Contraception & Infertility Flashcards

(39 cards)

1
Q

Why is progesterone needed when estrogen is being used

A

to prevent endometrial hyperplasia

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2
Q

If a women does not have a uterus does she need progesterone when using estrogen?

A

No, estrogen causes cell hyperplasia in the uterus leading to uterine cancer, but if there is no uterus progesterone is not needed to prevent the cell hyperplasia

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3
Q

Estrogen is used for?

A

Hot flashes, bone health

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4
Q

Which phase does menses occur during

A

follicular phase

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5
Q

What occurs during follicular phase

A

follicle stimulating hormone spurs follicle development and causes estrogen to surge. estrogen peaks by the end of phase the surge in estrogen causes luteinizing hormone and FSH to increase

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6
Q

What occurs during the ovulatory phase

A

the LH surge triggers ovulation 24-36 hours later.

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7
Q

What occurs during the luteal phase

A

the start of ovulation begins the luteal (last) phase which lasts ~14 days. progesterone is dominant in this phase

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8
Q

Which hormone causes release of the oocye (egg)

A

luteinizing hormone

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9
Q

What is released from the body when a fertilized egg attaches to the lining of the uterus

A

human chorionic gonadotropin (hCG)

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10
Q

how do hormonal contraceptives work

A

inhibit the production of FSH and LH which prevents ovulation

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11
Q

List progestin in oral contraceptives

A

northindrone
levonorgestrel
drospirenone

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12
Q

what is monophasic oral contraceptives

A

have the same dose of estrogen and progestin throughout the pill pack

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13
Q

unique property of drospirenone

A

is a mild potassium-sparing diuretic which decreases bloating

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14
Q

primary use of progestin only contraceptives

A

women who are lactating b/c estrogen decreases breastmilk

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15
Q

major counseling point for progestin only pills

A

must have good adherence b/c must be taken within 3 hours of scheduled time

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16
Q

patch contraindications

A

anyone with clotting risk factors b/c patch has higher estrogen exposure

17
Q

What does “Lo” mean in a birth control name

A

< 35 mcg of estrogen

18
Q

What does “Fe” mean in a birth control name

A

contains iron supplement

19
Q

What does “24” mean in a birth control name

A

24 active pills and 4 placebo

20
Q

SE of estrogen

A
nausea
breast tenderness
bloating
weight gain 
elevated BP
21
Q

insufficient estrogen can lead to?

A

spotting in early to mid cycle

22
Q

insufficient progestin can lead to?

A

spotting in late cycle

23
Q

BC for acne

A

lower androgenic activity (ortho-cyclen)

no androgenic activity (Yaz)

24
Q

BC for breastfeeding

A

progestin only

25
BC for estrogen contraindications
progestin only
26
BC for migraines
if aura-progestin only | no aura-any
27
BC for fluid retention
drospirenone
28
BC for heavy menstrual bleeding
NAtazia levonorgestrel-releasing IUD mirena COC with only 4 placebo pills
29
BC for HTN
if uncontrolled progestin only
30
BC for mood changes or disorder
monophasic COC extended cycle continuous with drospirenone
31
BC for nausea
take at night with food | decreasing estrogen
32
BC for overweight
any | avoid DMPA
33
BC for postpartum
do not use CHC for 3 weeks or 6 weeks if increased VTE risk | use progestin only
34
BC for PMDD
Yaz | antidepressant
35
BC for spotting
usually resolve in 3-6 months
36
MOA of plan B
preventing or delaying ovulation and thickens cerviacal mucus
37
First line treatment for irregular or absent menstrual cycles
clomiphene
38
clomiphene MOA
SERM: selective estrogen receptor modulator which is an estrogen agonist will cause LH and FSH surge to trigger ovulation
39
gonadotropin MOA
trigger ovulation by acting like endogenous gonadotropins FSH or LH