1- Contraceptives Flashcards
Women 18-24 yrs, black or hispanic, low education/SES, and cohabitating but never married are at higher risk for what?
Higher risk for unintended pregnancy
Delay in prenatal care, reduced likelihood of breastfeeding, depression, and risk of physical violence during pregnancy are consequences of what?
Consequences of unintended pregnancy affecting the mother
Birth defects/ low weight, more likely to experience poor mental/ physical health during childhood, lower educational attainment, and more behavioral issues in teen years are consequences of what?
Consequences of unintended pregnancy affecting the child
What are the barriers to contraception use?
Unnecessary medical tests, cost, inability to receive contriception on same days as office visit, objection to contraception (religious beliefs), difficulty obtainined continued contraception, lack of understanding of confidentiality law by adolescents
In order to start contraception, a patient only needs to meet what?
Reasonable certainty that she is not pregnant
What are the requirements, that if any are met, there is > 99% positive predictive value the Pt is not pregnant?
ā¤ 7 days after start of menses, no sex since start of last menses, correctly/ consistently using reliable contraception, ā¤ 7 days after spontaneous/ induced abortion, w/in 4 weeks postpartum, fully/ nearly fully breast feeding + amenorrheic + < 6 mos postpartum
What are the most effective methods of birth control?
LARC (impant, IUD), surgical sterilization
What are the least effective methods of birth control?
Fertility-awareness based methods, spermicide
What should always be used to reduce the risk of STIs?
condoms
The standard days method of natural planning (although high failure rates) may be used by who?
Women with menstrual cycles from 26-32 days long
A pt using the standard days method of natural planning should abstain from intercourse on which days?
8 to 19
When would a pt use the calendar method of natural family planning?
If cycle is outside of 26-32 day range
What is required to āeffectivelyā use the calendar method of natural family planning?
Monitor cycle X 6 months, avoid sex during fertile peroid
How do you calculate your fertile peroid if using the calendar method?
First day of fertile period = length of shortest menstrual cycles - 18 days, last day of fertile peroid = length of longest menstrual cycle - 11 days
In the cervical mucus method of natural family planning, you should check cervical mucus daily and your peak day is when?
Last day of āstretchyā clear mucus
How can the fertile period be identified when using the cervical mucus method of natural family planning?
Occurs with 1st signs of mucus and continues until 4 days after peak day
When should you abstain from sex if using the cervical mucous method?
From time of ANY cervical sercretion until 4 days after peak day
What is the two day method?
If no secretions for 2 consecuative days, okay to have intercourse
How do you use the basal body temp method of natural family planning?
Check basal body tempe each a.m. before getting out of bed, rise in tempe of 0.5-1deg F = ovulation
When should you abstain from sex if using the basal body temp method of natural family planning?
From end of menstrual period until 3 days after temp increase
Which natural family method is a combination of mucus and basal body temp methods?
Symptothermal methods
How do you idenitify the fertile peroid if using the symptothermal method?
Monitor for 1st sign of ovulation (temp change, last day stretchy cervical mucus) until 3 days after temp rise or 4 days after peak mucus
What are the barrier methods of contraception?
Diaphragm, condoms, cervical caps, cervical sponge
What male condom is more likely to slip or break?
polyurethane base
What type of condoms for men have lower level of STI protection than latex?
Natural membranes
Use of what should be avoided if using condoms?
Petroleum-based vaginal products (includes vaginal yeast infection tx)
What is the typical use failure rate and perfect use failure rate of condoms for men?
18% vs 2% (often incorrectly used)
What are the advantages of male condom use?
reduces transmission of STIs, readily available, inexpensive
What is a disadvantage of male condom use?
May break or fall off
What types of female contraceptives can be left in place x 48 hours and must be left in for a minimum of 6 hours after sex?
Cervical caps and diaphragm
What type of female contraceptive can be inserted up to 8 hours in advance?
Condoms for women
What are the advantages of female controlled barriers?
immediately active (spermicide requires 15 minutes for activation), no effect on menses or hormones
What are the disadvantages of female controlled barriers?
UTI risk w/ diaphragm, no HIV protection
What type of female contraceptive releases continual spermacide and must be left in for a minimum of 6 hours after sex?
Sponge
What is the MOA of female spermicides?
Attack sperm flagella and body, reducing motility (can be used alone or w/ additional barrier)
What is Plan B or Preven?
Emergency oral contriceptive. Two doses of contraceptive pills taken within 72 hrs of unprotected intercourse
How can an IUD be used as a form of emergency contriceptives?
IUD inserted w/i 5 days of unprotected intercourse
What form of emergency contriceptives is a selective protegesteron receptor modulator (SPRM)?
Ulipristal Acetate (Ella)
What is the advantage of a SPRM vs hormone emergency contriceptives?
SPRMs are effective for up to 120 hrs post unprotected intervourse vs hormones which are only effective for 72 hrs.
Oral contraceptive pills, NuvaRing, OrthoEvra Patch, and Depo Provera are all what types of contraception?
Short acting/ frequent use