Contraception Flashcards
1
Q
Methods of contraception?
A
Sterilization (15.5%)
OCPs (16%)
Long-acting reversible (7%)
Injectable (3%)
2
Q
Properties of Contraceptives Desired by Women?
A
- Highly effective
- Prolonged duration of action
- Rapidly reversible
- Privacy of use
- Protection against STI
- Easily accessible
3
Q
Behavioral Methods of contraception?
A
- Abstinence
- Fertility Awareness
- coitus interruptus
4
Q
Barrier Methods of contraception?
A
- condom
- diaphram
- cervical cap
- sponge
5
Q
Hormonal methods of contraception?
A
- OCP’s
- injectable
- transdermal
- vaginal ring
- implantable
- IUD
- Emergency contraceptions
6
Q
Example of Monophasic
COC?
A
Loestrin
Ortho-Cyclen
Alesse
7
Q
Example of Biphasic COC pills?
A
Mircette Ortho-Novum 1
8
Q
Example of Triphasic COC pills?
A
Ortho Tri-Cyclen
9
Q
Ortho Tri-Cyclen is what type of contraception?
A
Triphasic COC pills
10
Q
Mircette Ortho-Novum 1 is what type of contraception?
A
Biphasic COC pills
11
Q
Extended Cycle Oral Contraceptives?
A
- Lybrel
- Seasonale
- Seasonique
12
Q
Signs of potential complications with COCs/ OCPs?
A
ACHES:
- Abd pain
- Chest pain or SOB
- Headache (sudden or persistent)
- Eye problems
- Severe leg pain, cramps or warmth
13
Q
Contraindications for CHC’s?
A
- hx of clotting disorders or thormoembolisms
- hx of CV issues (HTN)
- migraines with halos
- breast or endometrial cancer
- pregnant
- > 35 and smokes
- any age and >15 cig/day
- BMI > 40
- liver disease
14
Q
How often is Depo-Provera given and at what dose?
A
150mg IM q 12 wks (3 months)
15
Q
What type of contracetpion is Depo-Provera
A
Progesterone IM injection
16
Q
AE of Depo-Provera?
A
spotting and irregular bleeding for 1st 6-12 months, then amenorrhea
17
Q
How long does a woman have to wait after stopping the Dep-Provera tx to get prego?
A
6-12 months
18
Q
Dep-Provera mechanism of action?
A
stops ovary from releasing an egg and thickens cervical mucus
19
Q
Possible hormonal side effects IUD?
A
- Mood changes
- Acne
- Headache
- Breast tenderness
- Nausea
- Persistent ovarian follicles
20
Q
Signs of IUD complications?
A
“PAINS”
- Period late; abnormal spotting
- Abd pain; dyspareunia
- Infection exposure; abn vag d/c
- Not feeling well, fever, chills
- String missing, shorter or longer
21
Q
Medical term for painful sex?
A
dyspareunia
22
Q
Single Contraceptive Implant drugs?
A
Nexplanon
Implanon
23
Q
Single Contraceptive Implants are effective for how long?
A
3 years
24
Q
Single Contraceptive Implants mechanism of action?
A
inhibits ovulation
25
Diaphragm & Cervical Cap insertion and removal teaching?
insert up 6hrs before sex and keep in for a minimum of 6hrs after
26
Contraceptive Sponge teaching?
- Contains N-9 spermicide
- Fits over the cervix
- Moisten w/ H2O prior to use
- Protection for 24hrs
27
Why must a contraceptive sponge be removed at the 24 hr mark?
leaving it in longer places woman at risk for Toxic Shock Syndrome [TSS]
28
Medical term for the pull out method?
Coitus Interruptus
29
Lactational Amenorrhea Method?
- Temporary method (6 months)
| - Prolactin inhibits estrogen production, suppress ovulation, & delays menses
30
Best results for Lactational Amenorrhea Method required that?
- Exclusive breastfeeding
- No menses since delivery
- Infant younger than 6 months
31
What is Essure?
non surgical contraception where a spring like device is placed into the fallopian tube and scar tissue forms around it to block the p-way
32
Plan B MOA when taken during the 1st month of the menstrual cycle?
prevents ovulation
33
Plan B MOA when taken after ovulation?
thickens cervical mucus and may directly inhibit fertilization
34
An induced abortion should e down within what time frame?
< 20 wks of prego
35
Good candidates for the Extended Cycle Oral Contraceptives?
- women with endometriosis and painful menses
- PMS, PMDD
- want fewer menses
36
How does Combined Hormonal Therapy work?
- tricks body into thinking it is prego
- thickens cervical mucus
- thins endometrial lining so implantation cannot occur
37
Examples of IUD's?
Mirena (5 yrs) and Skyla (3 yrs)
38
IUD MOA?
- Thickened cervical mucus
- Inhibits sperm motility and function
- Endometrium suppressed
- Ovulation inhibited in some
39
Dosing frequencies:
1) injectable
2) implant
3) IUD
4) Ring
5) Patch
1) 12 wks
2) 3-5 yrs
3) 3-5 yrs
4) q 4 wks
5) weekly
40
Hormonal Contraception mechanisms of actions?
1) tricks the body into thinking it's already prego
2) makes endometrial lining unsuitable for implantation
3) increases cervical mucus production
41
Combined hormonal contraception are contraindicated for who?
cancer patients, smokers, and breastfeeding mothers
42
Why are combined hormonal contraception not indicated for breastfeeding mothers and cancer patients?
estrogen decreases milk production and increased levels can contribute to or cause cancer
43
What are the non-contraception benefits of combined hormonal therapy?
- regular, less painful and lighter periods
- protects against certain benign ovarian and breast cysts, fibroids and endometriosis
- may improve hirsuism and acne
44
Side effects of CHT?
- HA, N, breast tenderness and mood swings
- few months: HTN, breakthrough bleeding/spotting
- links to thrombosis and breast cancer
45
Vaginal or Nuva Ring patient teaching?
- self inserted and removed
- remains in for 3 wks and removed on the 4th wk
- bleeding should occur once removed
46
Contraindications for the HCT patch?
- hx of thromboembolism, clotting disorders or CV issues
- migraines with auras
- breast or endometrial cancer
- prego
- > 35 y/o + > 15 cig/day
- BMI 40
- diabetes with vascular complications
- liver disease
47
HCT Patch patient teaching?
- place on abd, arm or butt (NOT BREAST)
- leave on of 7 days then replace x 3 wks
- 4th week is patch free
48
How does the progesterone only (min-pill) work?
makes cervical mucus thick and hostile to sperm
49
CHT injection patient teaching?
- last 3 months
- causes decreased bone density first 2-3 yrs
- may cause irregular bleeding or amenorrhe
50
CHT implantable patient teaching?
- implanted into upper arm
- lasts 3 - 5 yrs
- does not cause decrease of bone density
51
IUD patient teaching?
- inserted and removed by health professional
- have lighter periods after 1 yr, but worse initially
- if gets prego, need to have the IUD removed
52
What is Mirena?
IUD that last up to 5 yr
53
What is Skyla?
IUD that last up to 3yrs
54
How long does a postpartum woman need to wait before starting the Mini-Pill?
3 weeks post partum
55
How often should a woman check the string of her IUD?
q month after her menses
56
Diaphragm & Cervical Cap teaching?
- fitted by a provider
- insert up to 6hrs b4 sex
- apply spermicide for increased effectiveness
- remains in for minimum of 6 hrs post coitus
57
How long does it take for scar tissue to form around the Essure microinsert?
3 months, then get the Essure test
58
How does the provider prove the effectiveness of the Essure?
Essure test 3 months after insertion, dye is injected into the uterus and an xray is taken to view its spread
