contraception Flashcards
what emergency contraception can be taken within 5 days of unprotected sex
Paragard IUD placement Ella (Selective Receptor Modulator)
what emergency contraception can be taken within 72 hours of unprotected sex
Plan B or Preven (2 oral tablets)
MOA of hormonal contraception
(POP, OCP, depo, implant, IUD)
suppresses ovulation
thickens cervical mucous
thins endometrial lining
absolute contraindications for:
combo oral contraceptives
transdermal contraception (ring/ patch)
CAD
uncontrolled HTN
uncontrolled DM
complex migraines (incl. aura)
hx of VTE
hormone sensitive CA
smoker over the age of 35
who is typically given the POP
postpartum moms who are breastfeeding
estrogen contraindications
immediately postpartum period
hx of VTE
hx of CVD
smoker over the age of 35
classic migraines
liver dysfunction
side effects of POP
spotting
depression
hair/skin changes
libido change
side effects of depo
spotting
anovulation
weight gain
depression
hair/skin changes
libido changes
delay in pregnancy once the shot is DC’d
implant (nexplanon) side effects
irregular bleeding
+/- anovulation after 1 year
progestin IUD (mirena, skyla, liletta, kyleena) side effects
lighter periods/ spotting/ anovulation
non-contraceptive benefits of OCPs
cycle regulation
treats heavy menses and dysmenorrhea
treats acne
prevents ovarian cysts
prevents endometrial, ovarian, and colon CA
which contraceptive method does not need backup contraception until it goes into effect
copper IUD (paragaurd)
do you need to do a cervical and bi-manual exam before starting contraception
only for IUD placement (copper or levonorgestrel releasing)
which contraceptive method needs a BP measurement prior to initiation
combo oral contraceptives
Which contraceptive methods need backup contraception if it’s been more than 5 days since menses began? For how long do you need to use backup contraception?
- use back up for 7 days:
- hormonal IUD
- implant
- depo
- combo oral contraceptives
- use back up for 2 days:
- POP
when can you start contraception
anytime
as long as you’re certain that the woman is not pregnant
and even if pregnant for paragaurd
what is the hormone in depo
medroxyprogesterone acetate
contraindications for depo
NO absolute contraindications!!
but caution w/: DM, HTN, CVD
depo side effects
irregular cycles
amenorrhea
bone mineral density loss
combo oral contraceptives
and
transdermal contraception (ring/ patch)
should be used with caution for patients with:
DM
HTN
smokers under 35
common migraines (no aura)
controlled liver disease
what are long acting reversible contraceptives?
IUDs and implants
subdermal implants: brands?
what hormones do they contain?
brands- implanon, nexplanon
hormone- progestin only
sub dermal implant contraindications
allergy to materials
hormonal IUDs: brands?
what hormones?
brands- mirena, skyla, liletta
hormone- progestin
non-hormonal (copper) IUD: brand?
paragard
side effects of IUDs
hormonal- follicular cysts
non-hormonal- inflammatory
contraindications for IUDs
active infection
uterine anomaly
untreated cervical disease
sensitivity to copper (w/ Paragard)
non-contraceptive benefits of IUDs
treats menorrhagia
Paragard does emergency contraception
when placing an IUD, how long should you cut the strings
1.5 cm
benefits of long acting reversible contraceptives
(what you can tell pt)
eliminates user error b/c they don’t have to remember to do anything
hormonal levels are continuous which is lessens chance of ovulation
less visits to the OBGYN (cheaper)
one less thing for mom to remember
allows mom to plan her pregnancies better
what are the options for “tube tying” (sterilization)?
laproscopic
post partum via mini laprotomy
laparoscopic sterilization requires what?
intubation
general anesthesia
hospital/ surgery center
(outpatient)
When doing a well womans visit, what are the 5 P’s you should discuss when taking a history
- Partners
- M/W/Both
- how many in the last year
- when was the last time you had sex)
- Practices- oral/vaginal/ anal?
- Prevention of pregnancy
- do you want to become pregnant?
- what are you doing to prevent pregnancy
- Prevention of STI’s (freq of condom use)
- Past hx of STIs (theirs and their partners)
