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18 Cards in this Set
- Front
- Back
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What are the two families of contraceptive progestins?
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Gonanes (Levonorgestrel Family) and Estranes (Norethindrone Family)
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Where are progestins derived from?
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Testosterone
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What is the point of combining estrogen with progestin?
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Cycle control
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What is sex hormone binding globulin...what effect does OC's have on SHBG levels?
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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. |
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What are combination OC's effects on androgen pathway?
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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. |
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What are the clinical effects of OC's?
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1) Reduced blood loss/anemia
2) Decrease testosterone (decreased hirsutism and acne) 3) Suppressed ovarian cysts |
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How many days of the month must combined OC's be taken?
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21 concurrent days out of the 28 day cycle.
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With progestin only, what occurs to menstrual cycles?
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Progestin only means little or no menstruation.
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What are the three types of Emergency Contraception?
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The Combined Pill (morning after)
The Progestin-only Pill (Plan B). The Copper Intrauterine Device |
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What are advantages and disadvantages of combination pill?
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1) Prevents 75% of unintended pregnancies
2) Take up to 5 days after intercouse DISADVANTAGES 1) Increased incidence of side effects due to high estrogen. 2) TWO DOSES NEEDED 3) Nausea and vomiting |
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What are advantages and disadvantages of Progestin-only pill?
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Advantages
1) Only ONE DOSE NECESSARY 2) OTC 3) Bettered tolerated and more effective than morning after DISADVANTAGES Mild side effects: nausea, vomiting, dizziness |
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What are side effects of estrogen in combined OC's?
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HYPERTENSION, headache, nausea, excess discharge
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What are side effect of progestin in combined OC's?
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Mood swing, depression, increased apetite, decreased libido
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Which is the best contraceptive device to obtain amenorrhea?
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DEPOT MEDROXYPROGESTERONE ACETATE
Progestin only. |
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If patient is a smoker and is considering OC's, what would you recommend?
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Smoking is a risk factor for hypertension. Since estrogen's side effects INCLUDE hypertension and other CV related issues, CONSIDER PROGESTIN ONLY PILLS
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What effect do OC's have on breast/ovarian cancers?
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REDUCE RISK!
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What part of menstrual cycle does progestin inhibit?
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PROGESTIN inhibits LH surge and subsequent ovulation.
PROGESTIN also thickens cervical mucous. Also decreases estrogen-driven cell proliferation. Convers proliferatives tissues until functional tissues. |
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What part of menstrual cycle does estrogen inhibit?
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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. |
