Contraception Flashcards
T/F: Oral contraceptives either contain progestin or estrogen but never both.
False: Oral contraceptives either contain progestin alone or progestin plus estrogen
Give the advantages and disadvantages of condoms as a contraceptive.
Advantages: protect against HIV and STI
Disadvantages: require motivation and consistency
Give the advantages and disadvantages of diaphragm and cervical cap as a contraceptive.
Advantages: n/a
Disadvantages: not effective without spermicide
Give the advantages and disadvantages of spermicide as a contraceptive.
Advantages: n/a
Disadvantages: must be used w/ barrier method and must be applied 1 hour pre-intercourse
Give the advantages and disadvantages of contraceptive sponge as a contraceptive.
Advantages: n/a
Disadvantages: placement 1 hour before intercourse
Give the advantages and disadvantages of oral contraceptives.
Advantages: highly effective and decreased risk of cancer
Disadvantages: adherence, various AEs –> significant AE with estrogen products
Give the advantages and disadvantages of fertility awareness and withdrawal as a contraceptive.
Advantages:
Disadvantages: not effective
Give the advantages and disadvantages of surgical sterilization as a contraceptive.
Advantages: generally 100% effective
Disadvantages: permanent and 3 months of alternate contraception required
Give the advantages and disadvantages of transdermal patches as a contraceptive.
Advantages: need only be placed once every week
Disadvantages: adherence, less effective in overweight women, black box warning = increased estrogen s/p no first pass metabolism meaning increased risk of thrombosis
Give the advantages and disadvantages of a vaginal ring as a contraceptive.
Advantages: generic, movement in vagina ok, can remove during sex
Disadvantages: irritation or wetness, discharge, foreign body sensation
Give the advantages and disadvantages of injectable progestins as a contraceptive.
Advantages: q 3 months
Disadvantages: weight gain, decreased bone mineral density, delayed return of fertility
Give the advantages and disadvantages of subdermal progestin implants as a contraceptive.
Advantages: can remain in place 3 - 5 years
Disadvantages: surgical procedure, takes about 30 days for return of fertility after removal
Give the advantages and disadvantages of an IUD as a contraceptive.
Advantages: long term contraception, quick return of fertility, decreased risk of thrombosis
Disadvantages: surgical placement, inflammation, doesn’t protect against STI
Give the advantages and disadvantages of a copper IUD as a contraceptive.
Advantages: can be used as emergency contraception, effective for 10 years
Disadvantages: contraindicated in patients with PMH of endocarditis, inflammation, increased cramping, increased volume of menstruation
What is the number one AE associated with use of estrogen in an oral contraceptive?
Thrombosis –> DVT, PE, etc.
What activity, when combined with the use of an estrogen containing contraceptive, greatly increases the risk of its main AE?
Smoking
What are the three options for emergency contraception?
Plan B
Ella
Implanted copper IUD
T/F: Plan B is a legend drug.
False: It is available OTC –> anyone can purchase it.
Why is Ella not commonly used as an emergency contraceptive?
Because it requires a prescription
What is the major problem with using Plan B as an emergency contraceptive?
The patient may experience nausea –> repeat the dose if vomiting occurs within 2 hours of ingestion
What is a caution in prescribing an oral contraceptive that contains drospirenone?
Drospirenone is an analogue of spironolactone, a K sparing diuretic. Use caution in patients on an ACEi or ARB or any patient at risk for hyperK.
What are the advantages and disadvantages of the progestin-only “mini pill”?
Advantages: lower risk of thromboembolism.
Disadvantages: adherence - must be taken within same 3-hour time window each day.
What is the advantage of oral contraceptives that contain iron?
Some women become anemic from blood loss during menstruation. Iron containing pills help combat the anemia.
