by mtoom

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What are the ingredients of viable in vivo pregnancy? (7)
  • Ovulation
  • Intercourse
  • Viable sperm
  • Cervix that will admit sperm
  • Patent fallopian tubes
  • Eggs and sperm must meet
  • Receptive endometrium
How long does luteal phase last?
  • How many days for ovulation?
  • How many days for corpus luteum?
14 days
  • 2 days for ovulation
  • 12 days for corpus luteum
What are some general reasons that contraception is important? (3)
  • In developed world, women spend 3 decades trying not to get pregnant
  • Unplanned teen pregnancies have serious social implications
  • In developing countries, childbirth and abortion and major causes of maternal morbidity and mortality
Is there a perfect contraception method?
  • How should contraception be picked? 
No perfect method
  • Contraception should be tailored to individual needs 
What are "natural" methods of contraception? (2)
  • Withdrawal
  • Fertility awareness 
How do you do fertility awareness?
Use cycle length and physical manifestations of ovulation to predict the fertile days in the menstrual cycle and void intercourse on those days
  • Sperm and egg never meet 
What happens to the basal body temperature that is relevant to fertility awareness
  • What does it indicate? 
Increase in body temp follows the LH surge as progesterone levels rise
  •  Indicates ovulation
When is a woman most fertile?
In the 3-5 days prior to ovulation, and at ovulation, a woman is most fertile
  • Fertility continues for about 48 hours after ovulation
What does the thickness of cervical mucus mean?
Post-ovulation, the cervical mucus thickens due to progesterone
  • Prior to ovulation, the mucus is thin, stretchy and clear
What are methods of permanent contraception? (2)
  • Give the mechanisms of action 
  • Tubal ligation: Blocks fallopian tube patency (sperm and egg never meet)
  • Vasectomy: Interrupts the vas deferens (sperm and egg never meet) 
What are barrier methods of contraception? (4)
  • Mechanism of action? 

Sperm and egg never meet
  • Condoms (male, female)
  • Cervical cap
  • Diaphragm
  • Sponge
What hormones are in the combined contraceptive pill? (2) *
  • Estradiol
  • Progesterone
In general, what is the mechanism of action of the combined contraceptive pill? *
Inhibits gonadotropin secretion via negative feedback on pituitary and hypothalamus
  • But also has other specific effects 
What is the mechanism of action of estradiol specifically? (1) *
Primarily inhibits FSH release
  • Inhibits follicular recruitment, prevents ovulation
What is the mechanism of action of progesterone specifically? (4) *
  • Suppresses LH release (prevents ovulation)
  • Endometrium not receptive to ovum (decidualized bed with atrophic glands)
  • Cervical mucus thick and impervious
  • Reduced tubal peristalsis (stops sperm) 
What are options for combined contraceptive? (3)
  • Oral contraceptive pills
  • Transdermal patch
  • Vaginal ring 
What is the mechanism of action for progesterone-only contraception? (4)
It has the same 4 effects as the when progesterone is found in the combined pill
  • Suppress LH
  • Endometrium not receptive
  • Mucus thick
  • Tubal peristalsis reduced 
What effect does progesterone have on endometrium in contraception? *
  • Explain this in detail
  • Stabilizes endometrium
  • However, continued exposure causes a dense network of thin-walled fragile veins to develop 
Effects of this:
  • Menses on hormonal contraception tend to be light and short
  • Menses may be non-existent or irregular and light 
What is an important clinical application for progesterone-only contraception? *
Can be used to treat dysmennorrhea and menorrhagia
  • Use it to treat heavy, painful periods 
What are some other benefits of contraceptives? (9) *
  • Don't need to be able to list these, but good to be aware of 
  • Menorrhagia
  • Decrease anemia
  • Dysmenorrhea
  • PMS
  • Acne
  • Peri-menopausal Sx
  • Decrease PID
  • Decrease Ectopic pregnancy
  • Decrease Ovarian & Endometrial cancer
In what ways is progesterone-only contraception available? (4)
  • Pills
  • IM/SubQ injection
  • IUD
  • Implants
What is the mechanism of action of emergency contraception?
Multifactorial, poorly understood
Is emergency contraception abortive or non-abortive?
In general, in what ways do IUDs prevent contraception? (2)
  • Prevent implantation
  • Prevent entry of semen
What is the mechanism of action of copper IUD?
Chronic inflammatory changes within endometrium and fallopian tubes
  • Toxic to sperm, ova
  • Prevents fertilization
  • Discourages implantation
What is mechanism for levonorgesterel-releasing IUD? (2)
  • Changes in cervical mucus
  • Thinning and glandular atrophy of endometrium
What methods prevent ovulation? (1)
  • Hormonal contraception
What methods work in fallopian tube? (2)
  • Hormonal contraception
  • Tubal ligation
What methods work by preventing implantation? (2)
  • Hormonal contraception
  • IUD
What methods work by preventing entry of semen? (4)
  • Barrier methods
  • Vasectomy
  • Hormonal contraception
  • Coitus interruptus
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