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15 Cards in this Set
- Front
- Back
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What is the potential risk of tubal ligation (beyond normal surgx risk)?
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potential ectopic pregnancy
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What is Essure?
- pro? - con? |
transcervical sterilization: polyester fibers (PET) places hysteroscopically induce local tissue growth and tubal blockage.
- outpatient w/o general anesthesia - may req more than one procedure, tubal spasm, possible expulsion --> need verification of occlusion w/ hysterosalpinogram 3m afterwards. |
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How does the pill work?
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inhibits the LH surge w/ progestin --> inhibits ovulation, thickens, cervical mucus, decreases tubal mobility, thins endometrium.
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What are some additional pros of the pill?
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decreased:
- anemia - dysmenorrhea - mittelschmerz - benign breast dz - ovarian cancer - endometrial cancer (80% reduction!) - decreased corpus luteum cysts - decreased death from colorectal cancer |
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Given the following, give whether it is an absolute or relative contraindication of the pill:
- diabetes - smoking and under <35y - hepatoma - pregnancy - previous or active thromboembolic dz - obesity - migraines - gallbladder dz - HTN - undx'ed genital bleeding - estrogen dependent neoplasm |
Absolute: preg, thrombolic, undx'd genital bleeding, smoking/age<35, E2 dependent neoplasm, hepatoma
Relative: HTN, diabetes, Gallbladder dz, obesity, migraines |
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What has the lowest E/Progestin dose of any combined hormonal method?
- cons? |
Nuvaring
- 25% of cycles accompanied by additional spotting, possible expulsion. |
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Does Nuvaring get felt by sexual partners?
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no, not scientifically speaking.
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What are some downsides to the patch?
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application site problems, increased nausea and breast tenderness compared to oral, lower efficacy in women >90kg.
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What is the failure rate (relatively speaking) of an IUD?
- what hormone is in the IUD? - can it cause amenorrhea? - does it always stop ovulation? - how long does it take to return to normal after removal? - does the IUD prevent implantation? |
0.1% This is LOWER than tubal ligation!!
- ONLY progestin - yes; 20% of women after one year have no cycles. - no; most women are still ovulating. - ~3m, usually - NO, just thickens the cervical mucus, alters tubal motility, and thins endometrium. Also inhibits, but doesn't stop, ovulation. |
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How does the copper IUD work?
- how long does it last - disadvantages? |
spermicidal effect of copper ions
- can last for up to 10 years - w/o progestin, typically increased menstrual bleeding. |
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What is the failure risk of diaphragm? condoms?
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6-16%
2-15% |
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What is the failure risk of natural family planning?
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1-25%...
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What are the 3 options for emergency contraception?
- what are the time periods of use for each? - which is most effective? |
Plan B (progestin only): ASAP, but can be up to 5 days
- less side effects b/c no estrogen E + progestin: ASAP, but up to 3-4 days Copper IUD: up to 8 days Copper is most effective, the others are <1% if used in <12hrs. |
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Do Plan B and COC (progestin + E) disrupt an implanted pregnancy?
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No. They only work if taken before ovulation --> blocking LH surge.
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A 23 year old presents to your office for her annual exam. She tells you that she has concerns about taking the Pill because a friend of hers just had a blood clot in her leg while on the Pill. She would like another form of birth control. She is married; she has completed her childbearing. She was originally placed on the pill because she had heavy menstrual cycles. You suggest:
A different brand of oral contraceptive The Mirena IUD The copper IUD A tubal ligation |
Mirena!
Not copper, b/c she was orginally placed on pill b/c of heavy menses, which copper can make worse (mirena lessens). |
