Contraception Flashcards
Which hormone is required for contraceptive purposes?
Progestin
How do contraceptives work?
Exogenous progestin and estrogen decrease endogenous production of LH and FSH which suppresses the HPO function, stopping ovulation and endometrium prep
What are some advantages to barrier methods?
- STD protection
- Good for occasional intercourse
- Avoid hormonal methods
- OTC
What are some disadvantages to barrier methods?
- Not as effective
- Depends how you use them
- May require fitting by healthcare provider
- Many require concomitant use of spermicide
What are the two components of spermicides?
- Spermicidal chemical (nonoxynol-9–>surfactant that disrupts sperm membrane)
- A delivery base
What are some advantages to the copper IUD?
- > 99% effective
- Effective up to 5 days after intercourse
- Well tolerated
- 12 Years
- Immediately reversible
What are some disadvantages to the Cu IUD?
- Req healthcare professional to insert
2. Bleeding changes
How do we do male sterilization?
No-scalpel vasectomy is the standard of care. A small opening is made in the skin of the scrotal sac to deliver vas deferens. Ligate. No scalpel or sutures required
What are 3 methods of female sterilization?
- ligating
- blocking with clips/rings
- cauterizing
What % of women have sterilization regret
20% of women 30y/o
What is tubal occulusion?
It is non surgical where micro-inserts are placed into proximal fallopian tubes. Brand name=Essure
What is the combination pill
Is emergency contraceptive with estrodiol and progestin. 2 doses 12 hours apart, first within 120 hours of sex
What % of unwanted preg does the combo pill prevent?
Prevents 75% of unintended pregnancies
What are some disadvantages of the combo pill?
- High estrogen=inc side effects
2. Nausea, vomiting
What is the progestin only EC?
1 dose within 120 hours of sex (“plan B”)
What are some advantages and disadvantages to progestin only EC?
- More effective than combo
- Better tolerated
- Single dose
No disadvantages, mild nausea
What is ulipristal acetate/ella?
A progesterone receptor modulator that inhibits/delays ovulation
What are some advantages of Ella?
- Single dose
2. FDA approved 120hrs after sex, but isn’t time sensitive so works just as well on day 5 as day 1
What are some disadvantages of Ella?
- Mild side effects (nausea)
2. Req prescription, few pharmacies carry it
List the 2 purposes of the menstrual cycle
- Transport gametes to site of fertilization
2. Provide a suitable site for implantation
What 4 things does exogenous progestin do to prevent pregnancy?
- It inhibits the LH surge which inhibits ovulation
- It thickens the cervical mucus impeding sperm travel
- Decreases estrogen driven cell proliferation in the endometrium inhibiting egg implantation
- Converts reproductive tissues from proliferative modes to functional modes (ie endometrial atrophy?)
also causes ovarian inhibition
What 4 things does exogenous estrogen effect?
- Inhibits FSH surge and subsequent follicle development
- MAY inhibit ovulation
- Thins the cervical mucus (so you need more progestin than estrogen in your pill)
- Increases endometrial proliferation
Where do we make endogenous estrogen and progestin?
Ovaries!
What is the most common form of synthetic estrogen?
ethinyl estradiol (EE)
