Chapter 55 : Womens Reproductive Health

Question 1

What is a combined hormonal contraceptive?

Like what does it contain?

Answer 1

Really your birth control

Synthetic version of estrogen and progestin

Question 2

What is the action of combined hormonal contraceptives?

Answer 2

Inhibits ovulation by preventing formation of dominant follicle

Suppress lutenizing hormone surge

Question 3

How can you administer combined hormonal contraceptives?

Answer 3

Oral
Transdermal
Transvaginal
Emergency contraception

Question 4

Patients who are on combined hormonal contraceptives can have something called withdrawal bleeding when they are trying to get off the medication

What is it trying to do?
When does it occur

Answer 4

Mimics normal 28- day menstrual cycle

Occurring during monthly 7 day hormone free period

Question 5

Some patients can have an extended use combined hormonal contraceptives

They can have a ___day continuous dosing

Causing them withdrawal bleeding only ___ x a year

Answer 5

91 days

4x a year

Question 6

When you’re on your birth control it helps decrease cramping, acne, bleeding

Continous use combined dont have what?

Answer 6

No period

Question 7

What is progestin contraceptives?

Answer 7

Don’t contain estrogen

Question 8

What is the biggest benefit from progestin contraceptives?

Answer 8

Circulation disorders

Question 9

Progestin contraceptive has a higher Incidence of what?

Answer 9

Irregular bleeding and spotting !!

Depression, mood changes, fatigue, decreased sexual desire, weight gain

Question 10

Progestin contraceptive must be taken what?

Answer 10

Same time a day.

Question 11

What is the action of progestion only?

Answer 11

Alter cervical muscus, make it thick and viscous, which block sperm penetration

Endometrial lining thinner

Slow transport of egg through fallopian tube

Interferes with luteinzing hormone

Question 12

Side effects of excess estrogen birth control?

Side effect of deficiency of estorgen?

Answer 12

Breast tenderness
Cholasma
Leg cramps
Fluid retention
Decreased tearing

Vaginal bleeding
Oligomenorrhea
Nervousness
Dysperarunia

Question 13

Side effect of excess progestin?

Side effects of deficiency of progestin?

Answer 13

Increased appetite
Weight gain
Oily skin
Excess hair growth

Bleeding late in the cycle
Heavy menstrual cycle
Changes in Labs ( thyroid, sugar )

Question 14

What are some basic contraindications of hormonal birth control?

Answer 14

DVT
Pregnancy
Vascular disease
History of liver disease
Smoking > 15 a day after 35

Question 15

When a patient is on birth control you want to teach them this anagram which is?

what does each stand for?

Answer 15

ACHES

Abdominal pain
Chest pain
Headaches
Eye disorders
Severe leg pain

Question 16

What is primary infertility
What is secondary infertility

Answer 16

Never had a baby
Had a baby but now trouble with another

Question 17

Infertility’s
Assessment the infertile couple
- complete health history
- complete physical exams
- PAP testing
- HPV testing
- cultures for STI testing
- lab tests, other diagnostic tests

Question 18

What is the drug to help with fertility?

Answer 18

Clomiphene citrate

Question 19

Notes
Clomiphene citrate

Breast discomfort
Dizziness
Fatigue
Depression
Anxiety
Weakness
Increased appetite
Nausea
Abdominal bloating
Heavier menses
Flushing
Dermatitis
Headaches
Photophobia
Diploid
Decreased visual acuity

Question 20

What is menopause?

Answer 20

Transitional process experienced by women as they move from reproductive years into non reproductive stages of life

Question 21

What is perimenopausea
What is menopause
What is postmenopause

Answer 21

Period before menopause’s, hormones change, last 10 years

Cessation of menus of 12 months!! Can get pregnant

Once 12 months without a period

Question 22

What is treatment of menopause symptoms?

Medicatoon(

Answer 22

Hormone therapy
- estrogen progestin for females with an intact uterus

Question 23

For hormone therapy is used to help with menopause’s

What to give with a female uterus

Vs
What to give without a uterus

Answer 23

Estrogen and progestin

Estrogen

Question 24

What is the boxed warning regarding menopause’s hormonal therapy?

Answer 24

Should be used only for the treatment of menopausal symptoms, at the lowest dose possible for the shortest duration, possible less than 5 years

Question 25

What are contraindications of hormone replacement?

Answer 25

Undiagnosed vaginal bleeding
Liver disease
DVT
Personal history of breast change
Absolute contraindication of MI, VTE, dementia, stroke

Question 26

What are 3 other medications for menopause?

Give me the function too

Answer 26

SSRI - mood swings

Gabapentin - vasomotor shmtpoms

Clonodine- reduce vasomotor symptoms

Question 27

In women who are post menopause’s
They have a high increase risk for developing osteoporosis

Which we have to give them what?

Answer 27

1200mg calcium with 600 mg vitamin D daily in divided doses

Question 28

We also can take ____!!! for osteoporosis

Notes
Hormonal therapy is used to help PREVENT.

Answer 28

Bisphosphonates

Question 29

How do we take Bisphosphonates?

And why?

Answer 29

take with a full glass of water 30mins before a meal, stay up right for 30mins

Because it can cause esophageal erosion