1: Contraception Patient Education

Question 1

• These contraceptive methods have minimal effects on coagulation factors, blood pressure, or lipid levels.
• Safer for women who have contraindications to estrogen, such as cardiovascular risk factors, migraine with aura, or a history of VTE.
• Unscheduled bleeding is common.

Answer 1

• POPs
• Mini pills (POPs) contain 0.35 mg norethindrone.

Question 2

Users must be cautioned to avoid other sexual practices (e.g., oral sex and anal sex) that put them at risk for STIs.

Answer 2

Abstinence

Question 3

Three conditions must be met to be effective:

1. Exclusive or near-exclusive breastfeeding.
2. Amenorrhea.
3. Infant younger than 6 months.

Answer 3

Lactational Amenorrhea (Breastfeeding)

Question 4

Should be educated about emergency contraception as a backup method.

Answer 4

Coitus Interruptus

Question 5

• These contraceptive methods have minimal effects on coagulation factors, blood pressure, or lipid levels.
• Safer for women who have contraindications to estrogen, such as cardiovascular risk factors, migraine with aura, or a history of VTE.
• Unscheduled bleeding is common.
• Counsel about weight gain (2 kg at 12 months).

Answer 5

Depot medroxyprogesterone acetate injection (DMPA or Depo-Provera)

Question 6

• Should not be used simultaneously with a male condom, as this practice increases the risk of breakage.
• It should not be used with the diaphragm, cervical cap, or contraceptive vaginal ring, as the inner ring fits into the same place by the cervix as those methods.

Answer 6

Female Condom

Question 7

• Does not protect against STIs.
• Compliance is important.
• Side effects should be mentioned.

Answer 7

COCs

Question 8

Men need to be counseled that it does not prevent STIs.

Answer 8

Vasectomy

Question 9

Counseling for women contemplating this should include the continued need for preventive health services.

Answer 9

Female Sterilization

Question 10

• These contraceptive methods have minimal effects on coagulation factors, blood pressure, or lipid levels.
• Safer for women who have contraindications to estrogen, such as cardiovascular risk factors, migraine with aura, or a history of VTE.
• Unscheduled bleeding is common.
• Must return in 3 years for another dose.

Answer 10

1. Subdermal Implant (Implanon, Nexplanon [newer])
2. Progestin IUDs (Mirena is 5 years)

Question 11

T/F Unscheduled bleeding is more common and persistent in implant users than IUD users and is the most common reason for discontinuation.

Answer 11

True