exam 2 Flashcards
(64 cards)
hormonal bc
combination pill, mini-pill, patch, ring, emergency contraception
combination pill
- estrogen + progestin
- higher doses of estrogen and progesterone than natural for 21 days, 7 days placebo
- inhibits ovulation
- thickens cervical mucus
- body thinks already ovulated
- seasonal: 84 days on, 7 off; loestrin 24 (24 on, 4 off, shorter period)
- could protect from endometral and ovarian cancer
health risks of combination pill
- thromboembolic disorders (blood clots)
- STIs incr
- incr or decr desire
- Reduce flow and cramps, covered by insurance under the ACA
failure rate of combination pill
typical: 7% (forgetting 2+ days)
perfect: .3%
mini-pill
- progestin only
- avoid estrogen-related side effects like blood clots
- can be used duing breastfeeding unlike combo pills
- start during the period and take every day
the patch
1 patch/wk x 3 weeks, 1 wk no patch
less effective if > 200lbs
the ring
ring w hormones
3 weeks in, remove for 1 week, new ring
emergency contraception
high dose of progestin
within 24 hr, must be within 120
prevents ovulation and fertilization
62-85% effective, 0.5-2% pregnancy rates
- Ella is similar but prescription only, anti-progestin
- insertion of IUD within 5 days (<1% failure rate)
LARCs
injection, implants, IUDs
injection
- progestin
- every 3 months, 4% failure rate
- minimal side effects
implants
- progestin
- thin rod or tubes in arm
- 3yr
- typical use: .05% fail more effective than pill
Copper IUD (paraguard)
- no hormones, changes enzymes
- .8% failure rate, goes dwn after 1 yr
- 12 yr
hormonal IUD
- progestin
- disrupts ovulation
- 3-6yr
- -.8% typical fail
About 20% stop menstruating
barrier methods
condoms, diaphragm, femcap, sponge, dental dam, spermicide
condom failure rate
perfect: 2% typical: 13%
female condoms 5% and 21%
diaphragm
6 hr before and 6hr after sex, typical use 17%
femcap
use w spermicide, similar to diaphragm, silicone, 3 sizes
sponge
polyurethane + spermicide
spermicides
foam cream jelly
21% fail
rhythm methods
- fertility awareness (abstain from sex during ovulation)
- calendar method (abstain 3 days before and 2 days after ovulation, assume ovulation on 13-15 of 28 day cycle)
- standard days method (26-32 day cycle, abstain days 8-19)
- basal body temperature (BBT)
- cervical mucus method (changes in discharge)
- sympto-thermal method: cervical mucus and basal body temp
typical users: 15%
sterilization
- vasectomy: vas clamped, segment removed, ends tied, scrotume elevated
- laparotomy: fallopian tubes tied off and cut apart
how many teen pregancies/yr
450,000 in US
29% -> abortion
57% -> live births
14% -> miscarriages
pill based abortion
42% in the first 8 weeks
surgical abortion
49% in first trimester, vacuum aspiration (13 wk)