Contraception

Question 1

contraceptive

Answer 1

block conception of a fetus and keep sperm and egg from uniting

Question 2

contragestational

Answer 2

work to keep the fertilized egg from implanting

Question 3

abortifacients

Answer 3

cause termination in an established pregnancy

Question 4

calendar methods of birth control

Answer 4

fertility awareness and rhythm method

Question 5

fertility awareness

Answer 5

noticing ovulation signs such as slight body temp. drop/increase before and after ovulation. production of thin water clear cervical mucus, Mittelscherz, cervix position

Question 6

rhythm method

Answer 6

abstaining from sexual intercourse around the time of ovulation

Question 7

barrier contraceptives

Answer 7

products that provide a physical barrier to prevent conception e.g. condoms, diaphragm, cervical cap

Question 8

spermicide

Answer 8

agent that kills sperm

Question 9

what is the purpose of birth control?

Answer 9

to provide negative feedback on the hypothalamus and pituitary and to produce an atrophic and hostile endometrium + thick mucus

Question 10

combination pills

Answer 10

oral contraceptives containing both estrogen and progestin that inhibit GnRH release to suppress HPG-axis

• low FSH so low follicle development
• no LH surge so no ovulation

Question 11

effectiveness of combination pills

Answer 11

most effective reversible form of birth control, but requires very high compliance

Question 12

what are other forms of delivering the oral contraceptive?

Answer 12

transdermal patch, injectables, cervical ring, IUD

Question 13

progestin-only contraception

Answer 13

formulated to avoid side effects of estrogen

- nausea, vomiting, breast tenderness, increased risk of DVT

Question 14

progestin only pills (POPs)

Answer 14

taken PO everyday except for 7 days in a 28 day cycle

• missing a dose of the pill can lead to ovulation/possible pregnancy
• risk of contraceptive failure greater than combination OC; increased risk of ectopic pregnancy

Question 15

progestin-only contraceptive injection

Answer 15

IM to buttock or deltoid q 3 months, only during first 5 days after onset of a normal menstrual period, within 5 days postpartum if not breastfeeding or 6 weeks postpartum if breastfeeding

Question 16

risks of progestin-only contraception

Answer 16

abnormal uterine bleeding (AUB), amenorrhea, decreased libido, slightly more ectopic pregnancies, mean time to pregnancy of 10 months after cessation

Question 17

postcoital contraception

Answer 17

morning after-pills (MAPs), emergency contraceptive pills (ECPs), plan B, SPRM

Question 18

high dose progestin (plan B)

Answer 18

administered within 72 hours of coitus (2 pills; one right away and other within 12 hours) to seemingly inhibit natural progesterone and estrogen production

Question 19

selective progesterone receptor modulator (SPRM)

Answer 19

ulipristal acetate can act as an agonist or antagonist at progesterone receptors to prevent ovulation/alter endometrial physiology (poorly understood)

Question 20

vasectomy

Answer 20

bilateral surgical removal of a part of the vas deferens; scrotal incision, cutting of the tube and clamping, cauterization
- less invasive

Question 21

tubal ligation

Answer 21

a surgical sterilization procedure in which the fallopian tubes are sealed or cut to prevent sperm from reaching a mature ovum

• incision through anterior abdominal wall muscles, isolating the oviduct, suturing + tying off tubes
• now usually laparascopic

Question 22

coitus interruptus

Answer 22

pull out method

Question 23

intra-uterine device (IUD)

Answer 23

presence of foreign object causes local tissue reaction and prevents implantation, IUD also increases contractions (abort)
- can be used as long-acting reversible contraceptive (LARC)

Question 24

mifepristone (RU-486)

Answer 24

anti-progesterone used as abortifacient; wakes up the myometrium to induce contractions

Question 25

D&C

Answer 25

dilation and curettage (widening the cervix and scraping off the endometrial lining of the uterus)