Birth Control Flashcards
Contraception failure rates
Depo <1%
For 1st year of use oral contraceptives have <3% if used right
Diaphragm 18%
Spermicide 21%
Depo shot
Negatives:
Injection, may cause cycle irregularities, may reduce HDL, weight gain, delayed return to ovulation/fertility of up to 18 months
Spermicide
SEs: vaginal irritation, UTIs
Ortha Evra Patch
60% more estrogen released than c OCP so increased risk for thrombosis
If it falls off for >24h restart a new four-week cycle and use backup protection
remove patch q7-10d and apply a new one
remove for 7d q3patches
Ethyl estrodiol
Synthetic estrogen
Progestins
Thicken cervical mucosa making it harder for sperm to implant
Progesterone only pills have daily schd that’s easier to remember and less nausea
May be less effective if dose is missed
Implanon, mirena and depo (decline in bone density reversible in 5y advise to take calcium, vitamin D, exercise avoid cigs and ETOH shouldn’t take >2y)
Combined ocp COC
Decreased cramps and PMS symptoms and PID, ectopic pregnancy, hersutism, ovarian cysts and acne
Nuva ring is combo
Increased risk for thyroid disease and cervical cancer
Natural family planning
Prolonged breastfeeding
Monitor mucosa
Basal body temp
Calendar
Diaphragm
Leave in place at least 6h after sex
Refit if 20lb weight gain
Increased risk for UTI
OCP
Risk for gallbladder disease
Wait 4w post birth to start COC
Missed OCP
If currently menstruating then on non hormonal pills so she can resume taking the next day. If she missed an active pill then she should take two and resume normal the next day.
excessive estrogen causes
breast tenderness, HA, melanoma, increased BP and syncope
Use progestin-only pills for pt with migraines
Progestin-only options
Implanon, Mirena IUD, Depo
Estrogen and progestin combos
NuvaRing
Nonhormone option
Paraguard IUD
