Contraceptive Flashcards
Hormones in birth control
Estrogen +Progestin
Progestin only
Type of hormonal contraceptive
Oral tablets Skin patch Injection Implant Vaginal ring Intrauterine device IUD
Two types of oral contraceptive
Combined Progestin only ( minipill)
Concentration of hormones in combination birth control
Œstrogen - ethinyloestradiol (EE) 20-35micrograms
Progestins ( progestogen ) - 19 - nortestosterone
MOA combination birth control
Œstrogen - Inhibits FSH for suppression of follicle growth
Progestin - Prevents ovulation
Scanty and viscous mucus which inhibits sperm transport
Atrophic , unreceptive endometrium
Effectiveness of combination birth control pill
92-99%
When should you start taking oral pill
Within first 7 seven days of menses
Can you start combination therapy anytime as long as pregnancy is excluded
Yes
How many days should you drink active pill
21 days
Number of pill to take each day
1
Menstrual and diseases advantages of birth control pill
Decreased blood loss, anemia, menstrual cramps
Decreased ovulation pain
Deceased PCOS symptoms
Decreased endometriosis symptoms
Decreased risk endometrial carcinoma
Decreased risk ovarian cancer
Decreased risk of corpus Luteal cyst and colorectal carcinoma
Sexual psychological Advatanges of birth control
No interruption during intercourse
Pleasurable intercourse due to less risk of pregnancy
Menstrual disadvantages of birth control
Spotting Scant, missed periods Amenorrhea post pill Decreased libido Mood changes Depression Anxiety Fatigue Stressful daily pill taking
Sexual / psychological disadvantages of pill
Decreased libido Mood changes Depression Anxiety Fatigue Stress
Other Disadvantages of pill
No sti hiv protection Breast tenderness Breast pain Headaches Increased varicosities
Absolute contraindications of birth control pill
Previous thromboembolic event Previous stroke History estrogen dependent tumor Active liver disease Pregnancy Abnormal uterine bleeding Valvular heart disease in women over 35yo who smoke
Relative contraindications of brith contro
Poorly controlled hypertension
Anticonvulsants drug therapy
Migraine and headaches
Do you need backup contraception if missed pill
Yes
How long should you use backup if missed 2 active hormonal pills
7 days
Direct side effects of birth control pill
Bloating Nausea Breast tenderness Mood changes Weight gain Bleeding Amenorrhea
Who has higher failure rate and higher breakthrough bleeding
COC or progestin only
Progestin only
Is there a pill free interval in progestin only
No
Composition of combined injectable contraception
50mg norethisterone enantate
50mg estradiol valerate
Progestin only injectable types
Depot medroxyprogesterone acetate (DMPA) Norethisterone enanthate (NET-EN) - noristerat
Progestin only injectable reduce risk of endometrial cancer and volume of menstrual bleeding
T or F
True
Interval of injection of combined contraception
4 weeks
Effectiveness of combined injectable contraception
99.6%
Type of administration of DMPA
IM
Effectiveness of progestin only injectable
99.7%
Women that should consider DMPA
Estrogen is contraindicated
SS anemia
Fibroids
Older women who smoke
Side effects of DMPA
Menstrual changes Menstrual irregularities Gradual weight gain Mood changes Headache
Compound released form contraceptive implant
Progestin
Types of contraceptive implants
Jadelle - 5 years efficacy - 75mg levonorgestrel /rod (2 rods)
Implanon - 3 years efficacy - 68mg progestin etonogestrel
Effectiveness contraceptive implant
99%
Side effect implant
Like for progestins
Infection, pain at incision site
Amenorrhea
What are intrauterine device used for
Prevent pregnancy
New compounds found in modern IUD
Copper
Progestin
Are modern IUD safe, effective, private and long acting >?
Yes
Benefits of IUD
Allow for niiiice sex Non contraceptive health benefits No estrogen good for some women Non surgical alternative to surgical sterilization Cost effective
MOA IUD
Prevent fertilization Sterile inflammatory rxn -> toxic to sperm and ova -> impairs implantation Inhibition of sperm motility Reduced sperm capacitation Increased spern phagocytosis s
Three types of modern IUD
Copper iud
Progestin releasing IUD
Unmediated IUD
Benefits of levonorgestrel IUC
Decreased dysmenorrhea Decreased menstrual bleeding Endometrial hyperplasia and cancer treatment PID protection Endometriosis treatment
What do you find in un medicated IUDS
Inert materials like stainless steel , plastic
Advantage of inert IUD
Never need to be replaced
Contraindications do IUD
Suspected pregnancy
Active pelvic infection
IUD postpartum placed how long after delivery
48h
Podisadvantages of postpartum IUD
Expulsion rate high
Requires education of women about expulsion
Missing strings recurrent
Careful monitoring
Contraindications of IUD
Active STI STD High risk for STDs Recurrent PID Prolonged ROM Abdominal infection, pelvic infection Intrapartum , postpartum hemorrhage after emptying of uterus
