Dunn OB/GYN IX Flashcards
ibuprofen
decreases bleeding
in CO
can treat any age for contraception or STI treatment
54% of women having abortions
report using contraception in month they became pregnant
unintended pregnancy
10% women per year
age 18-24yo
LARC
long acting reversible contraception
etonogestrel implant
rod of ethylene vinyl acetate copolypmer
68mg of etonogestrel
-progesterone only**
effective 3 years
implanon
bleeding pattern with implant
total number of bleeding/spotting days decreased
irregular and unpredictable bleeding**
to stop unscheduled bleeding
NSAIDS
adverse of implantable
acne
weight gain
implantable in obese
no contraindication
implanon and bone
does not change bone density
most common reason to discontinue implantable
bleeding irregularity
migraines
discontinue implantable
contraindications for implantable
SLE - anti-phospholipid Abs
hepatocellular adenoma
migraines with aura
intrauterine contraception
copper IUD - paragard
levonorgestrel - mirena
paragard
copper IUD
-no hormones
get heavy periods
10 year use
mirena
levonorgestrel
-local progesterone**
5 year use
light irregular periods
hormonal contraception
take a while to get fertile again
IUD
fertile again right a way
copper IUD
mass effect
-alters uterine and tubal fluid
inhibits fertilization
not abortifacient**
progestin IUD
impairs spermatozoa motility and function
not an abortifacient
thick cervical mucus
atrophy of endometrium
underdeveloped country contraception
IUD
efficacy of IUD
> 99%
risks for IUD
younger - difficulty to get in
higher expulsions in adolescents
copper IUD problem
increased menstrual flow
increased cramping
give NSAID
dakon shield
old IUD - terrible
gave IUDs a bad rap
infertility and IUD
does not cause it
contraindication of IUD
current PID or within past 3 months
risk for gonorrhea/chlamydia - screen before put IUD in
depo provera
progesterone
shot every 3 months
thick cervical mucus
depot medroxyprogesterone acetate
initiate anytime in cycle - rule out pregnancy
recommend condoms for 7 days
side effects DMPA
bleeding irregularity
delayed return to fertility
weight gain
decrease bone density
most common cause discontinue DMPA
bleeding irregularity
bleeding and spotting
decrease with each reinjection of DMPA
weight gain and DMPA
yes there is
early weight gain may predict excessive gain
bone mineral density and DMPA
after stopping - recovers
DMPA contraindications
severe HTN
diabetics
nuvaring
E and P
combined hormone contraceptives
safe for most women
92% effective - typical use - because forget it
contraceptive patch
change 1x week
E and P
venous thombolic event
is weight dependent**
vaginal ring
continuous - leave in all time - lighter periods
lowest ethinyl estradiol dose
take out for 3 hours - other method necessary
weight gain
only depot provera
21-7 dosing for OCPs
catholic creator wanted to mimic normal cycle - not against god that way.. they are so dumb.
breakthrough bleeding
common reason for discontinuation of OCPs
higher rates - smoke and cervical infections
if severe - give estrogen
acne
all pills reduce acne
no consistent results on which progesterone
risk of venous thromboembolism
pregnancy** - highest risk
high dose OC
low dose OC
who cannot go on pill
history of VTE thrombogenic mutations migraines with aura HTN - poorly controlled lupus with antiphospholipid Abs
condom
good for prevention STIs
NOT for pregnancy contraception
15% failure
emergency contraception
plan B - 72 hours
if missed some OCPs
