Contraception

Question 1

2 most popular methods

Answer 1

OCP and condom

Question 2

what is pearl index

Answer 2

failure rate per 100, typical and perfect

Question 3

4 non-hormonal

Answer 3

1. fert. awareness
2. lactartional amenorrhea
3. bariers/spermicide
4. copper IUD

Question 4

2 types of hormonal

Answer 4

1. OCP

2. long acting - depo and mirena

Question 5

what is awareness method

Answer 5

avoid sex during fertile period (~6 days)

Question 6

methods to tell when ovualtig

Answer 6

• calender
• mucous
• temp (up 0.5)
• ovulation detection

Question 7

what is rules of 4 for lactational method

Answer 7

• 4 weeks for non-breast feeding
  4 months if breast feeding
  4 hours during day and 6 at night

Question 8

what is permicide

Answer 8

nonoxynyl 9 - inserted before

- best used as an add-on

Question 9

what are barrier methods

Answer 9

condoms

• diaphragm
• cervical cap
• lea shield
• sponge

Question 10

risk for barrier method

Answer 10

• inconsistent use

- age

Question 11

feat. of diaphragm

Answer 11

must be fitted
fail 6-20%
- some STI protect

Question 12

2 types of IUD and MOA**

Answer 12

1. copper - toxic to sperms
2. levonorgestrel
   - thickens mucus
   - alteres tubal transport
   - alters uterine lining
   - ihbibits ovulation

Question 13

adv of mirena

Answer 13

adds control of menorrhagia and dysmenorrhea

Question 14

IUD risks/issues

Answer 14

• expulsion
• perf
• vasovagal on insertion
• pevic infection related to STI
• higher miscarriage and ectopic

Question 15

5 contraindicartions to IUD

Answer 15

1. PID
2. distorted cavity due to fibroids
3. undiagnosed bleeds
4. wilson’s disease (copper)
5. immunocomp

Question 16

2 types of OCP

Answer 16

1. combined

2. prog. only

Question 17

reason to add E

Answer 17

for cycle control - less breakthrough bleeds

Question 18

MOA of combined (4)

Answer 18

1. inhibs ovulation by LH/FSH supress
2. thickens mucus
3. decidualizing endo
4. affecting tubal transport

Question 19

non contraceptive benfits of OCP

Answer 19

less
- flow
acne
ovarian cancer
cysts
fobrocytic breast disease

Question 20

OCP SEs

Answer 20

nuisance

• headaches
• bleeds
• depression
• bloating

Question 21

main risk of OCP

Answer 21

VTE

- stroke and MI in smokers

Question 22

what are SEs due to

Answer 22

E only, progesterone alone is safe

Question 23

what is realistic risk of VTE

Answer 23

very low, lower than that of being preg

Question 24

3 ways to imprve compliance in OCP

Answer 24

1. risg
2. continuous
3. patch

Question 25

why 21/7

Answer 25

to mimic real life, no good evidence for it

- continuous is fine

Question 26

what is adv. of 24/4

Answer 26

better in case miss a pill - no follicle develops

Question 27

how to take prog (issues)

Answer 27

must eb taken within 3 hours of same time every days

- slightly less effective

Question 28

what is in all long acting

Answer 28

progestin only

Question 29

what is depo

Answer 29

very effective

• may take 9 months to get back period
• less bleeds

Question 30

disadv with depo

Answer 30

1. irregular bleeds
2. weight gain
3. mood
4. may decrease bone density

Question 31

3 contra to depo

Answer 31

1. breast cancer
2. undiagnosed vaginal bleeding
3. severe liver disease

Question 32

2 methods of emercency

Answer 32

1. hormonal (72hrs)

2. IUD insertion (5 days)

Question 33

2 hormonal types

Answer 33

1. yuzpe 2x 100 estradiol (can use any OCP)

2. 2x progestin

Question 34

safety of EC

Answer 34

no absolute contra, except known preg.

- won’t interfere with estabished preg

Question 35

what is more recent EC

Answer 35

can maybe just do one dose