Contraception & Infertility Flashcards
Why is progesterone needed when estrogen is being used
to prevent endometrial hyperplasia
If a women does not have a uterus does she need progesterone when using estrogen?
No, estrogen causes cell hyperplasia in the uterus leading to uterine cancer, but if there is no uterus progesterone is not needed to prevent the cell hyperplasia
Estrogen is used for?
Hot flashes, bone health
Which phase does menses occur during
follicular phase
What occurs during follicular phase
follicle stimulating hormone spurs follicle development and causes estrogen to surge. estrogen peaks by the end of phase the surge in estrogen causes luteinizing hormone and FSH to increase
What occurs during the ovulatory phase
the LH surge triggers ovulation 24-36 hours later.
What occurs during the luteal phase
the start of ovulation begins the luteal (last) phase which lasts ~14 days. progesterone is dominant in this phase
Which hormone causes release of the oocye (egg)
luteinizing hormone
What is released from the body when a fertilized egg attaches to the lining of the uterus
human chorionic gonadotropin (hCG)
how do hormonal contraceptives work
inhibit the production of FSH and LH which prevents ovulation
List progestin in oral contraceptives
northindrone
levonorgestrel
drospirenone
what is monophasic oral contraceptives
have the same dose of estrogen and progestin throughout the pill pack
unique property of drospirenone
is a mild potassium-sparing diuretic which decreases bloating
primary use of progestin only contraceptives
women who are lactating b/c estrogen decreases breastmilk
major counseling point for progestin only pills
must have good adherence b/c must be taken within 3 hours of scheduled time
patch contraindications
anyone with clotting risk factors b/c patch has higher estrogen exposure
What does “Lo” mean in a birth control name
< 35 mcg of estrogen
What does “Fe” mean in a birth control name
contains iron supplement
What does “24” mean in a birth control name
24 active pills and 4 placebo
SE of estrogen
nausea breast tenderness bloating weight gain elevated BP
insufficient estrogen can lead to?
spotting in early to mid cycle
insufficient progestin can lead to?
spotting in late cycle
BC for acne
lower androgenic activity (ortho-cyclen)
no androgenic activity (Yaz)
BC for breastfeeding
progestin only
BC for estrogen contraindications
progestin only
BC for migraines
if aura-progestin only
no aura-any
BC for fluid retention
drospirenone
BC for heavy menstrual bleeding
NAtazia
levonorgestrel-releasing IUD mirena
COC with only 4 placebo pills
BC for HTN
if uncontrolled progestin only
BC for mood changes or disorder
monophasic COC
extended cycle
continuous with drospirenone
BC for nausea
take at night with food
decreasing estrogen
BC for overweight
any
avoid DMPA
BC for postpartum
do not use CHC for 3 weeks or 6 weeks if increased VTE risk
use progestin only
BC for PMDD
Yaz
antidepressant
BC for spotting
usually resolve in 3-6 months
MOA of plan B
preventing or delaying ovulation and thickens cerviacal mucus
First line treatment for irregular or absent menstrual cycles
clomiphene
clomiphene MOA
SERM: selective estrogen receptor modulator which is an estrogen agonist will cause LH and FSH surge to trigger ovulation
gonadotropin MOA
trigger ovulation by acting like endogenous gonadotropins FSH or LH
