Repro(Ost527)-Contraceptionii-Seiler(Scribe15)

Front 1

How does progesterone prevent pregnancy?

Back 1

Suppresses ovulation and supports/atrophies the endometrium with long-term doses

Front 2

How does progesterone support pregnancy?

Back 2

When pregnant, progesterone is made on the corpus luteum and it supports the pregnancy
Estrogen makes the endometrium ready for the egg and then it is stabilized so that the women doesn't start her period
If someone has multiple miscarriages, it may be that they are not making enough progesterone to support their uterus.

Front 3

What are all IUD's?

Back 3

-Spermicidal, not abortifacient, no effect on ovulation
-All IUDs have 2 strings that come out of the cervix and into the vagina. The doctor and patient are able to monitor for appropriate IUD placement

Front 4

What are the 3 types of IUD's?

Back 4

1.ParaGuard(Copper T-380)
2.Progestasert-Progesterone released
3.Mirena-Lovongestrel released

Front 5

What are 2 FDA approved IUDs in the US?

Back 5

1.ParaGuard=Copper IUD
2.Mirena

Front 6

In the Levonorgestrel Intrauterine System, where is the steroid reservoir?

Back 6

On the shaft

Front 7

In the Levonorgestrel Intrauterine System, how is progesterone released?

Back 7

Released at a slow and constant rate

Front 8

In the Levonorgestrel Intrauterine System, what does progesterone do?

Back 8

Suppresses ovulation in some cycles

Front 9

How is the Levonorgestrel Intrauterine System inserted?

Back 9

1.Small and soft, rubbery arms that fold during insertion
2.Insertion is generally quick and does not cause pain to the woman

Front 10

What is the advantage of the progesterone released from the Mirena: Levonorgestrel IUD?

Back 10

-It does all of the good things that progesterone does
-Does not give all the systemic effects of progesterone (i.e. acne, depression, decreased libido, etc.)
-Fertilization inhibition

Front 11

Does the Mirena: Levonorgestrel IUD cause abortions?

Back 11

NO

Front 12

What has lower failure rates, IUDs and shots or oral contraceptives?

Back 12

IUDs and shots

Front 13

What is the best time to insert the Mirena: Levonorgestrel IUD?

Back 13

Best time to put it in is the 1st week of the period
-->Usually women are not pregnant at this time
-->Cervix is open so it is easier to insert the IUD
-->Allows for less discomfort and cramping

Front 14

If expulsion of the Mirena-Levonorgestrel IUD occurs, when does it generally occur?

Back 14

Generally happens soon after insertion

Front 15

Do Paraguard or Mirena result in decreased fertility?

Back 15

NO

Front 16

If a patient with an IUD wants to get pregnant, what can be done?

Back 16

The IUD is removed easily without pain. Patient may get pregnant as soon as the next cycle.

Front 17

What are the absolute contraindications for an IUD?

Back 17

1.Active, recent, or current PID
2.Prenancy
3.Uterine anomalies for PID or STDs

Front 18

What are the relative contraindications for IUD's?

Back 18

1.Undiagnosed irregular bleeding
2.Risk factors for PID of STDs
3.Uterine anomalies (Fibroids)

Front 19

What are the 3 types of infections that can occur with an IUD?

Back 19

1.Immediate Infections
2.Later Infections
3.Bacterial Vaginosis

Front 20

Standard of care-->if the patient becomes pregnant, what should be done with the IUD?

Back 20

Remove the IUD

Front 21

If the IUD is left in place in a pregnant patient, what happens?

Back 21

-Strings/IUD gets pulled up
-Intrauterine infection can occur
-1st trimester-->spontaneous abortion=more common
-2nd trimester-->life-threatening

Front 22

In a pregnant patient, removing the IUD can cause what?

Back 22

Miscarriage

Front 23

1.What type of pregnancy does an IUD prevent?
2.What type of pregnancy does an IUD allow?

Back 23

1.IUD prevents intrauterine pregnancies
2.IUD allows ectopic pregnancies

Front 24

When can an IUD be inserted?

Back 24

-8 weeks after delivery
-During menses

Front 25

Early insertion of an IUD after delivery leads to what?

Back 25

-Migration of the IUD from the uterus and into the belly
-This requires laparoscopy for removal

Front 26

Can an IUD be put in at the time of a spontaneous abortion?

Back 26

Yes

Front 27

What are the 4 main contraindications to inserting an IUD?

Back 27

1.STD history=CRITICAL
2.Wilson's Disease (Don't want to put copper into these patients)
3.Immunocomprimised (Problems with foreign body insertion)
4.Uterine anomalies

Front 28

What is the only contraceptive patch on the market?

Back 28

Ortho-Evra Patch

Front 29

What does the ortho-evra patch contain?

Back 29

Progesterone and estrogen

Front 30

What is the main side effect of the patch?

Back 30

-3Xs risk of thromboembolic events compared to OCs
-Higher systemic levels of estrogen result in increased risk of blood clots

Front 31

What are the contraindications for the patch?

Back 31

1.Do NOT give to anyone over 35 years old who smokes
2.Do NOT give to anyone with a family history concern
3.NOT recommended if > 198 pounds

Front 32

If a woman is > 198 lbs, why should the patch not be used?

Back 32

More tissue-->less diffusion and decreased efficacy

Front 33

How does the compliance for the patch compare to that for OCs?

Back 33

Better compliance-->b/c patch only involves once a week dose

Front 34

What is the cycle for the patch?

Back 34

-3 weeks on, 1 week off

Front 35

Where is the Nuva Ring inserted?

Back 35

Vagina

Front 36

How long is the Nuva Ring worn?

Back 36

Worn for three out of four weeks

Front 37

When the Nuva ring is removed during the 4th week, what happens?

Back 37

Menstrual period should begin

Front 38

If Nuva ring is removed or slips out of place for more than 3 hours, what happens?

Back 38

Back-up contraception is necessary for 7 days

Front 39

How many days of medication does the Nuva Ring have?

Back 39

Has 34 days of medication so can be used as continuous birth control (off label use)

Front 40

Does the Nuva Ring go through th hepatic first pass effect?

Back 40

NO

Front 41

What does the Nuva Ring do to vaginal discharge and infections?

Back 41

Increase in vaginal discharge
NO increase in infections

Front 42

What is the most common form of contraception in the US?

Back 42

Sterilization

Front 43

For whom is a sterilization not recommended?

Back 43

Young women

Front 44

Can a vasectomy be reversed?

Back 44

Yes, 50% successful reversal rate for vasectomy

Front 45

Once a patient gets a vasectomy, what must they do?

Back 45

Go back to the physician and have their sperm count measured