Duke PA Contraception
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| smokers 35 years and older: never put them on __ containing contraception | estrogen
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| what is the Pearl Index | the number of unintended pregnancies per hundred women per year
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| failure rate of coitus interruptus | 4-27%
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| failure rate of fertility awareness-based contraception if used perfectly | 9%
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| general failure rate of fertility awareness-based contraception | 20-25%
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| average fertile period is __ days per cycle | 6
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| unprotected intercourse __ days before ovulation results in 15% pregnancy rate | 3
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| unprotected intercourse __ days before ovulation results in 30% pregnancy rate | 1-2
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| unprotected intercourse the day of ovulation results in __% pregnancy rate | 12
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| sperm can survive in the female up to __ days | 5
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| the mature egg may be fertilized over a __ period | 24 hour
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| the time from ovulation to implantation is about __ days | 7
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| different barrier methods | spermicide, cervical cap, diaphragm, condom, sponge
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| the only readily available spermicide in the US | nonoxynol-9
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| nonoxynol-9 has a __% failure rate | 10-29
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| cervical caps can be worn for up to __ hours | 48; insert up to 24 hrs before intercourse
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| cervical caps have a __% failure rate | 9-32
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| diaphragms have a __% failure rate | 10-20
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| diaphragms increase the risk of __ | UTIs, vaginitis, and nonmenstrual toxic shock
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| female condoms have a __% failure rate | 5-20
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| never use a __ and a female condom at the same time | male condom
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| __ condoms break more than latex ones | polyurethane
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| male condoms have a __% failure rate | 3-15
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| contraceptive sponge increases the risk of __ | nonmenstrual toxic shock
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| contraceptive sponge has a __% failure rate | 10-40
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| oral contraceptives have a __% failure rate | 3-9
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| oral contraceptives decrease risk of __ | ovarian and endometrial cancer
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| oral contraceptives may increase the risk of __ cancer | breast
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| oral contraceptive effects due to estrogen | inhibit ovulation (suppressed FSH surge), alters endometrium, luteolysis (degeneration of corpus luteum)
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| oral contraceptive effects due to progestin | inhibit ovulation (suppressed LH surge), thickened cervical mucus, sperm become less effective, hampers implantation
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| __ only oral contraceptives are less effective than combination type | progestin
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| absolute contraindications to estrogen containing OCPs | Cardiovascular dz, smoker >35 yo, coagulation disorders, dyslipidemia, DM, neurologic dz, PG, undiagnosed vaginal bleeding, estrogen dependent neoplasm, liver disease or adenoma
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| relative contraindications to estrogen containing OCP's | HTN, DM w/ CAD or PVD, gallbladder dz, h/o cholestatic jaundice in pregnancy, epilepsy, leg injury/cast/immobilization, elective surgery, sickle cell, migraines, obesity, FH of CVD
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| negative effects of OCPs | no std protection, take everyday, benign liver tumors, worsened gallbladder problems, clots, expensive, insurance issues
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| common side effects of OCPs | GI, wt changes, menses changes, breast changes, migraines, edema, Rash, melasma, depression, decreased libido
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| oral contraceptive that may be a good option for breastfeeding women, smokers over 35, and those who are good pill takers | minipills (progestin only)
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| injectables have a __% failure rate | 1-2
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| depo-provera has a __% failure rate | 0.3
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| depo-provera shots are given IM every __ months | 3
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| what is the FDA black box warning for dep-provera | risk of osteoporosis; use >2 yrs only if no other options
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| implants have a failure rate of __% | 1-4
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| problems with implants | menstrual irregularities,amenorrhea, wt gain, acne, depression, less effective in obese
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| the patch has a failure rate of __% | 1-2; less effective in pt >90 kg
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| black box warning for the patch | greater risk of thrombotic events than OCPs
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| nuva ring has a failure rate of __% | 1-2
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| emergency contraception is best if initiated within __ hours after unprotected intercourse | 72; but can be taken up to 120 hrs after
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| emergency contraception can be given up to __ days after unprotected intercourse | 5
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| emergency contraception is not an __ | abortifacient
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| the two emergency contraceptives that are effective after implantation | mifepristone (RU486), paragard-t IUD
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| 2 intrauterine devices/systems available in the US | paragard, mirena
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| IUDs have a __% failure rate | 0.5-1.5
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| paragard copper has a failure rate of __% | 0.7
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| how does the copper in paragard work to prevent pregnancy | changes cervical mucus and makes a hostile environment for sperm
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| paragard copper is approved to last for __ years in US | 10
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| there is a decrease in __ cancers with paragard use | cervical and endometrial
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| mirena IUS has a failure rate of __% | 0.1
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| mirena lasts for __ years in the US | 5
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| lactation has a __% failure rate | 10 +
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| medical abortion has a failure rate of __% | 15
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| vasectomy has a failure rate of __% | 0.15
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| female sterilization has a __% failure rate | 0.5
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| tubal ligation increases the risk of __ slightly | ectopic pregnancy
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| probably the most widely used mechanical contraception in the world | condom
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| suckling results in a reduction in the release of what hormones | Gnrh, LH and FSH
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| which version of vaginal diaphragm are the easiest for women to use | arcing spring
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| what is the rate of pregnancy with typical use of vaginal diaphragm | 15-20 per 100 woman years
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| small cup like diaphragms placed over the cervix and are held in place by suction | cervical cap
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| only spermacide available in US | nonoxynol 9
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| when used alone spermacides have a failure rate of | 15%
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| ovulation occurs __ days before the first day of the next menstrual period | 14
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| the fertile interval should be assumed to extend from at least __ days before ovulation and no less than __ days after ovulation | 2, 2
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| although this is the most commonly used method of periodic abstinence it is the least reliable with a failure rate of about 35% | calendar method
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| the __ day after the onset of elevated temperature is considered the end of the fertile period | third
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| starting several days before and until just after ovulation the mucus becomes __ | thin and watery
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| the __ method if used properly is the most effective of all the periodic abstinence approaches | symptothermal
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| the most accurate method of determining ovulation time is to demonstrate the __ | LH peak
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| most women experience __ when taking the 7 days of placebo pills that come with OCPs | withdrawal bleeding
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| it is good practice to recommend an additional form of contraception during __ of taking OCPs to maximize efficacy | the first week
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| withdrawal bleeding can be expected in __ days after completion of the 21-day regimen of active pills | 3-5
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| what are the reasonably established benefits of OCPs | reduction of ovarian and endometrial cancer risk, ectopic pregnancy, PID, menstrual disorders, benign breast disease and acne
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| use of most current combinations of OCPs roughly __ a user's risk of venous thromboembolism | triple
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| __ provides reasonably good protection against pregnancy without suppressing ovulation | progestin-only minipill
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| __ must be taken each day promptly. even a delay of 2-3 hours diminishes contraceptive effectiveness for the coming 48 hours | progestin-only minipill
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| ideal candidates for progestin only contraceptives | older women who smoke, women with sickle cell anemia, mental retardation, migraine, hypertension, SLE, women who are breastfeeding
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| plan B emergency contraception must be given within __ of intercourse | 72 hours
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| major side effects of combination hormonal emergency contraception | nausea and vomiting
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| the vaginal ring is worn for __ | 3 weeks per month
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| the vaginal ring may be removed for up to __ although it is designed to be left in place even during intercourse | 3 hours
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| if the patch has become detached for __ or less the cycle continues as usual, however if it has been longer than __ a new patch should be applied and back up contraception should be used for 1 week | 24 hours
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| what are the two types of IUDs available in the US | copper T 380A, and a levonorgestrel-releasing device
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| Sponge can be worn for: | 24 hours
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| Sponge: contraindication: | sulfa allergy
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| Depo Provera AE | bleeding abnormalities (80%); wt gain (60%); lipid changes, depression, acne
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| common myths about OCPs | Need to take a break; Causes infertility ; Women over 35 shouldn’t take OCPs; cause weight gain
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