Gynecology and Obstetrics: Contraception and Endocrinology

This set of vocabulary flashcards covers contraceptive methods, their efficacy (Pearl Index), hormonal mechanisms, PCOS diagnosis (Rotterdam criteria), and clinical endocrinology including menopause and abortion procedures.

LARC

Long Acting Reversible Contraception, which includes IUCDs and SC implants.

Pearl Index (PI)

The number of conceptions per $100$ women per exposure years ($13$ cycles); used to measure the efficacy of a contraceptive method.

Life-table Analysis

A longitudinal follow-up of real contraceptive users that calculates monthly, yearly, and cumulative conception percentages, accounting for variation over time.

Calendar Method

A natural family planning method where the fertile period is calculated as day (shortest cycle $-20$ days) to day (longest cycle $-10$ days); typically days $8-18$ of the cycle.

Mucus Method (Ovulation Method)

A method where the fertile period is identified by the presence of stretchable cervical mucus; coitus is allowed only after $3$ dry days following the peak mucus symptom.

Temperature Method

A method based on the rise in basal body temperature ($0.3-0.5^{\circ}C$) caused by progesterone after ovulation; coitus is safe once BT has remained elevated for $3$ consecutive days.

Symptothermic Method

The best form of natural family planning (NFP) that combines cycle registration, mucus detection, and basal body temperature measurement.

Rule of Three (Postpartum Contraception)

Guideline stating contraception should start at $3$ months post-partum if fully breastfeeding, or at $3$ weeks post-partum if partially breastfeeding.

Coitus Interruptus (Withdrawal)

A common but non-recommended method with a typical use PI of $20$; failures can occur due to sperm in pre-ejaculatory fluid from Cowper's glands or premature ejaculation.

IUCD (Intra-Uterine Contraceptive Device)

A plastic device (Copper or Progestogen-containing) that creates a low-grade serial inflammatory reaction in the uterus, acting as a spermicide and preventing implantation.

Heavy Menstrual Bleeding (HMB)

Excessive menstrual blood loss; the $LNG-52$ IUCD is considered the most effective therapy for this condition.

LNG-IUCD (Levonorgestrel IUCD)

A T-shaped device releasing levonorgestrel ($52$, $19.5$, or $13.5\,mg$) that thins the endometrium and thickens cervical mucus to prevent sperm passage.

Asherman Syndrome

An intra-uterine adhesion condition caused by deep destruction and scarring of the decidua, leading to hypomenorrhea, amenorrhea, and infertility.

COC (Combined Oral Contraceptives)

The pill, which uses ethinylestradiol ($EE$) and a progestagen (often a $19$-nortestosterone derivative) to inhibit FSH and LH, thereby suppressing follicle maturation and ovulation.

7-7-7 Rule

A guideline for missed pills: $7$ days is the maximum hormone-free interval to suppress FSH/LH; $7$ days of continuous intake is required to allow a pill-free interval; and spermatozoa can survive for $7$ days in the genital tract.

Evira

A transdermal patch releasing $20\,\mu g/day$ of ethinylestradiol and $150\,\mu g/day$ of norelgestromin; used for $3$ weeks followed by a $1$-week patch-free interval.

Nuvaring

A vaginal ring releasing $15\,\mu g$ EE and $130\,\mu g$ etonogestrel daily; it remains in place for $21$ days followed by a $7$-day ring-free period.

DMPA (Depot Medroxyprogesterone Acetate)

A progestagen injection ($150\,mg$ IM) every $3$ months that consistently suppresses the LH peak and ovulation; slow reversibility (avg. $9$ months to concept).

Implanon NXT

A subcutaneous implant ($4\,cm$) releasing $etonegestrol$; provides highly effective contraception for $3$ to $5$ years and is quickly reversible.

POP (Progestogen-Only Pill)

Also called the minipil; primary contraception for smokers over $35$, those with VTE history, or breastfeeding women, though it requires very strict intake timing.

Virilism

Serious hyperandrogenism characterized by hirsutism, alopecia, amenorrhea, increased muscle mass, and clitoral hypertrophy; often caused by androgen-producing tumors.

PCOS (Polycystic Ovary Syndrome)

A functional disorder involving androgen overproduction in theca cells and arrested follicle maturation, leading to anovulation and polycystic ovarian morphology.

Rotterdam Criteria

Diagnostic criteria for PCOS requiring 2 out of 3: clinical/biochemical hyperandrogenism, oligo/amenorrhea, or PCO morphology on ultrasound ($>25$ follicles or volume $>10\,cm^3$).

Acanthosis Nigricans

Brown, velvety skin thickening in the neck and armpits; a clinical sign of insulin resistance often seen in obese PCOS patients.

PCT (Progestin Challenge Test)

Intake of progestagen for $5-7$ days to check for a withdrawal bleed; a positive bleed indicates a proliferative endometrium and sufficient endogenous estrogen.

Kallman Syndrome

A rare cause of primary amenorrhea and hypo-estrogenism featuring hyposmia or anosmia due to developmental failure of olfactory neurons.

Female Athletic Triad

A syndrome consisting of energy deficiency, menstrual dysfunction (amenorrhea), and low bone mineral density, typically seen in intense athletes.

Sheehan Syndrome

Acute necrosis of the pituitary gland following massive obstetric hemorrhage, leading to panhypopituitary insufficiency and failure of lactation.

Vasomotor Symptoms

Classic menopausal symptoms including hot flashes (flushing) and night sweats caused by a narrowed thermoneural zone in the hypothalamus.

HST (Hormone Substitution Therapy)

Treatment for moderate to severe menopausal symptoms; involves estrogen monotherapy (post-hysterectomy) or combined estrogen-progestagen (with uterus).

LOOP Events (Luteal Out of Phase)

Superimposed cycles in late reproductive years where high FSH levels cause a new dominant follicle to develop during the luteal phase of the previous cycle.

GnRH Agonists

Pharmacological agents that cause a short 'flare up' of FSH/LH followed by desensitization, creating a state of pharmacological castraton/hypo-estrogenism used for endometriosis or leiomyomas.

Mifepristone

A progesterone receptor blocker used in medication-induced abortion to cause lysis of pregnancy tissue and softening of the cervix.

Misoprostol

A prostaglandin used following mifepristone to induce contractions and expulsion of pregnancy tissue; effective for up to $10$ weeks of pregnancy.

Asherman's Syndrome

Intra-uterine adhesions resulting from deep destruction of the decidua and scarring, often following a curretage, appearing as hypomenorrhea or infertility.