contraceptive counseling Flashcards
Efficacy
unintended pregnancy will occur even when method used consistently and as prescribed
Effectiveness
unintended pregnancy occur if method not used properly
a man uses a condom every time is an example of efficacy or effectiveness?
a man uses a condom every time except for once or twice is an example of efficacy or effectiveness?
efficacy;
effectiveness
if patient has migraines with aurora what should you give them?
estrogen!
lactational amenorrhea method (LAM) of birth control
breastfeeding. Only works when mother is strictly breastfeeding meaning baby is not supplimenting with food, breastfeeding occurs at leasat q3 hours and baby is <6 months old
Fertility awareness birth control
they use their body to tell when they are ovulating. (temp, discharge)
Diaphragms
fitted by PCP, inserted in women, protects against some STIs
vaginal sponge
single use, over the counter, needs to stay in for a period of time
female condom
condom that gets inserted in vaginal, over the counter
Does a vasectomy have influence over sex drive, hormone production or sexual function?
no
copper paragard action
interferes with ability of sperm to pass through uterine cavity, cervical mucus thickens, endometrial lining becomes acidic, slows down cilli so egg never reaches sperm
what conditions should you avoid using the copper paragard?
copper allergy, fibroid infections, undiagnosed uterine bleeding.
can women who have never had kids use the copper paragard?
yes
monophasic BC
has same amount of estrogen throughout all pills
noraml side effects of BC
headaches, nausea, irregular period of 3 months when starting BC
Medications that will effect BC
antiretrovirals, antibacterials, antidepressants, anticonvulsants
Absolute contraindications to BC
> 35 and smoker, liver tumor, clotting disorders, CAD, breast ca, undiagnosed genital bleeding
when do you estrogen only?
if woman has no uterus and for hormonal replacement
estrogen action
prevents ovulation, suppresses action of other hormones (LH, FSH)
progestrone action
prevents ovulation, blocks LH, thickens cervical mucus,
1 common side effect of BC
breakthrough bleeding 1-3 months, *breast tenderness, headaches and nausea
Danger s/s of BC (ACHES)
abdominal pain, chest pain, headaches, eye problems, severe leg pain
contraceptive patch and vaginal ring are changed at what intervals?
patch: changed weekly for 3 weeks
ring: in place for 21 days and removed for one week
is estrogen or progestin preferred with breastfeeding?
progestin because estrogen can decrease milk production
what is the difference between combo BC and progestrone only BC pills?
Progestin only there is no week off, don’t work as well
1 side effect of progestin BC
irregular bleeding for 6-8 months then you dont get a period
what does progestin BC do to women that we have to monitor?
decreases bone density
side effect of progestin implant
bleeding wont be consecutive, youll get the same number of bleeding days just not all at once
how often is the Depo (progestin only) shot given?
12 weeks
What is the time frame for taking the morning after pill? and what is the dose
within 120 hours after sex; 2 pills at the same time
dysmenorrhea
pain with period
menorrhagia
excessive period bleeding
IUD (mirena and Skyla) can stay in place for how long, what does it have in it and who are they good for?
may stay in place for 5 years, has progestrone, good choice for smokers and patients with migraine with auroras
Can women who have had a hx of endometriosis, anemia, DVT, etopic pregnancy, HTN, smokers and PID use IUDs?
yes
IUD mechanism of action
thickens cervical mucus, alters endometrium lining, inhibits sperm survival
what should patients do after every cycle with IUD?
check string measurement.
patients with IUD should follow up in how many weeks after IUD placed?
3 to 6 weeks after first period then 1 year
signs of IUD perforation or infection
severe bleeding,abdominal cramping for 3-5 days after insertion
signs of expulsion or perforation of IUD
shorter or longer string
when do you place an IUD?
anytime during period or right after delivery
IUD insertion steps
inspect vagina, bimanual exam, disinfect vag, sound uterus and insert IUD
