225. Pregnancy Prevention

Question 1

Examples of LARCs

Answer 1

Long Acting Reversible Contraception = LOWER use effective rates
Separating act of intercourse from act of contraception improves efficacy

Methods: hormone-releasing implants, IUDs

Question 2

Beneficial SE to OCPs

Answer 2

Less anemia (less bleeding)
Less risk of endometrial Ca (more atrophy)
Less risk of ovarian Ca (suppression)
Less dysmenorrhea
Less PID (more viscous cervical mucus)
MORE BMD (more E)

Question 3

Medroxyprogesterone Acetate: what is it

Difference b/w CU and P-releasing IUD

Advantages/SE of Nonoxynol-9

Answer 3

P only injectable, repeat every 3 months (LARC)

Copper: sterile inflammation of endometrium (spermacidal)
SE: Heavier menses, cramps, irregular bleeding

P-releasing IUD: thickens cervical mucus, endometrial atrophy
SE: less bleeding, decreased cramps, irregular breakthrough bleeds due to endometrial atrophy

Nonoxynol-9 Spermacide (surfactant damages cell membranes)
SE: few = allergy, topical irritation, UTIs maybe
Pros: PROTECTION FROM STDS, OTC availability

Question 4

Emergency Contraception

- name them, how to get them, when

Answer 4

1. High Dose Levonorgestrel = PLAN B
   - mech: hormonal regimen
   - take <3 days exposure
   - OTC
2. Ulipristal Acetate = Anti-P
   - mech: hormonal regimen
   - take <5 days exposure
   - Prescription

Hormones: delay/alter ovulation, impede tubal transport, change endometrium to prevent implantation

3. Copper IUD insertion
   - prevents implantation
   - implant <5 days exposure
   - effective for exposure and provides future contraception
   - considered MORE effective than Plan B!