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18 Cards in this Set

  • Front
  • Back
What are the two families of contraceptive progestins?
Gonanes (Levonorgestrel Family) and Estranes (Norethindrone Family)
Where are progestins derived from?
What is the point of combining estrogen with progestin?
Cycle control
What is sex hormone binding globulin...what effect does OC's have on SHBG levels?
Sex hormone binding globulin binds free testosterone.

OC's increase the levels of SHBG's. This means less free testosterone.

Less free testosterone means less conversion via 5a-reductase to DHT.
What are combination OC's effects on androgen pathway?
Estrogen inhibits FSH/LH production, which therefore blocks ovary's testosterone (~25% of total) production.

Progestin also blocks 5a-reductase, which in turn decreases DHT levels.
What are the clinical effects of OC's?
1) Reduced blood loss/anemia
2) Decrease testosterone (decreased hirsutism and acne)
3) Suppressed ovarian cysts
How many days of the month must combined OC's be taken?
21 concurrent days out of the 28 day cycle.
With progestin only, what occurs to menstrual cycles?
Progestin only means little or no menstruation.
What are the three types of Emergency Contraception?
The Combined Pill (morning after)

The Progestin-only Pill (Plan B).

The Copper Intrauterine Device
What are advantages and disadvantages of combination pill?
1) Prevents 75% of unintended pregnancies
2) Take up to 5 days after intercouse

1) Increased incidence of side effects due to high estrogen.
3) Nausea and vomiting
What are advantages and disadvantages of Progestin-only pill?
2) OTC
3) Bettered tolerated and more effective than morning after

Mild side effects: nausea, vomiting, dizziness
What are side effects of estrogen in combined OC's?
HYPERTENSION, headache, nausea, excess discharge
What are side effect of progestin in combined OC's?
Mood swing, depression, increased apetite, decreased libido
Which is the best contraceptive device to obtain amenorrhea?

Progestin only.
If patient is a smoker and is considering OC's, what would you recommend?
Smoking is a risk factor for hypertension. Since estrogen's side effects INCLUDE hypertension and other CV related issues, CONSIDER PROGESTIN ONLY PILLS
What effect do OC's have on breast/ovarian cancers?
What part of menstrual cycle does progestin inhibit?
PROGESTIN inhibits LH surge and subsequent ovulation.

PROGESTIN also thickens cervical mucous. Also decreases estrogen-driven cell proliferation.

Convers proliferatives tissues until functional tissues.
What part of menstrual cycle does estrogen inhibit?
BLOCKS FSH and subsequent follicular development.

Thins cervical mucous.

Estrogen boosts proliferative endometrium, which together with thin cervical mucous help couterbalance the effects of progestins.