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14 Cards in this Set
- Front
- Back
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How does estrogen based contraception work?
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It suppresses the estrogen induced midcycle surge of gonadotropins, which prevents ovulation
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Why is estrogen only contraception not used?
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The risks of thromboembolism are too high on estrogen-only contraception
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Why is progestin-only contraception not widely used?
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Progestin has potent hyperandrogen effects, pills cannot be missed or taken late (more than 3 hours)
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how does progestin only contraception work?
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If variably suppresses the ovarian cycle, it increases cervical mucous viscosity and it thins the endometrial lining
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How regularly does the patient have to take the mini-pill? What should she do if she misses?
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within 3 hours of the regular time. If she misses this window, she should take the next pill immediately and resume the normal schedule and use back-up contraception for 1 week.
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Is physical exam or testing necessary prior to starting OCPS?
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no, although a pregnancy test, a pap, screening for STIs and a breast exam are good ideas.
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What are the contraindications to estrogen-containing contraception?`
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History of VTE or stroke, history of migraines or Pseudo-tumor cerebri, active liver disease, undiagnosed abnormal uterine bleeding, pregnancy, women over 35 who smoke more than 15 cigarettes a day or hypertriglyceridemia.
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What is considered a "missed dose" for estrogen containing pills? What should the patient do?
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The dose is missed if greater than 12 hours. The patient should take the missed dose immediately. If the patient misses two doses, she should use back-up contraception for 1 week.
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What is the typical use pregnancy rate for OCPs?
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8%
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HOw should obese women be counselled when given OCPs?
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Obese women may be at greater risk for pregnancy on OCPs, although reducing non-compliance may be effective.
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What conditions are helped by taking estrogen containing contraception?
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Perimestrual disorders (Dysmenorrhea/menorrhagia, PMS/PMDD, migraine), Hyperandrogenism (acne/hirstuism), pelvic pain d/t endometriosis, bleeding due to lieomyomas, decreased cancer risk
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What are some adverse effects of estrogen?
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Breakthrough bleeding (should resolve within 3 months), VTE (FH, older than 35, smoker, prior event, obese), Hypertension, hepatic adenoma.
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Is estrogen contraception associated with weight gain?
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No.
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What are the recommendations of giving OCPs to women with migraines?
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Estrogen containing OCPs increase risk of migraines and ischemic stroke with a personal history of migraines, and are contraindicated in women with migraine with aura.
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