Mehl. Contraception 03-24 (1) Flashcards
M. Barrier (condoms). Sheaths made of latex, polyurethane, or lambskin worn over the penis (male condom) or inside the vagina (female condom).
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M. #1 way to ̄ pregnancy and STD risk.??
Barrier (condoms). Self-explanatory, but apart from abstinence, male condoms are #1 way to decr. pregnancy and STD risk.
M. Barrier (condoms). Recommended for use in women using what?
Recommended for use in women on isotretinoin, even if they are already on other contraceptive method.
M. Barrier (condoms).
OCPs incr. risk of cervical cancer slightly, not as a direct effect, but because of decr. barrier contraception use, where HPV exposure is incr.
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M. Combined oral contraceptive pills. Contains what?
Contain both estrogen and progesterone.
M. Combined oral contraceptive pills. efect of estrogen/progesterone?
Estrogen helps to decr. breakthrough bleeding risk (i.e., metrorrhagia).
Estrogen decr. probability of ovulation;
Progesterone decr. penetration of sperm by incr. thickening of cervical mucous. In some women, and depending on dose, progesterone can also decr. ovulation.
!!M. Combined oral contraceptive pills. Contraindicated in???
Contraindicated in smokers >35 (HY on USMLE), migraine with aura, Hx of thrombotic disorders, or current breast/gynecologic cancer due to the estrogen-containing component.
M. Combined oral contraceptive pills.
2CK forms can be nebulous and, rather than writing OCPs as the answer, they can write “synchronization of endometrium,” or “triphasic oral contraceptive pills,” which mean the same thing.
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M. Combined oral contraceptive pills. decr risk of what?? 2
Decr. (2 arrows) risk of ovarian cancer the most due to synchronization of cycles (asked on NBME). Also decr. risk of endometrial (probably also due to synchronization).
M. Combined oral contraceptive pills. incr. risk of what??
Incr. risk of cervical cancer due to decr. barrier contraception use (as mentioned above); some studies have suggested slight incr. in breast cancer risk, albeit without significance.
M. Progestin-only pills. Aka “mini-pill”; only contain progesterone analogue. effect?
Thicken cervical mucous.
M. Progestin-only pills. when must take it?
Must be taken precisely at same time every day, so require female is well- adherent / compliant.
M. Transdermal patch. what components?
Releases both estrogen and progesterone and acts same as combined OCP.
M. Transdermal patch. how long to wear?
Worn for one week at a time.
M. Vaginal contraceptive ring. release what?
Aka NuvaRing; releases both estrogen + progesterone.
M. Vaginal contraceptive ring. How long to wear?
Worn monthly.
M. Copper IUD. Mechanism?
Copper intrauterine device; releases (you wouldn’t have guessed it) copper ions into the uterine cavity, creating an environment that is toxic to sperm + inhibits their motility, thereby preventing fertilization.
M. Copper IUD. emergency contraception - within what days?
Known for being one of the most effective forms of emergency contraception when inserted within five days post-coitally and can provide up to 10 years of contraceptive protection.
M. Copper IUD. risk for what?
IUDs have risk of migration through uterine wall.
M. Levonorgestrel IUD. release what?
M. Levonorgestrel IUD. release what?
Release progesterone analogue
M. Levonorgestrel IUD. how long lasts?
usually last 3-7 years and are ideal in women who desire longer-term contraception or have poor medication compliance.
M. Levonorgestrel IUD. Mechanism?
Thicken cervical mucous.
M. Levonorgestrel IUD. Risk for what?
IUDs have risk of migration through uterine wall.
M. “Depo shot”. what is it?
Depot medroxyprogesterone acetate injection form of contraception.
M. “Depo shot”. administer every??
3 months
M. “Depo shot”. does what?
Thicken cervical mucous.
M. “Depo shot”. effect on bone?
Known to decr. bone mineral density; rebounds with discontinuation.
M. “Depo shot”. whats regarding bleeding?
Known to cause erratic bleeding in 1/3, no changes in cycle bleeding in 1/3, and complete amenorrhea is 1/3.
M. “Depo shot”. The answer on 2CK form for woman who normally forgets to take contraception + needs something more reliable + has had STI within the past 3 months. This is because IUD is contraindicated if STI within past 3 months.
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M. IUD is contraindicated when??
IUD is contraindicated if STI within past 3 months.
M. Implantable rod. what component?
Aka Implanon/Nexplanon. Releases progesterone analogue.
M. Implantable rod. mechanism?
Thickens cervical mucous
M. Implantable rod. how long?
Lasts 3 years.
M. Diaphragm. Cervical cap that covers the uterus; often inserted with spermicidal jelly. Prevents sperm from entering uterine cavity.
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