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Undeleted > contraceptives > Flashcards

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
Q

vaginal ring: considerations

A

convenient, must be comfortable inserting

Nuvaring side effects: similar to COC, vaginal irritation/yeast infection, breast changes
⇓ libido
⇑risk clots, stroke, heart attack

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26
Q

patch

A

3 weeks on/1 week off

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27
Q

patch: effectiveness

A

> 92%

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28
Q

patch: duration

A

1 mo

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29
Q

patch: consideration

A

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
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30
Q

pills (combined oral contraceptive OR progestin only pill)

A

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
Q

pills (COC or POP): effectiveness

A

> 92-97%

32
Q

pills (COC or POP): duration

A

1 or 3 months

33
Q

pills (COC or POP): considerations

A

⇓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
Q

condoms (male/female)

A

male: cheaper.
female: more expensive, non-latex.

35
Q

condoms (male/female): effectiveness

A

79-84%

36
Q

condoms (male/female): duration

A

each time

37
Q

condoms (male/female): consideration

A

apply properly, use consistently! decreases risk of STI, may break.

male: water-based lubricant only.
female: water and oil based lubricant okay.

38
Q

diaphragm

A

cervical cap with spermicide OR sponge

place over cervix before sex, leave in place 6-24 hr after

39
Q

diaphragm: effectiveness

A

80% diaphragm

60-80% cap/sponge

40
Q

diaphragm: duration

A

each time

41
Q

diaphragm: consideration

A
  • no need for hormones
  • toxic shock syndrome possible but rare
  • refit after childbirth, > 20lb wt change
42
Q

coitus interruptus: effectiveness

A

78%

43
Q

fertility awareness methods

A

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
Q

fertility awareness methods: effectiveness

A

76%

45
Q

fertility awareness methods: considerations

A

?

46
Q

vaginal spermicide

A

use before sex

47
Q

vaginal spermicide: effectiveness

A

74%

48
Q

vaginal spermicide: considerations

A

may cause vaginal irritation, leakage

49
Q

lactational amenorrea method

A

exclusively breastfeed Q4H during the day, Q6H at night AND there is no menses.

50
Q

lactational amenorrea method: effectiveness

A

98%

51
Q

lactational amenorrea method: duration

A

6 months after childbirth

52
Q

lactational amenorrea method: considerations

A

period = NOT WORKING

53
Q

emergency contraception for unprotected sex

A

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
Q

emergency contraception for unprotected sex: effectiveness of Plan B, One-step, Next Choice

A

85% effective when used within 3 days
• less effective days 4/5 -or- BMI >25%
• may not work if BMI > 30%

55
Q

emergency contraception for unprotected sex: considerations for Plan B, One-step, Next Choice

A

don’t use after Ella

may not work if BMI > 30%

56
Q

emergency contraception for unprotected sex: effectiveness of Ella

A

89% - nonbreastfeeding!
• effective when used up to 5 days
• less effective if BMI >35%

57
Q

emergency contraception for unprotected sex: considerations for Ella

A

• less effective if BMI >35%

use backup method for 14 days

58
Q

Plan B, One-Step, Next Choice

A

emergency contraception for unprotected sex

59
Q

Ella

A

emergency contraception for unprotected sex

60
Q

Ortho Evra

A

patch, DISCONTINUED

61
Q

Xulane

A

patch, estrogen and progestin

62
Q

Nuvaring

A

vaginal ring, estrogen and progestin

63
Q

Depo-Provera

A

injectable progestin

64
Q

Nexplanon

A

implantable progestin

65
Q

Paraguard + specific considerations

A

IUD, copper

not for copper allergy, Wilsons disease

66
Q

Hormonal IUD: specific considerations

A

not for breast cancer, liver disease

67
Q

Mirena

A

5 yr IUD

68
Q

Skyla

A

3 yr IUD

69
Q

Wilson’s disease

A

rare inherited disorder that causes too much copper to accumulate in liver, brain, other vital organs

70
Q

Essure

A

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
Q

Nuvaring

A

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

72
Q

rhythm method

A

determine ovulation by calendar based on menstrual history

73
Q

basal body temp

A

determine ovulation by temp first thing in morning (look for an increase)

74
Q

cervical mucous ovulation

A

assess vaginal secretion color and consistency

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