Chc Flashcards
Chc consists of
Estrogen and progestin
Failure rate of chc?
8%
After stopping chc how many months before return of fertility?
Avg 3 months
Which chc labeled for acne?
Estrostep, orthotrcyclen, yaz
Which chc have been FDA labeled for premenstrual dysphoric disorder?
Yaz
Benefits of chc
- Preventing pregnancy
- Controlling acne and mood
- Decrease hirsutism
- Help women with irregular menses have more consistent and regular cycles
- Dysmenorrhea Headaches Pain - with endometriosis 6.Bleeding associated with fibroids
- Pms Menorrhagia
- Iron deficiency anemia
How does estrogen help to prevent pregnancy?
by feedback inhibition of hormones to the pituitary gland. With synthetic estrogens circulating in the bloodstream, follicle stimulating hormone (FSH) is not secreted.
Without FSH… what happens?
follicles in the ovary do not develop, and ovulation does not occur. At the same time, corpus luetum is not formed and lutenizing hormone (LH) is not secreted, thus disrupting menstrual cycle and preventing ovulation.
what is the mechanism for progesterone to prevent pregnancy?
Progestogens help thicken cervical mucus, making it difficult for sperm to travel; inhibit LH surge; and cause atrophy of the endometrial lining making the uterus an environment prohibiting implantation of a fertilized egg.
Side Effects if too much estrogen
- bloating
- breast tenderness
- mood changes
- headache
- nausea
- heavy menses
- fibroid growth
- melasma
- vision changes
- cyclic weight gain
side effect if not enough estrogen
- breakthrough bleeding early in cycle
- light menses
- vaginal dryness
- spotting
- no withdrawal bleeding
Side effect if too much progestin
- acne
- hirsutism
- decrease in sex drive
- depression
- increased appetite
- increase in sex drive
- noncyclical weight gain
- less energy
- cholestatic jaundice
- yeast infections
- hair loss
- swelling in arms/legs
Side effect if not enough Progestin
- breakthrough bleeding late in cycle
- no withdrawal bleeding
- heavy menses
Combined Hormonal Contraceptives SE
- blood clots in the lungs (pulmonary embolism) and legs (deep vein thrombosis)
- liver changes
- retinal and corneal changes
- stroke
ACHES
serious potential side effects that warrant a physician’s attention
A - Abdominal pain - liver problem, gallbladder disease, or blood clot
C - Chest pain (SOB, coughing) - pulmonary embolism, heart attack
H - Headache (severe headache, dizziness) - hypertension, stroke, migraine
E - Eye proglem (seeing double, blurry vision)- Stroke or hypertension
S - Severe Leg Pain (calf or thigh) - DVT
If withdrawal bleed does not occur while a patient is taking the placebo pills, what does this mean?
excess estrogen
The ___ is generally responsible for the buildup of the lining, and the ____ maintains it.
estrogen, progestogen. If there is not enough estrogen, lining will be weak, frail and easily shed. If there is not enough progestogen to hold the lining to the uterine wall, endometrium will be weak and shed, resulting in breakthrough bleeding.
CHC reduces risk of ovarian cancer by how much? lifetime risk of ovarian cancer is 1.4%
by 41% after 4 years of use
54% after 8 years of use
61% with 12 years of use
CHC also decreases endometrial cancer. lifetime risk of endometrial cancer is 2.4%
decreases by about 50% and remains protective 15-20 years after discontinuation.
triphasic formulations have varying levels of progestogen starting at a low dose the first week and gradually increasing the second and third weeks. what are SE of triphasic pills?
breakthrough bleeding and mood changes as a result of varying weekly doses. Not the best choice in women with history of breakthrough bleeding or mood changes while taking COCs.
