Contraceptives Lecture Flashcards Preview

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Flashcards in Contraceptives Lecture Deck (35):
1

What can unprotected sexual activity result in:

Unintended pregnancy
STI (lifetime costs)

2

Teens sexually activity?

40% of teens are sexually active
1/5 engage in unprotected activity

3

How are STIs acquired contact with?

Genital tissues, mucous membranes, body fluids
Women more adversely affected: long-term complications, easier to transmit infections to

4

Group 1 STIs?

Genital Warts
Hepatitis B

5

Group 2 STIs?

Chlamydia
Gonorrhea
Nongonococcal urethritis
Syphilis
Trichomoniasis

6

Group 3 STIs?

AIDS
Herpes
Hep C

7

Group 4 STIs?

Bacterial vaginosis
VVC

8

Prevention strategies for STIs?

Abstain
Avoid multiple partners
New condom each time
Examine partner for genital lesions
Avoid sex if signs of STI
Vaccinations

9

Perfect vs typical use?

Perfect use: theoretical, accidental pregnancy rate in first year, method-related failure, assumes accurate and consistent use every time
Typical use: realistics, accidental pregnancy rate in the first year, use-related failure

10

Define male condoms

Important method of barrier contraception
Only non-prescriptive method more effective is abstinence
Available in: latex, polyurethane, lamb cecum

11

What are latex condoms?

Various sizes, thickness, shapes
ARE degraded by oil-based lubes
Can be luned, reservoir tips, ribs or studs
PROTECT AGAINST STI AND PREGNANCY

12

What are polyurethane condoms?

Conduct heat well
Come prelubed
Not degraded by oil-based lubes
Not as stretchy as latex
PROTECT AGAINST STI AND PREGNANCY (higher pregnancy rates than latex and higher breakage rates than latex)

13

What are lamb cecum condoms?

Conduct heat well
Very strong
Porous and allow passage of viral organisms
Not degraded by oil-based lubes
PROTECTIVE AGAINST PREGNANCY AND SOME STIs

14

What leads to condom breakage?

22% of the time
Manufacture defects
Incorrect placement
Oil-based lubes
Reuse
Increased duration, intensity or frequency
Jewelry or nails
--- if it breaks consider spermicide or EC

15

Guidelines for use of male condoms?

Only if: no previously opened, not stored in wallet, within expiration date, discard if brittle, sticky, discolored
Do not test for leaks prior, only check after
Discard if put on backwards
Remove immediately after ejaculation
Pinch 1/2 inch space at tip

16

What if a condom tears?

Insert spermcidal foam or jelly with high concentration of spermicide into vagina

17

Complaints of male condoms?

Contact dermatitis
Decreased sensation (thin or ridged condoms, nonlatex synthetic condoms, natural skin condom

18

Female condoms?

Polyurethane FC: prelubed, not degraded, scant availability
Nitrile: synthetic latex (thinner than male condoms) and has an outer ring (vaginal mucosa) and inner ring (cervix)

19

Counseling points for female condoms

Initial application difficult
Single use only
Lower breakage rates but higher slippage rates
Inserted up to 8 hours prior

20

Complaints about female condoms?

Vaginal irritation
Squeaky
Decreased sensation
Discomfort during intercourse
Cumbersome and unattractive

21

What are vaginal spermicides?

Use surface-active agents to immobilize (kill) sperm
Certain dosage forms also act as a physical barrier
Dosage forms: gel, foam, suppository, film, sponge
PROTECTIVE AGAINST PREGNANCY BUT NOT STIs

22

Gel Spermicides?

Provide additional lubes
Safe to use with condoms
Higher concentration if alone
Insert 1 hour prior
Last for 1 hour
Reapply for each encounter

23

Foam Spermicides?

Distribute and adhere better than jelly
Difficult to know when canister empty
Insert 1 hour prior
Last for 1 hour
Reapply for each encounter

24

Suppository Spermicides?

Solid/semisolid dosage forms
Activated by moisture in vaginal tract
Unpleasant grittiness if not completely dissolved
Insert 15 minutes prior to intercourse
Last 1 hour
Reinsert for each encounter

25

Film spermicides

Paper-thin sheets
Activated by vaginal secretions
Most difficult to use but less "messy"
Insert 15 minutes before intercourse
Last 1-3 hrs
Reapply for each encounter

26

Counseling points for vaginal spermicides?

Low efficacy if used alone
High efficacy if used with barrier method
Inactivate STI pathogens
Frequent use may lead to genital lesions (increases risk of STI, FDA warning)

27

Sponge Spermicide?

Small, circular, mechanical barrier
Provides a spermicide
Absorbs semen
Made of polyurethane permeated with spermicide
High risk of pregnancy if poorly fitted
Placement is vital
Risk of cervical infections

28

Complaints about the sponge?

Vaginal dryness
Associated TSS
Insert 24 hours prior to intercourse
Duration of benefit 6 hours
Not during periods

29

What is the fertility awareness-based methods?

Do not use a chemical or physical barrier
Do not protect against STI
Require fertile day determination
Require periods of abstinence or secondary contraception
Monogamous relationships
25% pregnancy rate

30

Examples of fertility awareness methods?

Basal Body temperature Method
Calendar Rhthym Method
Bilings Ovulation Method (cervical mucous method
Lactational Amenorrhea Method
Standard Days method
Withdrawal

31

What are disadvantages of the fertility awareness methods?

Require 6-12 months of cycle history
Do not experience temperature fluctuation during ovulation
Some require strict interpretation
Require normal cycle lengths
Some require breast feeding
Some require extreme self-control

32

What is emergency contraceptions?

Involves the use of pills or IUD after intercourse but within 72 hours after intercourse, method failure, or sexual assault
Mechanisms: suppresses ovulation and interferes with transport of egg (thickens cervical mucous)

33

Examples and availability?

Plan B One Step
Next Choice One Dose
My Way
OTC FOR EVERYONE (no age point of sale restrictions

34

Adverse effects of emergency contraceptions?

Nausea, vomiting
Heavier or light period or irregularities
Severe ab pain --> etopic pregnancy

35

Counseling on emergency contraception?

Take one tablet one hour immediately after unprotected sex or ASAP
If vomiting occurs, repeat
89% effective