Unit 6 Turner Contraception

Front 1

effects of reduced population growth include

Back 1

improved food supply
less habitat destruction
better air/water quality
better health and quality of life for humans and other species

Front 2

contraception in the USA

Back 2

education is inadequate- 1999 study indicated 40% of american women have been pregnant by age 20

Front 3

contraceptive use in 2006 as % of total users

Back 3

29.7% hormonal
28% tubal sterilization
11% vascetomy
17% condom

Front 4

hormonal contraception includes

Back 4

oral pills
progestin
depot injection
subdermal implant

Front 5

categories of contraceptive action

Back 5

prevent ovulation
render female tract in hospitable to sperm tranport/survival
prevent implantation
inhibit spermatogenesis
physical barrier
spermicide
surgical/chemical sterilization
forms of abstinence

Front 6

oral E and P (the pill)

Back 6

primary action is to prevent ovulation by providing continuous estrogenic negative feedback to the hypothalamus, thereby preventing the preovulatory LH surge needed for ovulation
all present day contraceptive steroids are synthetic, modified to enhance activity or duration

Front 7

progestin actions

Back 7

primary action is to interfere with sperm transport/survival
secondary actions:
render endometrium hostile to implantation
prevent ovulation

Front 8

formats used for progestin administration

Back 8

"mini' pill (oral)
depot injection
subdermal implant
patch
vaginal ring

Front 9

progestin should be used in women who

Back 9

have SEs from estrogen-containing pill

Front 10

androgens in contraception

Back 10

inhibit spermatogenesis
low incidence of use due to initial 2-month delay in effectiveness and behavioral side effects

Front 11

intrauterine device (IUD) MOA

Back 11

induces invasion of leukocytes, thereby preventing implantation
can be ejected without woman noticing

Front 12

barrier methods of contraception

Back 12

male/female condom
diaphragm
cervical cap

Front 13

spermicide

Back 13

a foam injected into vagina near cervix
nonoxynol-9 is most common agent
often used in combination with condom or diaphragm

Front 14

surgical/chemical contraceptive methods

Back 14

vasectomy
transcutaneous cyanoacrylate injection (blocks vas deferens)
tubal ligation
transcervical cyanoacrylate injection (blocks uterine tubes)

Front 15

abstinence

Back 15

total
partial (no intercourse)
periodic

Front 16

periodic abstinence

Back 16

calendar rhythm, a method that works only for women with very regular cycles
natural family planning

Front 17

natural family planning

Back 17

monitors physiological changes during the cycle
based on concept of "safe" period for unprotected intercourse in each cycle
1-3% failure rate with proper use
requires 7-10 continuous days without intercourse per cycle

Front 18

natural family planning monitors menstrual cycle patterns of

Back 18

basal body temp
cervical mucous production and quality
cervix condition

Front 19

contraception can occur via actions on

Back 19

hypothalamic-pit system
ovary and female tract
testis or male tract
sperm or ovum directly

Front 20

great variation in responsiveness among people to contraceptive hormones is due to

Back 20

individual variation in receptor competency and level of endogenous hormone production

Front 21

most of the SEs of oral contraceptives are due to

Back 21

estrogen
~40% of pill users have SEs

Front 22

serious SEs of oral contraceptives

Back 22

thromboembolism
blurred vision
loss of vision
gallbladder disease
HTN

Front 23

less serious SEs of oral contraceptives

Back 23

nausea (alleviated by taking pill with food)
weight gain, fluid retention, breast tenderness
headaches
depression, anxiety, fatigue, mood changes
spotting, decreased menstrual flow
more yeast infections
acne

Front 24

cervical neoplasia and oral contraceptives

Back 24

risk increased up to 200%

Front 25

breast cancer and oral contraceptives

Back 25

no increase of up to 200% increase depending on study
tamoxifen decreases this risk but increases risk of endometrial cancer

Front 26

endometrial cancer and oral contraceptives

Back 26

cancer risk decreased 10-80% (in nulliparous)
risk increased in multiparous, unless P is present in pill
safest if taken before 51

Front 27

ovarian cancer and oral contraceptives

Back 27

decreased 10-60% (lowest occurrence in long time users)

Front 28

family history of a specific cancer and oral contraceptive use

Back 28

family history usually moves an individual to the higher end of the risk scale for that cancer type

Front 29

emergency contraception is strictly for

Back 29

pregnancy prevention after unprotected intercourse

Front 30

two major types of emergency contraception

Back 30

copper IUD
oral contraceptives in multiple doses

Front 31

copper IUD

Back 31

99% effective if inserted within 7 days after unprotected intercourse

Front 32

oral contraceptives in multiple doses for emergency contraception

Back 32

E+P type:
effective if started within 72 hours
4-5 pills, then repeat in 12 hours
progestin-only type:
effective if started within 48 hours
2 pills, then repeat in 12 hours

Front 33

for sexual intercourse occuring in the week before or after ovulation, treatment with emergency contraceptives reduces probablility

Back 33

75-88%

Front 34

drugs used to cause abortion

Back 34

mifepristone plus misoprostol

Front 35

antagonist GnRH analogs

Back 35

false GnRH leads to ovulation block
given IM injection for timed-release or nasal spray
efficacy ~90%
easily self-administered

Front 36

SEs of antagonist GnRH analogs

Back 36

irregular bleeding
inhibits steroid production, so need replacement therapy

Front 37

immunocontraception action, route, and efficacy

Back 37

specific Abs bind surface proteins on sperm or egg that are essential for sperm-egg binding prior to fertilization
vaccine, oral, or injection
98-100% effective
single, annual IM injection

Front 38

immunocontraception SEs

Back 38

none demonstrated
potential for autoimmunity?