Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
50 Cards in this Set
- Front
- Back
|
• Non-contraceptive benefits of oral contraceptives
|
Lower incidence of endometrial and ovarian cancers
Fewer ovarian cysts Decreased risk of ectopic pregnancy Minimize acne Regulation of menses – lighter flow Reduction in dysmenorrhea Reduction in symptomatic fibrocystic breast disease Decrease upper genital tract infection (PID) |
|
|
• Contraindications to use of contraceptives
|
Migraine with aura
Smokers over the age of 35 History of thromboembolic disease Coronary artery disease Diabetes or hypertension with vascular disease or older than 35 Lupus erythematosus Hypertriglyceridemia |
|
|
• Injectable contraceptives – down side
|
Depo Provera
FDA approval for contraception in 1991 Given as an IM injection every 11-13 weeks Suppresses ovulation Depresses ovarian steroidogenesis Estradiol can dip into menopausal ranges leading to increased bone mineral resorption Continuous use should not exceed 2 years (not lifetime) Menstrual changes 50% amenorrheic by 12 months 75% amenorrheic by 24 months Weight gain more variable than with other methods Return to fertility can be delayed (median 9-10 months) May be used in breast feeding May be used in women with contraindications to estrogen containing products (eg. Smokers over 35, thrombophilias) depo provera suppresses estradiol so low that it can cause osteoporosis |
|
|
• Common types of contraception (general)
|
Intrauterine contraception
Male Sterilization (Vasectomy) Female Sterilization (Tubal Ligation) Intrauterine Contraception (UID) The Shot (Depo-Provera) The Pill The Patch (Orto Evra) The Ring (Nuva Ring) Barrier Method (male condom, female condom, diaphragm w/ spermicide, spermicides) |
|
|
• Types of contraception safe in breast feeding
|
Condom, diaphragm, copper uterine contraception devices, cervical cap, vaginal sponge, spermicidal cream, jelly, or foam
|
|
|
• Effect of age on fertility and miscarriage rates
|
As age increases follicular phase becomes shorter and estradiol begins to rise earlier
Increased rate of follicular atresia after 37-38 Increased rate of spontaneous miscarriage |
|
|
Intercourse on most fertile day
|
50% achieve pregnancy age 19-26
40% achieve pregnancy age 27-34 30% achieve pregnancy age 35-39 |
|
|
SHORT HALF LIFE
|
birth control pills have a very short half-life, which is why they fail quickly if one pill is missed
|
|
|
• Hormones tested on pregnancy test and ovulation test
|
Pregnancy-HCG Ovulation-Test
|
|
|
• Mullerian abnormalities – common ones and structures involved
|
UTERUS DIDELPHYS (UTERUS DUPLEX SEPERATUS)
|
|
|
• Effect of age on fertility and miscarriage rates
|
As age increases follicular phase becomes shorter and estradiol begins to rise earlier
Increased rate of follicular atresia after 37-38 Increased rate of spontaneous miscarriage |
|
|
Intercourse on most fertile day
|
50% achieve pregnancy age 19-26
40% achieve pregnancy age 27-34 30% achieve pregnancy age 35-39 |
|
|
SHORT HALF LIFE
|
birth control pills have a very short half-life, which is why they fail quickly if one pill is missed
|
|
|
• Hormones tested on pregnancy test and ovulation test
|
Pregnancy-HCG Ovulation-Test
|
|
|
• Mullerian abnormalities – common ones and structures involved
|
UTERUS DIDELPHYS (UTERUS DUPLEX SEPERATUS)
UTERUS DUPLEX BICORNIS (SEPTUS) UTERUS BICORNIS UNICOLLIS UTERUS SEPTUS UTERUS SUBSEPTUS UTERUS UNICORNIS |
|
|
• Howto interpret an ovulation predictor test
|
Couldn’t find in notes so here are random facts from the internet:
- Less concentrated urine should be used so do not use the first void of the day - Looking for the LH surge (only lasts 48-60 hrs) - Have intercourse just before and during ovulation for best chance of pregnancy |
|
|
• Components of a semen analysis and normal values
|
Physical exam
Environmental/occupational exposures Semen analysis 20 million Motility > 50% Volume > 2mL Morphology > 30% normal Endocrine evaluation if warranted |
|
|
• Effect of nicotine on fertility (male and female)
Female |
Interferes with gametogenesis, fertilization & implantation
Reduces estrogen levels Nicotine alters FSH/LH release decreasing LH surge Nicotine stimulates cortisol secretion Earlier menopause by 2-3 years Fertility rates lower (30%) Male Impaired sperm concentration, motility & morphology Decreased libido Combined with caffeine consumption increases number of non-viable sperm |
|
|
• Interpretation of basal body temperature chart
|
Temperature first thing in the morning
Biphasic pattern suggestive of ovulation Common to have dip the day of ovulation Temperatures rise after ovulation due to progesterone from corpus luteum If temperatures drop late in the luteal phase don’t waste money on a pregnancy test! |
|
|
• Effect of menopause on cholesterol
|
50 million women have Total cholesterol >200 mg/dL
More than 50% of women (>55 years old) have TC >240 mg/dL The prevalence of CHD in women aged 45-64 is 1 in 7 and >65 is 1 in 3 Deaths from CHD and cancer are equal in younger women, but over 65 years old, CHD is the major cause of death (more than all cancers combined) Cholesterol levels increase after menopause |
|
|
• Definitions of menopause
|
Decline in ovarian function
Permanent cessation of menses Average age in the United States 51.4 years of age Defined as the time when there has been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified. The end of fertility, the end of the childbearing years. |
|
|
• Evaluation of post menopausal bleeding (might be in Complications of Menstruation lecture)
|
-Cancer until proven otherwise
-typically: lining of the uterus adenocarcinoma (endometrial cancer) |
|
|
• Protective mechanism of estrogen
|
Phytoestrogens
Plant derived estrogens have to consume A LOT of soy to help with hot flashes Asian women experience fewer menopausal symptoms traditional diet rich in phytoestrogens (200 mg) compared with Western diet (<5 mg) Isoflavones (soy beans, chick peas, lentils) Lignans (apples, onion, garlic, cereals, fruit & vegetables) Coumestans: clover |
|
|
Phytoestrogens
Effects |
1. Reduction of menopausal symptoms & prevention of osteoporosis: data are conflicting.
2. FDA has approved food substances containing soy protein to reduce the risk of heart disease Adverse effects No adverse effects Risks No randomized studies. So, it is not possible to draw absolute conclusions without large long-term RCT. |
|
|
• Basic data that we discussed regarding the Women’s Health Initiative
|
Average age 63 years of age (30% > 70yo)
Women with significant menopausal symptoms were excluded Dropout rate high Estrogen only group 58% Combined Therapy 42% Only one estrogen/estrogen-progestin product examined 35% being treated for hypertension 35% overweight 34% morbidly obese 13% on cholesterol meds already 4% had diabetes 16% strong family history of breast cancer |
|
|
How to calculate cholesterol given the values
|
1. Divide triglyceride value by 5 to get the VLDL
2. Subtract the VLDL+HDL from the TC to get the LDL |
|
|
• Definition of a bioidentical hormone
|
I also did not find this in the notes but google says:
Bioidentical hormones are lab synthesized hormones that are identical to the body’s natural hormones |
|
|
• Menopausal symptoms
|
Hot flashes
Vaginal dryness Breast Tenderness Mood disturbances Sleep disturbances Urinary tract infections/incontinence Menstrual changes Sexual dysfunction Slowing of metabolism Weight gain Changes in lipids Increase in heart disease Osteoporosis 90% experience changes in menstrual pattern 90% report symptoms of vasomotor instability 75% lack of energy 68% forgetfulness |
|
|
• Hot flash treatments
|
Avoid:
Stress Caffeine Alcohol Spicy foods Tight clothing Heat Cigarette smoke Treat with: Prescriptions: Catapres, Catapres-TTS, and Aldomet, blood pressure medications Birth control pills Antidepressants, such as Zoloft, Paxil, and Effexor Other hormones, such as Provera and Megace Neurontin, an anti-seizure drug Hormone Replacement Therapy Nonprescriptions: Vitamin B Complex Vitamin E Ibuprophen |
|
|
• Non-contraceptive benefits of oral contraceptives
|
• Lower incidence of endometrial and ovarian cancer
• Fewer ovarian cysts • Decreased risk of ectopic pregnancy • Minimize acne • Regulation of menses- lighter flow • Reduction in dysmenorrhea • Reduction in symptomatic fibrocystic breast disease • Decrease upper genital tract infection (PID) |
|
|
• Contraindications to use of contraceptives
|
• Migraine with aura
• Smokers over the age of 35 • History of thromboembolic disease • Coronary artery disease • Diabetes or hypertension with vascular disease or older than 35 • Lupus erythematosus • Hypertriglyceridemia |
|
|
• Injectable contraceptives – down side
|
• Weight gain is more variable than with other methods.
• Return to fertility can be delayed (9-10 months) |
|
|
• Common types of contraception (general)
|
• Barrier methods (condoms, diaphragm, cervical cap, contraceptive sponge)
• Injection (Depo provera) • Intrauterine devices (Mirena) • Implants (Implanon) • IUD (intrauterine devices) • Oral contraceptives (Estrogen/Progestin) |
|
|
• Types of contraception safe in breast feeding
|
• Contraceptives that contain only progestins
|
|
|
• Effect of age on fertility and miscarriage rates
|
• Age 20-25, 90%, 9.7 miscarriage
• 26-30, 85%, 10 miscarriage • 31-35, 75%, 11.5 miscarriage • 36-40, 65%, 21.4 miscarriage • >40, 50%, 42.2 miscarriage |
|
|
• Hormones tested on pregnancy test and ovulation test
|
• Ovulation test: LH hormone
• Pregnancy: hCG hormone |
|
|
• Mullerian abnormalities – common ones and structures involved
|
• Bicornuate uterus
• Arcuate uterus • Incomplete septum • Uterus didelphys • Complete septum • Unicornuate uterus |
|
|
• How to interpret an ovulation predictor test
|
• If the test band is an equal or darker color than the control band, it is a positive test.
|
|
|
• Components of a semen analysis and normal values
|
• Volume: >2.0 ml
• pH: 7.2-7.8 • Concentrations:> 20x106/ml • Motility: >50% • Morphology: >30% with normal morphology • WBC: <1x106/ml |
|
|
• Effect of nicotine on fertility (male and female)
|
• Impaired sperm concentration, motility, and morphology
• Decreased libido • Increases number of non-viable sperm |
|
|
• Interpretation of basal body temperature chart
|
• In a biphasic chart, the menstrual cycle is divided into 2 phases, the cool and the hot phase, with each reflecting dominance of either estrogen or progesterone. Ovulation represents the middle point separating these 2 phases. In the second half, the temperature remains high until the end of the cycle, or if implantation occurs, hCG will keep progesterone high.
|
|
|
• Effect of menopause on cholesterol
|
• Cholesterol rises after menopause. Before menopause, estrogen has beneficial effects on lipid profiles
|
|
|
• Definitions of menopause
|
• Premature menopause: menopause before the age of 40
• Surgical/Induced menopause: chemo, radiation, or removal of ovaries inducing menopause • Postmenopause: the years after menopause • Male menopause: age-related reduction in menopause |
|
|
• Evaluation of post menopausal bleeding (might be in Complications of Menstruation lecture)
|
• Cancer until proven otherwise
|
|
|
• Protective mechanism of estrogen
|
• Reduction of menopausal symptoms
• Prevention of osteoporosis • Reduces risk of heart disease |
|
|
• Basic data that we discussed regarding the Women’s Health Initiative
|
• The WHI was launched in 1991 and consisted of a set of clinical trials involving 161,808 healthy postmenopausal women.
• It was designed to test the effects of postmenopausal hormone therapy, diet modification, and calcium and vitamin d supplements on heart disease, fractures and breast and colorectal cancer |
|
|
• How to calculate cholesterol given the values
|
• Express cholesterol levels in units of milligrams per deciliters of blood
• Record measurements for total cholesterol, LDL, and HDL • Calculate ratios (Total/HDL and LDL/HDL) • Total cholesterol should be less than 200 mg/dl • Total/HDL should be between 3.5 and 5 (ideally below 3.5) • LDL/HDL should be between 2.5 and 3.5 (ideally below 2.5) |
|
|
• Definition of a bioidentical hormone
|
• Bioidentical hormone therapy replaces the hormones that your body needs
• Bioidentical hormones are molecule by molecule the same as the hormone being replaced • Examples are estrogen, testosterone, cortisol |
|
|
• Menopausal symptoms
|
• Hot flashes
• Vaginal dryness • Breast tenderness • Mood disturbances • Sleep disturbances |
|
|
• Urinary tract infections/incontinence
|
• Menstrual changes
• Sexual dysfunction • Hot flash treatments |
