Contraception Flashcards
Copper IUD
Benefits: SOLAE
-Low maintenance, Q10 years
-Emergency contraception
-Can be used in obese, SLE, APS
Risks: WIP B
-Bleeding risk, higher menstrual flow
-Avoid if low platelets
-Insertion pain
-Avoid in Wilson’s disease
Screen for STI before inserting
Progestin: MOA
-Suppresses LH (stop ovulation)
-Decreases fallopian motility
-Thickens cervical mucus
-Alters endometrial lining
MELF
-Norethindrone, Drospirenone: oral
-Levonorgestrel: emerg
-Medroxy: IM
Estrogen: MOA
-Suppresses FSH (stop follicle)
-Stabilizes endometrial lining (stop menstrual bleeding, cycle control)
FEB
-Ethinyl estradiol, estradiol validate, estetrol
Do Not Use Criteria
-DVT/PE, IHD, VHD
-Diabetes with nephro, neuro, retino
-Breast Cancer
-Pregnancy
-Cirrhosis, hepatitis
-Migraines with aura
-HTN uncontrolled
-Smoking 15+ at 35+
-SOT complicated
BCD SMH P
Age and Smoking: Tx
> 35
-15+ cig/day: avoid estrogen, progestin only
-<15: limit estrogen to 20 mcg/day
-nonsmoker, quit 1+ yr ago: lowest estrogen dose
< 35
-15+: limit estrogen to 20 mcg/day, DC age 35
-<15: lowest estrogen dose
-nonsmoker: safe
COC - Adverse Effects: serious
Serious: ACHES
-Abdominal pain
-Chest pain, SOB, coughing blood
-HA
-Eye problems, vision loss
-Severe leg pain
Estrogen: AE
Excess (E=MEH, like on your period sx)
-Nausea, bloating, HTN, migraine, breast tenderness, edema, mucorrhea, melasma
Def (period HAS passed, no period)
-Spotting, amenorrhea, hypomenorrhea
Progestin: AE
Excess (Eh WHAT D)
-Increase appetite, weight gain, tired, depression, hypomenorrhea
Androgen effects (HAH)
-Acne, hair loss, hirsutism
Def (HD)
-Dysmenorrhea, hypermenorrhea
CI for Progestin Only
Current breast cancer
Emergency Contraception
-Levo 1.5 mg (OTC, within 72 hours - 5 days but less effective)
-Uli acetate 30 mg (Rx, within 120 hours, NO IF BF)
-Copper IUD
Efficacy Based
Best: implant, IUD
Mid: Inj, pill, patch, ring
Low: spermicide, fertility awareness
