Contraception Flashcards
(50 cards)
1
Q
Benefits of Family Planning
A
- Improved health of women
- Lower rates of induced abortions
- Fewer unwanted pregnancies and births
- Improved socioeconomic status
2
Q
4 Major Types of Contraception
A
- Behavioral
- Barrier
- Hormonal
- Permanent
3
Q
Fertility Awareness, Combined Methods
A
Use of a barrier method during fertile days
4
Q
Natural Family Planning
A
Abstinence during fertile days
5
Q
Fertility Awareness Methods
A
- Basal body temperature method
- Ovulation method (Billings method)
- Calendar rhythm method
- Symptothermal method
6
Q
Basal Body Temperature Method
A
Take temperature every morning; record on graph; 3-4 months
7
Q
Ovulation Method (Billings Method)
A
Cervical mucus
8
Q
Calendar Rhythm Method
A
Ovulation occurs day 14
9
Q
Symptothermal Method
A
Several factors combined: temperature, mucus
10
Q
Situational Contraceptives
A
- Abstinence
- Lactational amenorrhea
- Coitus interruptus
11
Q
Why is coitus interruptus a poor method of birth control?
A
Withdrawal fails because
- Demands great self-control on part of male
- Preejaculatory fluid can contain sperm (increases after recent ejaculation)
12
Q
Is douching after intercourse an effective method of birth control?
A
No, it can actually facilitate conception
13
Q
Spermicides
A
Inserted into the vagina before intercourse; works by destroying sperm by disrupting the cell membrane Nonoxynol-9 available as: - Jelly - Foam - Vaginal film - Suppository
14
Q
Barrier Contraceptives
A
Work by blocking the transport of sperm to the ovum, immobilizing sperm, or are lethal against them; often used with a spermicide
- Male condom
- Female condom
- Diaphragm
- Cervical cap
- Vaginal sponge
15
Q
Male Condom Effectiveness
A
86%
16
Q
Male Condom Advantages
A
- Small, disposable, inexpensive
- No SE (except if latex allergy)
- Protection against both pregnancy and STIs (except with natural “skin” condoms made from lamb’s intestines)
17
Q
Male Condoms Disadvantages
A
- Breakage
- Displacement
- Perineal or vaginal irritation
- Dulled sensation
* * KY jelly can be used to prevent possible condom breakage or irritation if the condom is not lubricated or if the vagina is dry
18
Q
Female Condom Advantages
A
- Available OTC
- May be inserted up to 8 hours before intercourse
- Pre-lubricated
- Better protection than other methods against some pathogens (covers some of vulva)
19
Q
Female Condoms Disadvantages
A
- Not designed to be used with male condom
- High cost
- Noisy during intercourse
- Cumbersome feel of the condom
- Slightly less reliable than the diaphragm, male condom, vaginal sponge, cervical cap
20
Q
Diaphragm Fitting
A
Requires fitting by HCP and re-eval
- After each childbirth
- 10-15 weight gain or loss
- Annually
21
Q
Diaphragm Use
A
Spermicidal jelly is used with diaphragm. Additional spermicidal jelly or cream is necessary if:
- More than 4 hours lapse between insertion and intercourse - Repeat act(s) of intercourse desired before diaphragm removed * * Must be left in place at least 6 hours following intercourse * * Should not be left in longer than 24 hours
22
Q
Diaphragms are a good choice for women who…
A
- Are breastfeeding
- Cannot or do not want to take the pill
- Smokers over 35
- Want to avoid increased risk of PID associated with IUDs
23
Q
Diaphragms are not for women who…
A
- Object to inserting, checking, or removing their diaphragm
- History of UTIs
- History of TSS
- During menses
- Abnormal vaginal discharge
24
Q
Cervical Cap
A
- Cup shaped, used with spermicidal cream or jelly, fits snugly over the cervix
- Must remain in place 8 hours after coitus; may be left in place 48 hours
- Repeated acts of intercourse do not require additional spermicidal
- May be more difficult to fit than diaphragm because of limited size options
- Tends to be more difficult for women to insert and remove
25
Cervical Cap Advantages
1. No use of hormones
| 2. Provides continuous protection while in place
26
Cervical Cap Disadvantages
1. Requires accurate fitting by health care professional
| 2. Odor may occur if left in too long
27
Cervical Cap Contraindications
1. Women who object to inserting, checking, or removing their diaphragm
2. History of UTIs
3. History of TSS
4. During menses
5. Abnormal vaginal discharge
28
Vaginal Sponge
- Effective immediately once inserted
- Remains effective 24 hours with repeated acts of intercourse
- Should be left in place 6 hours following last coitus, no longer than 24 hours
- Available OTC - one size fits all
29
IUD Advantages
1. Very effective
2. Provides continuous contraceptive protection
3. No need of coitus interruption
4. Relative inexpensive over time
30
IUD Risk/Side Effects
1. Uterus perforation during insertion
2. Infection
- Risk greatest for 3 weeks after insertion
- Not recommended for those with multiple sex partners
3. Irregular bleeding/spotting
4. Expulsion of the device
- String checks
31
Warnings for IUD System Users of Potential Complications
```
P = period late, pregnancy, abnormal spotting or bleeding
A = Abdominal pain, pain with intercourse
I = Infection exposure, abnormal vaginal discharge
N = Not feeling well, fever, chills
S = String length shorter or longer or missing
```
32
Copper IUD
- Contraception for 10 years
- Copper and presence of the foreign body cause the spermicidal and inflammatory effects of endometrium
- May cause some increase in menstrual length, flow, and cramping (manage with NSAIDs)
33
Levonorgestrel-Releasing Intrauterine System
- Contraception for 5 years
- Possibly some suppressive effects on ovaries
- Usually decrease menstrual length flow and even amenorrhea after about 3 months
- Can help with menstrual pain
34
Combined Hormonal Contraceptive Estrogen + Progestin
1. Prevents release of ovum
2. Contains estrogen and progestin
- Safe, highly effective, easily reversible
- Taken 21 days (skip 7 days or take inert pills for 7 days)
- Should be taken the same time every day
35
Contraindications for Combined Hormonal Contraceptives
1. Thrombophlebitis, thromboembolic disease, or history
2. Stroke, diabetes, gallbladder disease
3. Coronary artery disease
4. Estrogen dependent carcinoma
5. Known or suspected pregnancy
6. Impaired liver function or liver cancer
7. Heavy smokers and those over 35
36
Advantages of Combined Hormonal Contraceptives
1. Highly effective and safe
2. Scheduled periods, decreased bleeding and cramping
3. Improve acne
4. Decreased:
- Risk endometrial and ovarian cancer
- Risk ectopic pregnancy
- Risk of acute PID and resultant tubal scarring
- Benign breast disease
- Functional ovarian cysts
37
Transdermal Patch (Combined Hormonal Contraceptives)
- Applied to upper arm, hip, abdomen, shoulder
- Change weekly for 3 weeks; 4th week no patch
- Weight < 200lbs
- High incidence of nausea due to amount of estrogen
38
Vaginal Ring (Combined Hormonal Contraceptives)
- Low dose, flexible contraceptive ring
- Inserted into the vagina by the woman
- Remains in place for 3 weeks, discard, no ring for 1 week
- Must use back-up method for 1 week, if removed for more than 3 hours
39
Progestin Only Contraceptive
- "Mini pill"
- Used primarily for breastfeeding women or women who can't take estrogen
- Less effective than combined oral contraceptives
- Must be taken at same time every day (backup method for 48 hours if more than 3 hours late taking pill)
40
Side Effects of Progestin Only Contraceptive
Amenorrhea or irregular bleeding, spotting
41
Implanon (Progestin Only Contraceptive)
- Single rod implant that provides continuous etonogestrel release for 3 years
- Placed inner aspect upper arm
- Amenorrhea more frequent than Norplant
42
DMPA Injection (Progestin Only Contraceptive)
- Injection administered IM or SQ every 3 months (12-14 weeks)
- Must start within 1st five days of menstruation
- Suppresses ovulation
- Safe for breastfeeding women
** Also called Depot Provera
43
Side Effects of Depot Provera
- Menstrual irregularities
- Headaches
- Weight gain
- Breast tenderness
- Depression
- Use longer than 2 years may cause bone mineral loss
- Return of fertility usually in 8-10 months
44
Emergency Contraception
1. Plan B - available OTC, need Rx in under 18
2. Progestin only pills
3. Used if concern of pregnancy (unprotected intercourse, rape, broken condom, slipped diaphragm, missed pills)
4. Taken within 72 hours of intercourse
5. Copper IUD (inserted within 5 days after unprotected sexual episode)
45
Female Sterilization Methods
1. Tubal ligation
| 2. Essure
46
Tubal Ligation
1. Postpartum - performed through umbilical incision, tubes ligated and portions removed
2. Interval - usually laparoscopically tubes fulgurated, banded, clipped; may perform mini-lap
47
Tubal Ligation Side Effects
Risks of injury to other organs, tissue, anesthesia, infection, bleeding
- Some women develop heavier periods and cramping
48
Essure
- Stainless steel micro-inserts placed into each fallopian tubes
- Causes scar tissue formation which blocks the tubes
- Must follow up in 3 months to confirm tubal occlusion
- Perform in the office; no anesthesia required
- Risks of uterine perforation, pain during procedure, infection, local reaction
49
Vasectomy
Vas deferens severed in both sides of scrotum
- Must have 2 negative semen analysis to confirm sterility
* Usually takes 6 weeks and 6-36 ejaculations to clear remaining sperm from vas deferens
- Much safer, less expensive and less invasive than female sterilization
50
Side Effects of Vasectomy
Pain, swelling, infection
