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Women's Health > Oral Contraceptives > Flashcards

Oral Contraceptives Flashcards

1
Q

What question should you always ask women ages 15-55?

A

What are your plans for pregnancy in the next yr?

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2
Q

5 birth controls that work best

A

IUD - mirena

IUD - paraguard

IUD - skyla

implant - Nexplanon

Sterilization (men and women)

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3
Q

4 birth controls that work “okay”

A

pill

patch

ring

depo

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4
Q

4 birth controls that do not work well

A

withdrawal

diaphragm

fertility awareness (natural family planning)

condoms

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5
Q

oral emergency contraception

A

two doses of contraceptive pills taken within 72 hours of unprotected intercourse

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6
Q

old school emergency contraception versus current emergency contraception (pill)

A

old - estrogen/progesterone based on estrogen dose of 200 mcg

now - plan B

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7
Q

other form of emergency contraception (besides pills)

A

IUD insertion within 5 days of unprotected sex - paraguard

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8
Q

Selective progesterone receptor modulator used for emergency contraception

A

Ella (ulipristal acetate)

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9
Q

Differences between Ella and plan B

A

elle - selective progesterone receptor modulator AND effective for up to FIVE days after unprotected sex

plan B - only effective up to THREE days after unprotected sex

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10
Q

IUD insertion can be emergency contraception if placed ____ days after unprotected sex

A

UP TO FIVE DAYS

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11
Q

Short acting or frequent use contraception (4)

A

pill

nuva ring

patch

depo

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12
Q

methods that require increased frequency of use have _____ proportionate efficacy

A

inversely - anytime you add in USER ERROR, efficacy decreases

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13
Q

who are the best candidates for short acting or frequent use contraceptives

A

women who have short interval prior to wanting a pregnancy (exception to this is depo shot)

women not looking for long term pregnancy prevention

women using methods for non-contraceptive benefits

uninsured women with financial concerns

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14
Q

what three things do oral contraceptives do

A

suppress ovulation

thicken cervical mucos

thins the endometrial lining

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15
Q

what two things do progestin ONLY oral contraceptives do

A

thicken cervical mucus AND thins endometrial lining

DOES NOT SUPPRESS OVULATION

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16
Q

when do you use mini pill “progestin only”

A

when estrogen is contraindicated - thrombosis, CAD, HTN, diabetes

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17
Q

____ helps with cycle regulation

estrogen or progesterone

A

estrogen

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18
Q

three types of combination pills

A

monophasic

triphasic

continuous

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19
Q

single dose of estrogen and progesterone for 21-24 days with placebo pills for 4-7 days

A

monophasic pills

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20
Q

differing dose of estrogen and progesterone throughout course of the pack + placebo pills

tend to have lower dose of estrogen

A

triphasic pills

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21
Q

which has lower dose of estrogen - monophasic or triphasic

A

triphasic

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22
Q

continuous pills - monophasic or triphasic

A

monophasic

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23
Q

why would you use continuous pills?

A

anemia

people with painful periods

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24
Q

what medical conditions should combination hormonal contraceptives (including ring and patch) be used WITH CAUTION

A

DM

HTN

Smoking (+ under age 35)

Common migraine headaches

liver disease

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25
Q

What conditions are ABSOLUTE contraindications with combination estrogen/progestin contraceptives?

A

uncontrolled HTN

CAD

uncontrolled DM

Complex migraines (with aura)

hx of thromboembolism

hormone sensitive cancers (breast)

smoking + age of 35+

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26
Q

which is more likely to fail if not taken properly - combo or progesterone only

A

progesterone only - due to inadequate ovulation suppression due to non-therapeutic levels

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27
Q

which has more breakthrough bleeding - combined oral contraceptives or progesterone only?

A

progesterone only

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28
Q

4 progesterone only options

A

progestin only pills (mini pill)

depo

implant (nexplanon)

IUD (mirena, skyla, liletta, kyleena)

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29
Q

what is the ONLY progesterone only option that does not allow for immediate pregnancy after removed/stopped talking?

A

depo!

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30
Q

contraindications to estrogen

A

immediate postpartum period (increased risk of VTE)

early lactation can be suppressed

hx of thrombophelias

hx of CVD

older women who are smokers (over 35)

classic migraines

liver dysfunction

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31
Q

5 things to consider when choosing a pill

A

lifestyle (breastfeeding)

health hx

existence of dysmenorrhea, acne, menorrhadia

desire for suppression of menses

cost (if uninsured)

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32
Q

non-contraceptive benefits of oral contraceptive pills (6)

A

cycle regulation

tx of heavy menses

tx of acne

tx of dysmenorrhea

prevention of functional ovarian cysts

prevention of ovarian, COLON, and endometrial cancers

33
Q

when can you start a new birth control pill

A

IF YOU KNOW YOU ARE NOT PREGNANT

34
Q

6 ways you can tell a woman is not pregnant

A

has not had intercourse since last period

has been correctly and consistently using reliable method of contraception

is within first seven days after menses

is within four weeks postpartum for nonlactating women

is within first seven days postabortion/miscarriage

is fully or nearly fully breastfeeding, amenorrhoeic and less than 6 months postpartum

35
Q

TIME you can start ANY contraceptive method

A

Does not matter as long as you are not pregnant

36
Q

additional contraception needed with copper-containing IUD

A

NONE

37
Q

additional contraception needed with progesterone releasing IUD

A

if more than 7 days since menses started use back-up or abstain for 7 days

38
Q

additional contraception needed with implant

A

if more than 3 days since menses started, use back up for 7 days

39
Q

additional contraception needed with injectable

A

if more than 7 days after menses started, back up needed for 7 days

40
Q

additional contraception needed with combined hormonal contraceptive

A

if more than 5 days after menses started, use back up for 7 days

41
Q

additional contraception needed with progestin-only pill

A

if more than 5 days since menses started, use back up for 2 days

42
Q

tests/exams needed before combined hormonal contraception

A

blood pressure

43
Q

tests needed before IUDs (copper and progestin)

A

bimanual pelvic and cervical

44
Q

drug name in depo

A

medroxyprogesterone acetate

45
Q

should you be cautious with depo and DM, HTN, and heart disease

A

YES - not absolute contraindication but be careful

46
Q

side effects of depo (3)

A

irregular cycles

amenorrhea (or irregular bleeding)

bone

47
Q

BLACK BOX WARNING on Depo

A

LOSS OF BONE MINERAL DENSITY

can be reversed

do weight-bearing exercise + calcium and vit D

48
Q

if depo is started during menses, what kind of back up is needed

A

none

49
Q

if depo is started over 7 days after menses, use back up for how long

A

7 days

50
Q

what kind of back up method should be used with depo

A

barrier

51
Q

transdermal failure rates are due to what?

A

user dependent

52
Q

transdermal - combined or progesterone only

A

combined

53
Q

transdermal (2 names)

A

nuva ring

ortho evra patch

54
Q

contraindications fot transdermal bc

A

same as combined oral contraceptives

55
Q

what back up methods are used with combined contraception and when

A

barrier

if started over 5 days after menses, use back up method for 7 days

56
Q

4 types of barrier methods

A

diaphragm

condoms

cervical caps

cervical sponge

57
Q

benefit of barrier methods

A

lower risk of STD transmission

58
Q

contraindications of barrier methods

A

allergic to materials

59
Q

should always talk to women about what kind of birth control

A

long acting reversible contraceptives

60
Q

types of subdermal implants

what kind - combo or progesterone only

A

implanon or nexplanon

both only progesterone

nexplanon can see on radiographs if they get lost

61
Q

contraindications for subdermal implants

A

allergies to material

62
Q

contraindications for intrauterine devices

A

active infection

sensitivity to copper

uterine anomaly (perforation risk)

untreated cervical disease

63
Q

4 types of IUDs

A

mirena

skyla

liletta

paraguard - copper

64
Q

what kind of IUD would you give someone who has follicular cysts

A

PARAGUARD

65
Q

what kind of IUD would you NOT give someone with follicular cysts

A

progestin containing

66
Q

what kind of IUD would you NOT give to someone who has painful periods

A

copper

67
Q

what kind of IUD would you give to someone with painful periods

A

progestin containing

68
Q

what progesterone is in progestin-only IUD

A

levonorgesterol (spelling error)

69
Q

only FDA approved IUD to tx menorrhagia

A

mirena (but they all do)

70
Q

how much of their reproductive life is spent trying to avoid unintended pregnancy?

A

3 decades

71
Q

most common method of sterilization

A

laparoscopic

72
Q

contraindications for sterilization

A

surgical restrictions

not done having babies

73
Q

non-contraceptive benefits of sterilizations

A

decreased ovarian cancer risk (not definite yet)

74
Q

3 ways of female sterilization

A

removal

clip

band

75
Q

most common female sterilization

A

laparoscopic

76
Q

male sterilization

A

vasectomy

77
Q

best birth control for married 40 y/o woman with well controlled HTN and on ACE-I

A

IUD - no effect on HTN

78
Q

best birth contro l for 14 y/o non-sexually active girl wit irregular menses

A

oral contraception - not having sex so don’t worry about user error

79
Q

best birth control for 30 y/o breastfeeding twins at 3 mos postpartum

A

IUD - no effect on milk and no follow-up (like you would need with depo)

Women's Health (2 decks)

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