Contraception Flashcards
What does an ovulation test check for?
What about a pregnancy test?
A rise inLH
beta-hCG
How does estrogen prevent pregnancy?
It inhibits release of FSH and LH by the hypothalamus
Decreases fertilization time
Inhibits fertilization
If the birth control is Loestrin 1/20 , what is the 1 and 20?
1mg norethinidrone
20mcg EE
What are the two chewable monophasic birth controls?
Ministrin 24 Fe
Femcon Fe
Drosperinone is = ___mg of ____ and brand names with progestin include ___ and ____.
___ and shorter periods.
25mg of spironolactone
Yasmin and Yaz
Yaz
How long do you need to backup when starting a BC?
Which one needs longer?
7 days
Natazia requires 9 days
What are three major side effects of androgenic contraceptives?
Increased appetite, weight gain, and depression
Absolute contraindication of contraceptives
What about CI’s from WHO?
thrombo emolic disorder
history of breast/uterus neoplasia
Undiagnosed vaginal bleeding
Liver issues
pregnant
WHO
Lactation
>35y.o + smoke >15 cigs
HTN
Migraines with aura
DM with end organ disease
Chest pain
When to start contraception after birth?
21 days with no risk factors
42 if risk factors for DVT
When to start contraceptice
1st day of menstrual bleeding or 1st sunday after menstrual bleeding starts
When to contact MD after starting contraceptive:
ACHES
Abdominal pain (severe)
Chest pain
Headache, dizziness
Eye problems
Severe leg pain
Worried about MI, stroke, DVT/PE
How do CYP3A4 inducers or inhibitors affect contraceptives ?
Inducers (rifampin and anticonvulsants) can decrease estrogen
Inhibitors will increase estrogen
What are the progesin-only meds and what are the three counseling points?
Who would you use these for?
micronor, norQD, aygestin, camila. errin, jovilette
Take at the same time everyday
Initiate on the first day of mensus
Use backup for 2 days if >3H late on dose
If you can’t take estrogen (like DVT risk) and during lactation
DepoProvera
dose and ROA
What is the advantage?
150mg IM every 3 months
No risk of clots
Xulane patch
Generic
ROA
What to do if it falls off?
Ortho-EVRA
Once a week- 3 weeks on and 1 week off
If <24H - replace or put new one
If >24H - new patch, new 4 week cycle, and backup for 7 days
Which contraceptive is preferred if they have bloating?
Acne?
Weight gain?
Dysmennorhea/PMS?
Yasmin or Yaz
Ortho-tricyclen, estrostep, yaz
Less androgenic ones
Extended/continuous cycle
What do if there is breakthrough bleeding early in the cycle?
What about later on?
Increase estrogen
Increase progestin
If 1 missed pill anytime in cycle what to do?
2 tabs in week 1-2?
> 3 or in third week?
Take 2 now
Take 2 not and 2 the next day and backup 7 days
Continue active tabs then start a new pack and backup 7 days
Ella
Generic
Ulipristal acetate 30mg
What to give if patient as endometrial cancer with intact uterus?
Estrogen and add progestin
If not intact, then only estrogen
Combipatch
Storage
Frequency
Refrigeratory and RT for 6 months
twice a week
Duavee
Generic
MOA
Estrogen and bazedoxifene
SERM (basedoxifene)
Recommendation for painful sex due to vaginal atrophy?
Moisturizers/lubricants
Ospemifene
Brand
MOA
Indication
Dose
Osphena
MOA
Dysparenunia (painful sex)
60mg QD with food
Fezolinetant
Brand
Indication
MOA
Dose
Contraindication
Veozah
Nonhormonal for hot flashes
NK3R antagonist
45mg QD PO
GFR <30
When do you NEVER use prometrium?
In peanut allergies
Bacterial vaginosis
s/sx
treatment
grayish white discharge, “fishy odor”, and increased pH
Metronidazole 500mg BID x 7d
Clindamycin 300mg BID x 7 days
Clomiphene
Brand
MOA
Indication
Clomid
SERM
Infertility
Flibanserin
Brand
MOA
Dose
Indication
ADE
Contraindicated
Addyi
mixed 5HT1a agonist/5HT2a antagonist
100mg PO at NIGHT
Pre-monopausal women with hypoactive sexual desire
Severe hypotension and syncope
Alcohol
Bremelanotide
Brand
Indication
Dose
Vyleesi
Premenopausal with hypoactive sexual desire
45min SUBQ prior to sex - max 8 doses/month
Annovera
Frequency
SAME RING FOR A YEAR
3 weeks on, 1 week off
OTC birth control
Generic
Brand
Dose
Progestin-only
OPill
Every day at the same time
