JOHN TYLER COMMUNITY COLLEGE NSG 170 - TEST
4 – SEXUALITY EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
Hormonal Contraceptives - Method of Contraception
Hormonal contraceptives alter the normal hormone fluctuations
of the menstrual cycle
Hormones are delivered by implant, injection, patch, or vaginal
ring, or can be taken orally
Hormone Implants
The progestin implant, Implanon (or Nexplanon), a single rod
implant, is inserted subcutaneously into the upper inner arm
Implanon is 2 mm thick and 4 cm (1.6 in) long and releases
progestin continuously to provide 3 years of contraception
Like other progestin-only contraceptives, it inhibits ovulation,
thickens cervical mucus to prevent sperm penetrability, and
makes the endometrium unfavorable for implantation
Increasing the use of hormone implants is recommended by
ACOG as a means of offering effective long acting reversible
contraception
Side effects include irregular menstrual bleeding
,The woman should be taught that bleeding is expected and not a
sign of abnormality
Amenorrhea can occur with longer use
Implanon is safe during lactation; body weight does not affect its
effectiveness, and fertility returns within a few weeks after the
implant is removed
If it is inserted within 7 days of the start of menses, no back-up
method is needed
If it is inserted later, a back-up contraceptive should be used for
at least 3 days
Hormone Injections
Medroxyprogesterone acetate, or DMPA (Depo-Provera), is an
injectable progestin that is available for intramuscular (IM) and
subcutaneous (Sub Q) administration
It is convenient, has no estrogen, and prevents ovulation for 14
weeks, although injections should be scheduled every 12 weeks
Action and side effects are similar to those of other progestin
contraceptives
Women who should not use other hormone contraceptives
should avoid Depo-Provera as well
,The IM form of Depo-Provera is given by deep intramuscular
injection
The Sub Q form is given in the anterior thigh or abdomen
The site should not be massaged after injection because massage
accelerates absorption and decreases the period of effectiveness
A back-up method of contraception should be used for the first 7
days unless the injection is given within 5 days after a menstrual
period starts
Back-up contraception is also recommended if the woman is
more than 2 weeks late in returning for subsequent injections,
and a pregnancy test may be performed
Menstrual irregularity is the major reason for discontinuation
Although spotting and break-through bleeding are common,
amenorrhea occurs in 80% of women using the IM form at 5
years and in 55% of women using the Sub Q form at 1 year
Other side effects include breast tenderness, weight gain,
headaches, depression, and decreased bone density
Because of the loss of bone density that occurs with prolonged
use, the prescribing information states that Depo-Provera should
not be used for more than 2 years unless no other contraceptive
is suitable
, Although bone density losses reverse after the drug is
discontinued, it is not known if the bone loss is fully reversible
Bone loss could be a bigger problem for women who begin
Depo-Provera during adolescence or in the perimenopausal
period
Women who use Depo-Provera should get adequate amounts of
calcium and vitamin D and should increase weight-bearing
exercises
Depo-Provera can be started in the immediate postpartum period
It increases the quantity of milk in lactating women, and its
effectiveness is not affected by a woman's weight
After the drug is discontinued, there is a delay in return to
fertility
Approximately 59% of women resume menses in 6 months, and
25% do not resume menses for a year or more
Progestin Only Oral Contraceptives
Progestin-only pills (POPs) are less effective at inhibiting
ovulation but avoid the use of estrogen, which cannot be used by
some women
POPs cause thickening of the cervical mucus to prevent
4 – SEXUALITY EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
Hormonal Contraceptives - Method of Contraception
Hormonal contraceptives alter the normal hormone fluctuations
of the menstrual cycle
Hormones are delivered by implant, injection, patch, or vaginal
ring, or can be taken orally
Hormone Implants
The progestin implant, Implanon (or Nexplanon), a single rod
implant, is inserted subcutaneously into the upper inner arm
Implanon is 2 mm thick and 4 cm (1.6 in) long and releases
progestin continuously to provide 3 years of contraception
Like other progestin-only contraceptives, it inhibits ovulation,
thickens cervical mucus to prevent sperm penetrability, and
makes the endometrium unfavorable for implantation
Increasing the use of hormone implants is recommended by
ACOG as a means of offering effective long acting reversible
contraception
Side effects include irregular menstrual bleeding
,The woman should be taught that bleeding is expected and not a
sign of abnormality
Amenorrhea can occur with longer use
Implanon is safe during lactation; body weight does not affect its
effectiveness, and fertility returns within a few weeks after the
implant is removed
If it is inserted within 7 days of the start of menses, no back-up
method is needed
If it is inserted later, a back-up contraceptive should be used for
at least 3 days
Hormone Injections
Medroxyprogesterone acetate, or DMPA (Depo-Provera), is an
injectable progestin that is available for intramuscular (IM) and
subcutaneous (Sub Q) administration
It is convenient, has no estrogen, and prevents ovulation for 14
weeks, although injections should be scheduled every 12 weeks
Action and side effects are similar to those of other progestin
contraceptives
Women who should not use other hormone contraceptives
should avoid Depo-Provera as well
,The IM form of Depo-Provera is given by deep intramuscular
injection
The Sub Q form is given in the anterior thigh or abdomen
The site should not be massaged after injection because massage
accelerates absorption and decreases the period of effectiveness
A back-up method of contraception should be used for the first 7
days unless the injection is given within 5 days after a menstrual
period starts
Back-up contraception is also recommended if the woman is
more than 2 weeks late in returning for subsequent injections,
and a pregnancy test may be performed
Menstrual irregularity is the major reason for discontinuation
Although spotting and break-through bleeding are common,
amenorrhea occurs in 80% of women using the IM form at 5
years and in 55% of women using the Sub Q form at 1 year
Other side effects include breast tenderness, weight gain,
headaches, depression, and decreased bone density
Because of the loss of bone density that occurs with prolonged
use, the prescribing information states that Depo-Provera should
not be used for more than 2 years unless no other contraceptive
is suitable
, Although bone density losses reverse after the drug is
discontinued, it is not known if the bone loss is fully reversible
Bone loss could be a bigger problem for women who begin
Depo-Provera during adolescence or in the perimenopausal
period
Women who use Depo-Provera should get adequate amounts of
calcium and vitamin D and should increase weight-bearing
exercises
Depo-Provera can be started in the immediate postpartum period
It increases the quantity of milk in lactating women, and its
effectiveness is not affected by a woman's weight
After the drug is discontinued, there is a delay in return to
fertility
Approximately 59% of women resume menses in 6 months, and
25% do not resume menses for a year or more
Progestin Only Oral Contraceptives
Progestin-only pills (POPs) are less effective at inhibiting
ovulation but avoid the use of estrogen, which cannot be used by
some women
POPs cause thickening of the cervical mucus to prevent
