Contraception and Fertility Flashcards
what hormone surges in the follicular stage
surge in estrogen causes LH and FSH to increase
what hormone triggers ovulation
LH surge
If someone is trying to conceive at what time in their cycle should they have intercourse
when LH is detected and for 2 days after
best time to test fot hcg
in the morning
which contraceptive delays return to fertility
medroxyprogesterone injection
What lubricant can be used with a latex or non latex condom
water or silicone based (never reccomend oil based)
what hormones do contraceptives inhibit?
FSH and LH - prevents ovulation
COCs are
combination ORAL contraceptives (estrogen/progestin)
CHC
combined hormonal contraceptives
what do most COCs contain
ethanyl estradiol and a progestin (norethindrone, levonorgestrel, drospinerone)
monophasic birth control
same dose of estrogenand progesten throughout the pill pack
biphasic, triphasic, and quadriphasic pill packs
mimick estrogen and progesterone levels
indications for cocs besides prengnacy
dysmenorrhea (menstrual cramps), premenstrual syndrome (PMS), acne, anemia (by reducing blood loss), PCOS, endometroisos
what is drospinerone
a unique progestin used in some COCs to reduce adverse effects commonly seen with oral contraceptives, a mild potassium sparring diuretic so less bloating
what can you track to determine ovulation
temperature and cervical mucus
what is required when dispensing oral contraceptives by the FDA
package insert
POP uses
progestin only pills are useful in women who are breastfeeding (estrogen decreases milk production) and in women who have migraines with aura (estrogen increases risk of stroke)
drawbacks of POP
adherance is essential (within 3 hours of same time every day otherwise need backup for 48 hours)
who should not use the patch and what does it contain?
estrogen (higher systemic) therefore no one with clotting risk and also not effective in >198 pounds (xulane) , also not supposed to be used in women >35 years old who smoke
what is in depo provera shot and how often is it given
DMPA (depot medroxyprogesterone acetate), a projestin and is given IM or SUBQ every 3 months
when does bleeding occur with COC?
normally every 4 weeks but extended cycle every 3 months (seasonique)
which contraceptive is approved for those who want no period
amthyst
which formulation contains drospinerone
Yasmin and Yaz
what are the progestin only brands
Errin, Camilla, Nora BE
what is a complaint of continuous contraception and advantage
no period but spotting that resolves in 3-6 months
boxed warning depo provera
loss of bone mineral density
boxed warning estrogen containing products
do not use in women over 35 years of age who smoke
do not use estrogen with these conditions
hx of DVT, stroke, CAD, breast/ovarian/liver cancer, migraines with aura
pneumonic for serious estrogen effects
a - abdominal pain severe C - chest pain H - headaches e - eye problems s - swelling
Thrombosis**
side effects of estrogen
nausea, breast tenderness, bloating, weight gain elecated blood pressure
benefit of a higher estrogen/progestin dose
les spotting (after three months). for estrogen its early cycle for progestin its late cycle
what pill would you give in a women who is prestfeeding, 3-6 weeks postpartum
progestin only pill (less androgenic)
when would you give a drospinerone containing product
acne, fluid retention, mmdd (yaz), mood changes
natazia or the iud mirenia is indicated for what
heavy menstrual bleeding
drugs that decrease hormonal contreceptive efficiency
tHINK INDUCERS: (ps porcs)
rifampin (need backup for 6 weeks, anticonvulsants, st. johns, tobacco, pis
QUICK START vs sunday start
quick start: start today but use contrception for 7 days
Sunday start: start the sunday after the onset of menstruation
missing coc
if you miss 1 pill take as soon as possible, but if you miss 2 then take the last one as soon as you remember and use contraception for 7 days *unless its during week three then just skip hormone free pills
where can you apply xulane patch and how long
once weekly for 3 weeks then 1 off to stomach, buttocks, upper arm, or upper torso
mirena
hormonal intrauterine device
paragard
copper T iud
nexplanon
implant that releases progestin + etonogestrel for three years
cutoff for emergency contraceptive
5 days
how to use nuvaring
in three weeks, out one week
plan b
levonorgestrel one 1.5mg tab
ella
ulipristal acetate aka RU 486
moa of plan b
prevents ovulation and thickens cervical mucus
s/e of plan b
nause/vomiting – if this occurs repeat dose
moa of ella
delays ovulaton
1st line for infertility
Clomiphene which is a selective estrogen receptor modulator that acts as a agonist and antagonist dependong on the tissue
side effect of clomiphene
hot flashes, clotting risks
2nd line for infertility
gonadotrophins which stimulate FSH and LH
