OB: PRECONCEPTION CONTRACEPTION

Question 1

This method causes changes in cervical mucus (limiting spermatozoal access to the reproductive tract), acts as a physical barrier to implantation, and, most importantly, prevents the proliferation of the stratum basale of the endometrium.

Answer 1

LNg-IUD

Note: This device cannot be used for emergency contraception (because it lacks FDA approval), if there is an active uterine infection at the time of placement, or following a molar pregnancy.

Question 2

This method last the longest (10 years) and offer no control or regulation of ovarian or uterine cycles. They are approved for contraception within 5 days of unprotected intercourse. Many patients consider the absence of hormones in this device beneficial, but women must be counseled on the increased blood loss with each menstruation.

Answer 2

Copper IUD

Question 3

Women of child bearing age is what age rang?

Answer 3

14 to 44

Question 4

Why is POP kind of not great

Answer 4

Progestin-only pill (POP, minipill) has the worst efficacy of all progestin-delivering contraception. It doesn’t have the same side effects and risks as estrogen-containing pills, so it was recommended for women with contraindications to estrogen but not progestin. The contraceptive effects would not last 24 hours and rigid adherence to timing (the same hour every day) made actual failure rates quite high.

Question 5

What does the depot shot schedule look like?

Answer 5

Medroxyprogesterone is administered as anintramuscular injection (depot). The injection lasts 12 weeks before another is required, but there is a 2-week grace period (roughly the 14 days leading up to ovulation). Because the injections are needed four times per year, they require frequent interaction with a health care provider.

Question 6

When do we not give estrogen contaning contraception?

Answer 6

All three components must be present to increase DVT risk: estrogen-containing hormone therapy AND tobacco smoker AND age 35 or olde

Question 7

Which IUD can be used as emergency contraception?

Answer 7

COPPER ONLY.

The Cu-IUD has been FDA approved for emergency contraception when placed up to 5 days after intercourse. It can be left in for 10 years. This requires access to a gynecologist’s office, whereas levonorgestrel pills can be purchased over the counter in the United States.