Test 4 - Contraceptives (Josh)

Question 1

Which two hormones are released to stimulated ovulation?

What are they released by?

Answer 1

FSH (Follicle Stimulating Hormone)
LH (Leutenizing Hormone

Released by the hypothalamus

Question 2

—- & —- trick the hypothalamus so that FSH & LH are not released

Answer 2

Progestin

Estrogens

Question 3

Blocking FSH & LH does what?

Answer 3

1) Stop Ovulation
2) Thicken cervical mucous
3) Thin uterine lining

Question 4

Classes of Contraceptives:

Answer 4

• Estrogen-Progestin Oral Contraceptives
• Progestin Oral Contraceptives
• Non-oral Contraceptives

Question 5

Combo oral contraceptives are all a combination of what?

Answer 5

Estrogen & Progestin

Question 6

What are other indications for Estrogen-Progestin Oral Contraceptives?

Answer 6

• Premenstrual Dysphoric Disorder (PMDD)

- Acne

Question 7

What is PMDD?

Answer 7

Premenstrual Dysphoric Disorder

• it is PMS w/ depression

Question 8

Why do you have inactive tablets on the fourth week?

Answer 8

Menstruation happens on that week

Question 9

A/E of Estrogen-Progestin Oral Contraceptives:

Answer 9

• Nausea
• Breast Tenderness
• Spotting
• Weight gain (edema)

Question 10

What is the worst case scenario adverse effect of E-P Oral Contraceptives?

Answer 10

Thromboembolism

• primarily caused by estrogen
• not as common today b/c the doses are lower

Question 11

E-P Oral Contraceptives are contraindicated for whom?

Answer 11

• smokers > 35 years old

- history of thromboembolism

Question 12

Drospirenone (4th-generation progestin) causes what adverse effect?

Answer 12

Hyperkalemia

• avoid ACE inhibitor, ARB, Spironolactione, K+ supplements

Question 13

Progestin Oral Contraceptives do not do what?

Answer 13

DON’T stop ovulation

They do thicken cervical mucous and thin uterine lining

50% of people will STILL ovulate

Question 14

Progestin Oral Contraceptives have which other uses?

Answer 14

• dysfunctional uterine bleeding
• amenorrhea
• infertility

Question 15

Which class of Oral Contraceptives do NOT have an off week?

Answer 15

Progestin Oral Contraceptives

Question 16

What are some other diff. b/t E-P Oral Contraceptives and Progestin Oral Contraceptives?

Answer 16

Progestin Oral Contraceptives:

• have more breakthrough bleeding
• no Thromboembolism risk
• have less room for error (can’t miss a dose)

Question 17

Typical Contraceptive Use Results:

Answer 17

E-P Contraceptives: 95% effective
Progestin Only: 95% effective
Condom: 86% effective

Question 18

Which class of oral contraceptives blocks ovulation?

Answer 18

Combo (E-P) Contraceptives

• remember, Progestin Only Contraceptives thicken mucous and thin lining but DON’T block ovulation

Question 19

Why should women using IUDs only be in monogamous relationships?

Answer 19

They should have a LOW risk of STD b/c there is a severe risk of PID (Pelvic Inflammatory Disease) secondary to STD

Question 20

Why should clients take extra precautions if taking a spermicide that has nonoxynol-9?

Answer 20

nonoxynol-9 may INCREASE risk of HIV by promoting lesions that facilitate HIV penetration of cells

Question 21

If a ring is expelled before it should be removed, what can you do?

Answer 21

It can be washed off in war water (not hot) and reinserted

If it’s been longer than 3 hours, use backup contraceptive for ~7 days

Question 22

When should a client begin taking her pill?

Answer 22

• on first day of menstrual cycle (immediate protection)

OR

• the first Sunday after onset of menses (protection may not be immediate and use a backup method for a while)

Question 23

Who should NOT take combo birth control?

Answer 23

• smoker > 35

- history of thromboembolism

Question 24

What should a client on oral contraceptives do if they take a CYP inducer medication?

Answer 24

Use an alternative form of contraception while on the medication