Flashcards in Exam 2 Deck (56):
when does pregnancy begin (when can bhcg be measured)?
when is the peak fertility window?
day 9-15 of cycle
7 main categories of contraception
1. surgical sterilization
3. barrier methods
4. E/P method
5. progestin only
6. emergency contraception
7. natural family planning
what needs to be considered when prescribing birth control?
4. secondary benefits
which methods are immediately irreversible?
1. copper IUD
3. natural family planning
4. birth control pills
which 5 birth control methods are the most effective?
1. progesterone implant
4. tubal ligation
5. copper IUD
which 5 birth control methods are the least effective?
2. natural family planning
4. female condom
which time frames are considered long acting (in terms of needing to think about it)?
2. Q3-10 yrs
which contraceptive method is reversible but takes 6 months?
what are the CIs to EP pills?
1. current breast disease
2. severe cirrhosis
3. hx of DVT/PE
4. DM nephropathy/retinopathy/neuropathy
5. headache w/aura
8. seizure d/o
which contraceptive methods are most expensive?
diaphragm, condoms, DMPA
which contraceptive method can be delivered as short acting or long acting?
how often is DMPA delivered?
how often are progestin IUDs good for?
which contraceptive method can be delivered as an injection, implant, IUD, or pill?
how do EP methods work?
1. suppress follicle development
2. thickens cervical mucus
3. inhibits ovulation
how does progesterone specifically act as a contraceptive?
1. LH suppression
2. thickens cervical mucous
3. atrophic endometrium
how does estrogen specifically act as a contraceptive?
1. FSH suppression
2. altered tubular transport
what can estrogen alone cause?
what can progestin alone cause?
acne, mood swings
what are the 3 methods of EP delivery?
what is the point of the triphasic EP pill and what causes this multiphasic nature?
to mimic nature (caused by progestin)
what are the common SE of EP?
3. breast enlargement/tenderness
4. libido alteration
5. breakthrough bleeding
6. acne, oily skin, hirsutism
7. hair loss
what are the secondary benefits of EP?
2. menstrual cycle control
3. lighter/shorter periods
4. improved cramps
5. bone protection
6. decr risk for ovarian and endometrial cancer
what are the types of IUD?
1. copper IUD
how do IUDs work?
inhibit fertilization & secondarily inhibit implantation
how does the copper T act?
reduces sperm motility and viability
how does the LNG-IUD work?
inhibits ovulation, thickens cervical mucus, reduces sperm motility and viability
CI for IUDs
1. current STI
2. unexplained uterine bleeding
3. large deforming fibroids
5. copper allergy
what are the SE of an IUD?
1. uterine perforation
5. heavy menses (copper)
6. irregular spotting (LNG)
what are two benefits of barrier contraception over hormonal?
most dont require prescription and they offer STI protection
what 2 types of barriers are there?
chemical and physical
what are the types of chemical barriers?
1. today sponge
3. diaphragm and cervical cap
when is natural family planning esp not the best method?
if you have irregular cycles (<21 days or >28 days)
what is natural family planning?
what are the forms of emergency contraception?
1. levonorgestrel (OTC)
3. copper IUD
4. combo EP pills (need to take multiple)
which emergency contraceptives are good for 120 hours?
ulipristal and copper IUD
how do hormonal emergency contraceptives work?
delay ovulation and may interfere with sperm migration and function at all levels of genital tract
for which patients may EC not work?
overweight (copper IUD will work)
what are the side effects of EC?
1. uterine bleeding
4. abd pain
which EC may cause early abortion?
what is medication abortion?
what needs to be done after admin mifepristone?
US to confirm
which contraceptive cannot be used while breastfeeding?
what are common problems with DMPA?
weight gain and decr bone density
for which women are estrogen alone pills ok?
those w/o a uterus
What is a w/d bleed?
when a woman takes the placebo pills in the EP pack
how is the nuvaring managed?
slow release and needs to be taken out Q3wks
how does copper IUD affect risk of PID?
not more risk than average person except for first month after insertion
what is NEVER a contraceptive method?
between the calendar method and monitoring cervical mucus, which is more effective?
monitoring cervical mucus
what is the failure rate with the calendar method?
how does EC work?
delays ovulation by giving lots of progesterone to stop LH surge and tricks your body into thinking it already ovulated
what will EC not do?
prevent pregnancy if implantation has already occurred
what is the second effect of the ECs?
makes the endometrium an inhospitable environment for implantation