Lecture 3 Exam 5 Flashcards
Estrogen (ethnyl estradiol) effect of FSH
suppresses FSH production, prevents dominant follicle and ovulation
Effect of estrogen (ethnyl estradiol) on sex hormone binding globulin
Increases sex hormone binding globulin and increases binding of free androgens
How does ethnyl estradiol improve acne
It increase binding of free androgens
how does progestin inhibit ovulation
prevents LH surge
effect of progestin on cervical mucus
thickens mucus (inhibits sperm penetration)
Effect of progestin on motility of fallopian tube
(impair sperm/ova transport)
effect of progestin on endometrium
impairs implantation
3 components of progestin
progestational
androgenic
antiestrogenic
progestational effects of progestin
prevents ovulation
lessens bleeding
desire high activity
androgenic effects of progestin
acne
hirsutism
desire low activity
antiestrogenic effects of progestin
androgenic side effects
desire lower activity.0
highest androgenic activity drug
levonorgestrel
highest progestational activity drug
levonorgestrel
desogestrel/etonogestrel
What are some signs of not enough progestin
breakthrough bleeding late in the cycle
no withdrawal bleeding
heavy menses
signs of too much progestin
acne
hirsutism
decreased sex
depression
increased appetite
increased sex drive
weight gain
less energy
Common side effects of progestin
Acne worsening
hair growth in weird places
heavier periods
drug name
Efficacy
hormone type
ROA
side effects
return of fertility
Of the Implant (nexplanon)
Nexplanon
>99% efficacy
only progestin
left in non-dominant arm for 3 years if inserted >5 days after start of period, use backup method for 7 days
side effects include- Acne, h/a, mood changes, bleeding
fertility returns within 6 weeks
drug name
Efficacy
hormone type
ROA
side effects
return of fertility
of levonorgestrel IUD
99% efficacy
progestin only
left for 3-7 years
use backup method for 7 days after inseertion
side effects- uterine perforation, expulsion, infection
Efficacy
hormone type
ROA
side effects
return of fertility
of depot medroxyprogesterone
94%
progestin only
15 weeks
weight gain, acne
delayed return of fertility
serious side effects of COC
blood clots(estrogen related)
What are some progestin only pills
Norethindrone (minipill)
Drosperinone
Timing for norethindrone (mini pill)
within 3 hours everyday
how long does it take for the mini pill to be effective
48 hours
What to do for the minipill if more than 3 hours late
take ASAP and use backup for 2 days
What to do if late for dose for COC
if 1 pill- take asap
of 2 pills- take asap and next pill at usual time, use back up contraceptive for 7 days
is minipill safe to breast feed?
yes
return to fertility for minipill
Immediate
number of placebo pills in norethindrone (minipill) vs drosperinone (slynD)
0 for mini
4 for drosperinone
how long should backup be used for drosperinone and COC if started more than 5 days after period
7 days
Name drugs for the monthly and annual vaginal ring. Difference is administration? hormone content?
annual- annovera
monthly- nuvaring, eluring
annual- left in place for 3 weeks and removed for 1, wash, reinsert
monthly- 3 weeks and removed 1 week.
both are progestin+estrogen
what to do for the rings if removed for more than 3 hours
reinsert and use backup for 7 days
What to do if ring was in for 3 weeks but less that 4 weeks
remove ring, put new ring in 7 days later
What to do if ring was in for more than 4 weeks
Put in new ring immediately and use backup for 7 days
Name 2 patch drugs
hormone type
strength
How to apply
Xulane, Zafemy
progestin & Estrogen
35 mcg estrogen/day (HIGH)
Put on a new patch every week for 3 weeks, 1 week no patch
What to do if patch was on for more than 9 dayys and off for 24 hrs
apply new patch and use backup for 7 days
serious side effects of patch? why?
blood clots, due to more estrogen
how many mcg of estrogen does the patch TWIRLA have
30 mcg (less than other patches)
Serious side effects of estrogen
ACHES
Abdominal pain
chest pain
headache
eye problems
swelling
