Contraception Flashcards
what controls the menstrual cycle
GnRH from the hypothalamus
FSH and LH from the anterior pituitary
estrogen, progesterone and testosterone
what are the 5 broad types of contraception
long-acting reversible contraceptives (LARCs): IUD, rods
Short-acting hormonal methods: OCP, injectables, patch
Barrier methods: condom, diaphragm, etc
Emergency contraceptives: copper IUD, emergency contraceptive pill
Sterilization
what are contraindications to estrogen-containing products
history of VTE or hyper coagulable state
smokers >35
personal hx of breast cancer
impaired liver function
AUB
<30 days post partum
breast feeding
hx of stroke
migraine
what are the hormonal and non hormonal LARCs options
non-hormonal: Copper IUD (paraguard)
hormonal: Levnorgesterel IUD (Progestin) - mirena, skyla, kyleena
Implant: Implanon, nexplanon: etonogestrel
what are the pros to IUDs
Ok for breastfeeding women
OK for women who can’t have estrogen
Quick return of fertility after removal
little for patient to ‘remember’
reduced risk for cervical, endometrial and ovarian cancers
what are the cons to IUDs
No STI protection
pain with implantation
$$$ upfront, but good for years
risk of expulsion, migration, perforation
?increased risk of breast CA (hormonal)
what is the MOA for injectable contraceptives
inhibits ovulation, decreases sperm motility, inhibits implantation
what are the SE of injectable contraceptives
irregular menstruation, weight gain, decreased libido, decreased DMB
- okay to use while breastfeeding
what are the contraindications of the patch
VTE, HTN, MI, stroke, DM, liver dz, breast cancer, HCV
what are the SE of the patch
breast pain/swelling, N/V, HA, skin irritation, spotting/bleeding, cramping, mood changes/anxiety/depression
what is the base of the implant contraceptives
progestin based (etonogestrel)
what are the SE of the short acting ring contraceptives
HA, nausea, breast pain, irregular/no menstruation, spotting, increased vaginal lubrication
what are the benefits of the diaphragm
non-hormonal
prescription only - needs to be professionally sized
silicone cup that covers cervix
what is the cervical cap
less effective than diaphragm - but smaller
non-hormonal - prescription only (need sized)
silicone cup that covers cervix
what are emergency contraceptions
Copper IUD
Ella (progestin R modulator)
Plan B (less effective)
