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Couple in their 40's seeking alternative contraceptive options other…
Couple in their 40's seeking alternative contraceptive options other than the pill.
Background
Anatomy of Reproductive Systems
Female
Ovaries
Produce estrogen and progesterone. Site of Oogenesis (Function)
Fallopian Tubes
Site of fertilization.
Passageway for ovum
Uterus
Consists of 3 layers:
Endometrium
Myometrium
Perimetrium.
Provides nourishment and womb for developing fetus if fertilization occurs
Vagina
Passage way for intercourse and delivery
Male
Scrotum
Contains Testes and Epididymis
Testes
Site for testosterone and spermatogenesis (Function)
Penis
For copulation and urination
Urethra
terminal portion for semen and urine
Cycles
Uterine Stages
Menstrual Phase
(Day 0-4)
Decrease levels of estrogen & progesterone >
Corpus luteum degenerates > Endometrium breaks down and sheds from uterine wall > on day 4 an increase of estrogen release occurs
Proliferative Phase
(Day 5-14)
In the presence of rising estrogen levels, Endometrium thickens and becomes more vascular,
progesterone
receptors are activated by estrogen, LH is released > ovulation occurs
Secretory Phase
(Day 15-28)
Endometrium prepares for plantation of embryo, endometrial glands secrete nutrients into uterus,
Progesterone
levels rise and cervical plug is formed
Ovarian Stages
Follicular Phase
(Day 1-13)
Release of FSH > Ovary releases a follicle with an
ooctye > follicle releases estrogen >
ovulation occurs
Follicle ruptures and leaves ovary for fertilization
Luteal Phase
(Day 14-28)
Release of LH
Follicle turns into Corpus Luteum and releases progesterone
Contraceptives
Condoms
How
: sometime lined with spermicides prevent fluids from entering each partner
Side Effect
decrease in sensation
IUD
Pro: in the presence of copper acts as a spermicide, causes a rise in WBC's which make it a hostile environment for sperm
Side Effect
its a foreign object, PID (increased risk)
The Pill
Pro: inhibits release of FSH, thins the wall of endometrium, thickens cervical mucus
Side Effect
weight gain
Important Factors that set them apart
They already have children
Happily married
Do not want anymore kids
Best Options
Vasectomy
-Minimally invasive
-99% effective
-no decrease in testosterone
Copper IUD
-99% effective
-minimally invasive
-no hormones
Stay on the pill
-Not what they want to hear, but reassure them there's no long term evidence for prolonged use
Worst Options
Abstinence
-because that's no fun
Tubule Ligation
-more invasive than vasectomy with longer recovery
Pull and pray
Not very logical