1: Contraception Disadvantages Flashcards

1
Q
  • Must be used with every act of intercourse
  • Need to exert the self-discipline and control
  • Does not prevent STI transmission because penile–vaginal contact occurs, and HIV and other STIs can be present in pre-ejaculatory fluid.
A

Coitus Interruptus

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2
Q
  • The surgical procedures are expensive.
  • Requirements for a waiting period after signing consent.
  • Minimum age requirements.
  • Less likely to return for annual checkups or to use other preventive health services such as Pap tests.
  • Less likely to use condoms for prevention of STIs.
  • The younger the woman is, the more likely she is during subsequent years to express regret.
A

Female Sterilization

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3
Q
  • Low contraceptive effectiveness
  • Potential for symptoms of cervicovaginal irritation
A

Spermicides. Women who engage in multiple daily acts of intercourse or who are at high risk for STIs should avoid use of spermicides containing N-9.

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4
Q
  • Only one formulation available.
  • Large amounts of active ingredients still present at disposal.
A
  1. Vaginal Ring (NuvaRing)
  2. Patch
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5
Q
  • The time to return of ovulation varies widely, ranging from 15 to 49 weeks.
  • Requires either a trained healthcare professional or a more expensive mode of home administration.
  • Does not provide any protection from STIs.
A

Depot medroxyprogesterone acetate injection (DMPA or Depo-Provera)

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6
Q

Their single-use application may prove more expensive over time than methods that can be reused.

A
  1. Vaginal Sponges
  2. Male Condoms
  3. Female Condoms
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7
Q
  • Need for careful adherence to the dosing schedule.
  • No protection against STIs.
  • Androgen effects possible.
A

Progestin-Only Pills (POPs)

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8
Q

Regret may occur with certain unanticipated life changes.

A
  1. Male Sterilization
  2. Female Sterilization
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9
Q
  • Increased risk of cervical cx in long-term users, only while using.
  • Increased risk of rare liver tumor.
  • Increased risk of DVT immediately postpartum.
  • Need for daily dosing.
  • Ongoing cost.
  • Lack of privacy may also be an issue.
  • Side effects.
A

Combined Oral Contraceptives (COCs)

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10
Q
  • High initial cost.
  • Visit to clinician.
  • Possible pre-insertion and post-insertion visits.
  • Possible increase in bleeding.
A

Copper IUD (T380A, Paragard)

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11
Q
  • Some women find them difficult to insert, although this problem decreases with proper education.
  • Although it is a female-controlled method, male partner cooperation may still be necessary for consistent use.
  • Partner’s lack of acceptance is often cited as a reason for discontinuation.
  • Can be used only once, so this method can be costly over time.
A

Female Condoms

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12
Q
  • During sexual excitement, the upper part of the vagina expands; thus, may no longer provide a complete physical barrier to sperm migration during intercourse.
  • Higher initial cost.
  • Must be fitted by clinician.
A
  1. Diaphragms
  2. Cervical Caps
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13
Q
  • Detailed education
  • Ongoing attention to identifying the fertile window, and abstaining from intercourse or using an additional contraceptive method several days each month.
  • Do not protect either partner from STIs.
  • Users should be educated about emergency contraception.
A

Fertility Awareness Based (FAB)

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14
Q
  • Require planning.
  • Require application at the time of intercourse and may be interruptive.
  • Breakage or slippage of may increase risk of unintended pregnancy.
  • Effectiveness is coitus dependent.
  • Correct use is critical to prevent breakage, slippage, and resultant unintended pregnancy.
  • Male controlled.
A

Male Condoms

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15
Q
  • It is effective only if it is administered correctly.
  • Only one formulation available.
  • Large amounts of active ingredients still present at disposal.
A

The Patch (OrthoEvra [discountinued], Xulane)

Must be completely attached to skin. Even partial detachment necessitates replacement.

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16
Q
  • High initial cost.
  • Visit to clinician.
  • Possible pre-insertion and post-insertion visits.
A

Progestin / Levonorgestrel (Mirena, Skyla, Liletta)

17
Q
  • Require higher initial cost.
  • Must be fitted by clinician.
  • Insertion and removal may be complex for some women; these women will need additional teaching and counseling to use this contraceptive method consistently and correctly.
  • More insertion and removal problems noted with this than with the more traditional version.
A

Cervical Caps

18
Q

Unrealistic for most couples in long-term relationships to use exclusively for an extended period of time

A

Abstinence

19
Q
  • It is available only to women who are breastfeeding.
  • Its duration of use is limited.
  • Women may have difficulty sustaining the patterns required to maintain contraceptive effectiveness.
  • Does not provide protection from STIs.
A

Lactational Amenorrhea (Breastfeeding)

20
Q
  • High initial cost.
  • Visit to clinician every 3 years.
A
  1. Subdermal Implant (Implanon, Nexplanon [newer])
  2. Some IUDs (Skyla, Liletta)