Contraceptives

Question 1

Side effects of too much estrogen

Answer 1

bloating
breast tenderness
mood changes
heavy bleeding
nausea
fibroid growth
vision changes
weight gain

Question 2

Side effects of not enough estrogen

Answer 2

bleeding early in cycle
light menses
vaginal dryness
spotting
no withdrawal bleeding

Question 3

Mechanism of action of progesterone

Answer 3

Prevents LH surge which inhibits ovulation
Thickens cervical mucus inhibits sperm penetration
Change motility of fallopian tubes which impairs transport of sperm
Atrophy of endometrium which impair implantation

Question 4

Side effects of too much progesterone

Answer 4

hirsutism
decrease sex drive
depression
increased appetite
weight gain
less energy
yeast infections
acne
hair loss

Question 5

Side effects of not enough progesterone

Answer 5

bleeding late in cycle
no withdrawal bleeding
heavy menses

Question 6

Implant

Answer 6

99%
Progestin
Rod inserted by provider non dominant upper arm
left in for 3 years
if inserted more than 5 days of start of period then use backup for 7 days
remove after 3 years
serious: headache, mood changes, acne
common: pain with insertion, irregular menses for 6-12 months
return: delayed 6 weeks

Question 7

IUD levonorgestrel

Answer 7

99%
Progestin
inserted into uterus by provider
left in for 3-7 years
use backup for 7 days after insertion
remove after 3-7 years
serious: uterine perforation, infection, expulsion
common: pain with insertion, spotting for 3-6 months, periods become lighter/less frequent
Return: immediate

Question 8

Copper IUD

Answer 8

99%
none
inserted into uterus by provider
left in for 10 years+
no backup needed
removed after 10 years
serious: uterine perforation, infection, expulsion
common: pain with insertion, periods may become heavier
benefits: long term protection, no hormone, safe to breastfeed, less risk for uterine cancer
return: immediate

Question 9

Shot medroxyprogesterone acetate

Answer 9

94%
progestin
150 IM injection or 104 SUBQ injection
every 3 months (11-13 weeks)
start today and use backup for 7 days
start within 7 days of period
return: possibly delayed

Question 10

Pill combined

Answer 10

91%
progestin and estrogen (EE)
take one pill by mouth daily same time every day
start today and if more than 5 days after period use backup for 7 days
next period start within 5 days of period
serious: blood clots, stroke
common: mood change, breast tenderness, nausea, spotting
benefits: less risk of cancer, helps with acne, more regular/lighter periods
return: immediate

Question 11

Mini Pill (Norethindrone)

Answer 11

91%
progestin
oral
one pill with 3 hours of same time everyday
serious: heavy bleeding, ectopic pregnancy, headaches
safe to breastfeed

Question 12

Mini pill (drospirenone)

Answer 12

91%
progestin
oral
daily + 4 placebo pill
late: one pill take ASAP
2 or more take one asap then the next at usual time use backup for 7 days