facts - contraception womens health

What does EE stand for?

Ethinyl estradiol (the estrogen in most combined contraceptives)

Combined oral contraceptive pills (6)

Natazia, Yaz/Yasmin, Aviane/Levora, Apri/Ortho-Cept, Ortho-Novum, Ortho Tri-Cyclen

Non-pill combined contraceptives (2)

Xulane (patch), NuvaRing (vaginal ring)

Progestin-only contraceptives (3)

etonogestrel implant (Nexplanon), medroxyprogesterone (Depo-Provera), levonorgestrel (Plan B)

Emergency contraceptive (1)

levonorgestrel (Plan B One-Step)

Estrogens for menopause/HRT (2)

conjugated estrogens (Premarin), estradiol (Estrace, Vivelle-Dot)

Progestins (2)

progesterone (Prometrium), medroxyprogesterone (Depo-Provera, Provera)

Uterotonic (1)

oxytocin (Pitocin)

Contraceptives also for acne (2)

EE/drospirenone (Yaz), EE/norgestimate (Ortho Tri-Cyclen)

Contraceptive implanted in the arm (1)

etonogestrel (Nexplanon), lasts up to 3 years

Injectable contraceptive (1)

medroxyprogesterone (Depo-Provera), every 3 months

Contraceptive patch (1)

norelgestromin/EE (Xulane), changed weekly

Vaginal ring contraceptive (1)

EE/etonogestrel (NuvaRing), 3 weeks in, 1 week out

Drug for labor induction and postpartum bleeding (1)

oxytocin (Pitocin)

Hospital-only drug in this module (1)

oxytocin (Pitocin)

OTC drug in this module (1)

levonorgestrel (Plan B One-Step), no age limit

How soon after sex should Plan B be taken?

Within 72 hours, sooner works better

Estrogen product made from pregnant horse urine (1)

conjugated estrogens (Premarin)

Estradiol patch brand

Vivelle-Dot

Medroxyprogesterone injection vs tablet

Depo-Provera = injection (contraception). Provera = tablet

Why add a progestin to estrogen HRT?

Protects the uterine lining from cancer (if uterus intact)

Combined contraceptive mechanism

Lowers FSH/LH, which blocks ovulation and thickens cervical mucus

Progestin-only mechanism

Mainly blocks ovulation and changes the uterine lining

Estrogen HRT purpose

Replaces estrogen to control hot flashes

Oxytocin mechanism

Stimulates uterine contractions

Common estrogen side effects (2)

Nausea, breast tenderness

Common side effect of all contraceptives

Breakthrough bleeding

Common progestin side effects (2)

Weight change, mood change

Serious estrogen risks (3)

Blood clots, heart attack, stroke

Who has the highest clot risk on estrogen?

Smokers 35 and older

Serious oxytocin risks (2)

Uterine rupture, fetal distress

Depo-Provera boxed warning

Bone density loss with long-term use

Drugs that make birth control fail (3)

rifampin, phenytoin, St. John's wort

What to do with a CYP3A4 inducer on birth control

Use backup contraception

Estrogen contraindications (5)

Active breast cancer, pregnancy, uncontrolled HTN, history of clots, heavy smoking over 35

Drospirenone + ACE inhibitors, ARBs, or spironolactone

High potassium risk

Missed one combined pill

Take it as soon as remembered, even if 2 in one day

Look-alike: Premarin vs Primaxin

Premarin = estrogen. Primaxin = imipenem (antibiotic)

Look-alike: Provera vs Premarin

Provera = progestin. Premarin = estrogen

Look-alike: Yaz vs Yasmin

Same drugs. Yaz has 24 active pills, Yasmin 21

Look-alike: Pitocin vs Pitressin

Pitocin = oxytocin. Pitressin = vasopressin