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contraceptives Flashcards

1
Q

abstinence: considerations

A

HSV and HPV can be spread by skin-to-skin contact!

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2
Q

female sterilization

A

tubal occlusion via tubal ligation or inserts w/ Essure

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3
Q

female sterilization: effectiveness

A

> 99%

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4
Q

female sterilization: duration

A

permanent

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5
Q

female sterilization: considerations

A

bilateral tubal ligation: $6k!

Essure effective after 3 mos

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6
Q

male sterilization

A

incision or puncture blocks vas deferens

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7
Q

male sterilization: effectiveness

A

> 99%

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8
Q

male sterilization: duration

A

permanent

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9
Q

male sterilization: considerations

A

< $1000

requires 3 month semen analysis confirmation

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10
Q

IUD

A

inserted in office by HCP
check for black strings before sex

  • Paraguard: not for copper allergy, Wilsons disease
  • Mirena, Skyla (hormonal): not for breast cancer, liver disease
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11
Q

IUD: effectiveness

A

> 99%

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12
Q

IUD: duration

A

copper: 10 y
Mirena: 5 yr
Skyla: 3 yr

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13
Q

IUD: considerations

A

all: irregular bleeding 1st 3 months, contraindicated w/ recent pelvic infection, STI, uterine/cervical cancer,

breastfeeding okay

Paraguard: not for copper allergy, Wilsons disease
- heavier periods. not good for dysmenorrhea

Hormonal: not for breast cancer, liver disease

  • decreased amount of bleeding/cramping
  • possible amenorrhea
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14
Q

implantable progestins

A

small rod inserted in skin by HCP at office

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15
Q

implantable progestins: effectiveness

A

> 99%

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16
Q

implantable progestins: duration

A

3 years

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17
Q

implantable progestins: considerations

A

Nexplanon: no estrogen, can breastfeed

side effects: irregular bleeding, weight gain, large upfront cost

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18
Q

injectable progestins

A

IM, SC injections at office

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19
Q

injectable progestins: effectiveness

A

> 99%

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20
Q

injectable progestins: duration

A

3 months

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21
Q

injectable progestins: considerations

A

Depo-Provera: no estrogen, can breastfeed

side effects: irreg bleeding (can be severe 1st 3-6 mos), wt. gain, venous thrombosis/embolism
⇓bone mineral density
⇑risk breast changes
⇓bone density if more than 3 years

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22
Q

vaginal ring

A

flexible ring inserted in vagina for 3 weeks, remove for 1 week for withdrawal bleed

Nuvaring: estrogen and progestin

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23
Q

vaginal ring: effectiveness

A

> 92%

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24
Q

vaginal ring: duration

A

1 mo

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25
vaginal ring: considerations
convenient, must be comfortable inserting Nuvaring side effects: similar to COC, vaginal irritation/yeast infection, breast changes ⇓ libido ⇑risk clots, stroke, heart attack
26
patch
3 weeks on/1 week off
27
patch: effectiveness
> 92%
28
patch: duration
1 mo
29
patch: consideration
OrthoEvra: discontinued Xulane: estrogen and progestin - side effects: similar to COC (may be less effective w/ anticonvulsant med or if overweight), skin reactions, may be less effective if overweight, - contraindications: smokers 35+, migraines w/aura, hx of clots/clotting disorders
30
pills (combined oral contraceptive OR progestin only pill)
take at same time each day, withdrawal bleeding on placebo pills during weeks 3 or 12 COC: estrogen and progestin POP: progestin only obvi
31
pills (COC or POP): effectiveness
> 92-97%
32
pills (COC or POP): duration
1 or 3 months
33
pills (COC or POP): considerations
⇓blood loss, anemia, cramps, ovarian/endometrial cancer, PID, benign breast conditions, ectopic, PMS COC: estrogen/progesterone. may be less effective w/ anticonvulsant med or if overweight POP: ok in smokers 35+, irreg bleeding common - may be less effective w/ anticonvulsant med or if overweight
34
condoms (male/female)
male: cheaper. female: more expensive, non-latex.
35
condoms (male/female): effectiveness
79-84%
36
condoms (male/female): duration
each time
37
condoms (male/female): consideration
apply properly, use consistently! decreases risk of STI, may break. male: water-based lubricant only. female: water and oil based lubricant okay.
38
diaphragm
cervical cap with spermicide OR sponge place over cervix before sex, leave in place 6-24 hr after
39
diaphragm: effectiveness
80% diaphragm | 60-80% cap/sponge
40
diaphragm: duration
each time
41
diaphragm: consideration
- no need for hormones - toxic shock syndrome possible but rare - refit after childbirth, > 20lb wt change
42
coitus interruptus: effectiveness
78%
43
fertility awareness methods
rhythm: determine ovulation by calendar basal body temp: determine ovulation by temp (1st thing in morning, look for an increase) cervical mucous ovulation: assess mucous
44
fertility awareness methods: effectiveness
76%
45
fertility awareness methods: considerations
?
46
vaginal spermicide
use before sex
47
vaginal spermicide: effectiveness
74%
48
vaginal spermicide: considerations
may cause vaginal irritation, leakage
49
lactational amenorrea method
exclusively breastfeed Q4H during the day, Q6H at night AND there is no menses.
50
lactational amenorrea method: effectiveness
98%
51
lactational amenorrea method: duration
6 months after childbirth
52
lactational amenorrea method: considerations
period = NOT WORKING
53
emergency contraception for unprotected sex
IUD or pills general side effects: earlier/later and/or heavier/lighter menses, breast tenderness, dizziness, headache, N/V. - repeat if vomit after 2 hrs of med - if no period in 3 wks OR s/s of pregnancy do pregnancy test and see HCP Plan B, One-step, Next Choice: 85% effective when used w/in 3 days. less effective days 4/5 and with a BMI >25%. May not work if BMI > 30%. Don’t use after Ella. Ella: for non-breastfeeding, 89% effective when used up to 5 days. Less effective if BMI >35%, use backup method for 14 days
54
emergency contraception for unprotected sex: effectiveness of Plan B, One-step, Next Choice
85% effective when used within 3 days • less effective days 4/5 -or- BMI >25% • may not work if BMI > 30%
55
emergency contraception for unprotected sex: considerations for Plan B, One-step, Next Choice
don’t use after Ella | may not work if BMI > 30%
56
emergency contraception for unprotected sex: effectiveness of Ella
89% - nonbreastfeeding! • effective when used up to 5 days • less effective if BMI >35%
57
emergency contraception for unprotected sex: considerations for Ella
• less effective if BMI >35% | use backup method for 14 days
58
Plan B, One-Step, Next Choice
emergency contraception for unprotected sex
59
Ella
emergency contraception for unprotected sex
60
Ortho Evra
patch, DISCONTINUED
61
Xulane
patch, estrogen and progestin
62
Nuvaring
vaginal ring, estrogen and progestin
63
Depo-Provera
injectable progestin
64
Nexplanon
implantable progestin
65
Paraguard + specific considerations
IUD, copper not for copper allergy, Wilsons disease
66
Hormonal IUD: specific considerations
not for breast cancer, liver disease
67
Mirena
5 yr IUD
68
Skyla
3 yr IUD
69
Wilson's disease
rare inherited disorder that causes too much copper to accumulate in liver, brain, other vital organs
70
Essure
non-hormonal, non-surgical, permanent female contraceptive - inserted into fallopian tubes, 10 minute procedure - while natural barrier forms, must use other birth control - after 3 months, imaging confirmation
71
Nuvaring
estrogen/progesterone flexible ring inserted in vagina for 3 weeks, remove for 1 week for withdrawal bleed
72
rhythm method
determine ovulation by calendar based on menstrual history
73
basal body temp
determine ovulation by temp first thing in morning (look for an increase)
74
cervical mucous ovulation
assess vaginal secretion color and consistency

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