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34 Cards in this Set
- Front
- Back
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Efficacy
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Rate of success with ideal use
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Effectiveness
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Real-world success rate
Higher failure rates with methods that use a lot of patient intervention |
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Unintended pregnancy epidemiology
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50% are unintended
50% of those end in abortion Mostly in blacks, Hispanics, and poor Teen pregnancy rates higher in US |
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Complications of unintended pregnancy
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Maternal death
Abortion Childbirth |
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COC mechanism of action
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Estrogen and progesterone
Estrogen suppresses FSH and LH surge, ovarian hormone production, and ovulation Progesterone thickens cervical mucus and alters endometrium 21 days active, 7 days inactive to cause bleed |
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Vaginal ring
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Higher levels of hormone due to no first-pass metabolism
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Transdermal patch
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No first-pass metabolism
Patch-site reaction, detachment, breast tenderness, nausea, less effective in obese people |
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COC contraindications
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Smoker over 35
Thrombosis DM with vascular involvement Migraine HTN or CAD Breast or genital cancer Liver disease Genital bleeding |
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COC benefits
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More regular and less painful periods
Suppress endometriosis Treat acne Decreased rates of endometrial and ovarian cancer Decreased incidence of PID |
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Progesterone only hormones
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Thickens cervical mucus, atrophies the endometrium
DMPA - injectable every 3 months Subdermal implant good for 3 years, but causes irregular bleeding |
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Progesterone only contraindications
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Breast cancer
Active liver disease Unexplained genital bleeding |
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Progesterone only benefits
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Treat menorrhagia and dysmenorrhagia
Treat fibroid symptoms Suppress endometriosis Reduce frequency of epileptic seizures Decreases risk of endometrial cancer |
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Copper IUC mechanism of action
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Copper in uterus induces PGs and macrophages in uterine and tubal fluids
Impairs sperm function |
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IUC contraindications
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Pregnancy
STI or cervicitis PID Genital cancers Copper allergy or Wilson's disease (copper) History of breast cancer (hormonal) |
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IUC benefits
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Effective and forgettable
Lighter period (hormonal) No hormones (copper) |
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IUC complications
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Can be expelled
Can cause amenorrhea Can perforate uterus Heavier and more painful periods with copper IUC |
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Condom contraindications
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Latex allergy
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Condom benefits
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Inexpensive
Protects against STIs Non-prescription |
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Condom disadvantages
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Must be used every time
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Diaphragm condaindications
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Latex allergy
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Diaphragm benefits
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Inexpensive
No prescription Protects against STI |
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Diaphragm drawbacks
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Needs to be fitted
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Family planning mechanism
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Only fertile from days 8-19
For women with regular cycles |
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Family planning drawbacks
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Temporary
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Family planning benefits
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Effective
Free |
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Lactational amenorrhea
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Breast feeding every 4 hours prevents pulsatile GnRH secretion
Effective up to 6 months Must have amenorrhea |
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Female sterilization method
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Mini-laporotomy to excise part of tube
Laporoscopic surgery to tie, clip, or burn part of tube |
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Female sterilization benefits
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Permanent
Effective |
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Female sterilization disadvantages
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Expensive
No STI protection Less effective at younger age |
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Risks of female sterilization
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Bleeding from surgery
Ectopic pregnancy Regret |
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Male sterilization method
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Ligate or excise the vas
Takes 20 ejaculations to flush sperm from tubes |
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Male sterilization benefits
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Permanent
Effective |
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Male sterilization drawkbacks
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High cost
Risk of regret |
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Emergency contraception
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High-dose levonorgesterol after unprotected or underprotected sex
Delays ovulation Must take within 120 hours of unprotected intercourse Over 90% effective in first 12 hours |
