193b contraception

Question 1

where does hormonal contraception affect?

Answer 1

all - ovary, tube, cervix, endometrium

Question 2

vagina contraception

Answer 2

barriers - condoms, cervical cap, diaphragm

spermicides

Question 3

cervix contraception

Answer 3

cervical mucus responds to hormone levels
hormones and progestin IUD change

during ovulation cervix opens to sperm - progesterin blocks this

Question 4

ovary contraception

Answer 4

prefent ovulation

depot hormonal - progestin inhection
OCP

Question 5

tube contraception

Answer 5

tubal ligation prevent fertilization

alter tubal motility - progestin reduces

Question 6

endometrium contraception

Answer 6

needs E and P to allow implantation - P makes atrophic and thin

IUD creates inflammatory environment that kills sperm

Question 7

OCP

Answer 7

combo - e and progestin
progestin only (adding e improves bleeding)

P –> supresses LH surge via decreased GnRH pulses; endo atrophy with prolonged exposure; thickens cervical mucus; decrease tube motility; 1st generation based on testerone –> norethindrone (SE of acne, oily skin (sebum), bad lipid changes that oppose E)

Dropirenone is newest generation P; spironolactone analog; anti-mineralcorticoid and anti-androgen affect (reduces acne, water retention) – can use for acne, increases K

E–> suppresses FSH but mostly to stablize endo and induces P; use Ethinyl Estradiol (improved solubility and absorption)

increases clots, irritablity, breast tnederness,

liver sees high levels - decreases albumin, increases SHBG

not natural hormones

3 weeks on/1 weeks of placebo

Question 8

alternative hormonal delivery formulation

Answer 8

injectables, implants, transdermal, intravaginal rings

bypass first pass, use active vice prodrug, increased compliance

Question 9

progestin only

Answer 9

use for E avoidance - lactation, risk for emboli, htn

alters ovulation, involutes endometrium (atrophy), thickens cervical mucus

must take everyday

Question 10

spermidices

Answer 10

nonoxynol 9

surfactant that damages cell membrane

not that great - use as a backup

Question 11

intrauterine devices

Answer 11

long term 5-10 years
few side effects

copper - increases inflammation

P releasing IUD

Question 12

natural family planning

Answer 12

use body temp chart

check cervical mucus

Question 13

E contraception

Answer 13

for 3 days
high dose EE and P - historic
high dose levonorgesterel - Plan B

for 5 days
Ulipristal acetate

delay ovulation
prevent implantation in endometrial

IUD within 7 days of sex