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What are the risks of using a diaphragm or cervical cap?
Increased UTIs, yeast infections and TSS
How is the cervical cap used?
Place of cervix ½ hour before intercourse and leave on at least 8 hrs after but NMT 48 hrs total
What is the pregnancy rate with male and female condoms?
What can destroy the integrity of condoms?
Mineral oil (by 90% in 60 seconds)
What advantage do spermicides have?
Some protection against cervical cancer
What is the today sponge?
How is the Today sponge used?
- Leave in 6 hours after intercourse
- NMT 24hrs total due to increased risk of TSS
Do spermicides protect against STDs?
What are the estrogens in OCs?
- Ethinyl Estradiol
Which Progestins are a potent progestin with no estrogenic effects and are less androgenic?
What is the effect Estrogens in OCs?
Suppress FSH and LH and inhibit implantation
What is the effect of Progestins in OCs?
Inhibit LH, Cervical mucus thickening an thinning of endometrial lining
What are estrogen side effects?
- Fluid retention
- Breast tenderness
Do combination OCs or progestin only OCs have more progestin mini-pills?
What should you counsel a patient on when dispensing Progestin only mini-pills?
- Start on the first day of menses
- Take at same time every day!!!
- There are No inactive pills
- Back up method for first 1 to 2 months
- Use a Backup method: whenever ANY pills are missed, If a pill is more than 3 hours late, mid-cycle and 4 days pre/post possible ovulation
What are the long acting progestin Contraceptives?
Medroxyprogesterone acetate (DepoProvera)
How does Medroxyprogesterone acetate (DepoProvera) work?
- Blocks LH surge, preventing ovulation
- Reduces ovum motility in fallopian tubes
- Thins endometrium
- Thickens cervical mucus
How should Medroxyprogesterone acetate (DepoProvera) be administered?
- 150mg IM Q3 months within 5 days of onset of menses
- Gluteal or deltoid muscle
- SQ = abdomen or thigh
What are the advantages of Medroxyprogesterone acetate (DepoProvera)?
- Good for: Breast feeding, seizures, Intolerant to estrogens, Women experiencing
- Premenstrual weight gain, Nausea, Acne, HTN, HLD, h/o VTE, premenstrual bleeding or h/o SLE
- May prevent PID due to mucus thickening
- Pregnancy rates similar to sterilization
- Fewer DDIs
What is the brand name for Medroxyprogesterone acetate?
What is the generic name for DepoProvera or Depo-SubQ Provera 104?
What are the disadvantages of Medroxyprogesterone acetate (DepoProvera)?
- Reduced bone mineral density with chronic use
- Black box warning!!! = only take for 2-3 years
- Return of fertility may be delayed = Median time to conception 10 months, 1 year fertility rate – 68%