contraceptives

Question 1

List the 5 barrier methods

Answer 1

spermicide
sponge + spermicide
condoms
diaphragm
cervical cap

Question 2

List the 5 non-barrier methods

Answer 2

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

Question 3

spermicide MOA

Answer 3

destroys cell wall to inactive sperm

Question 4

disadvantages of spermicide

Answer 4

increased discharge
could take time to melt

Question 5

sponge + spermicide MOA

Answer 5

mechanical barrier that inactivates sperm

Question 6

advantages of sponge + spermicide

Answer 6

absorbs excess fluids
lower risk of UTI than diaphragm

Question 7

disadvantages of sponge + spermicide

Answer 7

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

Question 8

do you NEED condoms w/ the sponge method?

Answer 8

it may be needed in first few months

Question 9

when can you put in the sponge?

Answer 9

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

Question 10

condom MOA

Answer 10

mechanical barrier
most have spermicide

Question 11

which one is more effective- male or female condom?

Answer 11

male is more effective and less expensive

Question 12

diaphragm MOA

Answer 12

sperm inactivation– mechanical barrier

Question 13

disadvantages of diaphragm

Answer 13

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

Question 14

cervical cap MOA

Answer 14

sperm inactivation– mechanical barrier

Question 15

what is the least effective barrier method?

Answer 15

spermicide (28% failure rate)

Question 16

what is the most effective barrier method?

Answer 16

diaphragm w/ spermicide

Question 17

fertility awareness MOA

Answer 17

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

Question 18

fertility awareness disadv

Answer 18

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

Question 19

combination OCP MOA

Answer 19

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

Question 20

Progestin only OCP MOA

Answer 20

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

Question 21

combination OCP advantages

Answer 21

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

Question 22

progestin only OCP advantages

Answer 22

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

Question 23

disadvantages of progestin only OCP

Answer 23

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

Question 24

contraceptive patch MOA

Answer 24

ovulation suppression
cervical mucus & endometrium changes

Question 25

contraceptive patch user directions

Answer 25

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

Question 26

contraceptive patch benefits

Answer 26

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

Question 27

contraceptive patch disadvantages

Answer 27

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

Question 28

vaginal ring MOA

Answer 28

same as patch and OCP

Question 29

user directions for vaginal ring

Answer 29

keep ring in for 3 weeks, remove for one week

Question 30

nuva ring disadvantages

Answer 30

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

Question 31

what are the Long Acting Reversible Contraceptives (LARCs)?

Answer 31

IUD nexplanon Depo shot

Question 32

IUD mechanism

Answer 32

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

Question 33

which IUD DECREASES menstrual sx and dysmenorrhea?

Answer 33

progesterone IUD

Question 34

which IUD could INCREASE dysmenorrhea

Answer 34

Copper IUD-- also heavier periods initially

Question 35

which IUD could cause irregular bleeding or amenorrhea?

Answer 35

non-copper/progesterone IUDs

Question 36

life span of various IUDs

Answer 36

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

Question 37

risks of IUD

Answer 37

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

Question 38

nexplanon MOA

Answer 38

changes in cervical mucus ovulation suppression

Question 39

advantages of nexplanon

Answer 39

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

Question 40

disadvantages of nexplanon

Answer 40

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

Question 41

user instructions for nexplanon

Answer 41

inserted while patient has period, use backup for 7 days

Question 42

Depo shot MOA

Answer 42

changes in cervical mucus and endometrium ovulation suppression

Question 43

two most effective LARCs

Answer 43

IUD & Nexplanon

Question 44

Depo shot instructions

Answer 44

shot ever 3 months

Question 45

advantages of Depo

Answer 45

no estrogenic SE

Question 46

disadvantages of Depo

Answer 46

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

Question 47

4 SEs of Depo shot

Answer 47

HA, wt gain, nausea, dizziness

Question 48

how does emergency contraception work

Answer 48

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

Question 49

which contraceptives can be used for emergency?

Answer 49

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

Question 50

what are the two methods of sterilization?

Answer 50

tubal ligation and vasectomy

Question 51

tubal ligation MOA

Answer 51

disruption of tubal patency removal of fallopian tube

Question 52

disadvantages of tubal ligation?

Answer 52

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

Question 53

complications of tubal ligation

Answer 53

hemorrhage adhesions bowel damage uterine perforation infection

Question 54

vasectomy MOA

Answer 54

disruption of vas deferens

Question 55

complications of vasectomy

Answer 55

hemorrhage hematoma infection

Question 56

contraindications for IUD

Answer 56

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

Question 57

contraindications for OCP

Answer 57

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

Question 58

NON-contraceptive benefits to OCP

Answer 58

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

Question 59

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

Answer 59

take 2 pills and use backup for 1 week

Question 60

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

Answer 60

skip placebo pills & start next pack

Question 61

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

Answer 61

they should consider emergency contraceptive