Sexual and Reproductive Health Medication Supports

What are the three primary ways hormonal contraceptives prevent pregnancy?

They prevent ovulation, thicken cervical mucus to block sperm, and alter the uterine lining to reduce implantation.

What are the two broad types of hormonal contraceptives?

Combined hormonal contraceptives (CHCs) and progestin-only contraceptives.

Give three dosage forms in which hormonal contraceptives are available.

Oral pills, transdermal patches, vaginal rings, intramuscular injections, intra-uterine devices, or subdermal implants (any three).

Which two hormones are contained in combined hormonal contraceptives (CHCs)?

Estrogen and progestin.

Explain how CHCs work to prevent pregnancy.

They inhibit ovulation, thicken cervical mucus, and make the endometrium unreceptive to implantation.

Provide one example of a combined hormonal contraceptive.

Ortho Tri-Cyclen.

List two common side effects of Ortho Tri-Cyclen.

Nausea, breast tenderness, mood changes (any two).

What serious vascular adverse effect is associated with CHCs, especially in smokers?

Thromboembolic events (e.g., deep-vein thrombosis, pulmonary embolism, stroke).

Which three parameters should nurses monitor in clients taking CHCs?

Signs of thromboembolism, blood pressure for hypertension, and abnormal vaginal bleeding.

What key daily teaching is essential for clients using CHCs?

Take the contraceptive at the same time every day without missing doses.

Do combined hormonal contraceptives protect against sexually transmitted infections?

No, CHCs do not protect against STIs.

When should clients use a backup contraceptive while on CHCs?

When taking interacting drugs such as certain antibiotics or after missed doses.

Which single hormone is found in progestin-only contraceptives?

Progestin.

State two mechanisms by which progestin-only pills prevent pregnancy.

They thicken cervical mucus and thin the endometrial lining.

Name one example of a progestin-only oral contraceptive (mini-pill).

Norethindrone.

Identify two common side effects of progestin-only contraceptives.

Irregular bleeding/spotting, headache, breast tenderness, nausea, weight gain, or mood changes (any two).

Why are progestin-only contraceptives preferred for breastfeeding women?

Because they lack estrogen and therefore do not reduce milk production.

How does the effectiveness of progestin-only pills compare to CHCs?

They are slightly less effective and require strict same-time daily dosing.

What is the primary mechanism of emergency contraception pills (ECPs)?

They delay or inhibit ovulation.

Within how many days of unprotected intercourse should ECPs be used?

Within 5 days (the sooner, the more effective).

List the four methods of emergency contraception.

Ulipristal acetate pill, levonorgestrel pill, combined oral contraceptive regimen, and copper IUD.

Give two situations that warrant emergency contraception.

No contraception used, contraceptive failure (e.g., condom break, missed pills), or sexual assault (any two).

State two facts about ECPs in relation to pregnancy and fertility.

They do not induce abortion or harm future fertility (also do not interrupt established pregnancy).

Do emergency contraception pills protect against sexually transmitted infections?

No.

What is the first-line pharmacologic treatment for symptomatic menopausal women?

Hormone replacement therapy (HRT).

Describe the mechanism of action of HRT.

It increases circulating estrogen, progesterone, or both to relieve menopausal symptoms.

Name the three main classes of HRT.

Estrogen-only HRT, progestogen-only HRT, and combined estrogen-progestogen HRT.

For which women is estrogen-only HRT appropriate?

Women who have had a hysterectomy (no uterus).

Provide one example of an estrogen-only HRT preparation.

Conjugated equine estrogens, synthetic conjugated estrogens, or micronized 17β-estradiol (any one).

Which HRT regimen is required for women with an intact uterus?

Progestogen-only or combined estrogen-progestogen HRT to protect the endometrium.

Give one example of a progestogen used in HRT.

Micronized progesterone, dydrogesterone, or medroxyprogesterone acetate.

How long may it take for HRT to improve menopausal symptoms?

Up to 3 months.

What major vascular risk is associated with HRT use?

Venous thromboembolism (VTE).

Which HRT route is preferred for women with high cerebrovascular risk?

Transdermal HRT.

At what age range is it generally recommended to initiate HRT?

At the onset of menopausal symptoms, typically 45–55 years old.

Define benign prostatic hyperplasia (BPH).

A non-cancerous enlargement of the prostate causing lower urinary tract symptoms.

Explain how alpha-1 antagonists alleviate BPH symptoms.

They relax smooth muscle in the prostate and bladder neck, improving urine flow.

Name two alpha-1 antagonists used for BPH.

Tamsulosin, terazosin, or doxazosin (any two).

How does tamsulosin specifically improve urine flow in BPH?

By blocking alpha-1 receptors in the prostate and bladder neck, causing smooth-muscle relaxation.

List two common adverse effects of tamsulosin.

Orthostatic hypotension, dizziness, ejaculation failure, headache, rhinitis, or infection (any two).

What key nursing action is necessary with the first dose of tamsulosin?

Monitor blood pressure for orthostatic hypotension.

What positional advice should be given to clients taking tamsulosin?

Change positions slowly to minimize dizziness from orthostatic hypotension.

What is erectile dysfunction (ED)?

A persistent inability to attain or maintain an erection sufficient for satisfactory sexual performance.

Which drug class is considered first-line therapy for ED?

Phosphodiesterase-5 (PDE-5) inhibitors.

List three commonly used PDE-5 inhibitors.

Sildenafil, tadalafil, and avanafil.

How do PDE-5 inhibitors work in treating ED?

They inhibit PDE-5, increasing cGMP levels, which enhances smooth-muscle relaxation and penile blood flow during sexual stimulation.

When should sildenafil be taken in relation to planned sexual activity?

About one hour before anticipated sexual activity.

Does sildenafil induce an erection in the absence of sexual stimulation?

No; sexual stimulation is still required.

Name two common side effects of sildenafil.

Headache, flushing, dyspepsia, visual disturbances, nasal congestion, or musculoskeletal pain (any two).

What counseling point regarding sexual desire should accompany sildenafil education?

The drug improves erectile and orgasmic function but does not increase sexual desire.