AMCB Contraception Review from SU
Study Guides -Questions and Answers.
Copper IUD (ParaGard) -
\small, T-shaped device wrapped in copper which acts as spermicide and inflames the
endometrium; 0.6% failure rate and can last up to 10 years (maybe 12 now)
non-hormonal contraception
MOA of copper IUD -
\1) Copper inhibits sperm mobilization and is toxic to ovum
2) Altered tubal/uterine transport of ovum - sperm and egg never meet to become
fertilized
3) Inhibited endometrium
Copper IUD: Impacts on menses -
\Increased length and amount of bleeding, increased cramping, especially in first
several months. Will often normalize after that.
Irregular bleeding or spotting common for 3-6 months after placement.
Increased bleeding can contribute to iron deficiency anemia
Copper IUD: Other side effects/risks -
\Serious complications rare!
PID (in first 20 days), spontaneous expulsion, perforation, pregnancy, ectopic more
likely if get pregnant.
Cramping/pain with insertion
Copper IUD: Benefits -
\Protection against endometrial cancer.
Effective, easy, not coital dependent, immediately reversible, no estrogen
Copper IUD: H+P initiation -
\History:
Assess for contraindications, discuss risks/benefits,
STI/HIV sx or risk, PAP hx, menstrual hx (heavy, painful?)
Physical: bimanual and speculum/ cervical exam,
STI sx and screening,
Pregnancy test
,Copper IUD: Other considerations -
\Breastfeeding: Safe immediately postpartum
Return of fertility: Immediate
Back-up contraception on initiation: not needed
5-7 day NSAID tx can help with bleeding and dysmenorrhea
Copper IUD: Contraindications -
\Cervical or uterine cancers, uterine issues, any infection of uterus or cervix, pregnancy,
lupus with severe thrombocytopenia, unexplained vaginal bleeding
Male condom MOA and failure rates -
\Barrier method
Barrier, prevents transmission of semen/STI transmission
Failure rate: 2% (perfect use)
Failure rate: 18% (typical use)
Male or female condom effects on menses
or diaphram or cervical cap
Why is this? -
\none
They are all barrier methods!
Male condom: Other risks/side effects -
\Decreased penile sensitivity, interrupts sex, interrupts erection for some, condom
rupture.
Male controlled
Male condom: benefits -
\Prevents STI transmission, prevents allergic reaction to semen, arrests development of
anti-sperm antibodies in infertility patients, helps with premature ejaculation
Male condom: other considerations -
\Use water based lube with latex
Natural membrane condoms - no STI prevention, can use any lube
Use with spermicide increases efficacy
Male condom: latex allergy -
, \Latex allergy - can use polyurethane condoms in this case
Female condom: MOA and failure rate -
\Barrier, protects vagina from direct contact with penis/seminal fluid.
Failure rate: 5% (perfect use)
Failure rate: 21% (typical use)
Female condom: considerations -
\Expensive, requires prescription
Female condom: benefits -
\Female controlled. Prevents STI transmission, prevents allergic reaction to semen,
arrests development of anti-sperm antibodies in infertility patients, less likely to break
than condom
Female condom: H+P? -
\vaginal anomalies ??
Female condom: contraindications -
\nitrile allergy
female condom is a barrier method
Diaphragm: MOA and failure rate -
\Reusable silicone cup-like devise that sits over cervix, used with spermacide
Barrier - traps semen in vagina.
Used with spermicide - destroys sperm cell membrane
Failure rate: 14% (perfect use)
Failure rate: 17.4% (typical use)
Diaphragm: other side effects/risks -
\Increased risk of STIs, spermicide can alter vaginal flora, vaginal wall abrasions, toxic
shock risk (esp if left in for longer than 24 hours)
Requires a trained clinician to fit
Diaphragm: Benefits -
\Can be used with condom for added contraception and STI protection.
Cost effective - replaced every 2 years
Some STI protection - but not complete
Study Guides -Questions and Answers.
Copper IUD (ParaGard) -
\small, T-shaped device wrapped in copper which acts as spermicide and inflames the
endometrium; 0.6% failure rate and can last up to 10 years (maybe 12 now)
non-hormonal contraception
MOA of copper IUD -
\1) Copper inhibits sperm mobilization and is toxic to ovum
2) Altered tubal/uterine transport of ovum - sperm and egg never meet to become
fertilized
3) Inhibited endometrium
Copper IUD: Impacts on menses -
\Increased length and amount of bleeding, increased cramping, especially in first
several months. Will often normalize after that.
Irregular bleeding or spotting common for 3-6 months after placement.
Increased bleeding can contribute to iron deficiency anemia
Copper IUD: Other side effects/risks -
\Serious complications rare!
PID (in first 20 days), spontaneous expulsion, perforation, pregnancy, ectopic more
likely if get pregnant.
Cramping/pain with insertion
Copper IUD: Benefits -
\Protection against endometrial cancer.
Effective, easy, not coital dependent, immediately reversible, no estrogen
Copper IUD: H+P initiation -
\History:
Assess for contraindications, discuss risks/benefits,
STI/HIV sx or risk, PAP hx, menstrual hx (heavy, painful?)
Physical: bimanual and speculum/ cervical exam,
STI sx and screening,
Pregnancy test
,Copper IUD: Other considerations -
\Breastfeeding: Safe immediately postpartum
Return of fertility: Immediate
Back-up contraception on initiation: not needed
5-7 day NSAID tx can help with bleeding and dysmenorrhea
Copper IUD: Contraindications -
\Cervical or uterine cancers, uterine issues, any infection of uterus or cervix, pregnancy,
lupus with severe thrombocytopenia, unexplained vaginal bleeding
Male condom MOA and failure rates -
\Barrier method
Barrier, prevents transmission of semen/STI transmission
Failure rate: 2% (perfect use)
Failure rate: 18% (typical use)
Male or female condom effects on menses
or diaphram or cervical cap
Why is this? -
\none
They are all barrier methods!
Male condom: Other risks/side effects -
\Decreased penile sensitivity, interrupts sex, interrupts erection for some, condom
rupture.
Male controlled
Male condom: benefits -
\Prevents STI transmission, prevents allergic reaction to semen, arrests development of
anti-sperm antibodies in infertility patients, helps with premature ejaculation
Male condom: other considerations -
\Use water based lube with latex
Natural membrane condoms - no STI prevention, can use any lube
Use with spermicide increases efficacy
Male condom: latex allergy -
, \Latex allergy - can use polyurethane condoms in this case
Female condom: MOA and failure rate -
\Barrier, protects vagina from direct contact with penis/seminal fluid.
Failure rate: 5% (perfect use)
Failure rate: 21% (typical use)
Female condom: considerations -
\Expensive, requires prescription
Female condom: benefits -
\Female controlled. Prevents STI transmission, prevents allergic reaction to semen,
arrests development of anti-sperm antibodies in infertility patients, less likely to break
than condom
Female condom: H+P? -
\vaginal anomalies ??
Female condom: contraindications -
\nitrile allergy
female condom is a barrier method
Diaphragm: MOA and failure rate -
\Reusable silicone cup-like devise that sits over cervix, used with spermacide
Barrier - traps semen in vagina.
Used with spermicide - destroys sperm cell membrane
Failure rate: 14% (perfect use)
Failure rate: 17.4% (typical use)
Diaphragm: other side effects/risks -
\Increased risk of STIs, spermicide can alter vaginal flora, vaginal wall abrasions, toxic
shock risk (esp if left in for longer than 24 hours)
Requires a trained clinician to fit
Diaphragm: Benefits -
\Can be used with condom for added contraception and STI protection.
Cost effective - replaced every 2 years
Some STI protection - but not complete
