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Life Cycles Unit 1 > Family Planning > Flashcards

Flashcards in Family Planning Deck (19):
1

Percentage of pregnancies that are unintended

49% (22% result in birth, 20% abortion, 7% fetal loss)

The 7% of women not using contraceptives account for 47% of unintended pregnancies

2

Consequences of unintended pregnancy

-inadequate prenatal care
-tobacco and alcohol use during pregnancy
-low birth weight
-infant mortality
-child abuse
-insufficient resources for child development

3

Which hormone dominates in follicular phase? luteal phase?

Follicular phase: estrogen dominates (follicle grows, uterine lining grows--proliferative phase)

Luteal phase: progesterone dominates (corpus luteum, uterine lining matures (secretory phase) to allow for implantation)

4

Contraceptive methods for stopping sperm production

-male hormonal contraception
-vasectomy

5

Blocking entry of sperm into/past cervix

-Male barrier methods:
male condom
-Female barrier methods:
female condom
diaphragm
cervical cap
sponge
+/- spermicide
-copper intrauterine device

6

Contraceptives that thicken cervical mucus

Progestin methods:
-pills (Micronor)
-depot medroxyprogesterone acetate(Depo-provera)
-implant (Implanon)
-progestin IUD

7

Female sterilization

ligate/occlude/remove fallopian tube

(Removal = salpingectomy)

8

Contraceptives that prevent ovulation

a.) Progestin alone
i. Progestin only pills Micronor®
ii. Depot medroxyprogesterone
acetate (Depo-provera®)
iii. Implant (Implanon®)
iv. Progestin IUD (Mirena®)

b) Estrogen & progestin
i.Oral contraceptive pills
ii.Transdermal patch
iii.Transvaginal ring

9

Natural family planning methods (and concerns)

-Billings ovulation method: recognize signs of fertility
-Symptothermal method: basal body temp rise after ovulation
-LH predictor kits

Concerns:
-sperm can last for 3-6 days
-variable cycles
-often retrospective

10

Methods that thin the endometrium

Progestin thins endometrium

Estrogen stabilizes endometrium= less bleeding

11

Pharm effects of progestins as contraceptives

-Inhibits ovulation by suppressing function
of hypothalamic-pituitary-ovarian axis
-Modifies mid-cycle surges of LH and FSH
-Diminishes ovarian hormone production
-Reduces activity of cilia
-Produces endometrial changes unfavorable to embryo implantation
-Thickens cervical mucus to impede
sperm transit

12

MOA Progestin only pills

-inhibits ovulation
-atrophic endometrium
-thickens cervical mucus

(Plasma level drops by 24 hrs, thickened mucus lasts 27 hrs; woman at risk if miss pill by greater than 3 hrs)

13

MOA Depo Provera injection

inhibits ovulation
atrophic endometrium
thickens cervical mucus

(Same 3 actions for Levonorgestrel IUD, but mucus even more thick; and for Progestin only pills)

14

MOA progestin only implant

inhibits ovulation
atrophic endometrium
thickens cervical mucus
decreases tubal mobility

15

MOA Combined hormonal contraception (pill, patch, ring)

inhibits ovulation
decreased tubal motility
thickens mucus

16

MOA copper IUD

-creates inflammatory rxn in uterus
-copper acts as spermicide

17

What impacts failure rates?

lower failure rate = less user dependent
From least to most failures:
Levonergestrel IUD
female sterilization
Copper IUD
injection
oral contraceptive
vaginal ring
patch
condom
diaphragm
fertility awareness
spermicide
no method

18

Effects of estrogen: contraceptive and noncontraceptive benefits

Contraceptive benefit
▪ Helps stabilize uterine lining- less breakthrough
bleeding
▪ Added suppression of FSH- less follicle
development

Noncontraceptive benefits
▪ Reduces SHBG
so less male effects (i.e. acne)
▪ Reduces ovarian cancer, endometrial, colon cancer risks

19

Emergency contraception

-MOA is same as other methods, but higher dose:
Disrupts follicular development
▪ Blocks LH surge
▪ Inhibits ovulation
▪ Disrupts luteal phase
• Not the same as abortion pill (RU-
486/mifepristone)

Examples:
-Yuzpe Method (Combined OCPs)
-Plan B: Levonorgesterol
-Copper IUD
-Ella (Ulipristal acetate= progesterone receptor modulator)