Sept10 A3-Non-hormonal contraception Flashcards
top tier of most effective contraception
- IUD (copper OR LNG-IUS)
- progesterone implants
- female and male sterilization
second tier of very effective contraceptive
- COC
- vaginal ring
- patch
- DMPA (P injection)
- P only pill
third tier of effective contraceptives
- condom (M and F)
- diaphragm
- fertility awareness
fourth tier of least effective contraceptives
- spermicides
- sponge
non categorized contraception
withdrawal
IUD risk of infertility
nonexistent
IUD risk in nulliparous women or adolescents (smaller uterus)
none
IUD risk of PID
none
Mirena vs other IUDs
Mirena has most P so more bleeding CONTROL
contraindications to IUDs
- pregnancy
- infection
- liver problem (can use copper IUD)
good patients for using LNG-IUS
dysmenorrhea
bad pts for LNG-IUS
pts with
- headaches
- breast tenderness
- acne
female sterilization def
TUBAL LIGATION 1. clip uterine tube 2. necrosis in tube 3. clip falls off anywhere in abdomen 4. tube region necrosed forever OR salpingectomy -removal of fall tube
male sterilization def
- vasectomy
- have to wait three months and come back for sperm analysis
female condoms advantages
- STI protection
- no need for prescription or fitting
- can be inserted 6-8 hrs before sex
- no allergic reaction
main advantage of male condom
protection against STIs
diaphragm def + how it works
- cup below cervix
- has spermicide
contraindication to diaphragm
women with pelvic organ prolapse (POP)
diaphragm how to use
- can put it well before sex but if >2 hrs, add spermicide again
- remove it between 6th and max 24th hour after sex
cervical cap def
- silicone cap surrounding cervix to block sperm passage
- contains SPERMICIDE
cervical cap how to use
- put any time before intercourse
- remove after 8th hour after intercourse
fertility based method with app and thermometer works how
- when ovulate = biphasic peak of temp
- based on temp, cycle prediction app tells you if you can have sex
spermicides ex
- creams, jellies, suppositories, aerosol foams, film
- no prescription
good candidates for spermicide
- other methods unacceptable
- need temporary protection, like during first week after starting CHC (combined hormonal contraception) or while nursing
spermicide active ingredient
nonoxynol-9 or octoxynol-9
spermicide MOA
- physical barrier to sperm penetration
- chemical spermicidal action
spermicide how to use
- put high in vagina close to cervix shortly before intercourse
- max effectiveness = 1 hour
spermicide problem
no protection against STIs
contraceptive sponge MOA
-same ingredient as spermicide
sponge how to use
- put up to 24 hrs before intercourse
- put against cervix
- efficacious until 6 hrs after intercourse
indications of emergency contraception
- failure to use any method of contraception
- condom slippage, breakage, leakage
- missed hormonal contraception
- error in withdrawal
- incorrect placement of diaphragm or cervical cap
- sexual assault
- mistimed fertility awareness
MOA of emergency contr
- delayed or inhibited ovulation
- endometrial changes preventing implantation
- interfere with sperm transport or penetration
- impaired CL fct
does emergency contr help if already implanted zygote
no, is not a medical abortion
CEP (one kind of emergency contr) how to use
- certain nbr of pills to take
- take within 72 hrs of unprotected intercourse
- 75% efficacy if using COC
progesterone method (plan B two tablets) how to use (is another emergency contr)
- take 1 dose within 72 hours of sex
- take 2nd dose 12 hrs later
- 97.8% efficacy
ulipristal acetate (emerg contr) MOA
- prevent P mediated endometrial prep for implantation
- P R modulator
- delays ovulation
UA how to use
one tablet up to 120 hrs after sex
copper IUD (emerg contr) MOA
inflammation that
- is toxic for spermatozoa and oocytes
- increases fall tube SM activity
- stimulate myometrial contractility
- alter cytokines and intergrins in endo lining (inhibits implant)
indications for non hormonal contraception
- medical contraindication to hormonal
- severe SEs from hormonal
