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23 Cards in this Set
- Front
- Back
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SHE SAID WE DON'T HAVE TO KNOW NUMBERS - HERE ARE THE MAIN CONCEPTS TO KNOW!!!
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high rate of unintended pregnancies and we arent good users of contraception
understand contraindicastions know which ones ocntain estorgen, which ones contain progestin how long are they effective - in case you are planning to start a family THERE WILL BE NO QUESTION ON NUMBERS FROM HER!!! |
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40% of unintended pregnancies are attributed to...
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the 5-7% of sexually active couples who use no method of birth control.
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Breakdown of the people getting pregnant
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1/2 are unintended (NOT TYPICAL OF DEVELOPED COUNTRIES!!!) and of those, 1/2 get an abortion, the other half have their baby born.
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Teens and abortion rate
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Although many unintended pregnancies, not many abortions (relatively).
40+ have the highest abortion rate. |
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If you have a baby before age 21...
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>90% chance spending >10 years in poverty
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A good approach to the unintended pregnancy problem...
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get the sexually active couples who use no birth control (only 5-7%) to start using something!!!
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Why is IUD superior to tubal ligation?
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non-invasive.
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percentage of couples using no protection that will have a preganncy in their first years
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85%
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Components of OCs
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Estrogen and progestin
Estrogen is either ethinyl estradiol (most often) or mestranol. There are tons of progestins on the market. |
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MiniPill
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Only progestin.
Not great because it doesn't always stop ovulation and only prevent sperm from going up the uterine cavity for 12 hours. So if ovulation wasn't stopped and you took the pill in the morning but had sex at midnight, this is no good. |
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Why do people think OCs are dangerous?
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Pills from the 60s had lots of estrogen (thrombogenic) and progestin (not a big deal) and they had adverse CV events.
People thought progestin was the issue so they made many different kinds - that is why there are so many on the market. |
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Multiphasic vs. monophasic OCs
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equally effective.
in multiphasic, the doses of the estrogen or progesterone varied within the 21+7 day cycle. |
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why is 21+7 better than 21+0 for OCs
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better pt compliance.
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Will periods be worse with OCs?
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No, because progestin (suppresses the endometrium) is the dominant hormone at the endometrium.
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Are you more likely to die of a complic of pregnancy if you are on some sort of birth control?
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No, unless you are over 40, where OCs make you more likely to die.
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Do OCs cause weight gain?
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no
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Do OCs cause cancer?
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Slight increase of breast CA but it is a less advanced form of breast CA
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new pills and lipophilicity
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lipid-neutral
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what is a better word than compliance?
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effective utilization - this shifts some of the blame on the doc, which is where it needs to be.
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birth control shot
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medroxyprogesterone acetate/Depoprovera
V. effective but can cause bone mineral density issues and lasts up to a year/18 months. |
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TCS EVRA issue
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it is a patch but not effective in women > 90kg
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levonorgestrel intrauterine system (LNG US)
also called Mirena |
releases levonorgestrel (a synthetic progesterone) into the uterine cavity - it is a little device in the uterus.
effective. |
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emergency contraception
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combos of ethinyl estradiol, nogestrel, levonorgestrel
can not interrupt after implantation. it probably stops follicular maturation can reduce preg rate, will not alter preg if it occurs. OTC for women > 17 years age. Rx with dramamine bc of N/V |
