Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Contraception > Contraception > Flashcards

Contraception Flashcards

(57 cards)

Start Studying
1
Q

Combination pills

A

Alter the dosage of estrogen and progestin throughout the cycle
Ethinyl estradiol + norgestimate (oath-cyclen, Ortho Tri-cyclen, Ortho Tri-cyclen Lo
Ethanol estradiol or menstranol, synthetic estrogens
Norethindrone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Progestin-Only

A

Mini-pills
Not as effective
MOA affects the cervical mucus and the endometrium
Most likely changes tubal transport of ocyte and sperms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Estrogenic effects of OCP’s

A
  • Ovulation inhibited by suppression of FSH/LH
  • Implantation inhibited by alteration of the endometrium
  • Ovum transport is accelerated
  • Luteolysis may occur as estrogen causes progesterone levels to fall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Progestational effects

A
  • Thick cervical mucus interferes with sperm transport
  • Capacitation may be inhibited
  • Ovum transport is accelerated
  • Implantation is hampered by suppression of endometrium
  • Ovulation inhibited by hypo-thalamic-pituitary-ovarian disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Advantages of OCP’s

A
  • Excellent protection against unwanted pregnancy
  • Safe for most women
  • Decreased menstrual cramps and pain
  • Less menstrual blood flow
  • Improvement to facial acne
  • Women control own fertility
  • Excellent reversibility and easy to use
  • May provide protection against ovarian and endometrial cancer, ectopic pregnancy, PID, functional ovarian cysts, endometriosis, uterine fibroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Disadvantages of OCP’s

A
  • May lead to mood changes
  • No protection against STD’s, HIV
  • Expensive for some women
  • Rare circulatory complications which may be dangerous
  • increased risk of rare liver tumors
  • pills must be taken every day
  • possible SE of Nausea, HA’s, breakthrough bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Excessive estrogenic effects

A
  • Dysmenorrhea
  • Nausea
  • Chloasma
  • CVA
  • DVT
  • Thromboembolic disease
  • PE
  • Telangiectasis
  • Hepatic adenoma/adenocarcinoma
  • Cervical changes
  • Breast tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Deficiencies in estrogen

A
  • No withdrawal bleeding
  • Decreased duration in menstrual bleeding
  • Continuous spotting/bleeding
  • Breakthrough bleeding on day of cycle 1-9
  • Atrophic vaginitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Excessive progestational effects

A
  • Breast tenderness
  • Transient hypertension
  • Depression
  • Fatigue
  • Decreased libido
  • Decreased duration of menstrual bleeding
  • Increased appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Deficiencies in progesterone

A
  • Breakthrough bleeding DOC 10-21

- delayed menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Excessive androgenic effects

A
  • Hirtuism
  • Acne
  • Oily skin
  • Edema
  • Increased libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Excess estrogen/deficient progesterone combo effects

A
  • Dysmennorrhea
  • Menorrhagia (excessing bleeding during menses)
  • n/v
  • HA
  • Irritability
  • bloating/edema
  • syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Absolute contraindications of OCP’s

A
  • H/o thromboembolic disorders
  • H/o CVA
  • CAD
  • Known breast carcinoma
  • Pregnancy
  • Benign or malignant liver tumor, impaired liver function
  • Previous cholelithiasis during pregnancy
  • Undiagnosed, AUB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

General consideration of OCP’s

A

Being with low-dose combined or multiphasic pill (35mcg or less)
Progestin only pills may be used for women w/ hx of migraine HA’s, who are breast feeding or who have contraindications to combo pills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Adverse effects of OCP’s

A
  • AUB (may need higher dose)
  • Amenorrhea or hypermennorrhea (may need progestin increased)
  • Birth defects (estrogen is preg category X)
  • Cancer (pts w/ + family hx of breast ca should not use)
  • Hypertension
  • Weight gain, increased appetite, fatigue, depression, acne, hirtuism (may need to decrease progestin)
  • Nausea, edema, breast tenderness (may need to lower estrogen)
  • Thromboembolic disorders
  • Abx and anticonvulsants can decrease effectiveness of OCP’s
  • OCP’s can decrease effectiveness of warfarin, insulin and some hypoglycemics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nuva RIng

A

Flexible, prescriptive contraceptive ring

Typical failure rate is <1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MOA of Nuva RIng

A

Releases synthetic estrogen and progestin for 1 month
Release of hormone through vaginal contact
Prevents ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Advantages of Nuvaring

A 
Convenient, once per month insertion
Easily reversible
Fewer mood swings 
Discreet
May lead to shorter, lighter and more regular menstrual periods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Disadvantages of Nuvaring

A

Similar to OCP’s
Diaphragm’s, cervical caps, or shields cannot be used as back up
May worsen depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Contraindications of Nuvaring

A

Age >35 yo
Smoking
Uncontrolled hypertension
Hx of any cardioembolic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of Nuvaring

A

Inserted 1x per month for 21 days (not more not less)
Must be inserted on the same day of the week as it was inserted last cycle or pregnancy may occur
If ring slides out–MUST be inserted within 3 hours
Unopened packages must be proceed from sunlight or high temps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The Patch- Ortho Evra

A

Transdermal contraceptive patch that releases synthetic estrogen and progestin
Failure rate <1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Advantages of the patch

Study These Flashcards
A

Once per week administration
can be worn for 3 weeks
easily reversible

24
Q

Disadvantages of the patch

Study These Flashcards
A

Site reactions
Same as OCP’s
Reduced effectiveness in women >90kg
More estrogen released than OCP’s–increased risk for cardioembolic effects

25
Contraindications of the patch
Age >35 Smoking Hypertension Hx of cardioembolic disorders
26
Management of the patch
Apply to arm, buttocks, torso, abdomen (NEVER breast) on either the 1st day of her menstrual cycle or the first sunday following that day Patch is removed after 7 days, then reapplied If the patch is off for >24 hours, restarting a new 4 week cycle is necessary
27
Depo-provera
Long-acting progestin administered IM | Typical first year failure rate <1%
28
MOA of depo
Suppresses FSH and LH, blocking the LH surge, inhibiting ovulation thickens cervical mucus interferes with sperm transport and penetration alters endometrium
29
Advantages of Depo
Highly effect, long-acting, convenient Prolonged amenorrhea possible Useful in reducing pain associated with endometriosis No-estrogen related side effects Possible reduction in risk of PID and endometrial and ovarian cancers
30
Disadvantages of Depo
``` Menstrual irregularities (usually amenorrhea) Delayed return of fertility (usually 1 year) Injection q3months Can cause lipid changes (decreased HDL) Possible reduction in bone density with long-term use ```
31
Contraindications of Depo
Allergy Unexplained uterine bleeding Pregnancy
32
Management of Depo
Must have pregnancy test if >2weeks since 3month period Two week grace period for injection DO NOT massage injection site Back up method should be used during first 2 weeks after injection , unless administered by DOC 5
33
Nexplanon
Single, thin flexible rod which contains etonogestrel Failure rate 0.01% MOA: same as other progestins, Long-acting reversible contraceptive (LARC)
34
Advantages of nexplanon
``` Continous protection for 3 years no estrogen related s/e few serious system complications Scanty or absent menses/decreased anemia decreased menstrual cramps may decrease risk of endometrial cancer ```
35
Management of nexplanon
Requires informed consent Irregular menstrual periods, including menses, spotting and absent periods initial expenses are higher
36
IUD
Artificial device with either metal wrapping or chemically impregnanted surface Failure rate 1-3%
37
Types of IUD's
``` Copper-releasing (Paragard)-10 years Progestin releasing (Mirena)- 5 years ```
38
Advantages of IUD's
Progestin-releasing may decrease menstrual loss and dysmenorrhea
39
Disadvantages of IUD's
Pain and cramping many accompany used Increased menstrual bleeding Pregnancy- SA in up to 50% of cases if IUD left in uterus Ectopic pregnancy occurs in 5%
40
Undesirable effects of IUD's
``` Spotting, bleeding, hemorrhage, anemia Cramping and pain Expulsion of IUD Loss of IUD string Pregnancy PID--rate is higher in the first 6 weeks of insertion ```
41
Contraindications of IUD's
Active, recent or recurrent pelvic infections including GC and Chlamydia pregnancy Risk for PID Undiagnosed, irregular or abnormal uterine bleeding
42
Management of IUD's
May be inserted anytime during the cycle | May insert 4-8 weeks postpartum
43
Diaphragm/Cervical cap
Flexible, dome shaped cup constructed of latex, rubber blocks sperm from cervical Os First year failure rate 18% May provide some protection against STD's when used with spermicidal gel Inserted before sexual activity
44
Management of diaphragm
Should have refitted if weight gain exceeds 20 lbs Avoid oil based lubricants Must be left in vagina for 6 hour post intercourse
45
Disposable BC
Spermicides & condoms
46
Spermicides
nonoxynol-9 or octoxynol 21% first year failure rate OTC Enhances effects of barrier methods
47
Condoms
Sheath-like covering usually made of latex Typical first year failure rate Male 12% female 21% OTC, safe, protection against STDs
48
Management of Condoms
Avoid use of oil-based lubricants | Leave 1/2 inch of empty space at end of condom
49
Emergency Contraception
Mechanisms used to either prevent fertilization or the implantation of a fertilized egg in the uterus
50
Oral emergency contraception
Levonorgestrel (plan B) OTC, w/o prescription for women 17 yo, need prescription for <17 Taken within 72 hours of unprotected sex NOT the "abortion pill" 85% effective SE: N/V, fatigue, HA, dizziness, diarrhea, breast tenderness
51
IUD emergency contraception
An alternative form of emergency contraception Must be inserted within 5 days of intercourse 99% effective
52
Sterilization
Failure rate: Female 1:400, male 1:600 Female tubal ligation, male vasectomy Permanent form of contraception for both
53
Calendar method
Record serial cycles, identifying longest and shortest cycles Determine fertile phase by subtracting 18 days from the shortest cycle and 11 days from the longest cycle Abstain during this time
54
Basal Body Temp graph
Record daily BBT prior to rising in AM over a 3-4 month period Temp drops 12-24 hours prior to ovulation and rises following ovulation Avoid intercourse from 2-3 days prior to expected drop and approx 3 days following the rise
55
Cervical mucus test (billings test)
Record changes in cervical mucus (Spinnbarkeit) over 3-4 month period Not when mucus changes from scant and thick amount to thin with increased spinnbarkeit Abstain from time of mucus change until approx 4 days after change
56
Symptothermal method
Uses both BBT and cervical mucus changes
57
Lactational Amenorrhea
Patient relies on breastfeeding for natural family planning, as breastfeeding often delays onset of ovulation and menstruation for approx 6 months

Contraception (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions