Contraception Flashcards
2 most popular methods
OCP and condom
what is pearl index
failure rate per 100, typical and perfect
4 non-hormonal
- fert. awareness
- lactartional amenorrhea
- bariers/spermicide
- copper IUD
2 types of hormonal
- OCP
2. long acting - depo and mirena
what is awareness method
avoid sex during fertile period (~6 days)
methods to tell when ovualtig
- calender
- mucous
- temp (up 0.5)
- ovulation detection
what is rules of 4 for lactational method
- 4 weeks for non-breast feeding
4 months if breast feeding
4 hours during day and 6 at night
what is permicide
nonoxynyl 9 - inserted before
- best used as an add-on
what are barrier methods
condoms
- diaphragm
- cervical cap
- lea shield
- sponge
risk for barrier method
- inconsistent use
- age
feat. of diaphragm
must be fitted
fail 6-20%
- some STI protect
2 types of IUD and MOA**
- copper - toxic to sperms
- levonorgestrel
- thickens mucus
- alteres tubal transport
- alters uterine lining
- ihbibits ovulation
adv of mirena
adds control of menorrhagia and dysmenorrhea
IUD risks/issues
- expulsion
- perf
- vasovagal on insertion
- pevic infection related to STI
- higher miscarriage and ectopic
5 contraindicartions to IUD
- PID
- distorted cavity due to fibroids
- undiagnosed bleeds
- wilson’s disease (copper)
- immunocomp
2 types of OCP
- combined
2. prog. only
reason to add E
for cycle control - less breakthrough bleeds
MOA of combined (4)
- inhibs ovulation by LH/FSH supress
- thickens mucus
- decidualizing endo
- affecting tubal transport
non contraceptive benfits of OCP
less - flow acne ovarian cancer cysts fobrocytic breast disease
OCP SEs
nuisance
- headaches
- bleeds
- depression
- bloating
main risk of OCP
VTE
- stroke and MI in smokers
what are SEs due to
E only, progesterone alone is safe
what is realistic risk of VTE
very low, lower than that of being preg
3 ways to imprve compliance in OCP
- risg
- continuous
- patch
why 21/7
to mimic real life, no good evidence for it
- continuous is fine
what is adv. of 24/4
better in case miss a pill - no follicle develops
how to take prog (issues)
must eb taken within 3 hours of same time every days
- slightly less effective
what is in all long acting
progestin only
what is depo
very effective
- may take 9 months to get back period
- less bleeds
disadv with depo
- irregular bleeds
- weight gain
- mood
- may decrease bone density
3 contra to depo
- breast cancer
- undiagnosed vaginal bleeding
- severe liver disease
2 methods of emercency
- hormonal (72hrs)
2. IUD insertion (5 days)
2 hormonal types
- yuzpe 2x 100 estradiol (can use any OCP)
2. 2x progestin
safety of EC
no absolute contra, except known preg.
- won’t interfere with estabished preg
what is more recent EC
can maybe just do one dose
