Womens Health Part 2 Flashcards
What condoms protect against STD
- Latex or synthetic
*do not use sheepskin
How does lactational amenorrhea work (contraceptive)
- Must breastfeed on demand at least 5 to 6 days a week with 10 min or longer per session or >65 min per day without supplementation from other sources
- <2% change within first 6 months after birth
What is the paragard / copper IUD (non-hormonal contraception)
- Copper is spermicidal
*prevention of implantation - Effective immediately for up to 10 years
- Emergency contraceptions
*insert within 5 days of unprotected intercourse
What are the ADEs of ParaGard / copper IUD
Heavy bleeding
Spotting
Cramping
How does estrogen + progestin products work for contraception
- Inhibit the LH and FSH hormone surges that normally lead to ovulation and change cervical mucus, preventing sperm from reaching the egg
How do progestin only contraceptive products work
- Makes endometrial less suitable for implantation
*long term cyclic or daily exposure of progestin leads to endometrial atrophy
*thickens cervical mucus
What are the combined hormonal contraceptives
- One synthetic estrogen (ethinyl estradiol + one progestin)
What are monophasic combination oral contraceptives
- Same dose of estrogen and progestin throughout the pack
What are biphasic, triphasic, and quadriphasic combination oral contraceptives
- Mimic estrogen and progesterone levels during menstrual cycle
*differ based upon the number of times the hormone amount changes
What are extended cycle combination oral contraceptives
- > 21 days of active hormone (monophasic only)
*period every 3 months
What is a “menstrual start” for combined oral contraceptives
- Start within the first 5 days of menstruation
*effective immediately
What is a “random start” when starting combined al contraceptives
- Randomly start on any day
*takes 7 days to work
What are the progestin only oral contraceptives
Mini pills
1. Nora
2. Camila
3. Errin
Norethindrone 35mcg
*taken daily with no placebo or pill free interval
*can start on any day
How long does it take for progestin only oral contraceptives to work and is it okay to miss a dose
- Works within 48 hours
- If >3 hours late, use alternative contraception for next 48 hours
What are the non oral contraceptives (injectable progestins)
- Depo-provera 150 mg IM every 13 wk
- Depo-subQ Provera 104 mg sc every 12-14 wk
What are the fertility problems with injectable progestins and BBW
- Return to fertility may be delayed 10 to 12 months
BBW: longer term use >2 years May cause bone mineral density loss that may not be reversible upon stopping
What is the transdermal patch
- 20mg EE and 0.15mg norelgestromin
- One patch weekly for 3 weeks then one week patch free
What are the efficacy problems with the transdermal patch and risk problems
- Efficacy may be compromised in women >90kg (198lb)
- Increased risk of VTE vs COC w/35 mcg EE
What is the contraceptive ring
Vaginal ring, one size fits all
*left in for 3 weeks, one week ring-free
1. 15 mcg EE and 0.12 mg etonogestrel
*least estrogen available in CHC
What are the levonorgestrel IUDs (effective for 3 years)
- Liletta
*15.6 mcg - Skyla
*6mcg
What are the levonorgestrel IUDs (effective for 5 years)
- Kyleena (19.5mcg)
- Mirena (20 mcg)