Contraception Management Flashcards
When using the calendar method, from when to when must the woman remain abstinent?
5 days prior to and 3 days after ovulation
How can a woman calculate when she is ovulating based on her cycle
14 days before the start of menses
luteal phase in constant in all women
Basal body temperature during cycle is increased when
progesterone spike
Cervical mucus in fertile period
consistency
watery, egg white consistency at ovulation
allows sperm to move easily to tube
Which method slightly increases the rate of UTIs
diaphragm
Which hormonal option is preferred for women who are breast feeding?
progesterone only formulations
combination formulations contain estrogen
estrogen feeds back to decrease prolactin secretion
Largest concern w/ estrogen-containing OCPs
risk of thromboembolic events
Basic ingredients in the pill
ethinyl estradiol + progestin (one of many)
How to think about which combination pill to use
think about how much estrogen
then what type of progestin to use (there are many options)
Norethidrone
first generation progestin
Levonoresterol
first generation progestin
Norgestimate
3rd gen progestin
used for acne
Desogestrel
3rd gen progestin
used for acne
Combination hormone patch is less effective in which population
very obese
>90 kg
Progesterone OCPs are first line in this population for sure
nursing mothers
Progesterone only formulations affect bleeding in this way
irregular bleeding
weird bleeding pattern to start
eventually periods stop all together
Be careful with administration of progesterone-only formulations because
need to take them within 3 hours every day
otherwise risk breakthrough ovulation
You can take a combination OCP this late and not really worry about breakthrough ovulation
up to 24 hr after missed dose
if longer, count on breakthrough ovulation
What do you do if there is a suspected breakthrough ovulation
cover with another method for the time being
Injectable and implantable birth control formations
progesterone only
Concern w/ injectable birth control
use only for 2 yr at a time
concern of bone health
Levonorgestrol use
emergency contraception up to 3-5 days
Ulipristal
MOA
TU
MOA: progesterone agonist/antagonist
TU: emergency contraception up to 7 days
Yuzpe method
use normal combo OCPs for emergency contraception
4 pills, repeat 12 hours later (low dose)
2 pills, repeat 12 hours later (high dose)
