Contraception and Infertility Flashcards
How long does a normal menstrual cycle range from in days?
23 - 25 days
average 28 day
In a woman’s menstrual cycle, what day is considered day 1?
The first day of bleeding
What happens during the Follicular phase?
A surge in estrogen causes Luteinizing hormone (LH) and FSH to increase
What happens during the Ovulation phase?
The Luteinizing hormone (LH) surge from the follicular phase triggers ovulation 24 - 36 hours later.
Ovulation is the release of egg (ova) from the ovary.
What happens during the Luteal phase?
The start of ovulation begins the luteal phase which lasts about 14 days.
Progesterone is dominate in the phase.
What the the phases of the menstrual cycle?
Follicular phase -> Ovulation -> Luteal phase
What is the function of the Luteinizing hormone?
It results in the release of oocyte (egg) from the ovary into the fallopian tube.
When is the best time to have intercourse in order to get pregnant?
When Luteinizing hormone surge is detected and for the following 2 days.
When is Human Chorionic gonadotropin (hCG) released?
It is released when fertilized egg attaches to the lining of the uterus aka implantation.
What does pregnancy tests detect in the case of pregnancy?
Human Chorionic gonadotropin (hCG)
What are some actions which should be taken preconception?
- Take folic acid
- Stop smoking and using illicit drugs or alcohol
- Keep vaccinations current
- Avoid toxic chemicals
Which contraception method has a delay in returning to fertility once it has been discontinued?
Medroxyprogesterone injection
How do hormone contraceptives prevent pregnancy? MOA?
- The inhibit the production of FSH and LH, which prevents ovulation.
- They form a mucous, which inhibits the sperm form penetrating the egg.
Work before implantations occurs.
How does progestin-only pills prevent pregnancy?
It suppresses ovulation
When are progestin-only pills preferred to be used?
- Primarily used in women who are lactating (breastfeeding)
b/c estrogen decreases milk production - In women who are at high risk for thrombosis
Progestin-only pills clinical pearls
- Must be taken within 3 hours of the scheduled time
What are other indication for combination oral contraceptive pills? (6)
- Dysmenorrhea (mensural cramps)
- Premenstrual syndrome (PMS)
- Acne
- Anemia
- Polycystic ovary syndrome (to regulate menses)
- Endometriosis
Xulane Contraindication?
- Do not use in anyone with clotting risk factors
- Less effective in women > 198lb
- Do not use in women > 35 years old who smoke
Depot medroxyprogesterone acetate aka Depo-Provera MOA
- Surpasses ovulation
- Thickens cervical mucus
- Causes thinning of the endometrium
Note: it is a progestin
How often is Depo-Provera injection given?
150mg IM
104mg SubCu
Every 3 months
How often does bleeding occur with extended cycle combination oral contraceptive pills?
84 days of active hormonal pill followed by 7 days of inactive or very low dose estrogen pill.
Bleeding occurs every 3 months
What does “Lo” mean on contraceptive pills?
It indicates ≤ 35mcg of estrogen e.g. Loestrin
- To avoid or minimize ADE of estrogen
What does “Fe” mean on contraceptive pills?
It indicates an iron supplement included
What does “24” mean on contraceptive pills?
It indicated a shorter placebo time: 24 active + 4 placebo = 28 day cycle
