Contraception and Sterilization -Nelson

Question 1

What are the 3 approaches to preventing a birth?

Answer 1

Contraception (prevention of fertilization)

Interception (after fertilization, before implantation)

Abortion (interruption of an established pregnancy)

Question 2

What percentage of pregnancies are unintended?

Answer 2

50%

Question 3

What are the positive features of using the Etonogestrel Contraceptive Implant?

Answer 3

incredibly effective for 3 years

rapid return of fertility once removed

rare contraindications

negatives:
unpredictable bleeding –> may change throughout months of use (better with time)

Question 4

How does the copper IUD work?

Answer 4

interfere with sperm transport from cervix –> fallopian tube

Inhibition of sperm capacitation or survival

Inhibition of fertilization: no normally dividing fertilized ova in tubes or uterus

Question 5

What can Merina (levonorgestrel-Releaseing Intrauterine System (LNG-IUS)) be used for other than as a contraceptive? How does it work?

Answer 5

control heavy menstrual bleeding

• Thickened cervical mucus
• Sperm motility and function impaired
• Weak foreign body reaction (spermicide)
• Fertilization inhibited (glycodelin-A)
• Ovulation inhibited (55% in the 1st year, 25% in the 5th)
• endometrium suppressed
• amenorrhea achieved by 24 months by 30%

Question 6

What health conditions is DMPA (depo) good for?

Answer 6

Sickle cell anemia

Mental retardation –> most stop bleeding at all

Breast feeding

Seizure disorders

not shown to increase weight gain

Question 7

What are the features of progestin-only pills? What is the only absolute contraindication for its use?

Answer 7

very safe and few complications

contraindication=breast cancer in the last 5 years

Question 8

What are the risks seen with estrogen-containing contraceptives?

Answer 8

Inc risk of DVT, PE, stroke

increased risk of MI in high risk pts

changes in bleeding patterns

slight inc in BP

Question 9

What are the non-contraceptive health benefits of oran contraceptives?

Answer 9

reduction in risk of:

• Ovarian Cancer
• Endometrial Cancer
• Pelvic Inflammatory Disease
• Ectopic Pregnancy
• Benign Breast Disease
• Menorrhagia
• Dysmenorrhea
• Iron Deficiency Anemia
• Low Bone Density

Question 10

What are some common hormone-withdrawal symptoms seen in OC users?

Answer 10

pelvic pain and headaches are most common

Question 11

What are some of the advantages of the vaginal ring?

Answer 11

• monthly
• lowest dose
• constant serum concentrations
• no first pass effect or GI interference
• very little bleeding

Question 12

What is the 2 day method?

Answer 12

Women checks secretions daily and asks herself if she was dry yesterday and today? If both are yes, intercourse is allowed