contraception

Question 1

IUD mechanism

Answer 1

sterile inflammation!!!

• -sperm destroyed by PMNs
• -thickens cervical mucus
• -inhibits ovulation
• -thins endometrial lining –> decreasing menstrual volume

Question 2

benefits of IUD

Answer 2

easy use
no hormones
lower menstrual blood loss
decrease in endometrial cancer risk
can use during breast feeding

Question 3

negative side effects to IUD

Answer 3

need to check string
increased acne
risk of uterine perforation
risk of pelvic infections

Question 4

depo-provera mechanism

Answer 4

acts like progestin; injected; inhibit ovulation, thickens cervical mucus and thins endometrial lining

Question 5

pros and cons to depo-provera

Answer 5

• Benefits – easy, decreases anemia, PID, and ectopic pregnancy, may decrease endometrial cancer, can be used in breast feeding
• Side effects – irregular bleeding, amenorrhea, acne, mood changes, headache, weight gain, permanent until worn off

Question 6

oral contraceptives mechanism

Answer 6

inhibit mid-cycle LH surge; thickens cervical mucus, disrupts tubal and uterine motility, alters glycogen production in endometrium (that would support implantation)

Question 7

oral contraceptives: pros and cons

Answer 7

• Benefits- all decreased = blood loss, PMS, acne*, ectopic pregnancy, symptomatic functional cysts, and PID
• Side effects – increased risk of cervical dysplagia and thromboembolism, breast tenderness, nausea, fluid retention

Question 8

vaginal contraception mechanism

Answer 8

• Circular silastic capsule releases – 15 micrograms ethinyl estradiol daily and 120 micrograms etonogestrel daily
o Kept in place for 3 weeks, 1 week off
• Mechanism – inhibits ovulation, thickens cervical mucus, may alter endometrial glycogen

Question 9

vaginal contraception pros and cons

Answer 9

• Benefits – easy, lower hormonal exposure, less impact on liver, improved menstrual cycle control, may help with ovarian/endometrial cancer prevention
• Side effects – vaginitis, break-through bleeding, nausea, breast tenderness, possible risk of cervical dysplasia and thromboembolism risk

Question 10

emergency contraception mechanism

Answer 10

alterations in tubal transport
interference with corpus luteum function
disruption of implantation

Question 11

emergency contraception pros and cons

Answer 11

• Benefits: reduces risk of pregnancy by 75-85%, no evidence of teratogenicity, could reduce surgical abortion rate by 40%
• Side effects; n/v, breast tenderness, headache, dizziness, not effective for established pregnancies
• **not effective if provided after ovulation/fertilization

Question 12

male contraception

Answer 12

• Inhibit LH and FSH and sperm production – must replace testosterone  drops sperm count BUT not 100%
• And takes weeks to kick in; months to a year to get back to 100% recover