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Repro 2 > Contraception and Sterilization - Wootton > Flashcards

Contraception and Sterilization - Wootton Flashcards

(42 cards)

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1
Q

Function of progesterone component in oral contraceptives

A
  • Suppress LH and ovulation
  • Thicken cervical mucous, inhibiting sperm migration
  • Creating unfavorable atrophic endometirum
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2
Q

Function of estrogen component in oral contraceptives

A
  • Improve cycle control by stabilizing endometrium and allowing less bleeding
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3
Q

Progestin-only oral contraceptives - fxn

Used by who?

Bad thing about it?

A

Making cervical mucous thick and impermeable

Breastfeeding women, or those w/ estrogen contraindication

MUST be taken w/in 2-3 hours of same time every day, or else must use backup for 2 days

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4
Q

Benefits of oral contraceptives

A
  • Cycle regularity
  • Less dysmenorrhea
  • Less iron deficiency
  • Less endometrial and ovarian cancer
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5
Q

Benign side effects of oral contraceptives

A
  • Breakthrough bleeding (10-30%)
  • Amenorrhea (1-5%)
  • Bloating, weight gain, breast tenderness, nausea, fatigue, headache
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6
Q

Serious side effects of oral contraceptives

A

Venous thrombosis, PE, GB disease, stroke, MI, hepatic tumors

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7
Q

Transdermal patch - caution?

Side effects?

A

Not effective if > 198 lbs

Same, increased thrombosis risk (more than oral)

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8
Q

Vaginal ring - benefits

A

Better compliance, less breakthrough bleeding, can be removed for 3 hrs w/o losing efficacy

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9
Q

Groups that can’t use combo contraceptives

A
  • Smokers > 35
  • Personal Hx of thromboembolic event
  • Hx of CAD, CVD, CHF, or migraine w/ aura
  • DM, chronic HTN, SLE
  • Moderate to severe liver disease (ex. hepatitis) or tumors
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10
Q

Depo – drug?

How to use?

MoAs

A

Medroxyprogesterone acetate

IM injection w/in first 5 days of menses, every 3 months

Thicken mucous, decidualize endometrium, block LH and ovulation

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11
Q

Benefit to Depo vs. patch

A

NOT affected by weight

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12
Q

Depo-provera – black box warning

Important in who?

A

Bone metabolism issue w/ decreased estrogen level

Adolescents

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13
Q

Side effects of Depo (3)

A
  • Irregular bleeding (add back estrogen to help)
  • Weight gain (HANGRY)
  • Depression exacerbation (post-partum)
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14
Q

Indications of Depo vs. combo drugs (5)

A
  • No estrogen (can use in contraindication)
  • Want better compliance
  • Women w/ seizures
  • Sickle cell anemia
  • Anemia 2º to menorrhagia
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15
Q

Contraindications to Depo (5)

A
  • Pregnancy
  • Unknown bleeding
  • Breast malignancy
  • Active or recent thrombophlebitis/thromboembolic event
  • Liver dysfunction/disease
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16
Q

Nexplanon - what is it

Used for how long?

MoA?

A

Etonogestrel - rod implant

3 years

Thicken mucous, inhibit ovulation

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17
Q

Main side effect of rod implant

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A

Irregularly irregular vaginal bleeding (no control of cycle)

18
Q

Indications for rod implant

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A
  • Want a convenient method

- Breastfeeding

19
Q

Contraindications for rod implant

Study These Flashcards
A

SAME AS DEPO - pregnancy, thrombosis, liver disease, bleeding, breast cancer

20
Q

Side effects of rod implant insertion

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A

Infection, bruising, deep insertion, migration, persistent pain or paraesthesia at insertion site

21
Q

3 IUDs in US (w/ durations)

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A

Paragard (copper) - 10 years
Mirena (Levonorgestrel) - 5 years
Skyla (Levonorgestrel) - 3 years

22
Q

Risks of IUDs

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A
  • Infection in first 20 days
  • Ectopic pregnancy
  • Uterine perforation at insertion
  • Malposition
23
Q

If IUD and pregnancy, do what?

Study These Flashcards
A

Remove it (if string is visible)

24
Q

Contraindications to IUD

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A
  • Breast cancer (Levonorgestrel ones)
  • Recurrent puerperal sepsis
  • Recent septic abortion
  • Active cervical infection
  • Wilson’s disease (copper one)
  • Uterine malformations)
25
Benefits of IUD (4)
- Decreased menstrual bleeding - Less dysmenorrhea - Protection of endometrium in obesity (high estrogen) - Convenient and long term
26
MoA of Copper IUD (Paragard)
- Interferes w/ sperm transport or fertilization and implantation
27
Only contraceptive method that protects from STIs
Condoms
28
Barrier methods are cheap, but ___
Have higher failure rate than others
29
Bad things about diaphragms (4)
- Must be used w/ spermicide - Must be left in for 6-8 hours after intercourse - Must be fitted and re-fitted - More likely to get UTIs
30
Differences about cervical cap than diaphragm
- Fits cervix itself | - High risk of displacement and toxic shock syndrome
31
Sponge Better in who Bad things??
Small pillow w/ spermicide that fits on/over cervix Nulliparous women - Only one size - Toxic shock risk if left in
32
What is Plan B? For who?
Progestin only (Levonorgestrel) - 2 pills 12 hrs apart OTC if older than 17
33
What is ella?
Ulipristal acetate
34
Male sterilization How long to be effective?
Vasectomy - occlusion of vas deferens 10 weeks
35
Laparascopy - methods
``` Occlude fallopian tubes via... - Electrocautery - Clips - Bands Bands Salpingectomy (removal of tube) ```
36
Most common surgical procedure for sterilization
Mini-laparotomy | - Small infraumbilical or supraumbilical incision
37
Hysteroscopy - 2 approaches w/ this
- Transcervical tubal ligation - Essure system - Small coils in the fallopian tube, cause complete occlusion
38
Essure system - contraindications
Nickel or contrast allergies Pelvic infection Pregnancy
39
Essure system - benefits
Good for obese patients
40
Things w/ estrogen in it Things w/ just progestin in it
Patch, ring, combo pills IUD, Depo, progestin-only pills
41
26, G3P3, was using basal body temp system but wants a more reliable, less intensive method. Not ready for permanent sterilization. PHx of DVT. Does not smoke. What are her best options? What if she was morbidly obese, did not want any more kids, and FHx of breast cancer?
IUD or Depo (NO ESTROGEN) Essure
42
Biggest risk for patient w/ permanent sterilization
Regret

Repro 2 (28 decks)

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