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14 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the general methods of contraception using progestins? |
1. Progestin only pills 2. Depot progestin injections 3. Progestin implants 4. Mirena |
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What is the composition of progestin only pills? |
Estrogen-free oral contraceptive pills, with low dose progestin (synthetic) |
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what is the MOA of progestin only pills/ progestin depot injections/ progestin implants? |
1. Inhibits ovulation (50%) 2. Thickens cervical mucus 3. Induce endometrial thinning and atrophy |
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Efficacy of POPs? |
0.5-10 per HWY failure rate 0.5-10% failure rate? |
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How to administer POPs? What if patient missed a pill? |
Take pills once daily, every day, at fixed time If missed a pill for < 3 hours Take the pill ASAP, resume next pill at usual time If missed a pill for >3 hours Take 1 pill ASAP, resume next pill at usual time But need to use barrier contraception for next 2 days |
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what are the benefits of POPs? |
Contraceptive benefits: - quick on, quick off - removed from coitus - decreased risk of ectopic preg - Does not affect lactation (unlike OCPs) Non-contraceptive benefits: - Menstrual benefits (reduce bleed, reduce pain) - Cancer benefits (reduce endometrial cancer risk) |
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What are the general side effects of progesterone only pills/ depot/ implants? |
- Menstrual irregularity (prolonged spotting, breakthrough bleeding, amenorrhea etc) - Bone loss if long term use - Progestogenic SE: - Breast engorged and tender - Headache, nausea - weight gain - Androgenic SE: acne, oily skin, hirsutism |
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What are the general contraindications of progesterone only pills/ depot/ implants? |
Absolute CI: - Breast CA - undiagnosed HMB relative CI: - severe liver disease - IHD, Stroke - migraine with aura - recent bariatric surgery |
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List a few types of POPs |
1st Gen - Norethiesterone 2nd Gen - variable androgenic SE - Levonogestrel - Norgestrel 3rd Gen - minimal androgenic SE - desogestrel - norgestimate - gestodone 4th Gen - minimal androgenic SE - Drospirenone - Dienogest (Visanne) |
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List some example of Progestin Depot Injection medications, and the route of administration What is the duration of action? |
1. Depo-provera, IM route, continuous release over 3 months, 150-300 mg, 3 mthly 2. Noristerat, IM route, continuous release over 2 months, 200 mg, 2 mthly |
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What is the efficacy of depot progestins? |
0.1-0.6% failure rate ; higher than POPs |
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What are the relative side effects of depot progestins versus POPs? |
- Depot progestin effects takes longer to wear off, leading to delay in return of fertility (about 10 months) - Depot has increased risk of bone loss if used long term - Depot should never be used in pregnant women |
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What are the examples of progestin implants? what is the frequency of replacement for each? |
1. Norplant (Levonogestrel implant, 2nd Gen) - 6 rods subdermally, replace every 5 years 2. Implanon (Etonogestrel implant, 3rd Gen) - 1 rod subdermally, replace every 3 years - Placed in medial compartment of non-dominant arm |
picture showing norplant |
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What is the efficacy of progestin implants? |
failure rate of 0.2% in 1st year, similar to efficacy of sterilization in 1st 3 years |
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