Contraception Management

Question 1

When using the calendar method, from when to when must the woman remain abstinent?

Answer 1

5 days prior to and 3 days after ovulation

Question 2

How can a woman calculate when she is ovulating based on her cycle

Answer 2

14 days before the start of menses

luteal phase in constant in all women

Question 3

Basal body temperature during cycle is increased when

Answer 3

progesterone spike

Question 4

Cervical mucus in fertile period

consistency

Answer 4

watery, egg white consistency at ovulation

allows sperm to move easily to tube

Question 5

Which method slightly increases the rate of UTIs

Answer 5

diaphragm

Question 6

Which hormonal option is preferred for women who are breast feeding?

Answer 6

progesterone only formulations
combination formulations contain estrogen
estrogen feeds back to decrease prolactin secretion

Question 7

Largest concern w/ estrogen-containing OCPs

Answer 7

risk of thromboembolic events

Question 8

Basic ingredients in the pill

Answer 8

ethinyl estradiol + progestin (one of many)

Question 9

How to think about which combination pill to use

Answer 9

think about how much estrogen

then what type of progestin to use (there are many options)

Question 10

Norethidrone

Answer 10

first generation progestin

Question 11

Levonoresterol

Answer 11

first generation progestin

Question 12

Norgestimate

Answer 12

3rd gen progestin

used for acne

Question 13

Desogestrel

Answer 13

3rd gen progestin

used for acne

Question 14

Combination hormone patch is less effective in which population

Answer 14

very obese

>90 kg

Question 15

Progesterone OCPs are first line in this population for sure

Answer 15

nursing mothers

Question 16

Progesterone only formulations affect bleeding in this way

Answer 16

irregular bleeding
weird bleeding pattern to start
eventually periods stop all together

Question 17

Be careful with administration of progesterone-only formulations because

Answer 17

need to take them within 3 hours every day

otherwise risk breakthrough ovulation

Question 18

You can take a combination OCP this late and not really worry about breakthrough ovulation

Answer 18

up to 24 hr after missed dose

if longer, count on breakthrough ovulation

Question 19

What do you do if there is a suspected breakthrough ovulation

Answer 19

cover with another method for the time being

Question 20

Injectable and implantable birth control formations

Answer 20

progesterone only

Question 21

Concern w/ injectable birth control

Answer 21

use only for 2 yr at a time

concern of bone health

Question 22

Levonorgestrol use

Answer 22

emergency contraception up to 3-5 days

Question 23

Ulipristal
MOA
TU

Answer 23

MOA: progesterone agonist/antagonist
TU: emergency contraception up to 7 days

Question 24

Yuzpe method

Answer 24

use normal combo OCPs for emergency contraception
4 pills, repeat 12 hours later (low dose)
2 pills, repeat 12 hours later (high dose)