Contraception/Infertility Flashcards by Christiana Antonio

menses occurs during which phase

follicular

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at the start of menses, estrogen is (low/high) and progesterone is (low/high)

low, low

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prenancy tests test for

hCG

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women planning to conceive should take which supplement

folate (B9)

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which contraceptive may cause delay in the return to fertility

medroxyprogesterone

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T/F: female internal condoms provide more protection than male external condoms

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Caya

diaphragm

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what type of lubricant should be used with condoms

water or silicone-based

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phexxi

Rx, vaginal gel that maintains acidic pH, do not use if vaginal ring or history of UTI

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hormonal contraceptives work by inhibiting

production of FSH, LH

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common estrogen in oral contraceptive

ethinyl estradiol

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common progestins in oral contraceptive

norethindrone, levonorgesterol, drospirenone

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monophasic

same dose estrogen and progestin throughout

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multi-phasic

mimic estrogen and progestin levels in menstrual cycle

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drospirenone is unique in that it…

is a mild potassium-sparing diuretic which dec bloating/weight gain

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which drug is used for moderate to severe pain associated with endometriosis

Orlissa (Elagolix)

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Which hormonal drugs are indicated for heavy menstrual bleeding (menorrhagia)

Natazia, Mirena (IUD)

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which drug is indicated for heavy bleeding associated with fibroids

Oriahnn

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what non-hormonal drug is available for menorrhagia

Lysteda

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which hormonal drug may be used for migraine prophylaxis and is safe in migraines with aura

mini-pill (progestin-only)

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why can’t estrogen be used in migraines with aura

risk of stroke

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what’s an important counseling point for mini pills

must take pill within 3 hours of scheduled time

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“Lo” indicates

= 35 mcg estrogen (i.e. less SE)

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“Fe” indicates

iron supplement is included

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"24" indicates

shorter placebo time

Monophasic formulations

Junel, Microgestin, Sprintec, Loestrin, Yasmin

Triphasic formulation

Tri-sprintec

extended cycle formulation

Seasonique

Xulane

transdermal patch

Nuvaring

vaginal ring

brand names of mini pills

Errin, Camila, Nora-BE

Injected contraception containing only progestin

depot-provera

depo provera is injected how often

every 3 months

which patient can receive Xulane? a) 35 yo F, plays golf professionally, smoker b) 30 yo F, uncontrolled HTN, does not drink alcohol c) 26 yo F BMI is 29, DM II d)24 yo F who recently gave birth two weeks ago

c; patches have higher estrogen exposure so do not use in pts with high clotting risk

which patients are considered high clotting risk

>35 and smokes, CVD/ blood clots, postpartum, BMI>/=30

Depot provera generic

DMPA (medroxyprogesterone acetate)

DMPA is injected how

IM or SC

T/F: all IUDs are hormone free

F; some can contain levonorgestrel

after 1 year, DMPA users may become

amenorrheic

which contraceptive is approved with no placebo pills and allows you to skip menses

amethyst

spotting usually resolves in

3-6 months

drospirenone is contraindicated in

renal or liver disease

nuva ring can be reused for how long

1 year

major side effects of estrogen

nausea, breast tenderness, melasma, bloating

what are symptoms you should watch out for that indicate clotting

ACHES (abdominal pain, chest pain, H/A, eye problems, swelling or sudden leg pain)

what lab may need to be reviewed for a patient taking drospirenone

potassium (can inc levels)

DMPA may have what side effect

loss in bone mineral density

which contraceptive product is best for a patient with acne or hirsutism

combination OC with progestin that has lower androgenic activity (drospirenone)

which contraceptive product is best for a patient who is breastfeeding

progestin only product or nonhormonal

which contraceptive product is best for a patient with a contraindication to estrogen

progestin only product or nonhormonal

which contraceptive is best for a patient who experiences migraine

if aura then progestin only or nonhormonal; if no aura then any product

which contraceptive is best for a patient with HTN

progestin only or nonhormonal

which contraceptive is best for a patient who has mood changes/disorders

monophasic combination OC or continuous drosperinone

which contraceptive is best for a patient experiencing nausea

dec estrogen dose, progestin only, nonhormonal

which contraceptive is best for a patient who is overweight

Any (but not the patch in obese patients, and no DMPA if planning to lose weight

which contraceptive is best for postpartum patient

nonhormonal (wait at least 3 weeks or 6 weeks with VTE risk factors to start hormonal therapy)

which contraceptive is best for PDD

drospirenone

early spotting may be fixed by increasing

estrogen

late spotting may be fixed by increasing

progestin

rifampin use may require patient to have backup contraceptive method for how long

6 weeks

what drugs may interact with hormonal birth control

anticonvulsants, St John's wort, tobacco, ritonavir, colesevelam, byetta

liver toxicity may occur in patients taking oral contraceptives with

Mavyret

How many days does it take hormonal pills to achieve contraceptive efficacy

7 days

No backup birth control method is needed if hormonal oral contraceptive is started when

Within 5 days after the start of the period

How many days does it take for progestin only pills to achieve contraceptive efficacy

2 days

Back contraception is needed for patients taking combined OC if they miss

2 pills

Progestin only pills require backup method if missed dose is

>3h past scheduled time

Para guard can be used for up to

10 years

Paraguard may have what side effects

Heavy bleeding and cramping

Nexplanon is used up to

3 years

Copper iud can be used as an emergency contraceptive if used within

5 days

Ella (does/ does not) require a prescription

Does

Ella can be be effective up to how many days after sex

5 days

Plan B can be effective up to how many days after sex

3 days

paragard is the brand name for

copper iud

primary side effect of levonorgetrel

nausea

diaphragms should be left in for how long

6-24 hours after intercourse

diaphragms can be reused for up to how long

2 years

sponge should be left in for how long

6-24 hours after intercourse

patients on medroxyprogesterone should have a daily recommended intake of

calcium, vitamin D

what treatment choices are available for infertile women with absent ovulation

clomiphene, letrozole

gonadotropins may be used in infertility in which situations

intrauterine insemination or in vitro fertilization

how is a gonadotropin administered

IM injection