Contraception Flashcards
contraception is…
prevention of conception by various methods
primarily utilized by women
fertility awareness methods
calendar rhythm - fertile period = 4days before to 3-4 days after ovulation - recorded for 6 mos. - abstain
basal body temp - lowest temp taken immed after waking - abstain from last day of menses to after 3 days of elevated temp
cervical mucous - recognition of cyclic changes in cervical mucous - abstain from presence of mucous to 4 days after the end
barrier methods
spermicides - placed deeply into vagina before intercourse - 71% effective
male condom - half-inch space left at tip - 85% effective
female condom - requires prescription and fitting by healthcare provider, replaced q2yrs, 84% effective, spermicide placed into diaphragm, remains for 6hrs after intercourse
cervical cap - must be left in 6-8 hrs after intercourse but no more than 48 hrs, no add’l spermicide needed for repeated sex contact, 75% effective
cervical sponge - 24hr. protection, should be left in 6 hrs but no more than 24-30.
Extended wear of cervical cap or cervical sponge places user at risk for toxic shock syndrome (TSS) T or F
True
hormonal methods
birth control using progesterone/estrogen
most effective method of birth control
administered orally, injected, inserted, topical, implants
s/e of hormonal methods
Irregular Bleeding Nausea Perceived weight gain Mood Changes Headache Breast Tenderness
Contraindications to hormonal contraceptive methods
Coronary artery disease Thrombophlebitis Endometrial or breast cancer Cerebral vascular accident Pregnancy
Smoking increases risk especially in women over 35 T or F
True
warning signs for hormonal methods of birth control
eye problems severe leg pain headache abd. pain chest pain/sob
types of hormonal birth control
oral contraceptives injectables transdermal patch vaginal ring implantable progestins intrauterine devices
oral contraceptives
Combined estrogen-progestin
Biphasics – Ortho-Novum 10/11: delivers same amount of estrogen; level of progestin ↑ half way through cycle
Triphasics – Ortho-Novum 777, Ortho-Tri Cyclen: delivers 3 different doses of hormones throughout cycle
Extended cycle – Seasonale/Seasonique: delivers estrogen/progestin in active form for 84 days followed by 7-day inactive placebo; only four periods/year
Progestin-only oral contraception – MicroNor: less interference of milk production in breastfeeding mothers
Advantages to OCs include
98% Effective
Decreased menstrual flow, regulation of menses
Decreased incidence of PMS
Convenience of knowing when to expect menstrual flow
Disadvantages to OCs include
must be taken same time every day and are associated
Injectables…
depoprovera - given during the 1st 5 days of the menstrual cycle
99.7% effectiveness rate.
Do not massage site after IM injection! (increases absorption rate)
Fertility may be delayed up to 18 months after discontinuance
Administered every 11-13 weeks
Transdermal Patch
Effectiveness = 95%, less effective in women >198 pounds
Applied weekly on the same day of each week for 3 weeks followed by a patch-free week
Ortho Evra: supplies continuous constant daily circulating levels of Estradiol and Norelgestromin
increased risk of serious cardiovascular side effects for those over 35 and who smoke.
Vaginal Ring
NuvaRing - flexible, transparent ring inserted into vagina
3 weeks of continuous use followed by one ring-free week
Women can insert the ring themselves
Effectiveness = 94%
Implantible progestins
single implantable rod
99% effective
FDA approved in 2006
up to 3 years protection
Intrauterine Devices (IUD)
T-shaped device inserted into the uterine cavity
Effectiveness 98%
ParaGard-T-380 - contains copper; damages sperm in transit to the uterine tubes and few sperm reach the ovum
Mirena - progesterone bearing IUD causes changes in cervical mucus and endometrial maturation
ovulation is not effected
signs of potential complications w/IUD
P = late period or abnormal bleeding A = abdominal pain, pain with intercourse I = infection, abnormal vaginal discharge N = not feeling well, fever or chills S = string missing; longer or shorter
Surgical Sterilization - Female
Transabdominal sterilization: surgical bilateral tying, cutting or cauterization of fallopian tubes, or tubal occlusion through surgical application of bands or clips to fallopian tubes.
Transcervical sterilization: hysteroscopic injection of occlusional implants into fallopian tubes that promote growth of scar tissue thus occluding tubes.
Advantages of surgical sterilization - Female
outpatient/after delivery
disadvantage of female sterilization
expensive/difficult to reverse
some discomfort after
Surgical Sterilization - Male
Vasectomy: tying, cutting of vas deferens interrupting sperm’s path from testes to penis
advantage male sterilization
outpatient
sterility
no effect on potency
disadvantage of male sterilization
contraception is needed until semen shows no sperm
Surgical procedure w/some discomfort
Difficult/expensive to reverse w/no guarantee of restored fertility
miscellaneous methods
coitus interruptus - full withdrawal before ejaculation - oldest method - 80% effective
emergency contraception - plan b - ↓ chances of pregnancy by 89% when taken correctly - does not affect an existing pregnancy - must be used ASAP, within 3-5 days of unprotected intercourse - no protection against HIV or STIs
lactation amenorrhea - 98% effective if criteria are met - feeding interval < q4hrs during day/no > q6hrs during night
