thera womens contraception

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coal
ID:
259677
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thera womens contraception
Updated:
2014-02-15 08:34:08
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thera womens contraception
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thera womens contraception
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thera womens contraception
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  1. management of AE - acne
    decrease progestin/androgen
  2. management of AE - amenorrhea
    increase estrogen
  3. management of AE - breast tenderness/swelling
    decrease estrogen
  4. management of AE - early cycle breakthrough bleeding
    increase estrogen
  5. management of AE - late cycle breakthrough bleeding
    increase progestin
  6. management of AE - hirsutism
    decrease androgen
  7. management of AE - irregular, heavy painful menses
    • decrease estrogen
    • increase progestin
  8. management of AE - irritability
    decrease progestin/androgen
  9. management of AE - nausea
    • decrease estrogen
    • increase progestin
  10. management of AE - depression/sleepiness
    decrease progestin/androgen
  11. management of AE - decreased libido
    • increase androgen
    • increase estrogen
  12. management of AE - headache
    decrease estrogen
  13. management of AE - weight gain (non-cyclic, increased appetite)
    decrease estrogen
  14. management of AE - weight gain (cyclic = fluid retention)
    decrease estrogen
  15. what AE effects could be treated with decreasing progestin
    • acne
    • irritabiliy
    • depression/sleepiness
    • weight gain (noncyclic = increased appetite
  16. what AE could be treated with increasing estrogen
    • amenorrhea
    • early cycle breakthrough bleeding
    • decreased libido
  17. what AE could be treated with decreasing estrogen
    • breast tenderness/swelling
    • irregular, heavy painful menses
    • weight gain (cyclic = fluid retention)
    • nausea
  18. what AE could be treated with increasing progestin
    • late cycle breakthrough bleeding
    • irregular, heavy painful menses
    • nausea
  19. 4 CI of birth controls
    • DM with vascular involvement
    • migraine HA with aura
    • liver disease
    • > 35 yo and > 15 cigarettes/day
  20. choosing doses of hormones inĀ  young healthy women
    • < 35 mcg EE
    • < 0.5 mg norethindrone
  21. choosing doses of hormones in adolescents, < 50kg, > 35 yo, perimenopausal
    20-25 mcg EE
  22. choosing doses of hormones in obese
    > 35 mcg EE
  23. choosing doses of hormones in heavy menses
    50 mcg EE
  24. choosing doses of hormones in oily skin, acne, hirsutism
    low androgenic oral contraceptives (drosperenone)
  25. CI to estrogen
    • estrogen dependen cancer
    • smoker > 35 yo
    • migraines
    • VTE
  26. CI to progestin
    • Breast cancer
    • undiagnosed vaginal bleeding
    • hepatic dysfunction or disease
  27. serious adverse effects of hormone contraception
    • A - abdominal pain (severe) (gall bladder)
    • C - chest pain, cough, SOB (pulmonary)
    • H - headache (severe), dizziness, weakness, numbness (stroke)
    • E - eye problems (vision loss or blurring), speech problems (stroke)
    • S - severe leg pain (DVT)
  28. 3 main risks of DMPA
    • weight gain
    • bone loss - 2 yr limit unless no other option available
    • return to fertility (9-12 months)
  29. missed dose of < 30 mcg of EE - 1 missed pill
    take as soon as possible (double up)
  30. missed dose of < 30 mcg of EE - > 2 missed pills
    double up for 2 days, use back up method 7d
  31. missed dose of < 30 mcg of EE - >2 missed pills in 1st week and unprotected sex
    consider emergency contraception
  32. missed dose of < 30 mcg of EE - > 2 missed pills in 3rd week
    finish active tablets in pack and start new pack the next day (don't take placebo tablets)
  33. missed dose using the patch
    • if restart active patches more than 9 days after 3 week active phase, use backup for 7d
    • if detached for more than 24 hrs, replace and use backup for 7d
  34. missed dose using the ring
    • if expelled for more than 3 hrs use backup 7d
    • if less than 3 hrs, wash and reinsert
  35. missed dose DMPA
    • IM > 13 weeks = exclude pregnancy
    • SQ > 14 weeks = exclude pregnancy
  36. intrauterine device effective for 10yrs and SE
    • paragard
    • increased menstrual blood flow and dysmenorrhea
  37. intrauterine device effctive for 5 yrs and AE
    • mirena - levonorgestrel
    • increased spotting in first 6 mo. then decline
    • amenorrhea

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