Contraception Flashcards
5 factors for contraceptive counseling
personalized/shared decisions rapport build goalset counseling hx, CI ID
The below are used to assess…
7 or fewer days after menses start or abortion
no intercourse since last menses
reliable contraception use
4 weeks postpartum
breast feeding, amenorrhea, < 6 mo post patum
pregnancy (99% predictive)
condoms should always be used for what reason
STI prevention
How effective?
implant
IUD
Vasectomy
tube tie
most effective
How effective?
OCPs injections patch ring diaphragm
2nd most effective
How effective?
male/female condoms
withdrawal
sponge
3rd most effective
how effective?
fertility awareness
spermicide
least effective
The below can have what side effects?
Pill, patch, ring
spotting for first few months
lighter periods
Which IUD can cause heavier periods?
copper
Which IUD can cause spotting, lighter, or no periods?
LNG
How long does an IUD last?
3-12 years
How long does an implant last?
3 years
Copper IUD lacks ______ and can therefore cause _______
hormones
cause more cramps
Does LNG IUD have estrogen? What effect on cramping?
no estrogen
reduced cramps
does an implant have estrogen?
no
Do injectables have estrogen? what effect on cramping
no estrogen
reduced cramps
These forms of contraception may reduce cramps/anemia, improve acne, lower CA risk
pill, patch, ring
how long does the patch last?
week
how long does the ring last?
month
women w. 26-32 day cycles can use what method of natural family planning?
standard days method
in the standard days method, sex is abstained from on what days?
8-19
women w/out 26-32 day cycles can use what method of natural family planning?
calendar method
calendar method requires monitoring cycles for how long?
6 mo
In the calendar method, the first day of the fertile period is…
length of shortest menstrual cycle - 18 days, add that number from 1st day of cycle
in the calendar method, the last day of the fertile period is
length of longest menstrual cycle - 11 days = add that number to the first day of that cycle
When is it ok to have intercourse using the 2 day method of natural family planning?
no cervical secretions for 2 consecutive days
Which method of natural family planning?
Check cervical mucus daily
Peak day = last day of “stretchy” clear mucus
Fertile period occurs w/ 1 st signs of mucus and continues until 4 days after
peak day
cervical mucous method
in the cervical mucus method, abstinence should occur when?
any cervical secretion until 4 days after peak day
Which method of natural family planning?
Check basal body
temperature upon
wakening every AM
before getting out of bed
Rise in temperature of
0.5 1* F = ovulation
Abstain from sex from
end of menstrual period
until 3 days after
temperature increase
basal body temperature method
Which method of natural family planning?
Combination of cervical
mucus + basal body temp
methods
Also monitor for physical
signs of ovulation
Fertile period: 1 st sign of
ovulation until 3 days after
temp rise or 4 days after
peak mucus
symptothermal
Which type of female barrier/spermicidal method?
can be left in place 48 hrs
must be in for 6 hours after cex
cervical cap
Which type of female barrier/spermicidal method?
can be left in place 24 hrs
must leave in for 6 hours after sex
diaphragm
how far in advance can condoms for women be inserted?
8 hours in advance
Which type of female barrier/spermicidal method?
release continual spermicide
must remain in place 6 hrs after sex
sponge
2 disadvantages of female barrier/spermicidal methods
UTI risk (diaphragm) no HIV protection
2 advantages of female barrier/spermicidal methods
no effect on menses
immediately active
Emergency OCPs must be taken as ___ doses within ____
2 doses within 72 hours of unprotected sex
an IUD can be used as emergency contraception if placed within ______ of unprotected sex
5 days
What type of emergency contraception?
selective progesterone receptor modulator
effective for 5 days after unprotected intercourse
ella/ulipristal acetate
Duration of the below…
Oral Contraceptive Pills (“the pill”)
Nuva Ring ® (vaginal ring)
OrthoEvra Patch ® (“the patch”)
Depo Provera ® (“the shot”)
short acting/frequent use
What type of contraceptive is good for women with the below:
Women who have a short interval prior to wanting a pregnancy
Women who are not looking for long term pregnancy prevention
Women using these methods for non-contraceptive benefits
Uninsured women with financial concerns
OCPs/ring/patch/shot (short acting)
why must BP be measured before starting COCs?
ID severe HTN
Which type of COC?
Single dose of estrogen and progesterone for 21-24 days; + placebo pills for 4-7 days
monophasic pill
What is the preferred monophasic formulation due to increased efficacy and decreased hormone withdrawal SEs?
24/4 or 21/7
Which type of COC?
Differing dose of estrogen and progesterone throughout the course of the pack; +placebo pills usually for 7 days
triphasic
Which type of COC?
Usually monophasic
Packaged with 84 active pills and 7 placebo pills (seasonale) or 365 days of active pills (lybrel).
continuous
The below are adverse effects of…
HTN
VTE
MI/CVA
Lipid/metabolic changes
COCs
Which OCP has the below mechanism?
thickens cervical mucus to prevent sperm entry Thin endometrium (inhibits implantation) Ovulation suppression in 50% of cycles Slows sperm motility
progestin only pill/mini pill
progestin only pills are used for…
nursing mothers or estrogen C/I
The below are adverse effects for:
Limited window for missed pills (>3 hours late taking dose will decrease effectiveness)
Increased spotting/intermenstrual bleeding
Intermittent amenorrhea
progestin only pills
The below are C/Is for what contraceptive method?
Age ≥35 years and smoking
Hypertension uncontrolled
Migraine with aura
Diabetes mellitus
VTE
Known ischemic heart disease
History of stroke
breast cancer
severe cirrhosis
COCs
implants have which hormone?
progestin only
implants can be a good choice for women with…
estrogen contraindications
Levonorgestrel IUD confers increased risk of…
ovarian cyst
how does a copper IUD work?
prevents sperm motility
IUD has increased risk of what conditions?
ectopic pregnancy
miscarriage
preterm delivery
three forms of female sterilization
tube ligation
salpingectomy
hysteroscopic
4 types of tube ligation…
removal
band
clip
essure
