Exam 2: Contraception Flashcards
When does pregnancy begin?
implantation
what is the window of ideal fertility?
Days 9-15 of the menstrual cycle
what is the average failure rate of barrier methods?
about 10-20 percent
What is the average failure rate of pills/rings/patches that are E/P or P only?
<10%
what is the average failure rate of IUDs, tubal ligation, vasectomy, progesterone implant?
less than <1%
what is contraindicated in a breastfeeding woman?
estrogen-containing contraception
what are the three ways progestin acts as contraception?
- hormonal feedback that prevents LH surge
- thick cervical mucous that forms a barrier
- atrophic endometrium
what is the reason people frequently stop progesterone depot?
weight gain (10-15 lbs/year)
E/P pills are contraindicated in patients
with hypertension
what’s the danger of giving unopposed estrogen (estrogen alone)?
endometrial cancer
what does estrogen do that acts as contraception?
FSH suppression
altered tubular transport of sperm
what are multiphasic OCPs?
dose of E or P mimics natural cycle levels
what are common side effects of E/P pills?
lower libido
headache
acne, oily skin
hirsutism
hair loss
what is the window where a woman can use emergency contraception after sex to prevent pregnancy?
120 hours (5 days)
what are contraindications to getting an IUD?
current STI (gonorrhea or chlamydia)
unexplained uterine bleeds
large deforming fibroids
Wilson’s disease or copper allergy (for copper IUDs)
your patient with an IUD comes to the office because she can’t find her strings. You can’t either. What do you do next?
ultrasound
how does emergency contraception act?
by delaying ovulation
What is the cut off for a short acting vs a long acting birth control method?
Lasts less than 3 months vs more than 3 months
When is estrogen used as a single agent?
HRT
after oophrectomy
during menopause (usually for 5 years or less)
hirsutism
amenorrhea
dysfunctional uterine bleeding
when is estrogen never used as a single agent?
contraception
where are estogens produced before ovulation
in the follicle by theca and granulosa cells
Where are estrogens produced after ovulation
In the corpus luteum by the luteinized granulosa and theca cells
