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28 Cards in this Set
- Front
- Back
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How many unintended pregnancies are terminated by abortion? |
About 4 in 10 |
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What is "typical use effectiveness"? |
Overall effectiveness rate in actual use for a specific contraceptive method
Previously called use effectiveness |
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How are contraceptive failure relates correlated with user's age, level of education, and socioeconomic class? |
Contraceptive failure rates are increased in inverse relation to the user's age, level of education, and socioeconomic class |
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What are the rules about adolescent patients obtaining birth control in North Carolina? |
Minors may consent to contraception services, STI testing and counseling and prenatal care, but need parental consent for abortion |
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What are the recommendations for gonorrhea and chlamydia testing? |
Yearly gonorrhea or chlamydia tests recommended for women under age 26 |
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What is the evidence that making contraception available to adolescents makes them sexually active at younger ages? |
There is NO evidence suggesting this |
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What are three examples of long acting reversible contraception (LARC)? |
IUD
Implanon
Depo-provera |
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What are three examples of hormonal reversible contraception? |
Oral contraceptive
Nuvaring
Ortho-Evra |
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What is the mechanism of action for IUDs? |
Spermicidal
Due to loval sterile inflammatory reaction within endometrium (sperm can't swim up past them)
Don't inhibit ovulation |
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What is physiologically happening when a patient has a Mirena or Skyla IUD? |
Slow release of progestin into endometrium -thicken cervical mucous -endometrial decidualization and glandular atrophy: hostile to implantation -progestins also increase expression of glycodelin A in endometrial glands, which inhibits binding of sperm to the egg -doesn't inhibit ovulation -decreased menstrual blood loss and cramps by making endometrium thin - less PID risk |
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What is physiologically happening when a patient has a Praguard IUD? |
It's copper → no hormones
Copper wiring causes cytotoxic inflammation to endometrium: toxic to ova and sperm -may increase menstrual blood loss/cramps -PID risk |
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In what patients is it safe to use an IUD? |
Adolescent Nulliparous women Patients with immunosuppression (not renal transplant) Patients with thrombosis Patients on anticoagulants (it prevents heavy menstural bleeding associated with coumadin) HIV patient Patient needing MRI |
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What is the MoA of Depo-Provera (the "shot")? |
Inhibits ovulation
Thickens cervical mucus
Thins endometrium |
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What is the major pro and con for Depo-Provera? |
Pro: no risk of thrombosis
Con: Major side effect is weight gain |
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Discuss the risks of stroke, MI, or VTE in progestin-only oral contraceptives |
Large epidemiologic studies have not identified an increased risk of stroke, myocardial infarction, or venous thromboembolism in users of progestin-only oral contraceptives |
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What is the big downside of spermicides? |
Increased rates of UTIs, local irritation
Don't protect against STDs, in fact may increase risk of viral transmission (HIV/HSV) |
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What kind of male condom is best if your patient is using it for contraception? |
Spermacide coated |
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If your patient is using a male condom purely for STD prevention, what kind of condom should they not use? |
Spermicide condom |
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What is the estimated typical use failure rate at 1 year for female condoms? |
~21% |
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What do female condoms provide better protection agains? |
STD transmission, especially HSV |
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What are contraindications to estrogen containing OCPs? |
Breast cancer hx Abnormal uterine bleeding, undiagnosed Hepatic tumors, benign or malignant Liver disease, active Thrombosis or thromboembolic disorders Atherosclerotic CV disease Uncontrolled HTN Smokers over age 35 Migraine with aura Pregnancy, known or suspected |
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What is the rule with combination OCs and smoking? |
Combination OCs should not be prescribed to women older than the age of 35 who smoke cigarettes or use alternative forms of nicotine (increased risk of thrombosis) |
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What are the lesser adverse effects of the pill? |
Nausea, breast tenderness, fluid retention, temporary increase in BP, weight gain (<2%), nervousness, amenorrhea |
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What are the two major drug classes that the pill has drug interactions with? |
HIV drugs and some antiepileptics |
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What is the correlation between OCs and breast cancer risk? |
No significantly increased risk of breast cancer occurs among current or former users of OC or in various high-risk subgroups of OC users |
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What is the most effective method of sterilization? |
Essure -permanent sterilization via hysteroscopic occlusion of tubes -safer than tubal ligation (local anesthesia, no risk of laproscopic trocar insertion) -can be done in office -not reversible |
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What type of sterilization lowers the risk of ovarian cancer? |
Tubal ligation |
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What are the complications of vasectomy? |
Hematoma (~2%)
Infection
Sperm granuloma (common, usually microscopic and asymptomatic)
Chronic testicular pain |
