Contraception Lecture Powerpoint Flashcards
with the frog man
How many US pregnancies are unintended?
Nearly half
Unintended pregnancy is associated with…
…low income status and poverty
Contraceptive use has had what impact on abortion rate? When do most abortions occur?
Decreased it, early in pregnancy, less than 9 weeks
Why are so many women at risk for unintended pregnancy?
-Over the course of a year many women have periods where they stop the method they use or do not use it properly (gaps in contraception)
A woman with an unintended pregnancy is…
…Just as likely to carry it to term as to have an aboriton
How many unintended pregnancies end in abortion?
Nearly half, including 1/6 of them being spontaneous abortions
Increased access to contraceptives does not….
….increase sexual activity, it remains constant
Noncontraceptive funcitons of oral contraceptive pills
- Treating acne
- endometriosis
- menstrual pain and regularity
- PMS/PMDD
- decreased risk of ovarian cancer including those with BRCA genes
Using no protection at all, within a year, what percent of couples who want to be pregnant will?
85%
What meethods of contraception have the highest failure rate
- Spermicides
- Fertility awareness
- Withdrawal
- Condom
Condoms non contraceptive benefit
STI prevention
Types of combination oral contraceptive pills, when does fertility return on all of them?
Monophasic - constant dose
Multiphasic - varying doses
21/7, 24/4, 84/7 - continuous formulations
Fertility returns within days of discontinuation
Ethinyl estradiol or mestranol definition and function
Exogenous estrogen found in combination OCP’s, funciton to suppress FSH/LH secretion
Progestin definition and funciton
Exogenous progesterone found in combo ocp’s, function to simulate pregnancy by suppressing ovulation
Many side effects of progestin include similar side effects to those of…
…pregnancy
Contraindications for OCP’s
- Those at increased risk for VTE (factor V ligand)
- patient is in early 50’s
- Smoker >35
- Migraines with aura at any age
- Obesity >35 years old (at risk for DVT)
Common OCP side effects
- Intermenstrual spotting
- Nausea
- Breast tenderness
- Headaches
- Weight gain
- Mood changes
- Decreased libido
Patch/ring
Applied weekly for 3 weeks, then removed for one free week if desired
Progestin only pills
A smaller dosage than other OCP’s and thus hav ea higher failure rate, taken consistently without free interval, irregular bleeding is common, often used in breastfeeding women because it has no impact on milk prodction
On progestin only pills, ovulation….
is NOT consistently suppressed
When should a OCP be started?
Immediately regardless of timing of menses is preferred method as long as there is no pregnancy
There is no evidence that OCP usage causes….
…birth defects
Hormone free interval birth control
21 days of pills, 7 days placebo to begin withdrawal bleeding mimicking the normal menstrual cycle
Extended cycle birth control
Reduce menstruation periods to only 4 a year opposed to the hormone free interval
Fraction of women who rely on pill yet use it inconsistently and miss at least one in a 3 month period
2/5
Depo-Provera definniotn and function
Approved contraceptive injection giving immediate protection repeated 11-13 weeks, inhibits follicle development and prevents ovulation
Depo-provera extended use contraindication
A long time usage could result in hypoestrogen resulting in osteopenia or other issues, recommended for no more than 2 years, return to fertility can take 12-18 months
Depo-provera benefits
Lack of estrogen so no incresaed risk of DVT, no further action required by patient (passive compliance)
COCP definition and function
Combined oral contraceptive, attempts to rpevent ovulation and implantation with about 50% effectiveness when taken within 72 hours in emergency
Plan B is available….
…OTC
Plan B is composed of….
Single 1.5mg levo norgesterel pills
Mifepristone 10mg one dose results in…
…early termination of pregnancy
LARC characteristics
Long acting reversible contraceptive has to last 3 years or more, require intervention to discontinue, compliance wihtout active attention, have results ocmparable to sterilization
Paragard
Copper IUD that acts as a spermicide via its main mechanism
Copper IUD also decreases risk of…
…endometrial cancer
Don’t put in an IUD if there is a known….
…STI causing cervicitis
Levonorgestrel
Another type of IUD
Skyla
Another smaller type of IUD
Nexplanon
A subdermal implant of etonogestrel that lasts for 3 years with rapid return to fertility after removal
LARC is particularly beneficial because…
…it promotes passive compliance
