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Flashcards in Contraception Deck (30)
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1

List the women more likely to experience unintended births

1. Black Women
2. Women w/ low education or income
3. Unmarried Women

2

What is the Standard Days Method? Who is the most appropriate for?

1. Women who have regular menstrual cycles: 26-32 days
2. Must abstain from sex between days of 8-19 of cycle

*Highly motivated couples

3

What is the Calendar Method?

1. 1st day of fertile period= subtract 18 days from total length of shortest menstrual cycle
2. Last day of fertile period= subtract 11 days from total length of longest cycle
3. Avoid sex during this time

*Must track menses x6 months before you can utilize

4

Define Cervical Mucus method

Abstinence with any cervical secretion until 4 days after last day of wet, car, slippery mucous

5

Define 2 day method

If no mucus secretions on 2 consecutive days, ok to have intercourse

6

Define Basal Body Temperature method

Abstain from sex from end of menstrual period until 3 days after rise in temperature (0.5-1 degrees)

7

What is the Symptothermal Method?

Cervical Mucus + Basal Body Temp Method
Fertile period:
First sign of ovulation until 3 days after temperature OR
4 days after peak mucus

8

What are the advantages of women controlled barrier methods?

1. Immediately active: Spermicides requires 15 minutes for activation
2. No effect on menses/hormones

9

What are the disadvantages of women controlled barrier methods?

1. UTI risk: Diaphragm
2. No HIV protection
3. NOT for HIV+ and/or high risk for HIV
4. Failure rate fairly high

10

Who is transdermal patches less effective in?

Obese women: >198 lbs

11

What are the advantages to prescribing CHC's?

1. Can be initiated at any time
2. No back up needed if started in first 5 days of bleed

12

What is the only thing you need to monitor PRIOR to starting a women on CHC's?

BP

13

What is the MAIN MOA in CHC's?

Suppress Ovulation=90-95%

14

CI to CHC's

1. Current breast CA
2. Severe HTN or vascular dz (PE/DVT)
3. Heart dz
4. Complicated DM (or DM >20 yrs)
5. Smoke > or equal to 15 cigs/day
6. Migraine w/ aura
7. Certain liver dz's (cirrhosis) or GB dz
8. Seizure disorders

15

What happens if you miss 1 pill?

Take missed pill ASAP and take next pill as usual

16

What happens if you miss 2 or more missed pills?

1. Take most recent missed pill asap
2. Remaining pills should be continued at usual time
3. Backup contraception for 7 days
4. Consider EC

17

What is the MAIN MOA of Progestin Only pills?

Thickens cervical mucus to prevent sperm entry to upper reproduction tract

18

What is one of the main advantages of Progestin Only pills?

May be used by women with CI or ADE's to Estrogen

19

Progestin Only pills SE's

1. Increased spotting/bleeding
2. Intermittent amenorrhea

20

What is considered a "missed pill" in Progestin Only pills? Recommendations?

>3 hrs late dose taking pill

1. Take another pill
2. Use back up x2 days
3. Consider EC

21

IUD CI/Limitations

1. Cervical CA
2. Purulent cervicitis
3. Current chlamydia or gonorrhea
4. High individual likelihood of STI exposure (partner w/ infix)
5. Increased risk of spontaneous AB and preterm delivery if become pregnant

22

With failure of the Mirena or Paragard IUD, what are women @ an increased risk for?

Ectopic pregnancy

23

Levonorgestrel IUD MOA

Causes Cervical mucus to become thicker

24

Copper IUD MOA

1. Copper ions inhibit sperm motility
2. Inflammatory reaction in the endometrium phagocytes the sperm

25

What is one of the main advantages of the Etonogestrel Implant?

Good for women with estrogen CI

26

List the EC pills options

1. Ulipristal acetate: More effective than levonorgestrel between days 3-5
2. Levonorgestrel (Plan B)
3. Combined Estrogen and Progestin: 2 doses-less effective and more SE's

27

How long do you need to use back up for with the use of LNG and combined estrogen/progestin EC?

x7 days

28

Hysteroscopic sterilization MOA? How long do you need to use back up for?

Tubal occlusion
Backup x3 months until you have confirmed sterility

29

List the risk of regret in women who are sterilized (Hysteroscopic or tubal ligation)?

1. Age <30
2. Low parity
3. Sterilization @ time of C-section
4. Changes in marital status
5. Poverty
6. Minority status
7. Minisinformation about permanence
8. Hurried decision

30

How long do you need to use alternative contraception with a vasectomy?

Until 2 consecutive sperm samples who no motile sperm