Hormonal Contraceptives and Emergency Contraception

Hormonal Contraceptives

• Vaginal Ring: Combined estrogen-progestin, low dose, sustained release, soft, inserted at home, in place for 3 weeks, removed for intercourse (up to 3 hours) without compromising effectiveness. DVT & PE risk.
• Subdermal Implants: Progestin only, inserted under the skin, prevents ovulation, thickens cervical mucus, effective up to 3 years.
• Depot Medroxyprogesterone (Depo-Provera): Long-acting progestin, 150 mg injection every 3 months, very effective, high side effect potential (menstrual irregularity, heart attack, weight gain, breast tenderness, depression, nausea), cannot be used for longer than 2 years without calcium concerns. Do not massage. Fertility may take up to 18 months to resume.

Emergency Contraception

• Morning-after pill (Plan B/Ella): Used after unprotected sex, rape, or contraceptive failure, taken within 72-120 hours, stops/delays ovulation, thickens cervical mucus. Plan B: up to 155 lbs, Ella: up to 195 lbs. Over 190 lbs, may require a prescription.

Operative Sterilization

• Vasectomy (male): Permanent sterilization.
• Tubal Ligation (female): Permanent sterilization.

Sexually Transmitted Infections (STIs) - Syphilis

• Primary: Systemically spread to organs, widespread skin rashes, mucous patches, sore throat, alopecia, flu-like symptoms, malaise (weeks to 6 months).
• Secondary: Internal organ damage (up to 20 years), localized skin, bone, and liver tumors may occur, loss of coordination and blindness. Can lead to mental illness, heart damage, paralysis, death, blindness, seizures, and nerve damage if untreated.
• Tertiary (latent): Internal organ damage, without treatment lesions resolve but localized tumors possible on skin, bone, liver; loss of coordination and blindness.
• Treatment: Penicillin G (single IM dose). Long-term testing crucial if diagnosed.

Parasitic STIs - Trichomoniasis

• Protozoa, male symptoms: thin white/gray discharge, dysuria, painful ejaculation, female symptoms: "strawberry spots" on cervix, easy bleeding, yellow/green, frothy discharge with foul odour.
• Treatment: Metronidazole PO (by mouth).

Non-STIs

• Bacterial Vaginosis (BV): Thin, white/gray discharge with fishy odor. Treatment: Metronidazole PO or intravaginally (by mouth or in the vagina).
• Candidiasis (yeast infection): Vulvar/vaginal itching, thick, creamy white (cottage cheese-like) discharge, no odour, can affect men. Can involve erythema and white patches. Treatment: Fluconazole PO (by mouth) or topically.
• Pelvic Inflammatory Disease (PID): Typically caused by untreated STIs, increases risk of ectopic pregnancy, infertility, and chronic pelvic pain. Symptoms: Fever, lower abdominal pain, irregular bleeding, pain during sex, burning during urination. Treatment: Ceftriaxone, with or without Doxycycline.

This quiz covers the various types of hormonal contraceptives, such as the vaginal ring, subdermal implants, and Depot Medroxyprogesterone. It also addresses emergency contraception methods like Plan B and Ella. Test your knowledge on their mechanisms, uses, and potential side effects.