contraception Flashcards
hormone replacement therapy - contraindications
- estrogen-depended carcinoma (breast or endometrial)
2. history of pulmonary embolism or DVT
contraception - types
- female condoms
- vaginal diaphragm
- OCPs
- vaginal ring
- trandermal Patch
- Intramuscular injetion
- intrauterine device
- sterilization
female condom - structure
2 rings and a thin material in between. 1 ring is placed deep into the vagina while the other is left at the introitus (opening that leads to the vaginal canal)
larger and bulkier than male condoms
female condom - properties
offer some protection against HIV and STDs and are under female control
Vaginal diaphragm - structure / placement
- circular ring with contraceptive jelly that covers the cervical canal (without the jelly is ineffective). The jelly is also used as a lubricant while placing the diaphragm
- should be placed 6 h before intercourse and left fot at least 6 h after
Vaginal diaphragm - disadvantages
- need to be fiitted properly
- proper use requires advance preparation
- improper placement or dislodging reduced efficay
OCP - structure / way of using
combination pill of both estrogen + prgesterone. The pill is taken for 21 days and a placebo is taken for 7 days. During the 7 days of the placebo pills, the patient will experience menstruation. Women should start again on the Sunday after menst.
OCP - properties
reduce risk of ovarian ca, endometrial ca, ectopic pregnancy
but increase the risk of thromboembolsim
vaginal ring - structure and properties
vaginal ring that releases both estr and prog is inserted into the vagina for 3 wks. Hormone are released on a constant basis. When the ring is removed, withdrawal bleeding will occur. similar side effect and efficacy to OCPs
Transdermal Patch - everything
a patch with a combination of estrogen and progest is placed on the skin for 7 days. Each wk the previous patch is removed and a new patch is placed. 3 wks of patches are follow by a free week (withdrawal bleeding).
NOT PLACED ONTHE BREAST
Similar side effect and efficacy to OCPs
intramuscular injection - everything
depot medroxyprogesterone acetate is an intramuscular injection that is effective contraception for 3 months
intrauterine device - location / properties
placed into the uterus and provides contraception for 10 years
intrauterine device - types
- copper device
2. levonogestrel device
intrauterine device - side effects
PID (genital culture before placement)
Sterilization?
surgical sterilization can done on both men + women/ Sterilization via tubal ligation and vasectomy is permanent of these devices
sterilization - types
- tubal ligation
2. vasectomy
sterilization - tubal ligation
- surgical procedure that women may choose to undergoo for permanent contraception
- very low risk of pregnancy (but it occurs)
- increase incidence of ectopic pregnancy
sterilization - vasectomy
surgical procedure in which ligation of the vas deferens is preformed
medroxyprogesterone - SE
similar to pregnancy: weight gain, fatigue, breast tenderness
emergency contraception options - methods and mechanism
- copper IUD –> inf reaction
- Ulipristal pill –> antiprogestin –> delays ovaluation
- Levonorgestrel –> progenstin –> delays ovaluation
- OCPs –> progenstin –> delays ovaluation
emergency contraception options - methods and time after intercourse (hours)
- copper IUD –> 0-120
- Ulipristal pill –> 0-120
- Levonorgestrel –> 0-72
- OCPs –> 0-72
emergency contraception options - methods and efficacy
- copper IUD –> 99%
- Ulipristal pill –> 85 or more
- Levonorgestrel –> 85%
- OCPs –> 75%
absolute ontraindications to combined hormonal contraceptives
- migraines with aura
- 15 or more cigarettes daily plus 35 or older years old
- hypertension more than 160/100
- heart disease
- DM with end organ
- history of thromboembolic
- antiphospholipid syndrome
- history of stroke
9 breast cancer - cirrhosis + liver cancer
- major surgery with prolonged immobilization
12 use less than 3 wks postpartum
Estrogen-progestin contracepties - benefits
- pregnancy prevention
- endometrial + ovarian cancer risk reduction
- menstrual regulation
- hyperandrogenism treatment
Estrogen-progestin contracepties - risks
DVT hypertension hepatic adenoma stroke or MI (both rare) cervical cancer
