Reproductive deck 3 Flashcards
Topical patch
Ortho Evra patch: releases 20 mcg of estrogen and 150 mcg of norelgestromin
patch is applied
weekly for 3 weeks, then 1 week off
start patch on
first day of menses
Can start other days if back up method is used
ADR for patch
similar to OC ADRs
Topical patch increased failure rate for
Increased failure rate in women weighing more than 198 lb
Vaginal ring
NuvaRing is a soft, flexible plastic ring that releases 15 mcg of estrogen and 120 mcg of etonogestrel daily.
ring is placed in the
vagina, left in place for 3 weeks, and then is left off for 1 week
vaginal ring better
cycle control and decreased breakthrough bleeding are achieved compared with OC.
Vaginal ring systemic exposure to
to estrogen is lower
Progestin only pills are used
when estrogen is contraindicated.
contraceptive effect of progetin only pills is
through thickening of cervical mucus and prevention of sperm penetration.
Progestin only pills users have to be
diligent about taking dose daily at the same time.
If a pill is taken even a few hours late, a back-up method is recommended for the following 48 hours.
Progestin-Only Pills ADR
changing bleeding patterns and breast tenderness are common
Injectable Progestins
Depot medroxyprogesterone acetate (Depo-Provera) is a long-acting, injectable progestin-only contraceptive.
Injectable one dose is effective in
suppressing ovulation for 12 to 13 weeks.
Advantages of injectables
Once every 12 week dosing
Effective
Injectables disadvantages
Once every 12 week dosing
Effective
Intrauterine Progestin
MirenaIUD: releases 20 mcg of levonorgestrel daily
Intrauterine Progestin
Can be left in
place for 5 years
Intrauterine Progestin
Only small levels of systemic
circulating hormone and minimal systemic side effects
Intrauterine Progestin
Changes in
menstrual bleeding, amenorrhea
Progestin Implants
Implanon: an implantable rod that contains 68 mg of etonogestrel
Progestin Implants
Provides contraception for up to 3 years
Emergency Contraception Should be implemented as
soon as possible (less than 72 hours) after unprotected intercourse
Emergency Contraception may be initiated up to
120 hours after
Methods of emergency contraceptoin
Combined OCs
Progestin only (Plan B and Next Choice)
Copper IUD
Contraceptives monitoring
History
Breast and pelvic examinations
Papanicolaou (“Pap”) test and sexually transmitted infection testing
Blood pressure (BP)
Specific to contraception: history and BP
Contraceptives monitoring continued
Physical examination, breast examination, pelvic examination, and PAP testing not required for contraception prescription
BP and ADRs monitored at 3 months, then annually
