HORMONAL CONTRACEPTION Flashcards
1
Q
combined pill of ESTROGEN + PROGESTIN → estrogen component:
A
- ethinyl estradiol
2. mestranol
2
Q
combined pill of ESTROGEN + PROGESTIN → progestin component:
A
- levonorgestrel
- norgestrel
- norethindrone
- desogestrel
- drospirenone
- gestodene
3
Q
combined pill of ESTROGEN + PROGESTIN → advantages:
A
- failure rate < 0.3% with perfect use (8% typical use)
- fertility returns rapidly
- bleeding is decreased & less painful
- better cycle predictability
- decreased risk of benign breast disease, PID, ovarian & endometrial cancers
4
Q
combined pill of ESTROGEN + PROGESTIN → DISadvantages:
A
- increased risk of stroke, acute MI, venous thromboembolic disease
- increased risk of hepatic adenoma, cervical cancer, breast cancer
- do NOT protect against STD’s
- interactions with antibiotics or anticonvulsants → efficacy may be decreased
5
Q
progesterone-ONLY pill: (drug names)
A
- norgestrel
- levonorgestrel
- norethisterone
6
Q
progesterone-IMPLANT: (drug name)
A
- etonogestrel
7
Q
progesterone-INJECTIONS: (drug name)
A
- medroxyprogesterone acetate
8
Q
pill of PROGESTIN only → advantages:
A
- REDUCED risk of serious complications to which estrogen contributes
- decreased dysmenorrhea, menstrual blood loss
- no migraine
- fertility returns immediately after cessation
9
Q
pill of PROGESTIN only → DISadvantages:
A
- require compliance
2. more common breakthrough bleeding
10
Q
mechanism of action:
A
- both estrogen & progestins → neg. feedback effects on LH & FSH secretion from the ant. pituitary
- progestins → local effects on cervical mucus composition
11
Q
CONTRAindications:
A
- smoker of > 35y. → encourage smoking cessation in pat. < 35y.
- history of breast cancer
- hepatic neoplasm
- cerebrovascular disease
- congenital hyperlipidemia
- IHD
- severe hypertension
- migraine
- diabetes >20 years OR with SEVERE vascular disease, nephropathy, retinopathy, neuropathy
- major surgery with prolonged immobilization
- AVH / Impaired liver function
- abnormal vaginal bleeding of unknown etiology
- thrombophlebitis, thromboembolic disease or known thrombogenic mutations
12
Q
side effects:
A
- hypertension
- breast cancer???! (risk of endometrial and ovarian is REDUCED)
- thromboembolism → pat. with higher risk of thromboembolism = sedentary, overweight, smokers, hypertensive, diabetic, hypercholesterolemic
- gall bladder disease
- weight gain, nausea, mood changes, skin pigmentation
