Contraception: Progestin-only Products

Question 1

Progestin-only tablet advantages

Answer 1

Decreased menstrual blood loss, cramps, and pain
Increased spontaneity, sexual enjoyment, easy to use
Decreased endometrial cancer
Preferred for CHC contraindications, reversible, efficacious

Question 2

Depo shot advantages

Answer 2

Decreased cramping, amenorrhea or lightened blood loss, decreased endometriosis pain
Increased compliance
Decreased endometrial cancer
Effective, good for patients on AED, postpartum

Question 3

Nexplanon advantages

Answer 3

Amenorrhea, menorrhagia improves
Adherence, increased spontaneity
Readily reversible, effective for 3 years, MRI safe, effective in all BMIs

Question 4

Mirena, Skyla, Kyleena, Liletta advantages

Answer 4

Amenorrhea, menorrhagia improves, endometriosis improves
Adherence, increased spontaneity
Decreased endometrial cancer
Extremely effective, readily reversible (immediate), approved efficacy for 3-6 years

Question 5

Efficacy for IUDs

Answer 5

Mirena and Liletta: 6 years
Kyleena: 5 years
Skyla: 3 years

Question 6

Progestin tablet disadvantages

Answer 6

irregular menses
Not good for forgetful patients, adherence, possible increase in depression, anxiety, and irritability, fewer contraceptive benefits, progestin-related side effects like weight gain and acne, have to be taken at the same time every day within a 3-hour window

Question 7

What do you do with a missed dose of POP?

Answer 7

BUM for 48 hours

Question 8

What has a 24-hour missed pill window?

Answer 8

Drospirenone, but is CI in women with hyperkalemia

Question 9

Depo shot disadvantages

Answer 9

Irregular menses, risk of depression, decreased BMD, weight gain, slow return to fertility (18 months), provider visit every 11-13 weeks (if you don’t return in that time period you have to use BUM), have to take calcium 1000-2000mg/day due to BBW of bone loss

Question 10

Nexplanon disadvantages

Answer 10

Irregular menses for the first 6 months possible

Expulsion, increased risk of infection 20 days after insertion, foreign body, progestin-related ADEs

Question 11

IUD disadvantages

Answer 11

Irregular menses for the first 3-6 months possible
Expulsion (but decreases over time), increased risk of PID 20 days after insertion, foreign body
Skyla may interfere with some MRIs
Mirena may have an increased risk of expulsion in patients who haven’t had children

Question 12

Progestin-only tablet ADEs

Answer 12

Progestin-related: acne, weight gain, hirsutism, etc.

Question 13

Depo shot ADEs

Answer 13

Progestin-related, progressive significant weight gain, severe depression, BBW of bone loss

Question 14

Nexplanon ADEs

Answer 14

Progestin-related ADEs, bleeding irregularities, inflammation, hematoma, pain, redness at site, difficulty removing rod, the rod breaking, fibrosis

Question 15

IUD ADEs

Answer 15

PAINS

Period late, abnormal spotting, increased or decreased bleeding

Abdominal pain, pain with intercourse

Infection (STI), abnormal vaginal discharge

Not feeling well, fever, chills

String missing, shorter or longer