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What would you recommend for someone: Don't want them to have period,
they have dysmenorrhea, anemic or other things interfere with their daily
lives
Ex: dysmenorrhea, endometriosis, anemic - 🧠 ANSWER ✔✔•Continuous
pills (Lybrel):
-Daily pill (no hormone free days)
inhibits FSH = suppress formation of dominant follicle - 🧠 ANSWER
✔✔estrogen
suppresses LH secretion = no LH surge = no ovulation. also inhibits
implantation by thinning endometrium and thickening cervical mucus
(making it less permeable to sperm) - 🧠 ANSWER ✔✔Progestin
,Most effective, reversible form of birth control - 🧠 ANSWER
✔✔Combination Oral Contraceptives
for "Sunday Start" of birth control, need to use backup method for __ days -
🧠 ANSWER ✔✔7
At any point if they miss ONE pill... - 🧠 ANSWER ✔✔take pill as soon as
they remember
if miss TWO pills during the first 2 weeks (follicular phase)... - 🧠 ANSWER
✔✔take 2 pills when the remember, 2 pills the next day, then 1 pill/day rest
of cycle but need backup method
If miss TWO pills during the 3rd week (luteal phase)... - 🧠 ANSWER
✔✔take 1 pill/day until day 21 & then instead of taking inert pills start a new
pack (use backup until first 7 days of new pack)
If miss THREE or more pills... - 🧠 ANSWER ✔✔take 1 pill/day until day 21
& then instead of taking inert pills start a new pack (use backup until first 7
days of new pack)
Combination - Nuva Ring initiation - 🧠 ANSWER ✔✔Initiation: Within first 5
days of cycle, use 7day back method
,• Placed in the vaginal for 3 weeks
Removed for 1 week to allow for withdrawal bleed (this can be skipped to
allow for continous dosing)
Combination - Nuva Ring advantages - 🧠 ANSWER ✔✔1 size fits all, easy
to put in on own, keep in for sex, lower hormones
Nuva ring rules for removal - 🧠 ANSWER ✔✔Do not remove for more than
3 hours, if so use backup for 7 days
Nuva ring disadvantages - 🧠 ANSWER ✔✔$, foreign body,
allergies/vaginitis, can be pushed out
Combo Nuva Ring components - 🧠 ANSWER ✔✔Releases Ethinyl estradiol
(EE) 15 mcg and 120mcg etonogestrol
Combo patch components - 🧠 ANSWER ✔✔• 150mg/day progestin/
35mg/day of EE
Combo patch initiation - 🧠 ANSWER ✔✔Initiation: Anytime with 7-day back-
up method. Can consider quick start.
Advantages of patch - 🧠 ANSWER ✔✔doesn't go thru first pass effect,
sustained level, few allergies, lighter periods
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, Disadvantages of patch - 🧠 ANSWER ✔✔higher exposure to estrogen
compared to pills/other methods. Don't give if HX of DVT!
-**Consider weight limitation - less effective if women is >90kg (198lbs)
rules for patch application/removal - 🧠 ANSWER ✔✔• Applied weekly for 3
weeks consecutively
-Leave off during period (1 week) for withdrawal bleed
Contraceptives should be started no earlier than --weeks after delivery in
non-nursing women - 🧠 ANSWER ✔✔4- 6 weeks, • want body time for their
natural estrogen to come down (don't want too much estrogen on board)
What if the patient has a miscarriage or abortion? How soon can you start
contraceptives? - 🧠 ANSWER ✔✔-If within 1st trimester can start hormones
right away, hormones aren't super high yet.
-If mid 2nd to 3rd, same recommendation if postpartum (4-6 wks)
what type of OCC should be started in breastfeeding women & why? - 🧠
ANSWER ✔✔Progestins promote breast milk production so progestin-only
OCs should be used in women who are breastfeeding (can start right
away)---