Contraception Flashcards
Pill - contents
Estrogen + Progestin
Progestin only
Estrogen - ethinyl estradiol
Prevent ovulation by suppressing GnR factors
Prevents FSH and LH secretion
Hepatic metabolism
Progestin - synthetic progesterone-like compound
Suppresses LH
Thickens cervical mucus
Endometrium incapable of implantation
Some hepatic metabolism
Progestin - Drosperinone
Aldosterone antagonism analog
~25 mg spironolactone
Monitor K
Caution with ACEIs and ARBs
Pill - other components
Iron - anemia
Folate - prevent neural tube defects
Pill - Monophasic
Consistent estrogen and progestin dose throughout cycle
Pill - Biphasic
Estrogen/progestin ratio varies one time during cycle
Pill - Triphasic
Estrogen/progestin ratio varies twice during cycle
Pill - Four-phasic
Initial high estrogen - dose red durign proliferative/follicular phase
Initial low progestin - dose increase during secretory/luteal phase
Pill - extended cycle
Monophasic with 84 days active/7 days placebo or 24 days active/4 days placebo
Pill - continuous cycle
No placebo
Pill - drug interactions
rifampin, griseofulvin, phenytoin, phenobarbital, carbamazepine, primidone, ethosuximide, tetracyclin, doxycycline, PCNs, cipro, ofloxacin, telaprevic, tipranavir, elvitegravir
Pill - not recommended for
Women > 35 w/ uncontrolled HTN, DM + vascular dz, smoking
Pill - thromboembolism risks
Protein C/S deficiency
HTN, obesity, DM, smoker, sedentary lifestyle
How long is the patch effective for?
9 days
How long is Nuvaring effective for?
Up to 4 weeks
How long is Nuvaring good until?
4 months after removal from fridge
How long is nexplanon effective for?
3 years
Nexplanon - Caution with
Body weight > 30% than IBW
Nexplanon - AE
irregular menses, weight gain, acne
How long is the copper IUD effective for?
10 years
How does the copper IUD work?
Spermicidal, thickens cervical mucus, release of leukotrienes and prostaglandins by endometrium, environment not preferable to eggs/sperm
Which contraceptive causes decreased BMD?
Progestin injections
What are the contraindications with IUDs?
PID, STD, Post-abortion sepsis, purulent cervicitis, abnormal vaginal bleeding, malignancy of genital tract, uterine abnormalities
Future fertility - OCs
1-2 weeks
Future fertility - Patch
1-2 weeks
Future fertility - Ring
1-2 weeks
Future fertility - Injection
10 months
Future fertility - Implant
30 days
Future fertility - IUD
Immediate - 30 days
Future fertility - POP
Immediate - 1 week
Estrogen monotherapy
Increased risk of endometrial hyperplasia and cancer
Must combine with progestin
Which emergency contraceptive is Rx only?
Ella
