Contraception and Sterilization Flashcards
What is the failure rate for withdrawal method?
27%
How does lactational amenorrhea work?
Prolactin-induced inhibition of pulsatile GnRH and suppression of ovulation
What is the caveat to lactational amenorrhea?
Ovulation returns before the return of menstruation
50% of mothers ovulate between 6-12 months postpartum even while breastfeeding
Can only be used for a maximum of 6 months
What is the actual efficacy of condoms?
85%
What are commonly used spermicides?
Nonoxynol-9 and octoxynol-9 which disrupt the cell membranes of the spermatozoa
What are the downsides to spermicides?
Can cause vaginal irritation and lead to increased susceptibility to STIs
What is the most commonly used method of reversible contraception in the world?
IUD
How do IUDs work?
Spermicidal and prevention of fertilizatoin = sterile inflammatory response
mirena also has progesterone that thickens cervical mucus and atrophies the endometrium
copper hampers sperm motility and capitation
What is the effectiveness of IUDs?
- 8% for paragard
0. 1% for mirena
What are contraindications for IUD placement?
Known or suspected pregnancy Undiagnosed abnormal bleeding infection copper allergy (paragard) recurrent breast cancer (mirena)
How do OCPs work?
Interfere with pulsatile release of FSH and LH = suppresss ovulation
Bleeding is due to withdrawal bleeding and not menstrual period
What is the failure rate of OCPs?
8%
What medications can interfere with OCPs?
Rifampin
Barbiturates
Carbamezepine
Phenytoin
What are the consequences of OCPs?
Coagulability (DVT, PE)
increased incidence of gall bladder disease, and benign hepatic tumors
Who are OCPs contraindicated in?
>35 yo smokers of 15 or more cigs a day CAD, CVA, breast/endometrial cancer abnormal liver function pregnancy severe hypercholesterolemia severe hypertriglyceridemia
