Contraception: 7 Flashcards
Gap should be how long between pregnancies?
at least 12 months between pregnancies
reduces risk of preterm birth, low birth weight, and other complications.
Tier 1: Permanent and Reversible Methods
Sterilization
considered to be?
what is it?
most commonly used method worldwide
Considered to be permanent
tubes tied
vasectomy
LARC: Long-acting reversible
contraceptive (IUD and Implant)
First line in contraception
Eliminates patient-use error
Allows for spacing and planning
High compliance, low risk & dissatisfaction
Contraindicated: suspected infection, pregnancy, cancer, distorted cavity
LNG IUD
what hormone?
shape?
how does it work?
Progesterone only
T-shaped device inserted into uterine cavity
Small amount of hormone daily to suppress ovulation
Thickens cervical mucus
Keeps uterine lining thin
Copper (Paragard) IUD
what hormone?
what shape?
copper does what?
Non hormonal
T-shaped device inserted into uterine cavity
Copper damages sperm prior to fertilization
LNG IUD Benefits
3
Reduces?
Reduces?
Suppresses?
Reduces menstrual blood loss
Reduces dysmenorrhea
Suppresses endometrial thickening,
thus decreasing risk of endometrial
cancer
IUD Benefits
Copper Paragard
What hormone?
effective when?
can be used as?
Only contraceptive IUD available that contains NO hormones
Effective immediately after insertion
Can be used as emergency contraceptive method
Implant (rod under skin)
what hormone?
placed where?
suppresses?
most common cause of discontinuation?
Nexplanon (3 yrs)
Progesterone only
Small, flexible rod placed under skin in upper arm- requires training to insert
Suppresses ovulation, thickens cervical mucus, thins endometrial lining
May cause irregular and unpredictable menses (*most common cause of discontinuation)
Tier 2
Pill, patch, ring, injectable
Combined Oral Contraceptives (COCs)
what hormone?
how many days of pills?
Stabalizes?
reduces?
Contains Estrogen and Progesterone
21-24 days of “active” pills, 3-7 days of
placebo
Stabilizes endometrium for less breakthrough bleeding (BTB)
Reduces risk of endometrial and ovarian cancer
Does NOT prevent STIs
Side effects: nausea, BTB, breast tenderness
Progesterone Only Pills (POPs)
no what?
thickens?
can be used?
Mini Pill
No estrogen
Thickens cervical mucus
Can be used while breastfeeding
OCPs Client Education
ACHES?
if u miss 2 pills?
if u miss a pill?
Abd pain
Chest pain
Headache
Eye/vision changes
Severe leg pain
If you miss 2, take 2 pills for 2 days & use a barrier method
If you miss a pill, take it as soon as you remember
NuvaRing
what hormone?
inserted?
stays how many weeks?
can improve?
Estrogen + Progesterone
Inserted once a month self administered into vaginal canal
Stays 3 weeks then removed for 1, can be continuous
Suppresses ovulation
Has local effect
Discrete, easy, can improve vaginal flora
Patch
brand name?
what hormone?
how many patches per week?
apply where? avoid?
higher risk of failure?
may have reaction to?
higher risk of
Ortho-Evra is brand name
Estrogen + Progesterone
1 transdermal patch per week
Must alternate sites (upper body, lower abdomen, buttocks), avoid breast /chest
Higher risk of failure >198 lbs
Risks /benefits same as OCPs
May have reaction to adhesive
Slightly higher risk of blood clot
Emergency Contraception
how to get ELLA?
ella is more effective at what weight?
Can be either IUD or pills (Plan B or
Ella)
Plan B available OTC, Ella is not
Ella is more effective at >165lbs
Injectable (DEPO)
what hormone?
shot how often
what does it do?
side effects?
Progesterone only
IM shot every 3 months
butt or arm
Suppresses ovulation, thickens cervical mucus, thins endometrial lining
Side effects:
Initial irregular sometimes heavy bleeding is possible
Tier 4
Natural Family Planning
Lactational Amenorrhea
Temporary for new moms
Must meet these conditions:
-Before bleeding has returned
-Requires exclusive breastfeeding day and night
-Baby is less than 6 months old
