Flashcards in Primer 19 - Birth Control And Menopause Deck (22):
What are the benefits of hormonal birth control?
Regulation of menses, Decrease in dysmenorrhea/menorrhagia, Decrease in acne, Decrease in ectopic pregnancy, Decrease in pelvic inflammatory infections, Decrease in endometrial and ovarian cancer.
What are the disadvantages of hormonal birth control?
Compliance (daily dosing), Increased coagulability (DVT/PE), Hypertension, elevated triglycerides, GI/Nausea, Mood changes, depression, Weight gain due to water retention (rare).
What are two contraindications of hormonal birth control?
1. Smokers > 35 y.o., 2. Migraines with aura.
What are the symptoms of estrogen toxicity?
Blood clots, Hypertension, cardiac disease, stroke, and abnormal bleeding.
What does Diethylstilbestrol cause in utero?
Association with clear cell adenocarcinoma of the vagina. Malformations of the genitalia, cervix, and vaginal wall.
What is the progesterone used in the Depo-Provera shot?
What is the form of delivery for Depo-Provera shot?
IM injection dosed q3m.
What type of contraception would be a good choice for patients with Mental retardation?
What is an important side effect of Depo-Provera?
It is associated with bone mineral density loss especially if long-term, therefore not ideal for more than 2 years of use.
What is the contraindication for itrauterine device (IUD)?
If there is a high risk of STD.
What does the Intrauterine device "Paragard" have and how long is it good for?
It is made of copper and lasts for 10 years.
What does the Intrauterine device "Mirena" have and how long is it good for?
It has progesterone and lasts for 5 years.
What does the Mirena IUD do inside the Uterus?
Reduces cramping and has anti-inflammatory properties that is good for menorrhagia and chronic pelvic pain.
What is the cause of menopause?
It is the reduction of production of estrogen due to atresia of the ovarian follicles.
What are the side effects of menopause?
Hirsutism (relative increase androgens), Hot flashes, Atrophy of the Vagina, Osteoporosis, Coronary artery disease.
What are the symptoms of menopausal hot flashes?
Occur in 75% of menopausal women, it starts in face/chest then generalizes. It lasts for 2-4 minutes and it causes diaphoresis and palpitations, followed by chills and shivering. Can cause sleep disturbances.
What are the treatments for menopausal hot flashes?
Estrogen replacement > SSRI or SNRI (venladazine) > clonidine or gabapentin.
What are herbal treatments for menopausal hot flashes?
Soy isoflavones, red clover, black cohosh, vitamin E.
Why is progesterone used in combination with estrogen during estrogen replacement?
Unopposed estrogen increases the risk of endometrial cancer.
What hormonal changes are seen during menopause?
Decrease in estrogen.
Increase in GnRH, FSH, and LH.
A 23-year old woman who is on rifampin for TB prophylaxis and on birth control (estrogen) gets pregnant. Why?
Rifampin causes induction of CYP450, causing an increase metabolism of birth control pills.