Sept10 A3-Non-hormonal contraception

Question 1

top tier of most effective contraception

Answer 1

• IUD (copper OR LNG-IUS)
• progesterone implants
• female and male sterilization

Question 2

second tier of very effective contraceptive

Answer 2

• COC
• vaginal ring
• patch
• DMPA (P injection)
• P only pill

Question 3

third tier of effective contraceptives

Answer 3

• condom (M and F)
• diaphragm
• fertility awareness

Question 4

fourth tier of least effective contraceptives

Answer 4

• spermicides

- sponge

Question 5

non categorized contraception

Answer 5

withdrawal

Question 6

IUD risk of infertility

Answer 6

nonexistent

Question 7

IUD risk in nulliparous women or adolescents (smaller uterus)

Answer 7

none

Question 8

IUD risk of PID

Answer 8

none

Question 9

Mirena vs other IUDs

Answer 9

Mirena has most P so more bleeding CONTROL

Question 10

contraindications to IUDs

Answer 10

• pregnancy
• infection
• liver problem (can use copper IUD)

Question 11

good patients for using LNG-IUS

Answer 11

dysmenorrhea

Question 12

bad pts for LNG-IUS

Answer 12

pts with

• headaches
• breast tenderness
• acne

Question 13

female sterilization def

Answer 13

TUBAL LIGATION
1. clip uterine tube
2. necrosis in tube
3. clip falls off anywhere in abdomen
4. tube region necrosed forever
OR salpingectomy
-removal of fall tube

Question 14

male sterilization def

Answer 14

• vasectomy

- have to wait three months and come back for sperm analysis

Question 15

female condoms advantages

Answer 15

• STI protection
• no need for prescription or fitting
• can be inserted 6-8 hrs before sex
• no allergic reaction

Question 16

main advantage of male condom

Answer 16

protection against STIs

Question 17

diaphragm def + how it works

Answer 17

• cup below cervix

- has spermicide

Question 18

contraindication to diaphragm

Answer 18

women with pelvic organ prolapse (POP)

Question 19

diaphragm how to use

Answer 19

• can put it well before sex but if >2 hrs, add spermicide again
• remove it between 6th and max 24th hour after sex

Question 20

cervical cap def

Answer 20

• silicone cap surrounding cervix to block sperm passage

- contains SPERMICIDE

Question 21

cervical cap how to use

Answer 21

• put any time before intercourse

- remove after 8th hour after intercourse

Question 22

fertility based method with app and thermometer works how

Answer 22

• when ovulate = biphasic peak of temp

- based on temp, cycle prediction app tells you if you can have sex

Question 23

spermicides ex

Answer 23

• creams, jellies, suppositories, aerosol foams, film

- no prescription

Question 24

good candidates for spermicide

Answer 24

• other methods unacceptable
• need temporary protection, like during first week after starting CHC (combined hormonal contraception) or while nursing

Question 25

spermicide active ingredient

Answer 25

nonoxynol-9 or octoxynol-9

Question 26

spermicide MOA

Answer 26

- physical barrier to sperm penetration | - chemical spermicidal action

Question 27

spermicide how to use

Answer 27

- put high in vagina close to cervix shortly before intercourse - max effectiveness = 1 hour

Question 28

spermicide problem

Answer 28

no protection against STIs

Question 29

contraceptive sponge MOA

Answer 29

-same ingredient as spermicide

Question 30

sponge how to use

Answer 30

- put up to 24 hrs before intercourse - put against cervix - efficacious until 6 hrs after intercourse

Question 31

indications of emergency contraception

Answer 31

- failure to use any method of contraception - condom slippage, breakage, leakage - missed hormonal contraception - error in withdrawal - incorrect placement of diaphragm or cervical cap - sexual assault - mistimed fertility awareness

Question 32

MOA of emergency contr

Answer 32

- delayed or inhibited ovulation - endometrial changes preventing implantation - interfere with sperm transport or penetration - impaired CL fct

Question 33

does emergency contr help if already implanted zygote

Answer 33

no, is not a medical abortion

Question 34

CEP (one kind of emergency contr) how to use

Answer 34

- certain nbr of pills to take - take within 72 hrs of unprotected intercourse - 75% efficacy if using COC

Question 35

progesterone method (plan B two tablets) how to use (is another emergency contr)

Answer 35

- take 1 dose within 72 hours of sex - take 2nd dose 12 hrs later - 97.8% efficacy

Question 36

ulipristal acetate (emerg contr) MOA

Answer 36

- prevent P mediated endometrial prep for implantation - P R modulator - delays ovulation

Question 37

UA how to use

Answer 37

one tablet up to 120 hrs after sex

Question 38

copper IUD (emerg contr) MOA

Answer 38

inflammation that - is toxic for spermatozoa and oocytes - increases fall tube SM activity - stimulate myometrial contractility - alter cytokines and intergrins in endo lining (inhibits implant)

Question 39

indications for non hormonal contraception

Answer 39

- medical contraindication to hormonal | - severe SEs from hormonal