Contraception

Question 1

What are the Advantages of Spermicides? MOA, Disadvantages?

Answer 1

Simple to use, no SE, no Rx
MOA: Physical and Chem barrier to sperm
Dis: No STD prot
High failure, Irritation, messy

Question 2

What are the Advantages of Condoms? MOA, Disadvantages?

Answer 2

No Rx needed, STD protection, few SE
Dis: User dependant, dulling of sensation, dec sexual satisfaction, allergies
Dec Barrier to HSV and HPV

Question 3

What are the Advantages of Diaphragm? MOA, Disadvantages?

Answer 3

Inc risk of UTI
Failure rate in first year of 12-17%
Left in place 6-8 hours after coitus, used w/ spermicide

Question 4

What are the Advantages of Periodic Abstinence? MOA, Disadvantages?

Answer 4

Decide when to abstain from intercourse based on calendar
High Pregnancy rates
Temp method/cervical mucous method
HIGHLY motivated and EDUCATED woman and cooperative partner

Question 5

What are the Advantages of Withdrawl Method? MOA, Disadvantages?

Answer 5

Coitus interuptus
High failure rate
Sperm in pre-ejaculate
Lack of timely or correct withdrawl

Question 6

What are the three types of Hormonal Contraception?

Answer 6

Fixed Dose Combo
Combination phasic
Daily progestin

Question 7

What is the MOA of Drospirenone?

Answer 7

17a-spirolactone

anti androgenic and anti mineralocorticoid

Question 8

What are the two synthetic eStrogens available?

Answer 8

Ethinyl Estradiol

Estradiol Valerate

Question 9

What is the MOA of Combination OC?

Answer 9

Supress ovulation

E supresses FSH secretion, progesterone supresses LH secretion

Question 10

What are the Metabolic Effects of Hormonal Contraception?

Answer 10

Estrogen: Nausea, Br Tenderness, fluid retention, melasma
Progestin: Wt gain, acne, mood change
Carb metabolism

Question 11

What are the contraindications with HC?

Answer 11

Smoking and >35
Vascular dis
Systemic disease that effects vascular system
Uncontrolled HTN
Estrogen dep neoplasm
CVA or MI
Pregnancy
Acute liver dis
Migraines WITH aura

Question 12

What are the reproductive effects of Hormonal Cont?

Answer 12

Br Cancer
Cervical CA
Endo Cancer
Ovarian CA
Liver Adenoma and CA

Question 13

What are the Relative Contraindications of Hormonal Cont?

Answer 13

HEavy cig smoking

Question 14

What are the Drug interactions with Oral Contraceptives?

Answer 14

Barbiturates, sulfonamides, cyclophosphamides, and rifampin

Question 15

What are the non-contrac

eptive health benefits of HC?

Answer 15

Red blood loss
Dec Endo CA
Dec Dysmennorhea
Dec Ovarian cysts 
Dec Ovarian CA
Dec risk of ectopic preggo
Protect against salpingitis

Question 16

What is the MOA of Emergency Contraception? SE?

Answer 16

Disrupt ovulation
take within 72 hrs of coitus
High dose E and/or P
N/V Br tenderness
Migraines(estrogen)

Question 17

WHat are the Long acting Contraceptive Steroids?

Answer 17

Depo- medroxyprogesterone Acetate

Return of ovulation may be as long as 1 year after discontinuing drug

Question 18

WHat are the SE of Long acting Contraceptive Steroids?

Answer 18

Irregular Bleeding
Wt gain
Depression
Headache

Question 19

What is the MOA of Progestin implants?

Answer 19

NEXAPLANON

Daily release of progestin causes ovulation supression, cervical mucous thickening, atrophic endometrium

Question 20

What are the Benefits of IUD?

MOA?

Answer 20

Very Effective
Lack of associated systemic metabolic effects
Produces a local sterile, inflam. reaction within the uterine cavity
Dec sperm penetration and migration

Question 21

Waht are the contraindications for IUD?

Answer 21

Pregnancy or supression of pregnancy
Acute PID
Postpartum endometriosis
Infected abortion
Uterine or cervical malignancy
Bleeding
Untreated acute cervicitis
Existing IUD

Question 22

What are the methods of female Sterilization?

Answer 22

Postpartum
Laparoscopic
Hysteroscopic
Saplingectomy (take tube out)

Question 23

What are the pros/cons of Male sterilization?

Answer 23

Outpatient procedure
VD isolated and cut ends are closed by ligation or fulgration
NEED TO TEST for SPERM!