Contraception Flashcards
Emergency Contraception Methods
Plan B - Levonorgestrel
Ella - Ulipristal
Copper IUD - most efficient, off label
PO Levonorgestrel
Plan B - synthetic progesterone
No need for pregnancy test or exam
No contraindications
SE: N/V, irregular bleeding, dizzy, fatigue, HA, breast tenderness
Effective up to 120 hours -> 2-3% failure rate
Ineffective after ovulation occurred, doesn’t interrupt pregnancy
Copper IUD
Paraguard
MOA: interfere w/ fertilization or tubal transport
Prevent transplant by altering endometrial receptivity
Copper interferes w/ sperm transport to prevent fertilization
Great alternative to hormonal methods
SE: heavy menses, dysmenorrhea
Oral Contraceptive Pills
Suppress GnRH to prevent LH surge; suppress FSH to prevent ovulation
Stabilize endometrium; progesterone thickens cervical mucus
Higher dose estrogen for spotting, recurrent ovarian cysts, acne
OCP Preparations
Monophasic
Multiphasic
Extended Cycle
Monophasic: no change in hormonal concentration throughout cycle
-usually start w/ these for younger or less compliant
Multiphasic: change in hormone concentration - biphasic or triphasic
Extended Cycle: take the same dose for 11 weeks then have period
- 84/91 day cycle
- Seasonale, Introvale, Quasense
Starting OCP
Quick start: regardless of day of cycle
Sunday start: 1st sunday after period begins for 7 days
-Need backup method for above 2
Start on 1st day of menses
Progesterone-only pill (POP) - start in 1st 5 days of menses
Highest risk of becoming pregnant
Failure to start new patch/pack/ring after 7 days of being off
Ortho-evra
Contraceptive patch
Transdermal - 20 mg Ethinyl estradiol
Change patch every 7 days for 2 weeks straight
Nuvaring
15 mcg estradiol & 120 mcg etonogestrel daily for 3 weeks straight
Progestin-only contraceptives & MOA
Depo medroxyprogesterone acetate
Progestin implant - Nexplanon
Progestin IUD - Mirena, Skyla
MOA: inhibit gonadotropin secretion, inhibits follicular maturation & ovulation, thickens cervical mucous, thins endometrium
SE: weight gain, decreased bone density - BBW
Progesterone Implants
Implanon/Nexplanon: 68 mg estronogestral rod in upper arm - lasts for 3 years
Jadelle: 2 levonorgestrel rods - lasts for 5 years
Progestin IUD/IUC
Lebonorgestrel - Mirena, Skyla
MOA: prevents fertilization w/ sterile inflammation from foreign body
May protect against endometrial cancer
SE: irregular bleeding, breast tenderness, acne, mood changes
Fertility Awareness Methods
Ovulation method: predict fertile time based on cycle length
Sympothermal: basal body temperature, cervical mucus used to track ovulation
Basal Body Temperature: increase 0.5-1.0 degrees F 2-3 days before
