Contraception
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| Pearl index measures | The number of unintended pregnancies per hundred women per year
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| Method with the greatest unplanned pregnancies | Calendar/Rhythm method
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| Method with the least unplanned pregnancies | Injectables
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| Average fertile period | 6 days per cycle (time from ovulation)
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| How long can sperm survive in the female? | 5 days
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| From ovulation to implantation is about __ days if the egg is fertilized | 7
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| Limitations of Spermicide | Does NOT protect against HIV, chlamydia, or gonorrhea. Also often causes irritation and allergic reactions in women and me
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| CI of female condom | never use male and female condoms at the same time
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| CI of contraceptive Sponge Today | Cannot use if sulfa allergy.
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| nonoxynol-9 is | spermicide
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| Physiologic effects of estrogen in COCPs | usually inhibit ovulation by suppressing FSH surge, alters endometrium, luteolysis (degeneration of corpus luteum)
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| Physiologic effects of progestin in COCPs | usually inhibits ovulation by suppressing LH surge, thickens cervical mucus, sperm become less effective, hampers implantation
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| Androgenic effects (from progestin) | testosterone-like effect, weight gain, hirsutism, acne
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| Absolute CIs to Estrogen containing OCPs | CV disease, smoker over 35 (equivalent to CV disease), coagulation disorders (inc. DVT, PE), dyslipidemia (Triglycerides>350mg/dl), Diabetes (with CAD or PVD), Neurologic Dz, pregnancy, undiagnosed vaginal bleeding, liver dz or adenoma
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| Relative CIs to Estrogen containing OCPs | HTN, Diabetes without CAD or PVD, Gallbladder dz, Hx of cholestatic jaundice in pregnancy, epilepsy, leg injury or cast, immobilization (DVT!), elective surgery, SS, Migraines, Obesity, Family hx of CVD
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| Negative effects of OCPs | No STD protection, daily dosing, benign liver tumors, worsening gallbladder problems, blood clots, strokes (more in smokers), expensive
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| Common AEs of OCPs | N/V, weight changes, change in menses (BTB, amenorrhea), breast changes, migraines, edema, rash, melasma, depression (progesterone), decreased libido
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| Dosage notes for Minipills | take every dat and the same time "obsessive regularity"
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| Who are minipills a good option for? | breastfeeding women, smokers>35 and for those who can't tolerate estrogen
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| OCPs may improve | ovarian cysts, uterine fibroids, fibroadenomas and fibrocystic breast dz, ectopic pregnancy, acute PID, iron deficiency due to blood loss, mittleschmerz, acne, persistent anovulation, ovarian failure
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| Dep Provera Notes | IM every 3 months, amenorrhea after a year or so, weight gain can be significant, lipid changes, depression, HA, acne, delayed return of fertility and ovulation (up to 1 year), risk of osteoporosis. CAN be used in smokers or nursing moms
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| Implanon | is a 1 rod etonogestrol (progesterone only) implant that is effective for 3 years.
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| Major reason for dc of implants | menstrual irregularities. Also AEs include: amenorrhea, weight gain, acne, depression, may be less effective if obese
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| Dosing of Ortho Evra patches | 1 patch per week for 3 weeks, then one week off.
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| Ortho Evra patch notes | less effective if >90kg, may be a higher risk of venous thromboembolic events than OCPs due to higher consisten estrogen blood levels
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| Black box warning of Ortho Evra patches | Greater risk of thrombotic events (CVA, MI) than OCPs. (use with caution in smokers at any age, do not use in smokers >35)
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| Nuva ring contains | progestin and estrogen
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| When do you insert a nuva ring? | day 5 of menstrual cycle, wear 3 weeks, off one week. Insert new ring every 4th week.
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| Emergency Contraception Dose | Most effective if given within 72 hours of unprotected intercourse (can be taken 120hrs/5 days later)
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| MOA of emergency contraception | suppresses ovulation, changes cervical mucus and endometrium. NOT AN ABOTIFACIENT
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| Dosage of Plan B | can take both tablets at once; progesterone only
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| Preven ingredients | Estrogen and progesterone
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| Hormonal Emergency contraception | If given prior to menses, menses is 3-7 days earlier than expected, if given after ovulation, menses is at expected time or delayed.
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| Which drug carries a risk of Osteoporosis? | Depo Provera
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| _______ may cause an increase of venous thromboembolic events than OCPs | Ortho Evra Patches
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| Which types of emergency contraceptions are effective post implantation and result in abortion? | Mifepristone (RU486) and Paragard-T IUD
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| ________ is AKA "reversible sterilization" and is an excellent choice for women who cannot take estrogen | IUDs. They set up a "hostile environment", are not abortifacients, and do not cause infection (organisms do!)
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| This IUD can cause heavy bleeding and cramping (so NOT for women w/ menorrhagia or dysmenorrhea) | ParaGard (copper IUD)
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| This IUD slowly releases progestin which changes the cervical mucus | Mirena (note: increased incidence of ovarian cysts)
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| Essure is what type of birth control? | Non-incisional permanent birth control
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| _____ is a transcervical sterilization system using electrothermal energy | Adiana
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