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General Medicine & Family Medicine > Family Planning/ Contraception# > Flashcards

Family Planning/ Contraception# Flashcards

1
Q

How does progesterone work as a contraceptive?

A
  • suppresses LH to prevent ovulation
  • atrophies endometrium to prevent ovum implantation
  • thickens the cervical mucus to prevent sperm transport
  • inhibits peristalsis of fallopian tubes
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2
Q

How does estrogen work as a contraceptive?

A
  • suppresses FSH to prevent emergence of a dominant follicle
  • provides stability to the endometrium to prevent breakthrough bleeding
  • potentiates the action of progesterone
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3
Q

How many weeks postpartum should a woman wait before resuming intercourse?

A

6 weeks

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4
Q

Which hormone should be avoided during exclusive breastfeeding because it decreases milk production?

A

Estrogen

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5
Q

What are birth control options for a breastfeeding woman?

A
  • barrier methods
  • progesterone-only pill (POP)
  • depomedroxyprogesterone (DMPA) injection
  • intrauterine device (IUD)
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6
Q

In a nonlactating woman, how early postpartum can you start an estrogen-containing contraceptive without increased risk of thrombosis?

A

3 weeks

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7
Q

If a woman using hormonal contraception prefers not to have her menses every month, what can you instruct her about timing of her pack/patch/ring?

A
  • Skip the 1 week of active pills or break from the patch or ring and immediately start the next pack/patch/ring
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8
Q

Do women have to take “breaks” from being on hormonal birth control?

A

No. Women who are healthy and do not smoke can use hormonal birth control continuously from menarche until menopause.

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9
Q

What percentage of sexually active women using no birth controll will experience an unintended pregnancy in 1 year with typical use?

A

85%

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10
Q

What percentage of sexually active women using male comdoms will experience an unintended pregnancy in 1 year with typical use?

A

15%

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11
Q

What percentage of sexually active women using period abstinence will experience an unintended pregnancy in 1 year with typical use?

A

25%

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12
Q

What percentage of sexually active women using OCPs, patch, or contraceptive ring will experience an unintended pregnancy in 1 year with typical use?

A

8%

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13
Q

What percentage of sexually active women using depot-medroxyprogesterone acetate (DMPA) injections will experience an unintended pregnancy in 1 year with typical use?

A

3%

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14
Q

What percentage of sexually active women using IUD will experience an unintended pregnancy in 1 year with typical use?

A

< 1% ( ParaGard 0.8%, Mirena 0.1%)

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15
Q

Is male or female sterilization more effective?

A
  • Male, although the failure rate is low for both (male—0.15%, female—0.5%)
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16
Q

In which group of women is a cervical cap most effective?

A

Nulliparous women

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17
Q

Which lubricants are safe to use with latex condoms?

A

Water-based or silicone gels

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18
Q

Condoms are effective at preventing or reducing the transmission of which sexually transmitted infections?

A
  • HIV
  • Gonorrhea
  • Chlamydia
  • Trichomonas
  • syphilis
  • Herpes
  • HPV
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19
Q

Which birth control methods contain progesterone, but no estrogen?

A
  • Progesterone-only pills (micronor)
  • DMPA injection
  • Mirena IUD
  • single-rod implantable device (implanon)
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20
Q

Which cancers have a proven associated decreased risk with combined oral contraceptive (COC) use?

A
  • Endometrial cancers
  • ovarian cancers
  • colorectal cancers
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21
Q

What are medical benefits do COCs offer?

A
  • reduced risk for certain cancers e.g. endometrial cancer
  • reduced risk of ectopic pregnancy and PID
  • treatment for acne, hirsutism, and androgen excess
  • reduced vasomotor symptoms in perimenopausal women
  • increased bone mineral density
  • decreased risk of hemorrhagic corpus luteum cysts
  • reduction in benign breast disease
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22
Q

What risks are associated with COCs?

A
  • increased risk of cervical adenocarcinoma (rare) and hepatic adenoma
  • increased risk of venous thromboembolism
  • increased risk of myocardial infarction (MI) and stroke in smokers over 35 years old or patients with a history of HTN
  • diabetes, hyperlipidemia, obesity
  • severe migraines
  • reversible HTN
  • Cholelithiasis
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23
Q

What class of COC may offer increased benefit to women with acne, hirsutism, or evidence of polycystic ovarian syndrome?

A

Drospirenone-containing pills (eg, yaz, yasmin)

24
Q

Patients who have had a history of bariatric surgery should avoid what forms of contraception?

A

Oral pills—due to difficulties with malabsorption

25
Q

What are contraindications to the use of COCs?

A
  • smoker over the age of 35
  • uncontrolled HTN
  • migraine headaches with aura
  • SLE with antiphospholipid antibodies
  • hypercoagulable state
  • seizure disorder (on medication that induces hepatic enzymes)
  • history of VTE
  • diabetes with complications
  • history of breast or endometrial cancer
  • prolonged immobilization
  • liver disease
26
Q

What side effects might COC users experience?

A
  • headaches
  • spotting
  • nausea
  • vomiting
  • breast tenderness
  • varicosities
  • VTE
  • stroke
  • MI

Average weight gain is no more than in placebo users

27
Q

How does DMPA affect menstruation?

A
  • Irregular menstruation during first several months and then possible amenorrhea, thereafter
28
Q

What are some possible side effects of DMPA use?

A
  • weight gain
  • acne
  • hirsutism
  • hair loss
  • mood changes
  • decreased bone mineral density
29
Q

How often do DMPA injections need to be given for effective contraception?

A

Every 3 months

30
Q

How often do the Ortho Evra patch and NuvaRing have to be changed?

A
  • Ortho Evra patch: once a week
  • NuvaRing: once a month
31
Q

How does the ParaGard copper T (IUD) work?

A

Copper ions inhibit sperm motility and a sterile inflammatory reaction created in the endometrium kills the sperm.

32
Q

For how long after insertion is the ParaGard copper T (IUD) effective?

A

12 years (approved for 10 years)

33
Q

How does the Mirena IUD work?

A

Contains progesterone which thickens cervical mucus, alters endometrium, changes uterotubal fluid to impair sperm migration, and sometimes causes anovulation

34
Q

For how long after insertion is the Mirena IUD effective?

A

At least 5 years

35
Q

Who are candidates for an IUD?

A

Women in stable mutually monogamous relationships (low STI risk) who want reversible long-term contraception

36
Q

What are side effects of an IUD?

A
  • Increased dysmenorrhea and blood loss (during first few months and more often with ParaGard)
  • amenorrhea (after 1 year with Mirena)
37
Q

A levonorgestrel-containing intrauterine contraceptive system (Mirena) can also be used in the treatment of what conditions?

A
  • chronic pelvic pain
  • menorrhagia
  • endometriosis
38
Q

The single-rod implantable contraceptive device containing etonogestrel (implanon) is effective for how many years?

A

3 years

39
Q

The Implanon a good contraceptive option for women with what conditions?

A
  • hypertension
  • diabetes
  • VTE
  • cardiovascular disease
  • migraine headaches
  • sickle cell disease
  • HIV infection
  • seizure disorder
40
Q

The implanon can be beneficial for women with what conditions?

A

Dysmenorrhea

41
Q

What contraceptive method can cause reversible bone mineral density loss?

A

DMPA

42
Q

What contraceptive method has been shown to decrease sickling or painful crises in sickle cell disease?

A

DMPA

43
Q

Approximately what percentage of pregnancies in the United States are unintended?

A

About 50%

44
Q

What options are available for a woman who has just discovered she has an unintended pregnancy?

A
  • continuation of pregnancy
  • adoption
  • elective abortion (some states require parental notification and/or consent for teens)
45
Q

What is emergency contraception?

A

High-dose hormones given to prevent pregnancy after a contraceptive fails or after unprotected sex

46
Q

What is the name of the only Food and Drug Administration (FDA)-approved emergency contraception pill being sold in the US today?

A

Plan B

47
Q

Plan B is the name of an FDA-approved emergency contraception pill being sold in the US. How does this work?

A
  • stops ovulation
  • may prevent fertilization
  • may prevent implantation
48
Q

Do the 0.75-mg Plan B pills used for emergency contraception need to be taken separately?

A

No. They can be taken one time in a dose of 1.5 mg.

49
Q

What other hormonal options are there for emergency contraception?

A
  • 0.1 mg ethinyl estradiol and 1.0 mg DL-norgestrel
  • two doses 12 hours apart starting within 72 hours of unprotected sexual intercourse
50
Q

Who may purchase Plan B(emergency contraception pil) over-the-counter?

A
  • Men and women over the age of 18 years (women under 17 need a prescription)
51
Q

How long after unprotected intercourse should plan B(emergency contraception pill) be taken?

A

Up to 120 hours, but it is more effective when taken as early as possible

52
Q

How can nausea and vomiting be decreased when taking emergency contraception?

A

Take antiemetic 1 hour before the first dose.

53
Q

What is the advantage of the progestin-only emergency contraceptive?

A

decreased nausea, dizziness and fatigue

54
Q

What is the only contraindication to the oral combination method of emergency contraception?

A

Pregnancy

55
Q

What is an alternative to hormonal methods for emergency contraception?

A
  • Insertion of the ParaGard IU up to 5 days after unprotected intercourse
56
Q

How often after taking emergency contraception can a patient resume hormonal contraception?

A

Immediately after taking emergency contraception

General Medicine & Family Medicine (150 decks)

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