Contraception and Sterilization

Question 1

Periodic Abstinence
Method?
Theoretical:Actual Failure Rate?

Answer 1

Abstinence shortly before and after ovulation period.

<10:25%

Question 2

Coitus Interruptus
Method?
Theoretical:Actual Failure Rate?

Answer 2

Pulling out.

4:27%

Question 3

Lactational Amenorrhea
Method?
How long can you use this method?
Theoretical:Actual Failure Rate?

Answer 3

Maintaining lactation (increased prolactin) inhibits GnRH and suppresses ovulation.
6 months.
2:15-55%

Question 4

Male Condom
Method?
Additional benefits?
Theoretical:Actual Failure Rate?

Answer 4

You put it over your penis.
Protects from STIs and HIV
2:15%

Question 5

Female Condom
Method?
Theoretical:Actual Failure Rate?

Answer 5

You put it in your vagina.

5:21%

Question 6

Diaphragm 
Method and timeline?
Theoretical:Actual Failure Rate?
Major side effects?
How long can you use it for?

Answer 6

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%.

Question 7

Cervical Cap
Method?
Most common cause of failure?
Theoretical:Actual Failure Rate for Parous Women?
Theoretical:Actual Failure Rate for Non-Parous Women?

Answer 7

The cervical cap (fitted by a clinician) and spermicide are placed on the cervix.
Dislodgement.
26:32%
9:16%

Question 8

Contraindication to spermicides?

Answer 8

Can make the user more susceptible to STI - should not be used by women with HIV.

Question 9

MOA of Minera IUD?

Answer 9

Progesterone thickens the cervical mucus and atrophies the endometrium

Question 10

Paragard
Theoretical:Actual Failure Rate?
How long is it approved to work for?
Side effects?

Answer 10

Copper IUD
0.6:0.8%
10 years
Heavier periods and dysmenorrhea.

Question 11

Minera
Method?
Theoretical:Actual Failure Rate?
How long is it approved to work for?
Benefits?

Answer 11

Progesterone IUD
Progesterone thickens the cervical mucus and atrophies the endometrium.
0.1:0.1%
5 years
Decreased menorrhagia and dysmenorrhea.

Question 12

Risk for spontaneous abortions and ectopic pregnancy with IUD?

Answer 12

40-50% and 30-50% IF SHE HAPPENS to get pregnant in the first place, which is very unlikely.

Question 13

OCP Combination Pill
Method?
Theoretical:Actual Failure Rate?
Absolute Contraindications?

Answer 13

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.

Question 14

Ortho Evra
Method?
Theoretical:Actual Failure Rate?
Contraindications?

Answer 14

Patch that releases progestin and ethinyl estradiol.
0.3:0.8%
Less effective in super fat people. Increased risk of DVT and PE.

Question 15

Nuva Ring
Method?
Theoretical:Actual Failure Rate?

Answer 15

Releases ethinyl estradiol and etonogestrel

0.8%

Question 16

Minipill such as Micronor
Method?
Theoretical:Actual Failure Rate?

Answer 16

Progesterin only. Must take every day at the same time. Thicken the cervical mucus

Question 17

Depo Provera
Method?
Theoretical:Actual Failure Rate?
Complications (3)?

Answer 17

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)

Question 18

Progestins reduce the risk of… (3)?

Answer 18

Pregnancy, PID, and endometrial cancer.

Question 19

Implanon
Method?
Theoretical:Actual Failure Rate?
Side effect

Answer 19

Single rod progestin (etenogestrel) implant good for three years.
0.4% for both.
Irregular bleeding.

Question 20

Plan B
Method?
Theoretical:Actual Failure Rate?
Side effects?

Answer 20

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.

Question 21

What is the most effective form of emergency contraception?

Answer 21

Insertion of Paragard. Only 1 in 1000 get pregnant after emergent insertion.

Question 22

How long do you have to use backup method of birth control before Essure tubal microinserts are effective?

Answer 22

Three months.

Question 23

Complication from reversal of tubal ligation?

Answer 23

Increased risk of ectopic pregnancy.