Family Planning Flashcards
Using the calendar method of family planning, unprotected vaginal sex should be avoided on which days of the menstrual cycle
Days 8-19
Color of beads that indicate the fertile window (days the patient can get pregnant)
White
Color of beads that indicate pregnancy is unlikely
Brown
Total number of beads on the CycleBeads
32
Family planning method wherein calculations of the cycle are updayed monthly using the 6 most recent cycles
Calendar rhythm method
Anna uses the calendar rhythm method for family planning. Her shortest cycle was 24 days while her longest cycle was 31 days. What is her fertile window for this month?
Day 6-20
[(short - 18) - (long - 11)]
She can start unprotected sex again on day 21.
The 2 day method for cervical secretions indicates that a patient can resume unprotected sex on day [num], after [num] _____ days
Day 3, after 2 dry days
Family planning method that looks at the peak in cervical secretions as a basis for starting unprotected sex
Billings (Ovulation) method
Using the Billing’s/Ovulation method of family planning, a patient can resume unprotected sex on day [num], after the peak in cervical secretions
Day 4
According to the Basal body temperature method, a woman is fertile up to ___ days after a rise in BBT
3 days after a rise in BBT
The Symptothermal method is a combination of which 2 methods
Billing’s (Ovulation) method
Basal Body Temperature (BBT) method
Using the Symptothermal Method of family planning, a patient can resume unprotected sex on day ___ after peak in cervical secretions or day ___ after rise in BBT. Whichever comes ______.
Day 4
Day 3
Later
3 conditions for successful Lactation amenorrhea method
1) Fully or nearly fully breastfeeding (75-100%)
2) Monthly menstrual cycle has not resumed
3) Baby is less than 6 months old
The 2 hormone components of combined oral contraceptive pills
Estrogen and Progestin
Within a 28-day pack of COCs, which pills are active and which pills are inactive
Pills 1 - 21/24 = Active
Pills 22/25 - 28 = Inactive
Use of COCs protects the user from _________ and _________ cancers
Ovarian and Endometrial
Use of COCs for ≥ 5 years appears to increase slightly the risk for _________ cancer
Cervical
True or False: COCs are contraindicated for Smokers > 35 years old
True
True or False: POPs are contraindicated for Smokers > 35 years old
False
For COCs use, a backup method should be used if pills are missed for ≥ ___ days
3
For patients who missed a COC pill ≥ 3 days:
ECP should be taken if the patient had sex in the past ____ days
5
Hormonal Component of POPs
Progestin
3 mechanisms of action of both COCs and POPs
1) Thickening of cervical mucus
2) Thinning of endometrial lining
3) Preventing ovulation
____ pills are more effective in breastfeeding women
POPs
T/F: All pills in a pack of POPs are active
True
Common Side effects of Progestin only injectables
Irregular bleeding
Weight gain 1-2kg
T/F: There is no delay in return of fertility with the use of Progestin only injectables
False
DMPA - 4 months delay
NET-EN - 1 month delay
2 classes of Progestin only injectables and the interval of their doses
DMPA (Depot medroxyprogesterona Acetate) - every 3 months
Norethisterone enanthate (NET-EN) - every 2 months
Contraceptive method that helps protect against iron deficiency anemia
Progestin only injectables (DMPA and NET-EN)
Injection window for DMPA and NET-EN
DMPA: up to 2 weeks early - 4 weeks late
NET-EN: up to 2 weeks early - 2 weeks late
Duration of protection with the use of Progestin-only implants
3-5 years
Progestin only implant that is composed of 2 rods containing levonorgestrel
Jadelle
Progestin only implant that is composed of 1 rod containing etonorgestrel
Implanon NXT (Nexplanon)
When to start progestin only implant if:
Having menstrual cycles/is switching from a nonhormonal method
Any time of the month.
> If starting within the first 7 days, no backup required
> if starting ≥ 7 days after start of bleeding, make sure not pregnant and have a backup method
When to start progestin only implant if:
Switching from another hormonal method
Immediately if using the hormonal method consistently and correctly
> no backup method required
When to start progestin only implant if:
switching from progestin only injectable
Implant can be inserted when the repeat injection would have been given. NO backup required.
Duration of effective protection for copper-bearing IUDs
up to 12 years
Common side effects of copper-bearing IUDs
Bleeding changes
Cramps/pain
The use of Copper-bearing IUDs protects against ________ cancer
Endometrial
Complication of the use of Copper bearing IUDs in patients with chlamydia or gonorrhea at the time of insertion
Pelvic inflammatory disease (PID)
Addition to the workup before administering an IUD
Pelvic examination
STI risk assessment
When to start copper IUDs if:
Having menstrual cycles
Any time of the month.
> If starting within the first 12 days, NO backup required
> if starting ≥ 12 days after start of bleeding, make sure not pregnant. NO backup required
When to start copper IUDs if:
switching from another hormonal method
Immediately if using the hormonal method consistently and correctly
> no backup method required
When to start copper IUDs if:
switching from progestin only injectable
Copper IUD can be inserted when the repeat injection would have been given. NO backup required.
When to start copper IUDs if:
Soon after childbirth (regardless of breastfeeding)
Any time within 48 hours after giving birth
If > 48 hours have passed, delay until 4 weeks up to 6 months
When to start copper IUDs if:
within 12 days after 1st or 2nd trimester
> Copper IUD inserted Immediately
NO backup required
When to start copper IUDs if:
After 12 days following 1st or 2nd trimester
> Confirm no more pregnancy
Copper IUD inserted Immediately
NO backup required
When to start copper IUDs if:
After 2nd trimester abortion
Delay insertion 4 weeks
When to start copper IUDs if:
within 5 days after unprotected sex, no intake of ECP
> Copper IUD inserted Immediately
NO backup required
When to start copper IUDs if:
within 5 days after unprotected sex, WITH intake of ECP
> Copper IUD can be inserted on the same day that she takes the ECPs
NO backup required
Duration of effective protection for Levonorgestrel (LNG) containing IUDs
up to 5 years
Complication of LNG IUDs on ovaries
Ovarian cysts
When to start LNG IUDs if:
Having menstrual cycles
Any time of the month.
> If starting within the first 7 days, NO backup required
> if starting ≥ 7 days after start of bleeding, make sure not pregnant. backup method IS required
When to start LNG IUDs if:
switching from another hormonal method
Immediately if using the hormonal method consistently and correctly
CAVEAT:
> If starting within the first 7 days, NO backup required
> if starting ≥ 7 days after start of bleeding, make sure not pregnant. backup method required
When to start LNG IUDs if:
within 5 days after unprotected sex, WITH intake of ECP
Delay insertion to the 7th day after ECP intake. LNG IUDs CANNOT be inserted on the same day and within 6 days following ECP intake
Dose regimen for Emergency contraceptive pills
2 dose regimen:
1 dose as soon as possible after unprotected sex, next dose after 12 hours
Contraceptive method safe for postpartum lactating mothers
Progestin only pills
Progestin only injectables
Progestin only implants
