Birth Control Flashcards
When does birth control interfere with the reproductive process?
Any step from gametogenesis to nidation?
How do combination OCs work?
Inhibit ovulation
What hormones do combo OCs work on?
Estrogen and progestin
Combination OCs
Adverse effects
-Thromboembolic disorders
-Cancer (breast cancer - debated - might be growth of pre-existing cancer)
-Hypertension
-Stroke (in patients with migraine w. aura)
What are the absolute and relative contraindications of hormonal contraception?
See Table 62-3
Absolute -
Smoker over 35
Noncontraceptive benefits of combined OCs
-Decrease risks of ovarian cancer, endometrial cancer
-Acne
-Diminished cramps, lighter, shorter, more predictable flow
What drugs and herbs reduce the effects of OCs?
-P450 inducers
-Rifampin
-Ritonavir
-Antiepileptic drugs
-St. John’s Wort
What drug effects decreased by OCs?
-Warfarin
-Insulin
-Oral hypoglycemics
What unique properties do drugs containing drospirenone have? (like Yaz)
Form of progestin
Raise potassium level
What are dosing schedules for birth control pills?
28 day cycle schedules
OR extended cycle (84 days OR indefinite continuous use)
Progestin-only contraceptives vs. combined OCs
-Lower risk of clotting
-Higher risk of irregular bleeding
-Less effective
What is the schedule for the patch and ring?
3 weeks on
1 week off
What hormones are in the patch?
Combined - estrogen and progestin
What are the long-active contraceptives?
-Etonogestrel implant (Nexplanon) and Depot medoxyprogesterone acetate (Depo-Provera)
How long does Etonogestrel implant (Nexplanon) work?
-Lasts 3 years
Depot medoxyprogesterone acetate (Depo-Provera)
Adverse effects
-Irregular bleeding
-Bone Loss
(both reversible)
-Like progestin, less clotting risk
What is the brand name for levonorgestrel-releasing intrauterine system?
Mirena
What is in Plan B One-Step and what is the dose?
One high-dose (1.5 mg) tab of levonorgestrel within 72 hours
What is mifepristone (RU 486 misoprostol) ? How does it work?
-Medical abortion pill
-Prostaglandin
-Blocks uterine progesterone receptors
-Causes shedding of endometrium
When do you take Mifepristone / misoprostol?
Effective if taken within 7 weeks of conception or 9 weeks after LMP
Prostaglandins
Therapeutic uses
-Induction of abortion
-Cervical ripening before induction of labor
-Control of postpartum hemorrhage
Progestin-only pills
Mechanism
Thicken uterine lining
