{Ch. 17} Women's Health

Terms in this set (51)

Traditional oral contraceptive pills have 21 days of "active" pills and 7 days of placebo pills.
■ The last 7 days are the "hormone-free" days. The menstrual period usually starts within 2 to 3 days after the last active pill was taken (from very low levels of
estrogen/progesterone).
■ Some brands of birth control pills (e.g., Loestrin FE) contain iron during the last 7 days of the pill cycle (instead of a placebo pill). The last 7 days (hormone-free) of the
pill cycle are there to reinforce the habit of daily pill-taking.
■ For the first pill cycle, advise patient to use "back-up" (an alternative form of birth control).
■ All the COCs, the patch, and the NuvaRing contain both estrogen and progesterone
(i.e., levonorgestrel, norethindrone, desogestrel, others).
■ The preferred birth control pill for breastfeeding women is the progestin-only pills or the "mini pill" (e.g., Microno, Nor-QD). Side effects includes spotting and
irregular menses.
■ Yaz or Yasmin contains estrogen and drospirenone. Has a higher risk of blood clots, stroke, heart attacks, and hyperkalemia.
■ The contraceptive patch (i.e., Ortho Evra) results in higher levels of estrogen exposure compared to COCs (higher risk of blood clots, DVT).
■ The estrogen in COCs can elevate blood pressure. Check patient's BP before and 2 to 4 weeks afterward.
■ Educate patient that she may have spotting/light bleeding during the first few weeks after starting birth control pills.
■ Discourage patient from switching to another pill brand during the first 3 months because of spotting. Advise patient that most cases resolve within 3 months.
Missed 1 Day
■ Take two pills now and continue with same pill pack ("doubling up"). Missed 2 Consecutive Days
■ Take two pills the next 2 days to catch up and fi nish the birth control pill pack (use condoms for the current pill cycle).
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