Contraception and Sterilization Flashcards
Periodic Abstinence
Method?
Theoretical:Actual Failure Rate?
Abstinence shortly before and after ovulation period.
<10:25%
Coitus Interruptus
Method?
Theoretical:Actual Failure Rate?
Pulling out.
4:27%
Lactational Amenorrhea
Method?
How long can you use this method?
Theoretical:Actual Failure Rate?
Maintaining lactation (increased prolactin) inhibits GnRH and suppresses ovulation.
6 months.
2:15-55%
Male Condom
Method?
Additional benefits?
Theoretical:Actual Failure Rate?
You put it over your penis.
Protects from STIs and HIV
2:15%
Female Condom
Method?
Theoretical:Actual Failure Rate?
You put it in your vagina.
5:21%
Diaphragm Method and timeline? Theoretical:Actual Failure Rate? Major side effects? How long can you use it for?
Diaphragm (fitted by clinician) and spermicide placed inside of vagina and is to be left in place 6-8 hours after intercourse.
6:16%
Staph aureus and TSS if diaphragm left in too long.
2 years or if patient has change in BW of 20%.
Cervical Cap
Method?
Most common cause of failure?
Theoretical:Actual Failure Rate for Parous Women?
Theoretical:Actual Failure Rate for Non-Parous Women?
The cervical cap (fitted by a clinician) and spermicide are placed on the cervix.
Dislodgement.
26:32%
9:16%
Contraindication to spermicides?
Can make the user more susceptible to STI - should not be used by women with HIV.
MOA of Minera IUD?
Progesterone thickens the cervical mucus and atrophies the endometrium
Paragard
Theoretical:Actual Failure Rate?
How long is it approved to work for?
Side effects?
Copper IUD
0.6:0.8%
10 years
Heavier periods and dysmenorrhea.
Minera Method? Theoretical:Actual Failure Rate? How long is it approved to work for? Benefits?
Progesterone IUD Progesterone thickens the cervical mucus and atrophies the endometrium. 0.1:0.1% 5 years Decreased menorrhagia and dysmenorrhea.
Risk for spontaneous abortions and ectopic pregnancy with IUD?
40-50% and 30-50% IF SHE HAPPENS to get pregnant in the first place, which is very unlikely.
OCP Combination Pill
Method?
Theoretical:Actual Failure Rate?
Absolute Contraindications?
Prevents FSH and LH surge, supressing ovulation. Progesterone also thickens the cervical mucus and alters endometrium.
0.1:8%
Women >35 that smoke >15 ciggs a day. History of PE, DVT, CAD, pregnancy, breast cancer, uncontrolled hyperlipidemia.
Ortho Evra
Method?
Theoretical:Actual Failure Rate?
Contraindications?
Patch that releases progestin and ethinyl estradiol.
0.3:0.8%
Less effective in super fat people. Increased risk of DVT and PE.
Nuva Ring
Method?
Theoretical:Actual Failure Rate?
Releases ethinyl estradiol and etonogestrel
0.8%
Minipill such as Micronor
Method?
Theoretical:Actual Failure Rate?
Progesterin only. Must take every day at the same time. Thicken the cervical mucus
Depo Provera
Method?
Theoretical:Actual Failure Rate?
Complications (3)?
IM release of progestin. Good for 14 weeks, but get the shot every 12.
0.3% for both
Irregular menstrual bleeding, amenorrhea (1/2 will get it after a year), reversible decrease in bone mineralization (after two years)
Progestins reduce the risk of… (3)?
Pregnancy, PID, and endometrial cancer.
Implanon
Method?
Theoretical:Actual Failure Rate?
Side effect
Single rod progestin (etenogestrel) implant good for three years.
0.4% for both.
Irregular bleeding.
Plan B
Method?
Theoretical:Actual Failure Rate?
Side effects?
Emergency contraception (progestin only). Taken within 72 hours of unprotected sex, in two doses 12 hours apart.
0.2-3%
Nausea and vomiting - not as much with Plan B, but more with with EC that contains estrogen.
What is the most effective form of emergency contraception?
Insertion of Paragard. Only 1 in 1000 get pregnant after emergent insertion.
How long do you have to use backup method of birth control before Essure tubal microinserts are effective?
Three months.
Complication from reversal of tubal ligation?
Increased risk of ectopic pregnancy.
