Gynecological therapies Flashcards
(30 cards)
What cancers do combined OCPs lower risks of?
ovarian and endometrial
What are ADRs to be aware of combined OCPs?
MI with cigarettes, thromboembolic disease, carcinoma, HTN, headache, obesity
T/F: should smokers stop use of combined OCPs
if >35 years, yes
how do combined OCPs work
suppresses ovulation
If an active combined OCP pill is missed
No intercourse in past 5 days = 2 pills taken immediately + backup method for 7 days
Intercourse in past 5 days = emergency contraception and backup method x 7 days
What are DDIs with combined OCPs?
phenytoin, phenobarbital, primidone, topiramate, carbamazepine, rifampin, St. John’s wort, antiretrovirals
What are absolute contraindications for combined OCPs?
pregnancy
thromboembolic disease
stroke/CAD
undiagnosed abnormal bleeidng
estrogen-dependent cancer
hepatocellular adenoma
uncontrolled HTN
age >/= 35 and smoking >/= 15 cigarettes
known thrombophilia
migraine with aura
active hepatitis
surgery or orthopeadic injury with prolonged immobilization
What are relative contraindications to combined OCPs?
Migraine without aura
HTN
heart/kidney disease
DM
symptomatic gallbladder disease
21-<30 days postpartum
30-42 days postpartum with RF
What birth control do you give to people with combined OCP CIs?
progestin-only pills
progestin-only pills —- the cervical —
thicken the mucus
What’s the ideal choice for breastfeeding women?
progestin only pills
What are CIs of progestin-only pills
Current breast cancer, malabsorptive disease, current/past ischemic heart disease, history of stroke
What are implantable contraception options?
Injectable progestin depot medroxyprogesterone acetate (DMPA)
Deep IM injection every 3 months
Single-rod subdermal progestin implant (nexplanon)
Rod of progestin etonogestrel inserted in inner aspect of nondominant arm, good for 3 years
What are ADRs of implantable contraceptives?
irregular bleeding, amenorrhea, weight gain, headache, bone mineral loss, delay in ovulation after discontinuation
No delay in return to fertility after removal
transdermal patches cannot be used with
BMI greater/equal to 30
Hormone = thickening of cervical mucus, suppress lining, inhibit ovulation
– Mirena (8), Liletta (8), Kyleena (5), Skyla (3)
Copper = spermicidal or inhibitory effects on sperm capacitation and transport
– paragard (10)
are all types of
IUD
what are absolute contraindications for IUDs?
pregnancy
acute/subacute PID or purulent cervicitis
significant anatomic abnormality of uterus
unexplained uterine bleeding
Wilson disease or copper allergy
breast cancer (hormonal)
cervical, endometrial or gestational cancer
What are relative CIs to IUDs?
active liver disease
menorrhagia or severe dysmenorrhea
insertable contraception should not be left in vagina for over
24 hours
What’s emergency contraception
Levonorgestrel, 1.5mg PO single dose (plan B) OTC
Other options for emergency contraception?
Combo OCP (ethinyl estradiol and levonorgestrel) twice in 1 hours
Ulipristal acetate
IUD insertion within 5 days
when is best to have emergency contraception
within 72 hours
when is the time limit for emergency contraception
within 120 hours
what’s the most effective method for emergency contraception?
copper IUD
