Contraception Flashcards
(38 cards)
WHO-Category 1
No restriction on use of the contraceptive method
WHO-Category 2
Advantages generally outweigh the theoretical or proven risks
WHO-Category 3
Theoretical or proven risks usually outweigh the advantages of using the method
WHO-Category 4
Condition that represents unacceptable health risk if the contraceptive method is used
What are contraindications for IUDs?
Recent exposure to STDs, Hx of pelvic inflammatory disease
CA of the cervix
Abnormalities of the uterine cavity
Plan B (Morning-after Pill)
Pill contains an elevated dose of a progesterone-like hormone, WILL NOT AFFECT AN EXISTING PREGANCY
How does Plan B work?
- Egg release from ovary could be prevented
- Could prevent fertilization of egg
- Could prevent fertilized egg from attaching to uterus
What is the time limit that someone can use Plan B after having unprotected sex?
3 days (72 hours)
What are risks involved with contraception in women over 35?
Risks for myocardial infarction stroke, VTE, Breast CA, osteoporosis and bone fx
What test should women at risk for osteoporosis get?
Women should get a bone mineral density (Densitometry)
Contraceptive use along with Current breast cancer…
Category 4 risk
Contraceptive use along with past breast cancer in remission for 5 years….
Category 3 risk
ACOG and the CDC on osteoporosis
ACOG and the CDC do not place a resriction on the use of DMPA related to older women
DMPA is associated with a decrease in bone mineral density, with is reversible in younger women.
Benefits to non-contraceptive
CHC can help regulate periods and decrease blood loss from heavy, prolonged, unpredictable bleeding
Reduction on endometrial cancer
CHC can help with hot flashes
ACOG recommends against use of CHC in women age 35 and older if the patient…
Smokes Has HTN DM Migraines headaches Uncontrolled dyslipidemia
Contraindications for IUDS
Recent exposure to STDs, Hx of pelvic inflammatory disease, CA of the cervix, abnormalities of the uterine cavity
IUD
Copper causes sperm dysfunction and prevents fertilization
How long does the copper IUD last for?
5-10 years
If patient cannot find IUD strings…
- The pt should take a urine pregnancy test, if negative, a cytology brush should be used to try and locate the strings
Expulsion rate after initial expulsion of IUD…
Expulsion rate of 30%
What is CHC?
Combined hormonal contraceptives
CBC+Diabetes
CHC use by women who have diabetes > 20 years or vascular disease is a category 3 or 4
CHC with no vascular disease is category 2
Progestin only pills, implants, or IUDs are category 2
CBC+Obesity
Use of combined hormonal contraceptives (CHC) in women with a BMI > 35 is contraindicated because of the contribution to cardiovascular issues
The ACOG recommends that CHC be used with caution in obese women over 35 because of the increased risk of VTE
Bariatric surgery may reduce absorption
Eating disorders to avoid weight gain may reduce absorption
Obesity+Contraceptive effectivess
Body fat can effect hormonal contraception through increased basal metabolic rate, increased hepatic enzyme metabolism, and drug sequestration in fat
Transdermal methods may be less effective in obese women
