OBN: Family Planning Flashcards
[Fertility Awareness-Based]
In basal body temperature, a woman is fertile if the BBT rises ___ deg C for ____ days
0.2 to 0.5 deg C
for 3 days
[Fertility Awareness-Based]
in BBT, when will you resume sex?
On Day 4 after a constant rise of BBT by 0.2 to 0.5 deg C for 3 days
[Fertility Awareness-Based]
In standard days method, no sex on ___
Day 8 to Day 19
[Fertility Awareness-Based]
In the bead method, what is the color of the bead that tells you that your cycle is shorter than 26 days?
dark brown bead
[Fertility Awareness-Based]
In calendar rhythm method, when is sex not allowed?
SC - 18 = start of no sex
LC - 11 = end of no sex
[Artificial Method of FP]
OCP suppresses ___
hypothalamic gonadotropin
[Artificial Method of FP]
What are the actions of your progestin?
- Suppress LH
- Thickens cervical mucus, retarding sperm
- Endometrium becomes unfavorable for implantation
[Artificial Method of FP]
What are the actions of estrogen?
- Suppress FSH
2. Stabilize endometrium
[Artificial Method of FP]
When will you start your first pill in OCPs?
- Start pill of day 1 of menses
2. Start pill regardless of day of cycle
[Artificial Method of FP]
How will you give your DMPA?
Depo-Provera/Depo-Trust 150mg/IM injection on either deltoid or gluteus muscle WITHOUT massage q3 months
[Artificial Method of FP]
When will you give you DMPA?
- Within 5 days of menses
2. If more than 7 days of menses, give injectable but back up for first 7 days
[Artificial Method of FP]
Etonogestrel implant provides contraception for ___
3 years
[Artificial Method of FP]
Iplanont NXT is ideally injested when
within 5 days of menses
[Artificial Method of FP]
What is the MOA of copper IUD?
Intense local EM inflammatory response
[Artificial Method of FP]
What is the MOA of LNG-IUS?
- Inflammatory reaction to EM
- Gladular atrophy and stromal decidualization
- Create scant viscous cervical mucus
When can you insert IUD?
- Any day provided the women is not pregnant
- Immediately post abortion
- Immediate postpartum following either vaginal or cesarean section delivery
Aside from suspicion of infectious endocarditis, IUD insertion can be delayed if there are
- Purulent vaginal discharge
- Adnexal tenderness
- Cervical motion tenderness
What is the most common cause of cervicitis?
- Actinomyces
What are the contraindications of IUD insertion?
- Pregnancy or suspicion of pregnancy
- Acute PID
- Postpartum endometritis or infected abortion
- Known or suspected uterine cervical malignancy
- Genital bleeding of unknown origin
- Previously inserted IUD that has not been removed
How many ejaculations are required after vasectomy to ensure that he has no more sperm?
13 to 20 ejaculation
What are the non-contraceptive benefits of DMPA?
- Reduces risk of developing IDA and PID
2. Reduces incidence of primary dysmenorrhea
Which component of COC has an anti-acne effect?
Progestin component
What are the effects of the estrogen component of the COC to the HDL and LDL levels
Estrogen increases HDL, total cholesterol; decreases LDL
Progestin increases LDL, decreases HDL, total cholesterol and TGs
The risk of VTE is greater in women taking more than ____ of estrogen
> 50ug
How will you take COCs?
Start within the first 5 days of the menstrual period
[Missed pill of COC]
1 missed pill or new pack started 1 day late
take hormonal pill ASAP
[Missed pill of COC]
2 pills missed or new pack started 2 days late
1 hormonal pill ASAP
[Missed pill of COC]
3 mossed pill in a row in the first or second week or new pack started 3 days late
1 hormonal pill asap
use backup for the next 7 days
[Missed pill of COC]
3 pills missed in the 3rd week
- Discard current pack
- Start new pack right away
- Use back up method for the next 7 daus
What drugs reduce the effectiveness of COCs
- Rifampicin
- Phenytoin
- Phenobarbital
- Carbamazepine
- Primidone
- Ethosuximide
What are the absolute contraindications for COCs
- History of vascular disease
- Systemic diseases affecting vascular system
- Smokers older than 35
- Existing breast and endometrial cancer
- Undiagnosed uterine bleeding
- Elevated triglycerides
- Pregnancy
- Functional heart disease
- Active liver disease
What are the relative contraindications for COC
- Heavy smokers <35 years old
- Migraines
- Undiagnosed cause of amenorrhea
- Depression
- Prolactin-secreting macroadenomas
A contraceptive patch contains
- 75 ug EE + 6 mg norelgestromin
A nuvaring contains ___
2.7mg of EE and 11.7 mg of Etonorgestrel
A diaphragm is left for at least ____ after the last coital act
at least 8 hours
used with spermicie
What are the criteria for lactational amenorrhea?
- Presence of amenorrhea
- Exclusive breastfeeding
- Performed up to 6 months after delivery
Emergency contraception is effective if given within ____
72 hours
4 tablets of 0.05 mg Ethinyl Estradiol and DL-Norgestrel 0.5 mg
2 doses 12 hours apart
What is the hallmark of perimenopause?
- Skipped periods
2. Longer intervals (40-60)
What are the initial endocrinologic changes in during menopausal transition?
- Decreased AMH
- Decreased ovarial inhibin B
- FSH
What are the hormonal changes after menopause?
- FSH Increase 10-20x
- LH increase 3x
- Testosterone decreases by 25%
- SHBG decreases
- Estradiol levels markedly decline
- Androgen/Estrogen ratio drastically increase
- DHEA/DHEAS decrease
What is the hallmark if female climacteric?
Hot flush
What is the absolute contraindication to HRT?
Porphyria Cutania Tarda