Contraception Flashcards
What are the two most common forms of contraceptions?
OCPs, Sterilization
What is the fastest growing form of contraception?
IUD
What form of contraception has the highest efficacy rate?
Nexplanon
What is the failure rate for nexplanon?
0.05%
What is the failure rate for Mirena IUD?
0.2%
What is the failure rate for paragard IUD?
0.6%
amount of estrogen in low dose OCP
30 - 50 ug
amount of estrogen in ultra low dose OCP
< 30 ug
What are the 2 main effects of estrogen in OCP pills?
- Potentiates negative feedback on HPA axis
2. Stabilizes endometrium to reduce frequency of breakthrough bleeding
What is the failure rate of OCPs with typical use?
3-9%
What is the failure rate of OCPs with perfect use
0.3%
Estrogen ___ the levels of SHBG, thus ____the levels of testosterone
increases, decreases
Breakthrough bleeding on OCPs occurs in ___ percent of patients in the first ____ months.
25%, 3 months
True or false: OCPs cause a decrease in sexual desire in up to 20% of users
True
What is the mean time to resumption of menses after discontinuation of OCPs?
32 days
what percentage of patients will continue to ovulate on POPs?
40%
By what mechanism do POPs work to prevent pregnancy?
Cervical mucus thickening
What are the two main advantages of using a Patch or Ring for contraception?
Ease of use and increased compliance
How many weeks do you keep a patch on for contraception?
3 weeks
What is the daily release of hormones in a birth control Patch?
150 ug norelgestrain, 35 ug ethinyl estradiol
A Patch has ____ total amount of estrogen but _____ Peak levels.
higher, lower
What are the two main side effects of the birth control patch
site reaction, breast tenderness
What is the daily release of hormones in a Nuva ring?
120 ug etonorgesterol, 15 ug ethinyl estradiol
How long do you leave a Nuva ring in for?
3 weeks
True or false: the nuva ring contains adequate hormones for 5 weeks of use?
True
The Nuva ring delivers ____ levels of estrogen compared to OCPs
lower
What is the dose of medroxyprogesterone in depo Provera?
150mg
How often do you give Depo Provera?
every 3 months
What is the failure rate of Depo Provera?
0.3 %
What are the three mechanism of action of Depo Provera?
- Inhibits ovulation, blocks LH surge
- Thickens cervical mucus
- Alters endometrium
What populations is it useful to use Depo Provera?
lactating women, seizure disorders, sickle cell
What weight gain is associated with Depo Provera?
4-8lbs per year
True or false: Depo Provera can cause decreased bone density?
True
True or false: There is a delay in return of fertility with Depo Provera Use?
True
How much etonogesterol is released by a Nexplanon daily?
60 - 70 mcg
Does Nexplanon consistently block ovulation?
Yes
What is the expulsion rate of a copper IUD in the first year?
5%
What percent of women report increased pain and bleeding with a copper IUD in the first year?
12%
How much levonorgesterol does a mirena IUD release in the Uterus per day?
20ug
What is the main mechanism of the Mirena IUD?
thickens cervical mucus, suppresses endometrium
For how long should you anticipate having irregular bleeding or spotting with a Mirena IUD following insertion?
3-6 months
What percent of patients experience ammenorhea at 6 months following Mirena insertion?
40%
How much levonorgesterel is released by a Skyla per day?
14 ug/day
How much levonorgesterel is released by a Liletta IUD?
18.6 mcg/day
How high is the expulsion rate of an IUD placed post placental?
up to 24%
True or false: postplacental IUD placement is contraindicated in the setting of chorioamnionitis/ endometritis
True
True or false: The absolute risk of an ectopic is higher when using an IUD
False
True or false: when a pregnancy occurs with an IUD in place it is more likely to be an ectopic?
True
What is the failure rate of a tubal ligation in the first year?
0.5%
What is the 10 year failure rate of postpartum tubal ligation?
0.75%
What is the failure rate of essure coils after 5 years?
0.25%
Is an alternative form of contraception required following essure placement?
Yes
What is required prior to discontinuation of alternative contraceptive method?
Hysterosalpingogram confirming blocked tubes
What is the failure rate of vasectomies?
0.1%
True or false: condoms made out of lamb intestine do not block STDs?
True
What is the failure rate of condoms with typical use?
18%
What is the main advantage of condoms?
Only method that prevents STD transmission
What is the failure rate of a female diaphragm with typical use?
16 - 24%
True or false: A female diaphragm can reduce the transmission of chlamydia and gonorrhea, but not HIV
True
There is a slight ____(increase/decrease) risk of UTIs with diaphragm use
Increase
What is the mechanism of action of the female sponge?
spermacidal action of nonoxynol-9
How long can a cervical cap be left in place?
48hrs
cervical caps have _____(increased/decreased) efficacy in parous women?
decreased
What is the Yuzpe regimen for emergency contraception?
two doses of 0.5mg levonorgesterel + 100 ug ethinyl estradiol 12 hours apart
What were the main side effects of the Yuzpe method for emergency contraception?
nausea and vomiting
What is the progesterone only method for emergency contraception?
2 doses 0.75mg progesterone given 12 hours apart
What is the mechanism of action of high dose progesterone method for emergency contraception?
Inhibition or delay in ovulation and prevention of fertilization
If Plan B is taken within ____ hours of coitus, it prevents___percent of pregnancies
72 hours, 85%
What is the mechanism of action of Ulipristal (Ella)
selective progesterone receptor modulator
what is the dose of Ulipristal (Ella)?
30 mg
Ulipristal (Ella) can be used within ___ days of coitus
5 days
What is the most effective method of emergency contraception?
Copper IUD
Copper IUD can be inserted within ____ days of coitus for emergency contraception?
5 days
