Contraception Flashcards
T/F: The rate of unintended pregnancy is 5-fold lower for women below poverty level, and continues to increase.
False
Its 5-fold higher
T/F: The health risks of pregnancy are greater than those of ANY contraceptive method.
True
Put these three things in order of contraceptive effectiveness…..
Depo-Provera
Condoms
Mirena (IUD)
Mirena (IUD) > Depo-Provera > Condoms
What is the primary purpose of contraception?
Preventing Pregnancy
T/F: Contraception failure rates differ between ideal use and actual use
True
What are examples of barrier contraceptive methods?
Diaphragm
Cervical Cap
Condoms (Female, Male)
What is a non-contraceptive benefit to barrier methods?
STI Protection
What is a drawback to using a natural membrane male condom?
May allow the passage of viruses (ie: HPV)
T/F: A diaphragm for contraceptive use requires a prescription
True
What are THREE important things to remember when using a diaphragm for contraception?
- Spermicide
- Place 2 hours before intercourse
- Leave in for 6 hours after intercourse
Diaphragm are associated with an increased risk of what?
UTI
What are the two main component of combination contraceptives?
Estrogen
Progestin
Depo-Provera is ________ (estrogen/progestin) only
Progestin
What are THREE actions of combination (estrogen-progestin) contraceptives?
- Suppress ovulation
- Thin the endometrium
- Thicken cervical mucus
Does Progestin or Estrogen carry the most risk in combination OCPs?
What are examples of these?
Estrogen
Examples….
MI
CVA
HTN
DVT
T/F: OCs are associated with an overall increase in cancer risk
False
They are NOT
What are contraindications to OCP use?
Smoker over age 35 Uncontrolled hypertension History of stroke or ischemic heart disease History of VTE Inherited thrombophilia Lupus (SLE) Migraine with aura Breast cancer Cirrhosis Liver tumor
What are common side effects of OCPs?
Which is most common?
Breakthrough bleeding- (Most common) Amenorrhea Bloating Nausea Breast tenderness Weight gain Headache
Why is breakthrough bleeding the most common side effect of OCPs?
Due to the thinning effect it has on the endometrium
What are the MANY non-contraceptive benefits to OCPs?
Decreased menstrual bleeding
Decreased dysmenorrhea
Improvement of PMS symptoms (extended cycle)
Prevention of menstrual migraine (extended cycle)
Decreased incidence of ovarian cysts
Decreased benign breast disease
Improvement of acne
Control of hirsutism
Management of uterine leiomyomata (fibroids)
Suppression of endometriosis
Decreased cancer risk: endometrium, ovary, colon
What are four recommended screenings that should be completed before starting OCPs?
Pelvic Exam
Pap Smear
STD Check
Measure BP
Why should you take the first OCP on Sunday?
To avoid menses on the weekend
T/F: You do not have to r/o pregnancy prior to starting OCPs
False
You do need to rule it out
What is the most common reason women stop using OCPs?
Unscheduled Bleeding
What types of medications interact with OCPs?
Anticonvulsants
Rifampin
T/F: Women over age 35 who smoke should not take combination OCs
True
T/F: Healthy women who do not smoke can continue combination OCs through menopause
True
How often is the transdermal patch changed?
Weekly
T/F: There is NOT an associated increased DVT risk with the transdermal patch
False
There is
How often is the Nuvaring changed?
Monthly
Is there a placebo phase associated with porgestin-only pills?
No
What are THREE contraindications to porgestin only pills?
- Breast CA
- Diagnosed Abnormal Uterine Bleeding
- Active liver disease
T/F: Progestin-only pills ARE contraindicated in women with a history of CVA, MI, or DVT
False
They are not contraindicated in these women
What are TWO side effects of progestin only pills?
- Irregular Bleeding
2. Amenorrhea
How often is the Depo-Provera injection given?
Every 3 Months
What are contraindication to Depo-Provera Use?
- Breast CA
- Undiagnosed Uterine Bleeding
- Active Liver Disease
T/F: There is some associated of osteoporosis with long term use of Depo-Provera
True
What are the TWO most common side effects of Depo-Provera?
Change in bleeding pattern
Weight Gain
What does LARCs stand for?
Long-Acting Reversible Contraceptives
How long is the Nexplanon effective for?
Who places this?
Nexplanon is effective for 3 years
These need to be placed and removed by trained providers
T/F: There is associated risk for MI, Stroke, and DVT with Nexplanon
False
There is NO associated risk for those things
What side effects are associated with the Nexplanon?
Unscheduled Bleeding Headache Weight gain Acne Breast tenderness Mood changes
What medication composes the Mirena IUD?
How long is this effective?
Levonorgestrel (52 mg)
These are effective for 5 years
How long is the ParaGard effective?
10 years
Which is more effective in hormone intolerant women…..
ParaGard or MIrena?
ParaGard
Which is more effective for decreasing menstrual bleeding…..
ParaGard or MIrena?
Mirena
What are two contraindications to ParaGard use?
Wilson’s Disease
Copper Allergy
What is a contraindication to Mirena use?
Active Breast CA
What is a concerning adverse reaction to IUD placement?
Uterine Perforation
What ADRs are associated with IUDs?
Missing Strings
Expulsion Risk
Partner Discomfort
Buyer’s Regret
When are patients with IUDs most at risk for pelvic infection?
Within the first 20 days following insertion
T/F: The health risks of pregnancy
are greater than those of
ANY contraceptive method
True
T/F: ParaGard is associated with an increase in menstrual bleeding
True
What is a permanent sterilization method in males?
Vasectomy
Which is more common?
Tubal Ligation or Vasectomy
Tubal Ligation is 5x more common than a vasectomy
What is the failure rate of vasectomy?
1 in 500
What are examples of laparoscopic sterilization techniques in females?
Tubal Cautery/Division
Tubal Clips
Tubal Bands
Tubal Rings
Patients with laparoscopic sterilization are at risk for what is pregnancy occurs?
Etopic Pregnancy
What are the risks of laparoscopic female sterilization?
Bleeding
Infection
Damage to internal organs
Anesthesia Complications
What is the most commonly occurring risk of sterilization?
Regret
___% of reproductive aged women used emergency contraception at least once between 2006-2010
What are examples of emergency contraception?
12%
Plan B (Levonorgestrel) Ella (Ulipristal)
Is there harm to an already existing pregnancy if a patient takes Plan B for emergency contraception?
No
What needs to be ruled out prior to prescribing Ella for emergency contraception?
Pregnancy
What is the most effective postcoital method of emergency contraception?
ParaGard
*Inhibits Fertilization, Need to r/o pregnancy first
