Contraception/Women's Health Flashcards
Normal range of menses is ___-___ days w/avg of ___.
Normal duration is ___-___ days w/avg of ___.
Normal blood loss is ___-___ ml w/avg of ___-___.
21-35, 28
2-6, 4
20-80, 30-35
___ is the absence of a period for 3 or more months in women w/past menstruation.
amenorrhea
___ is diminished menstrual flow (spotting)
hypomenorrhea
___ is bleeding > 35 day intervals.
oligomenorrhea
___ is painful periods
dysmenorrhea
___/___ is bleeding at regular intervals but marked w/prolonged bleeding > 7 days or excess of 80cc.
menorrhagia/hypermenorrhea
___ is irregular but frequent uterine bleeding in variable amts.
metrorrhagia
___ is uterine bleeding occurring irregularly in frequency and excessive in amt.
menometrorrhagia
___ is uterine bleeding occurring at intervals < 21 days.
polymenorrhea
___ is bleeding of variable amts occurring btwn regular menses.
intermenstrual
___ is any bleeding occurring more than 1 yr following menopause.
postmenopausal
___ is bleeding occurring after sexual intercourse
post-coital
___ is bleeding any time during a cycle outside of menses while on hormones.
breakthrough bleeding
___ is bleeding occurring when estrogen is withdrawn.
withdraw bleeding
About 90% of dysfunctional bleeding (DUB) is ___, which is menses < ___ days or > ___ days.
anovulatory, 21, 35
___ abnormal uterine bleeding is d/t ectopic and threatened abortion, infection, polyps, fibroids.
Organic
___ abnormal uterine bleeding is r/t ___ axis and typically d/t medications, IUD, and sexual trauma.
Systemic, hypothalamic-pituitary-ovarian
___ ___ are considered to be the gold standard in contraception. It decreases risk for ___ CA and supplies ___ to our bones.
oral contraceptives, ovarian, Ca+
Progesterone has a ___-___ metabolism where it is metabolized by the ___ after absorption from the ___ before it reaches the ___.
first-pass, liver, intestine, bloodstream
First-generation progestins include: ___. They have a decreased ___ effect, so they work well for ___ pt’s.
norethynodrel, norethindrone, norethindrone acetate, ethynodiol diacetate, progesterone, diabetic
Second-generation progestins include:___. They have a longer ___-___ and are associated w/___ s/e like increased lipids, oily skin, acne, and facial hair growth.
norgestrel and levonorgestrel, half-life, androgenic
Third-generation progestins include: ___. Major s/e is ___ ___, but helps to control ___.
desogestrel, noregestimate, sprintec, ortho-tricyclin, venous thromboembolisms, acne.
Fourth-generation progestins include: ___. Major s/e is ___ ___, but helps to control acne.
drospirenon-spironolactone, venous thromboembolisms, acne
Next-generation progestins include: ___. Help to control bleeding.
dienogestrel
___ provide for better cycle control.
estrogens
MOA for progestin: suppresses the release of ___ from the hypothalamus, suppresses the ___/___ surge that induces ovulation, and thickens cervical mucus to hamper ___. Also decreases risk of ___.
GnRH, LH/FSH, sperm, PID
MOA of estrogen: suppresses the release of ___ from the pituitary.
FSH
MOA of comb.: ___ tubal motility, endometrial ___ and localized ___ of the endometrium.
slow, atrophy, edema
As hormone levels ___, pregnancy rates ___.
decrease, increase
___ has a major impact on the effectiveness of BC.
obesity
Advantages of BC include: ___ reversible control of fertility, short-acting and out of system w/in ___-___ days, decreases risk of ___ and ___ CA, ___ risk of benign breast conditions, improvement of ___ and ___, decreases ___ ___ anemia, reduces ___ s/s.
rapid, 2-3, ovarian, endometrial, decreases, acne, and hirsutism, iron deficiency, endometriosis
Disadvantages of BC include: ___ administration, readily ___, does not protect against ___.
daily, accessible, STD’s
A condition for which there is no restriction for the contraception method is category ___.
Advantages outweigh the risk of taking is category ___.
Proven risks usually outweigh the advantages of use is category ___.
Unacceptable health risk if contraceptive method is used is category ___.
1
2
3
4
Health risks for BC include:
pregnancy, DVT/VTE, MI, stroke, HTN, gallbladder disease, benign liver tumors, risk of STD’s, cervical dysplasia and carcinoma
Breastfeeding women should take a ___-only BC.
progesterone
Drugs that BC may interact w/or cause a decreased hormone level:
antibx (Rifampin), anticonvulsants, antivirals, antidepressants, K-sparing antihypertensives, NSAIDS
Mainstay BC tx is: ___, which is a ___ generation.
Brevicon, first
___/___ is best BC for DUB/bleeders and is a ___ generation.
Lo/Ovral, third
___ is best BC for ovarian cyst and is a ___ generation and is also ___.
Ovcon, first, chewable
___ is best BC for headache pts b/c it ___ estrogen levels.
Mircette, increases
___ is the best BC for breastfeeding b/c it has increased amts of ___ which increases milk supply.
Micronor, progesterone
___ ___ is used for emergency contraception.
Plan B
Pt’s who smoke should not take a ___ BC.
combination
An annual pelvic exam is suggested but not ___.
required
True or False: if you miss a dose, take it when you remember.
True
Be consistent w/BC pills and take at ___ time every day in order to be effective.
same
Instruct pt to call the clinic immediately if they experience the acronym ___, which includes severe ___ pain, severe ___ pain, severe ___, severe ___ pain, and changes in ___.
ACHES, abdominal, chest, headaches, extremity (leg/arm), sight
Estrogen can cause ___.
hyperlipidemia
___ contraception substantially reduces the chances of pregnancy after an episode of ___ intercourse.
Emergency, unprotected
Advantages of Plan B: prevents ___ after unprotected intercourse, missed too many ___, breastfeeding woman had her ___, failed ___ method, cannot feel ___ strings or removed
pregnancy, OCP’s, period, withdrawal, IUD, 8, teratogens
Major s/e of Plan B is:
nausea/vomiting, menstrual changes
Plan B has no effect on ___ and does not disrupt an already ___ fetus.
fertility, implanted
The use of ___ is not recommended in lactation.
Ella
Major risks of IUD is ___
PID
Plan B should be used w/in ___hrs of ___ days of unprotected intercourse. Important to abstain from intercourse until next ___. Follow up if no menses in ___ wks.
120, 5, cycle, 3
___ are the most commonly used reversible method of contraception.
IUD’s
2 most common IUD’s include ___ and ___. The first is ___-free and has a duration of ___ yrs. The second is also ___-free and has a duration of ___ yrs.
Paragard, Mirena, latex, 10, latex, 5
MOA of an IUD is to prevent ___ from fertilizing ___. It does not interrupt an implanted ___. It creates ___ to eat/kill sperm.
sperm, ova, pregnancy, macrophages
___ are the superior long-term protection against unintended pregnancy.
IUD’s
Advantages of IUD’s include: highly ___ and ___, non-___, ___-term protection, reduced risk of ___ CA.
effective, safe, estrogenic, long, endometrial
Disadvantages of IUD’s include: ___ disturbances, ___/discomfort, ___, ___, ___ perforation, requires placement ___.
menstrual, cramping, expulsion, infection, uterine, training
Women who are contraindicated for using an IUD: young teens who have never been ___, ___, ___, ___, hx of ___ CA, women not in a ___ relationship, hx of ___, hx of ___.
pregnant, breastfeeding, immunocompromised, diabetes, breast, monogamous, VTE, c-section/uterine/cervical sgy
Educate pt’s to check for strings at least ___ per month and to abstain from intercourse for ___ days after placing/removing.
once, 7
Patches and rings are changed ___ and are applied to the ___, upper ___, lower ___, or ___.
changed, bottom, arm, abdomen, torso
MOA of patches/rings: works similar to ___ through suppression of ___ and prevention of ___. Cervical mucus ___ and endometrium changes to hamper ___ and prevent ___.
OCP’s, gonadotropins, ovulation, thickens, sperm, implantation
Advantages of patches: ___ of applying once wkly, no significant weight ___, rapidly ___, great for those who can not take a ___ or have ___ absorptive issues.
convenience, gain, reversible, pill, GI
Disadvantages of patches: risk of ___, ___, skin ___, ___, ___ compliance.
VTE, migraines, reaction, obesity, adolescent
Example of patch is ___.
ortho evra patch
Example of ring is ___.
nuvaring
Nuvaring is placed in ___ and is left for ___ wks, then removed during last week. Superior to ___.
vagina, 3, OCP’s
Advantages of rings: convenience of placing once/___, rapidly ___, can use w/___, can be removed for ___ hrs and still have proper efficacy.
month, reversible, tampons, 3
Disadvantages of rings: risk of ___, ___, ___, ___ symptoms, and ___ d/t not wanting to touch themselves.
VTE, Toxic Shock Syndrome (TSS), headache, vaginal, adolescents
Rings have a prolonged use and are effective for ___ wks.
4
The injectable contraception is ___ and it has a ___ wk interval and is a ___ only method.
Depo-Provera, 12, progestin
Depo-Provera is not compromised by ___ ___ like a lot of the others.
body wt
MOA of Depo-Provera is that it inhibits ___ w/suppression of ___ and ___. It eliminates the ____ surge and inhibits ___ pulsatility.
ovulation, FSH, LH, LH, GnRH
The major down-fall of Depo-Provera (injectable contraception) is that the return of ovulation takes btwn ___-___ months from last injection. You may also have increased vaginal ___.
15-45, discharge
Biggest disadvantage to Depo-Provera is ___ ___.
weight gain
Depo-Provera not a good method for those thinking about becoming pregnant anytime in future d/t lack of quick return of ___.
fertility
Implant devices (aka ___) are placed ___ under the skin in the upper arm in the office and last ___ yrs. This is considered to be the ___ effective type of BC.
Implanon, SQ, 3, most
Implanon has a ___ risk of ectopic pregnancy.
decreased
Disadvantages of Implanon include: uterine ___, weight ___, ovarian ___, no ___ protection, decrease in bone ___, risk of ___.
bleeding, gain, cyst, STI, density, VTE
A ___ remains the most widely available and most commonly used method of BC. It reduces risk of ___ and ___.
condom, pregnancy, STI’s
Advantages of barrier methods/condoms is that you can perform ___/___ sex.
anal/oral
Disadvantages of barrier methods is reduced ___, difficulty having an ___.
sensation, erection
Other available methods of contraception include:
spermicides (not really used all that often), diaphragm, cap, withdraw method, fertility awareness, PP contraception (breastfeeding), sterilization (permanent)
