1F - Family Planning Flashcards
This allow individuals to and couples to anticipate and
attain their desired number of children and spacing
and timing of their births
Family planning
What are the two permanent family planning methods?
Vasectomy and bilateral tube ligation
Reversible: Spermicide, barrier, OCP, Hormone, IUD or IUS
What is the active agent in spermicides?
Nonoxynol - 9
Spermicides can be used alone for contraception, T or F?
False. Used with barriers
*no increased risk for congenital and chromosomal abnormalities
What must be covered by diaphragm totally to prevent conception?
Cervical os
*used with spermicide
How long can a diaphragm stay within the genital tract post coitus?
8 hrs
If there is repeated intercourse after 8 hours of application of the diaphragm, what should be added?
Spermicide
How long is the maximum time a cervical cap can be placed on the cervix?
48 hrs
After use of cervical cap, what test should be done after 3 months?
Pap smear test
What is more comfortable, diaphragm or cervical cap?
Cervical cap
*also used with spermicide
What are the possible adverse effects if the cervical cap is placed for more than 48 hours?
Mucosal infections, unpleasant odor, infection
What is the most effective contraceptive method to prevent transmission of STDS?
Male condom
This contraceptive method makes us of loose fitting soft sheath with two polyurethrane rings?
Female condom
This contraceptive method has the ability to prevent infections of the external genitalia?
Female condom
How many should you subtract from the longest and shortest cycle to make use of the calendar method?
Longest - 11
Shortest - 18
*COMPUTE:
- 27 – 18 = 9, and
- 31 – 11 = 20
- Fertile period is from days 9 to 20, and couple should abstain or use barriers at
this time
How many months of monitoring should be done by the patient before starting calendar method?
6 months
Using the basal body temperature method when should couples abstain from sex or use barrier method?
onset of menses until the 3rd consecutive day of elevated body temperature
How many days post observation of the presence of slippery mucus should the couples abstain or use barrier method?
4 days
Based on cervical mucus method, the safe period is indicated by what consistency of the mucus?
Dry
Smypothermal method, what is used to establish the first and last days of fertile period?
First day - cervical mucus and calendar
Last day - Basal body temperature method
Most widely used reversible method of contraception?
OCP
In fixed dose combination, how many pills from the 28 are inert of free day pills?
7
*21 are active pills with E + P
What are two drugs used in fixed dose combination?
Estrogen and progestin
Without estrogenic stimulation, the endometrium usually begins to slough off after how many days without steroid stimulation?
3 days
What pill only has progestin as its content?
Minipil
*low dose progestin
This OCP is ideal for nursing mothers and is used daily at the same time?
Minipill
What is the action of progestin?
Thick scanty mucus preventing transport of sperm
Major effect of synthetic estrogen?
maintain the endometrium and prevent unscheduled bleeding and inhibit follicular development by feedback inhibition
The magnitude of the effects of synthetic estrogen is directly related to what?
Dosage and potency of the steroids
What antidiuretic hormone is increased due to synthetic estrogen?
Aldosterone
What kind of bleeding is experienced especially with progestin only pills?
irregular bleeding
The androgenic effects of progestins are attributed to their structural similarity to what?
Testosterone
Which of the 2 increases LDL levels, progestin or estogen?
progestin
*estrogen decreases LDL levels but increases HDL, TGs and total cholesterol
Progestin decreases HDL, TGs and total cholesterol
There is increased risk of stroke among users of estrogen pills, T or F?
False but there is increase in coagulation factors among users
Length of delay and reversibility is attributed on what factors after OCP use?
Dose and user age
OCPs are protective of what cancer types?
Endometrial, ovarian and colorectal
*may have increased risk for breast and cervical
A woman with PCOS can be recommended what anti androgenic OCP?
Cyproterone acetate
What is the dose for the contraceptive patch?
75 ug estradiol and 6 mg progestin
- 3 weeks patch 1 week rest
Dose for vaginal ring contraception?
- 7 mg estradiol 11.7 mg progestin
* same timing as OCP (3 w/ 1 w/o)
Most common formulation for injectable contraception?
DMPA
What are the 3 MOAs or DMPA (also OCPs)
inhibition of ovulation
thinning of endometrium
cervical mucus changes
When do we give DMPA?
within the first 5 days of the cycle
What is the formulation for the contraceptive implant?
Progestin only
If a patient has a contraindication for estrogen use as contraception, what alternative can be given?
DMPA (injectables) or progestin implant or progestin only OCP
How long can copper T 380A be placed in the uterus?
12 years
How long can LNG IUD be placed?
5 years
What is the MOA of IUDs?
Spermicide
When is IUD inserted?
Any day of the cycle as long as patient is not pregnant
When is the preferable day of insertion of IUD?
day 1 to 7 of menses due to cervical os opening for easier insertion
This form of contraception has the highest rate of discontinuance?
IUD
Which IUD can also be given for AUB and treatment for hyperplasia?
LNG
For the first 6 months, what problem may be encountered by those using Copper T380A as the uterus adapts?
Uterine bleeding or increased menstrual loss
After how many ejaculations post vasectomy will the patient be considered sterile?
14-20
Post vasectomy, how many months will the male use barrier method as contraception?
3 months
What kind of incision is required in bilateral tubal ligation?
Transperitoneal
