Contraception

effectiveness of a contraceptive method is expressed by

Pearl Index

fertile days calcualted for calendar method of natural contraception

11-18 days before menstruation

fertile window depending on cervical mucus

clear, fluid, abundant, stretchy

______ must be inserted before intercourse and left in place for at least 6 hours afterward, but not more than 24 hours.

diaphragm (barrier contraception)

diff bw generations of progestins

1. Norethindrone - moderate androgenic effects

2. levonorgestrel - strong progestogenic and androgenic activity

3. desogestrel - low androgenic effects

multiphasic vs monophasic COCs

mono - same dose estrogen and progestin

multi - variable concentrations

in COCs, the progestin inhibits ___ secretion and estrogen inhibits ___

LH

FSH

what contraception has reduced risk of ovarian cancer, endometrial cancer, and choriocarcinoma

COCs

side effects COCs

nausea, breast tender, metorrrhagia

increased risk dvt, pe, htn

COs to COCs

history DVT or PE

thrombogenic cardiac arrhythmias, valvular disease

stroke or coronary a. disease, htn

benefits of extended/continuous use COCs

reduces dysmenorrhea, endometriosis symptoms, menorrhagia

meds that reduce effectiveness of COCs

rifampin, phenytoin, tetra/doxycycline

contraceptive ring Consists of a flexible polymer ring that releases what

ethinylestradiol and etonogestrel

transdermal contraception releases

ethinylestradiol, progestin

transdermal contracerption has higher risk of what

DVT

progestin only COCs (mini pills) indication

breastfeeding, CO to estrogens

disadvtanges to progestin only COCs

irregular bleed, headache, breast tender

sidde effects IUD

dysmenorrhea, increased bleeding if copper, amenorrhea if progestin, metrorrhagia

increased risk PID

nausea, headache, breast tender if hormonal

COs to IUD

PID in past yr, bleeding disorders, unexplained vaginal bleed, uterine cavity abnormalities

cervical or endometrial cancer

emergency contraception drugs

• levonorgestrel

• ulipristal

• mifepristone