M4.1: Contraception

Question 1

how do BCPs work

what to they contain

Answer 1

contain progesterone and estrogen

stops ovulation from occurring
thickens cervical mucus so sperm can’t pass
changes endo lining

Question 2

how does the mini pill work

what does it contain

Answer 2

progesterone only

ovulation may occur
thickens cervical mucus

Question 3

how does the BC patch work

what do they contain

Answer 3

contain progestin and estrogen, hormones are absorbed through the skin

stops ovulation from occurring
thickens cervical mucus
changes endo lining

Question 4

how do BC injections work

what do they contain

Answer 4

only progestin, 1 shot every 3 months

stops ovulation
thickens cervical mucus

Question 5

advantage of BC injections over BCP

Answer 5

can be used by women who smoke, are over 35 and are breastfeeding

Question 6

BC injections can improve symptoms of which condition

Answer 6

endometriosis

Question 7

describe a nuva ring

how does it work

Answer 7

vaginal contraceptive ring thats placed in the vagina for 3 wks and replaced every month
-contains estrogen and progesterone

hormones are absorbed into the body
stops ovulation
thickens cervical mucus so sperm can’t pass
changes endo lining

Question 8

can you see a nuva ring on US

Answer 8

yes

Question 9

what is an emergency contraception pill

how do they work?

Answer 9

pill taken up to 5 days after unprotected sex contains high dosage of estrogen and progesterone

-changes endo lining (to stop implantation) and vaginal mucus

Question 10

describe IUCDs

2 types

Answer 10

copper or plastic device that prevents implantation

Mirena (called an intrauterine contraceptive sys because it secretes hormones)
Copper IUD

Question 11

how does the mirena IUCD work

Answer 11

plastic, T shaped, contains progesterone

thickens cervical mucus
changes endo lining
may stop ovulation

Question 12

mirenas and copper Ts can be used for up to how many years

Answer 12

5

Question 13

how does the copper T IUCD work

Answer 13

plastic wrapped in copper

changes endo lining so implantation doesnt occur
thickens vaginal mucus

Question 14

where should IUCDs be placed in the uterus

typical US appearance

Answer 14

fundus

hyperechoic
comet tail
posterior shadowing

Question 15

what type of IUCD can be hard to see with a full bladder

what is the best way to see it TA

Answer 15

mirena, post void is easier because the uterus regains an anteverted position

Question 16

complications w/ IUCDs

Answer 16

expulsion into abdo cavity
improper location
PID - infertility
ectopic preg
preg w/ IUCD leading to complications

Question 17

what is the chinese ring?

Answer 17

contraceptive used in china to enforce the 1 child policy, inserted after delivery of the placenta so the mom could not have more children

not meant to be removed.

Question 18

why are some preg w/ IUCDs aborted

risks of preg w/ IUCD

Answer 18

due to rupture of membranes or infection

preterm delivery w/ attempted removal of IUCD

Question 19

when may you see and IUCD w/ preg

Answer 19

<12 wks

Question 20

list some barrier contraception devices

Answer 20

condom female/male version
sponge w/ spermicide
cervical caps
diaphragms

Question 21

surgical methods of contraception for females

how is this done?

Answer 21

tubal ligation:
permanent
done through laparoscopy using ligation, cauterization or staples, sometimes coils in the tubes

Question 22

surgical methods of sterilization for males

how is this done?

Answer 22

vasectomy:
permanent
ligation of vas deferens
ejaculation w/o sperm

Question 23

how are medical abortions performed

what drug is used

Answer 23

w/ methotrexate, a growth inhibitor that blocks folic acid from embryonic cells so they cant divide

drug is injected into mom, preg ends a couple days after, but can take up to 4 wks to terminate

Question 24

2 types of induced abortions

Answer 24

therapeutic or surgical:

• manual vacuum aspiration
• D and C
• D and E (evacuation)

Question 25

when is a D&E performed

Answer 25

second trimester to terminate baby w/ lethal chromosomal abnormalities