LEC8 Flashcards
Non pharmacologic Therapy for contraception
Barrier Techniques contraception
4CD
1-Diaphragms (<24hrs)
2-Cervical Cap(<48)
3-Condom(protect against std)
4-Condoms with spermicides (increase vulnerability to std)
5-Female condom (worse than male condom)
Pharmacologic Therapy for contraception
mention them
1-Spermicides and Spermicide Implanted Barrier Techniques
2-The vaginal contraceptive sponge (Today) (<24hrs) to avoid TSS
3-Hormonal Contraception (estrogen with progestin or progestin alone)
the sponge must be left in place for at least 6 hours before removal
Non contraceptive benefits of OCs include
Decreased menstrual cramps and ovulatory pain;
Decreased menstrual blood loss;
Improved menstrual regularity;
Decreased iron deficiency anemia;
Reduced risk of ovarian and endometrial cancer;
Reduced risk of:
Ovarian cysts
pregnancy oEctopic
Endometriosis
Uterine fibroids, and benign breast disease,
Pelvic inflammatory disease.
The main safety concern about CHCs is?
is their lack of protection against STDs.
Encourage use of condoms to prevent STDs
Considerations with use of Combined Hormonal Contraceptives (CHC)
when to give Women over 35 Years of Age CHC?
May be considered in healthy nonsmoking women older than 35 years.
CHCs are not recommended for women older than 35 years with
Migraine
Uncontrolled hypertension,
Smoking or diabetes with vascular disease
(1)Progestin-only methods should be considered in which group of women?
1-Women older than 35 years who smoke.
2-women who develop migrane on CHC.
3-women with Systemic Lupus Erythematosus.
4-women over 35 yo and over 90kg.
OCs have been associated with an
increased risk of 1-……… 2-………..
myocardial infarction (MI) and stroke
Use of low-dose CHCs is acceptable in HTN women under the following criteria
1- women younger than 35 years with
2-well-controlled
3- monitored hypertension
uncontrolled HTN is systolic >100 and diastolic >160
Hypertensive women with 1) end-organ disease or 2)who smoke should avoid ………..?
should not use CHCs
contraceptives
Women younger than 35 years with diabetes but no vascular disease
who do not smoke can take …………?
can safely use CHCs
progestin and Estrogens effect on lipids?
1- progestins: Decrease (HDL)
increase (LDL).
2- estrogen: Decrease (LDL)
increase (HDL).
what contraceptives that has no effect on lipids
low Dose CHC and levonorgestrel
Women with controlled dyslipidemias can safely use ……….?
can use low-dose CHCs, with monitoring of fasting lipid profiles.
Women with uncontrolled dyslipidemias should use …………?
METFORMIN
the following OCs has increased risk of thrombosis
DDN
oOCs containing desogestrel, drospirenone, and norgestimate
contraceptives
Migranes without aura can safely take ……….?
CHCs
Women who develop migrane on CHC should……….?
should immediately discontinue their use
The choice to use CHCs should not be influenced by……… Rather by ……….?
1-The presence of benign breast disease or A family history of breast cancer with either BRCA1 or BRCA2 mutation,
2-current or past history of breast cancer should not use CHCs.
Monophasic OCs means?
Contain a constant amount of estrogen and progestin for 21 days, followed by 7 days of placebo.
Biphasic and triphasic pills means?
Contain variable amounts of estrogen and progestin for 21 days and are followed by a 7-day placebo phase.
Increases the number of hormone-containing pills from 21 to 84 days, Followed by a 7-day placebo phase results in?
Resulting in four menstrual cycles per year
The progestin-only “minipills tend to be 1-…………
2-………….?
1-less effective than combination OCs.
2-are associated with irregular and unpredictable menstrual bleeding.(مهم)
3-associated with more ectopic pregnancies.
contraceptives
In the first-day start method means?
women take the first pill on the first day of the next
menstrual cycle.
contraceptives
In the Sunday start method
the first pill is taken on the first Sunday after starting
the menstrual cycle.
