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WH Unit 1 > contraceptives > Flashcards

contraceptives Flashcards

1
Q

List the 5 barrier methods

A

spermicide
sponge + spermicide
condoms
diaphragm
cervical cap

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2
Q

List the 5 non-barrier methods

A

periodic abstinence/fertility awareness
combination OCP
progestin only OCP
patch
vaginal ring

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3
Q

spermicide MOA

A

destroys cell wall to inactive sperm

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4
Q

disadvantages of spermicide

A

increased discharge
could take time to melt

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5
Q

sponge + spermicide MOA

A

mechanical barrier that inactivates sperm

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6
Q

advantages of sponge + spermicide

A

absorbs excess fluids
lower risk of UTI than diaphragm

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7
Q

disadvantages of sponge + spermicide

A

increase risk of STI transmission
slight risk of toxic shock/infection
hard to place & remove

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8
Q

do you NEED condoms w/ the sponge method?

A

it may be needed in first few months

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9
Q

when can you put in the sponge?

A

put in up to 24 hrs before and can leave in for up to 30hrs

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10
Q

condom MOA

A

mechanical barrier
most have spermicide

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11
Q

which one is more effective- male or female condom?

A

male is more effective and less expensive

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12
Q

diaphragm MOA

A

sperm inactivation– mechanical barrier

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13
Q

disadvantages of diaphragm

A

must keep in for 6hrs AFTER sex but not more than 24hrs
increased risk of urethritis/cystitis
should add spermicide
discomfort

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14
Q

cervical cap MOA

A

sperm inactivation– mechanical barrier

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15
Q

what is the least effective barrier method?

A

spermicide (28% failure rate)

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16
Q

what is the most effective barrier method?

A

diaphragm w/ spermicide

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17
Q

fertility awareness MOA

A

avoid sex 5 days before and 3 days after ovulation; keep track of basal temp

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18
Q

fertility awareness disadv

A

some ppl cant identify cervical mucus changes and BBT patterns
irregular cycles make it hard
restricts spontaneity
needs extensive record for several cycles before its reliable

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19
Q

combination OCP MOA

A

suppresses GnRH, FSH, LH, LH surge, ovulation by giving hormones to induce negative feedback
stops follicle development
stops sperm penetration at cervix via cervical changes

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20
Q

Progestin only OCP MOA

A

keeps uterus at basal layer (right after menses) so proliferative phase never happens
suppresses the same things as combination OCP

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21
Q

combination OCP advantages

A

less menses, anemia, dysmenorrhea
can tx endometriosis, fibrocystic breast dz, functional cysts, PCOS, acne

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22
Q

progestin only OCP advantages

A

no estrogen makes it safer for lactating people
safer in smokers compared to combined OCP

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23
Q

disadvantages of progestin only OCP

A

must take everyday w/o placebos
breakthrough bleeding is common
less non-contraceptive benefits

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24
Q

contraceptive patch MOA

A

ovulation suppression
cervical mucus & endometrium changes

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25
Q

contraceptive patch user directions

A

change patch 1/week for 3 weeks then one week patch-free

26
Q

contraceptive patch benefits

A

same non-contraceptive benefits as combined OCP bc it has both estrogen and progesterone

27
Q

contraceptive patch disadvantages

A

less effective in ppl >198 lbs based on serum estrogen levels
possible increased risk of venous thromboembolism

28
Q

vaginal ring MOA

A

same as patch and OCP

29
Q

user directions for vaginal ring

A

keep ring in for 3 weeks, remove for one week

30
Q

nuva ring disadvantages

A

placement and expulsion issues
if it comes out it must go back in within 3 hrs!
systemic side effects like OCPs

31
Q

what are the Long Acting Reversible Contraceptives (LARCs)?

A

IUD
nexplanon
Depo shot

32
Q

IUD mechanism

A

inhibits sperm migration, fertilization
inhbits ovum transport
copper is toxic to sperm

33
Q

which IUD DECREASES menstrual sx and dysmenorrhea?

A

progesterone IUD

34
Q

which IUD could INCREASE dysmenorrhea

A

Copper IUD– also heavier periods initially

35
Q

which IUD could cause irregular bleeding or amenorrhea?

A

non-copper/progesterone IUDs

36
Q

life span of various IUDs

A

progesterone lasts 3-6 yrs
paraguard/copper lasts 10 years

37
Q

risks of IUD

A

rare- expulsion
risk of perforation of uterus or cervix
risk of infection w/ possibility of secondary infertility or long term pelvic pain
extra caution when inserting into soft uterus

38
Q

nexplanon MOA

A

changes in cervical mucus
ovulation suppression

39
Q

advantages of nexplanon

A

no estrogenic SE
decreased menstrual flow & related anemia
good for lactating women

40
Q

disadvantages of nexplanon

A

irregular bleeding patterns– frequent spotting, amenorrhea
SE– wt gain, HA, abdominal pain, acne, mood swings

41
Q

user instructions for nexplanon

A

inserted while patient has period, use backup for 7 days

42
Q

Depo shot MOA

A

changes in cervical mucus and endometrium
ovulation suppression

43
Q

two most effective LARCs

A

IUD & Nexplanon

44
Q

Depo shot instructions

A

shot ever 3 months

45
Q

advantages of Depo

A

no estrogenic SE

46
Q

disadvantages of Depo

A

risk of osteopenia esp in first 2 yrs of use; calcium, Vit. D intake needed
irregular bleeding common early, unpredictable, often leads to amenorrhea after several injections
possible delay to fertility

47
Q

4 SEs of Depo shot

A

HA, wt gain, nausea, dizziness

48
Q

how does emergency contraception work

A

1+ of the following:
delays ovulation
interfere w/ fertilization or tubal transport
altered endometrial receptivity to implantation
regression of corpus luteum

49
Q

which contraceptives can be used for emergency?

A

any IUD, paraguard can be used up to 5 days after
combination OCP
Plan B, progestin only contraceptive

50
Q

what are the two methods of sterilization?

A

tubal ligation and vasectomy

51
Q

tubal ligation MOA

A

disruption of tubal patency
removal of fallopian tube

52
Q

disadvantages of tubal ligation?

A

difficult to reverse
requires anesthesia since its a laparoscopic surgery
complications involved

53
Q

complications of tubal ligation

A

hemorrhage
adhesions
bowel damage
uterine perforation
infection

54
Q

vasectomy MOA

A

disruption of vas deferens

55
Q

complications of vasectomy

A

hemorrhage
hematoma
infection

56
Q

contraindications for IUD

A

PID
fibroids (+/-)- not all super bad

57
Q

contraindications for OCP

A

> 35 + smoker
liver, CV, PV dz
DVT
estrogen based tumor
undiagnosed AUB

58
Q

NON-contraceptive benefits to OCP

A

it can be used to address:
dysmenorrhea
acne
anemia from heavy periods
menstrual HA

59
Q

w/ OCP what happens if patient misses 2+ pills, 48hrs

A

take 2 pills and use backup for 1 week

60
Q

w/ OCP what happens if patient misses a pill in week 3?

A

skip placebo pills & start next pack

61
Q

what happens if a pill missed in first week & person had unprotected sex in the 5 days before?

A

they should consider emergency contraceptive

WH Unit 1 (5 decks)

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