Contraception

Question 1

natural fertility rate for heterosexual couples

Answer 1

80% at 6 months and 85% at 12 months 85% can be reduced by contraception

Question 2

Health benefits

Answer 2

STIs, lower endometrial cancer, lower ovarian cancer even in women with BRCA 1 and 2

Question 3

Combined hormonal methods CHC

Answer 3

Estrogen PLUS progestin

The pill, transdermal patch, vaginal ring

Question 4

CHC MOA

Answer 4

Prevents ovulation, progestin is the dominant hormone in CHC formulations

PRogestin diminishes frequency of hypothalmic GnRH pulse frequency, inhibits the estrogen induced LH surge at midcycle

Estrogen suppresses the FSH ptreventing selction and emergence of dominant follicle, small contribution

Inhibit sperm activity, thicken cervical mucous

Question 5

Oral combined contraceptive pill

Answer 5

in the 60s, usually ethinyl estradiol, progestins vary estranes gonanes and spironolactone 4th gen (can cause hyperkalemia, and antiandrogen as acne)

Over 70 formulation

Question 6

Venous thromboembolism

Answer 6

10x the risk of VTE, fatalities are low

and much higher in smokers (its contraindicated)

Question 7

Progestin only

Answer 7

thicks mucus, and thins the endometrium- can have more bleeding

Question 8

DEPO ma

Answer 8

injectoion every 12 weeks, only progestin, good for seizures

Question 9

Progestin implant

Answer 9

for 3 years

Question 10

Drug interactions

Answer 10

P450 3A4 for estrogens and progestins

increased metabolism of estrogen and progestin , anti epileptics, RIFAMPIN some HIV proteases

Question 11

IUC

Answer 11

Copper and progestin (5yr and 3yr)

Does not cause PID or infertility

Cu- prevents normal fertilization (Cu Ions reduce motility and viability of sperm, toxic to oocytes, and inhibits implantation

Highly effective (<1%)

Question 12

Really heavy period

Answer 12

Progesin IUD, thickens cervical

Question 13

IUD/IUs

Answer 13

Stay away if theres any issues,

Question 14

LARC

Answer 14

iud might fall out

Question 15

fertility awareness

Answer 15

Longest cycle -

Days 8-19 are fertile daus

Emergency- levonorgesterl, ulipristal