Contraception Flashcards
Disadvantages to barrier methods
not as effective as hormonals; efficacy dependent on consistent and correct use
Yuzpe regimen
2 doses of high concentration birth control pills
What is the time limit on insertion of an IUD after coitus?
5 days
How long does a copper IUD last?
12 years
T/F A copper IUD is immediately reversible.
T
What % of unintended pregnancies are avoided with EC?
75%
Progestin only pill
Plan B
Progesterone receptor modulator whose likely main effect is to inhibit or delay ovulation.
Ella
Ella is FDA approved for ___ days after sex.
5 days
MOA Progestin
inhibits LH surge and subsequent ovulation, thickens cervical mucus, decreases estrogen-driven cell proliferation, converts reproductive tissues from proliferative modes to functional modes
T/F cervical mucus is ineffective in preventing fertilization
F –> extremely effective –> much to do with the timing in natural family planning
MOA Estrogen OC
inhibits FSH surge and subsequent follicle development, may inhibit ovulation, thins cervical mucus, increases endometrial proliferation
Synthetic progestins are derived from ____
testosterone
Classes of progestins
testosterone derived estranes and gonanes; progesterone derived pregnanes, spirolactones, and anti-progestins
____ is an injectible progestin-only birth control derived from _____
Depo Provera/DMPA from progesterone
DMPA must be injected every ___ months
3
Main side effects of DMPA
weight gain, menstrual changes, injection every 3 months
T/F DMPA reduces risk of endometrial cancer
T
Drosperinone
used in Yaz/Yazmin
Estranes
earliest class of progestins; norethindrone
Gonanes
Levonorgestrel family
Pharmacologic effects of progestins
modify mid cycle surges of lh/fsh –> inhibit ovulation, diminish ovarian hormon production, endometrail and cervical mucus changes
Higher bioavailability permits higher/lower dose
lower
Effect of combination OC on androgen pathways
metabolized by liver –> sex hormone binding globulin increases –> more bound testosterone –> less free serum testosterone –> less binding // direct suppression of testosterone production by ovaries
Which of these are effects of hormonal contraception? decreased menstrual flow, improved anemia, suppressed ovarian cysts,decreased acne, cancer protection
all of the above
T/F The cyclic bleeding from birth control is non-ovulatory.
T –> withdrawal bleeding (cultural)
Contraceptive patch
transdermal patch with combined estrogen/progestin –> not effective in obese
T/F vaginal ring is a local delivery mechanism
F –> hormones absorb across vaginal mucosa and act centrally
Merena/skyla are ____ intrauterine systems.
levonorgestrel –> 5 year release
Cardiovascular risks of oc is due to progestin/estrogen.
estrogen but still low b/c has to do with interaction with other conditions
