorrhoea.

29
Q

What is the failure rate of using the 3 main fertility indicators to determine fertility as a contraceptive method?

A

1 - 20%.

30
Q

What is the failure rate of using lactational amenorrhoea as a contraceptive method?

A

2%.

31
Q

How do vasectomies work?

What is the failure rate of vasectomies?

A
  • By cutting and sealing / tying the vas deferens, preventing the sperm from entering the prostate.
  • Failure rate is 1 in 2000.
32
Q

How does female sterilisation work?

A
  • By clipping the uterine tubes or by a salpingectomy, where a part of the uterine tube is removed and the open ends are tied together.
  • Failure rate is 1 in 200.
33
Q

List 2 emergency contraceptives.

How long after sex are the contraceptives effective?

A

1 - Copper coil intrauterine device (effective for 120 hours after).

2 - Emergency contraceptive pills such as levonorgestrel (effective for 96 hours after) or ulipristal acetate (effective for 120 hours after).

34
Q

What is the failure rate for the copper coil as an emergency contraceptive?

A

<1%.

35
Q

What is the failure rate for emergency contraceptive pills?

A
  • 40% for levonorgestrel.

- 20 - 40% for ulipristal acetate.

36
Q

In women with premature ovarian insufficiency, when does menopause occur?

A

Before the age of 40.

37
Q

List 2 forms of hormone replacement therapy for treatment of symptoms of menopause.

A
  • In a woman with a uterus, offer combined oestrogen + progesterone.
  • In a woman without a uterus, offer oestrogen.
  • Symptoms of menopause are on other lectures.

RED (20 decks)

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