Contraception Flashcards
List the methods of contraception
- Periodic Abstinence (rhythm method)
- Barrier techniques
- Spermicides (contain nonoxynol-9 chemical surfactants)
- Spermicides-implanted barrier technique (sponge with spermicide)
- Hormonal contraception
Disadvantages of male condoms
-Efficacy decreased by oil-based lubricants
Absolute contraindications for female condoms
- Allergy to polyurethane
- History of toxic shock syndrome
What is important to remember about female and male condoms?
not meant to be used together
Why are spermicides no longer recommended?
No added benefit against pregnancy and may increase the risk of HIV transmission
What is important to remember about Diaphragm with spermicide?
- Insert 6 hours before intercourse
- Leave in place at least 6 hours after intercourse
- DON’T leave in for >24 hours= risk of Toxic shock syndrome
- Subsequent acts of intercourse, condom use recommended for additional protection
Diaphragm with spermicide: Absolute contraindications
- allergy to latex, rubber, or spermacide
- Recurrent UTI
- History of TSS
- Abnormal gynecologic anatomy
Diaphragm with spermicide: Advantages
- Inexpensive
- Decreased risk of cervical neoplasia
- Some protection against STDs
Diaphragm with spermicide: Disadvantages
- High user error/failure rate
- Decreased efficacy with increase intercourse frequency
- Increased vaginal yeast UTIs
- Efficacy decreased by oil-based lubricants
What is a unique contraindication for Cervical cap (FemCap)?
Abnormal papanicolaou smear (due to increased risk for cervical dysplasia)***
What are 2 disadvantages with the cervical cap?
- decreased efficacy in women who have given birth
- Can’t use during menses
In combined hormonal contraceptives, what hormone provides the most contraceptive effect?
Progestins
Name the effects progestins have to prevent pregnancy
- Thickening of cervical mucus
- Slow tubal motility (sperm transport)
- Induce endometrial atrophy
- Progestins block LH surge inhibiting ovulation**
What effects do estrogens have to prevent conception?
- Stabilize endometrial lining to provide cycle control**
- Suppress FSH release from pituitary, contribute to blocking LH surge
Which form of synthetic estrogen is a prodrug?
Mestranol
Why would you consider Mestranol?
50% less potent than Ethinyl estradiol
so…
if you want less estrogen this one is good
Which is the most common synthetic estrogen?
Ethinyl estradiol (EE)
Name a 1st Generation progestin and downside
Ex. Norethindrone
- well tolerated
- Lower doses have more breakthrough bleeding
Name a 2nd Generation progestin and pros and cons
Ex. Levonorgestrel
- long half-life (IUD*)
- More androgenic activity - better for libido, worse for hirsutism/acne/lipids
Name 3rd Generation progestin and indication for use
Ex. Desogestrel
-Similar to 2nd gen but less androgenic activity–> so think about this in someone with slight libido benefit needed
Name 4th Generation progestin and benefit
Ex. Drospirenone (Yasmin)
- anti-androgenic properties**
- Advertised for acne
For progestin only, what is importnat to know about the dosing?
- Must take at the same time every day (3 hr window)
- If window missed, need back up contraception for 48 hours
What is a main risk factor for progestin only birth control?
Higher risk of ectopic pregnancy
When might be a good time to use progestin only birth control?
right after giving birth, because with giving estrogen you would be concerned for increased risk of thrombotic events
