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Couple in their 40s do not want more kids, contraceptives? long-term…
Couple in their 40s do not want more kids, contraceptives? long-term effects of birth control?
Male Reproductive System
Epididymis
Comma-shaped structure, its head, body and tail lie on the testis; stores sperm until they are fully mature and capable of being motile
Ductus deferens
A thick-walled tube that travels within the spermatic cord through the inguinal canal, receives sperm from the epididymis
Testes
Housed within the scrotum, interstitial cells produce testosterone
Prostate gland
A compact, encapsulated organ located inferior to the bladder; secretes a slightly milky fluid that is weakly acidic and rich is citric acid for sperm health and PSA which acts as an enzyme to liquify semen following ejaculation
Bulbourethral gland
Aka Cowper glands, located within the urogenital diaphragm; secretes a clear, viscous mucin that forms mucus to protect the male urethra and acts as a lubricant during sex
Penis & Scrotum
Form the external genitalia of the male; the scrotum protects the testes and maintains warmth. The penis has both reproductive and urinary functions, providing a passageway for urine and semen
Uterine Cycle
Proliferative Phase
Follows the menstrual phase, lasts 6-14 days; initial development of new stratum functionalis occurs, overlaps the time of follicle growth and estrogen secretion by the ovary
Secretory Phase
Days 15-28, progesterone secretion from corpus luteum results in increased vascularization and development of uterine glands
Menstrual Phase
Days 1-5, sloughing of the functional layer and lasts through the period of menstrual bleeding
Contraceptive methods
Abstinence
Refraining from sex, most effective method of birth control however the couple's relationship may suffer or become strained
Oral contraceptives
Combination pill contains synthetic progestins and estrogens to inhibit ovulation; the mini-pill contains only progesterone-like substances which thins the endometrium and thickens cervical mucus, may inhibit ovulation
Morning-after pills
Preven or Plan B, can be taken within 72 hours of unprotected sex; work by inhibiting ovulation, altering the menstrual cycle, or irritating the uterine lining to inhibit implantation
Intrauterine devices
IUDs are T-shaped, flexible plastic structures placed into the uterus, prevents fertilization from occurring. May contain copper or synthetic progesterone, effective for up to 10 years
Special Considerations
This couple is in their 40s and with age comes reduced fertility, increased risk of complications during birth and the passage of genetic mutations to offspring due to paternal age over 45. If she has already been taking estrogen and progestin for years it may negatively affect her hormone levels
Worst options
If she were to continue using birth control pills, the synthetic hormones may interfere with her normal ovarian/uterine cycles
If she were to get pregnant, there may be various complications during labor or the baby might have health issues
The withdrawal method aka "pull-out method", high failure rate as it is difficult to predict point prior to ejaculation
Best options
Tubal ligation for the wife in which uterine tubes are cut and tied off to both prevent sperm from reaching the oocyte and the oocyte from reaching the uterus
IUD for the wife, effective for up to 10 years and she can take it out once she reaches menopause
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Ovarian Cycle
Ovulation
Day 14, defined as the release of the secondary oocyte from a mature follicle
Luteal Phase
Day 15-28, remaining follicle cells in the ruptured mature follicle become the corpus luteum which secretes progesterone and estrogen that stabilize and build up the uterine lining
Follicular Phase
Days 1-13; as ovarian follicles develop, granulosa cells release inhibin which helps inhibit FSH production, preventing ovarian follicle development