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R2F > Contraception > Flashcards

Contraception Flashcards

1
Q

2 general contraceptive mech’s

A
  • inhibit formation and release of egg

- mechanical, chemical, or temporal barrier b/w sperm and eggq

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2
Q

Hormonal contaceptives

A
  • pills
  • injectable
  • implantable
  • IUD
  • contraceptive patches
  • contraceptive rings
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3
Q

Injectable

A

-depo medroxyprogesterone acetate (DepoProvera)

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4
Q

Implantable

A

-etonogestrel rod implant (Nexplanon)

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5
Q

IUD

A
  • levonorgestrel (Mirena
  • Skyla
  • Liletta
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6
Q

Contraceptive patches

A

-OrthoEvra

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7
Q

Contraceptive rings

A

NuvaRing

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8
Q

Oral Contraceptives- combo- moa

A
  • suppress GnRH- suppression of FSH and LH
  • progesterone- major player- suppress LH and ovulation, thicken cervical mucus, creates an unfavorable atrophic endometrium for implantation
  • estrogen- improves cycle control- stabilize endometrium, allows less breakthru bleeding
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9
Q

Progesterone- consider what?

A

androgenic effect!!

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10
Q

Progestin-only oral contraceptives (mini-pill)- moa

A
  • make cervical mucous thick and impermeable
  • ovulation continues in 40%
  • used in breastfeeding women and women how have a contraindication to estrogen!!
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11
Q

Oral contraceptives- benefits

A
  • menstrual cycle regularity
  • improve dysmenorrhea
  • dec risk of iron def anemia
  • lower incidence of endometrial and ovarian cancers
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12
Q

oral contraceptives- SE’s

A
  • breakthru bleeding- in 1st 3 months
  • amenorrhea
  • mild SEs- bloating, breast tenderness, nausea, fatigue, HA
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13
Q

oral contraceptives- serous SE’s

A
  • venous thrombosis!!
  • PE!!
  • cholestasis and gallbladder dz
  • stroke and MI
  • hepatic tumors
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14
Q

Transdermal patch

A

(estrogen and progesterone)

  • for 3 wks
  • greater risk of thrombosis
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15
Q

vaginal ring

A

(estrogen and progesterone)

-for 3 wks

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16
Q

who CANT use oral contraceptives?

A
  • > 35 yo and smoke cigarettes
  • hx of thromboembolic event
  • CAD, cerebral vascular dz, CHF, migraine with aura, uncontrolled HTN
  • liver dz/tumors
17
Q

Depot Medroxyprogesterone Acetate (Depo Provera)

A
  • IM injection every 11-13 wks
  • maintains contraceptive level of progestin for 14 wks
  • thickens cervical mucus, decidualization of endometrium, blocks LH surge and ovulation
18
Q

Depot Medroxyprogesterone Acetate (Depo Provera)- bone effects?

A
  • alterations of bone metabolism (dec estrogen levels)

- reversible after discontinuation

19
Q

Depot Medroxyprogesterone Acetate (Depo Provera)- SEs

A
  • irregular bleeding!- menses can take up to a yr to regulate after discontinuation
  • weight gain (hungry)
  • exacerbation of depression!!!
20
Q

Depot Medroxyprogesterone Acetate (Depo Provera)- contraindications

A
  • pregnancy
  • vaginal bleeding
  • malignancy of breast
  • thromboembolic events
  • liver dz
21
Q

LARCs

A

-implants and IUDs

22
Q

Implant

A

etonogestrel- Nexplanon

23
Q

Nexplanon

A
  • radiopaque, implant- etonogestrel
  • used for 3 yrs
  • moa- thickens cervical mucus, inhibits ovulation
24
Q

Nexplanon- SEs

A
  • irregular vaginal bleeding
  • HA
  • weight inc
  • breast pain
25
Q

Nexplanon- contraindications

A
  • pregnancy
  • liver tumors/ active liver dz
  • breast cancer- only absolute contraindication!!
26
Q

Nexplanon- complications with insertion

A
  • infection
  • deep insertion
  • persistent pain or paraesthesia at insertion site
27
Q

IUD- 3 available in US

A
  • copper T (paragard)
  • levonorgestrel releasing- Mirena/Liletta and Skyla
  • expulsion rate- 1-5%
28
Q

risks with IUDs

A
  • infection within 1st 20 days
  • ectopic pregnancy
  • uterine perforation
  • malposition
29
Q

IUDs- contraindications

A
  • breast cancer
  • puerperal sepsis
  • septic abortion
  • cervical infection
  • wilsons dz (copper T)
  • uterine malformations
30
Q

Levonorgestrel IUDs

A
  • Mirena- 5 yrs
  • Liletta- 3 yrs
  • Skyla- 3 yrs
31
Q

IUDs- benefits

A
  • dec in menstrual blood loss
  • less dysmenorrhea
  • protection of endometrial lining from unopposed estrogen
  • convenient, long-term
32
Q

Copper T (paragard)

A
  • 10 yrs

- copper interferes with sperm transport or fertilization and prevention of implantation

33
Q

barrier contraceptives

A
  • condoms
  • diaphragm
  • cervical cap
  • sponge
  • spermicides
34
Q

diaphragms

A
  • must be used with a spermicide
  • must be left for 6-8 hrs after intercourse
  • more likely to get UTIs
35
Q

fertility awareness methods

A
  • calendar methods (cycle beads)
  • basal body T method (0.5 to 1 degree change at time of ovulation- avoid sex for 3 days after)
  • cervical mucus method
  • symptothermal method (cervical mucus and basal body T)
36
Q

Emergency contraception

A
  • prevent ovulation and fertilization
  • plan B- progestin only (levonorgestrel)- 2 pills, use within 120 hrs!!!
  • Ella- ulipristal acetate- up to 5 days- postpones follicular rupture/inhibit or delay ovulation
37
Q

Sterilization decision- counsel pts

A
  • permanent
  • address all other options- LARCs
  • reasons for choosing sterilization
  • risks/benefits
  • screen for regret (esp at young age)
  • possibility of failure and inc risk of ectopic pregnancy
38
Q

male sterilization

A

Vasectomy

-occlusion of vas deferens

39
Q

Female sterilization

A

-laparoscopy, mini-laparotomy, hysteroscopy

R2F (18 decks)

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