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Endo/Repro > Contraception > Flashcards

Contraception Flashcards

1
Q

Natural Methods

A

Avoid intercourse and/or ejaculation around time of ovulation to prevent conception from occuring
- requires female with regular, predictable cycles

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2
Q

Ovulation Timing

A

ovulation occurs 14 days prior to 1st day of menses

  • avoid intercourse 5 days prior and 3 days after ovulation
  • need to determine cycle variability
  • can use body temps –> if pregnant, body temp will stay elevated
  • cervical mucous -> most abundant, watery, and egg-whitey at time of ovulation
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3
Q

Barrier Method

A

prevent sperm from fertilizing egg by use of physical or pharmacologic barrier

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4
Q

Condoms

A

BEST STI PROTECTION

  • male is more effective and more common
  • most effective when used with spermicide
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5
Q

Diaphragm

A

requires fitting by trained physician

- decreases STIs, must take out within 24 hours to avoid bad infection

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6
Q

Cervical Cap

A

silicone rubber cap, needs to be fitted, take out within 24 hours to avoid infection
- increased risk of toxic shock

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7
Q

Sponge

A

circular disc that you moisten with tap water and insert into vagina, leave in place for 24 hrs
- increased rate of yeast infections, UTIs, and Toxic Shock Syndrome

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8
Q

Spermicides

A

foams, creams, jellies

- damages cell membranes of sperm cells and bacteria

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9
Q

Combined Estrogen/Progesterone

A

Pill, Ring, Patch
- estrogen/progesterone induced inhibition of midcycle surge of gonadotropin secretion –> ovulation does not occur
Absolute Contraindications = thromboembolic stroke, CAD, estrogen dependent tumor, liver disease, pregs, uterine bleeding, smoker, migrains

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10
Q

Combined Non-contraceptive benefits

A

Reduction in dysmenorrea
Reduction in menorrhagia
Reduction of ovarian, endometrial, colorectal cancers
Improves osteopenia and osteoporosis

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11
Q

Oral Combined “The Pill”

A

Estrogen -> ethinyl estrdiol
Progestin -> 1st and 2nd generation -> more androgenic, the newer ones are less androgenic (S.E. include increased LDL and decreased HDL)
General S.E. = breast tenderness, nausea, headaches, moody, irregular bleeding, weight change

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12
Q

Drospirenone

A

spironolactone analog -> improves weight stability/water retention
- may increase serum K

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13
Q

Phases of Combined Pill

A

Monophasic -> 3 weeks, then week off
Biphasic and Triphasic -> varying doses for 3 weeks, then week off
- use week off to avoid endometrial metaplasia/hyperplasia

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14
Q

Common side effects of combined pill

A

Breakthrough bleeding

  • first 10 day -> estrogen
  • after 10 days -> progestin
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15
Q

Combined Vaginal Ring

A

worn intravaginally for 3 weeks, then out for 1

  • can put back in if it falls out
  • comparable efficacy to oral
  • lower dose of hormone
  • rapid return to ovulation
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16
Q

Combined Patch

A

change once a week for 3 weeks, then one week patch free

  • similar efficacy, greater failure rate in heavier women
  • more breakthrough bleeding and breast discomfort
17
Q

Progesterone Only Method

A

inhibition of ovulation -> progestin effect also causes changes to endometrium and cervical mucous –> decreased sperm transport and implantation

18
Q

Progesterone Oral

A

patients who want effective contraception but want/need to avoid estrogen
- nursing moms
Issues to consider -> irregular bleeding, other SE, duration of effect and return to fertility, chance of breakthrough ovulation if pill missed

19
Q

Progesterone non-contraceptive benefits

A

eventual reduction of menstrual flow

  • no increased risk of stroke, MI, or thromboembolic event
  • reduced risk of endometrial cancer and PID
20
Q

Progesterone Only Pill

A

Start: first day of menses, or sunday, or immediate

  • take it daily at same time!
  • timing is critical - within 3 hours or back up needed
21
Q

Progesterone Only Injection

A

Medroxyprogesterone acetate (Depo)

  • return to fertility is longer!!!
  • concern with bone health
22
Q

Progesterone Only Implants

A

Rods implanted subcutaneously under skin

- remove once no longer effective

23
Q

Male Hormonal Contraception

A

in development -> stay tuned

24
Q

Emergency Contraception

A

Prevention of pregnancy within 72-120 hrs of unprotected intercourse of failed contraception method
Mechanism - inhibit ovulation of prevent fertilization

25
Q

Emergency Contraception Formulas

A

Plan B - progestin only
Ella - Ulipristal Acetate
Combo pack - estrogen and progestin
*Reduces pregnancy 75-95%, politcally controversial, state/pharmacy variability

26
Q

IUDs

A

Copper - pre-fertilization effect -> induces reaction of endometrium resulting in inflammatory response preventing viable sperm from reaching tubes
Mirean - slow release progesterone -> inhibits ovulation and inhibits sperm survival and implantation
Skyla - lower dose -> same as mirena

27
Q

Screening for IUD use

A

Copper - want regular periods, no hormones, no hx dysmenorrhea, no hx menorrhagia
Mirena - OK w/ irregular periods, OK w/ amenorrhea, hx dysmenorrhea, hx of menorrhagia

28
Q

Myths about IUDs

A 
Not abortifacients
Don't cause ectopic pregnancies
Don't cause pelvic infection
Don't increase risk of fertility
Aren't big
Can be used in nulliparous women
29
Q

Contraindications for IUD

A
  • pregnancy, congenital or acquired uterine cavity malformation
  • acute STD, cervicitis, vaginitis
  • known or suspected cervical neoplasia
  • liver disease
  • immunodeficienct
30
Q

Sterilization

A

should be considered permanent -> appropriate counseling and selection, reversible procedures do exist but come with limited success
Tubal or Vasectomy

31
Q

Surgical Tubal Occlusion

A

laproscopic procedure
- ligation, section removal, clips, rings, coils, plugs, cautery
Nonsurgical -> microinserts placed into proximal fallopian tubes, or radiofrequency delivered to fallopian tubes

32
Q

Vasectomy

A

procedure that results in ligation of vas deferens

  • under local anesthesia
  • safe, effective
  • need 20 ejaculations or 3 months following of sperm analysis

Endo/Repro (34 decks)

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