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Couple in their 40's seek advise on contraceptives (Background…
Couple in their 40's seek advise on contraceptives
Upstream
factors to consider when choosing a birth control method
how effective it is
some are more effective than others
more effective
lower chances of getting pregnant
less self control
less responsibility
less effective
higher chances of getting pregnant
more self control
more responsibility
Is it reversible
reversible
want to get pregnant in the future
temporary
exp
condoms
oral contraceptives
IUD
irreversible
be positive about the decision
family is complete
exp
vasectomy
ligation
side effects
hormonal effects
breast tenderness
irregular bleeding
nausea
cramping
wight gain
depression
hair r skin changes
headaches
heavy periods
Does it fit your lifestyle
bad memory
might forget to take a pill every day
smoker
avoid hormone contraceptives
increases
risk of blood clots
risk of heart disease
your relationship
mutiple partners or single partner
protect yourself
prevent pregnacy
STDs
best option
condoms
health conditions
hormonal contraceptives
not safe with other health conditions
exp
history of blood clots
stroke
beast or uterine cancer
liver disease
migraine headaches
age
young
might change your mind
something permanent might not be the best option
older
had kids already and don't want anymore
someting permanent would be a good option
Background
Anatomy
Gonads and Reproductive organs
Gonads
ovaries
produce
gametes
ova
sex hormones
progesterone
estrogen
testes
gametes
sperm
sex hormone
testosterone
Male Reproductive System
testes
produce
sperm
protected
scrotum
sac of skin and superficial fascia that hangs outside abdominopelvic cavity
muscles
dartos muscle
smooth muscle in superficial fascia, wrinkles skin
cremaster muscles
skeletal muscles that arise from internal oblique muscles of the trunk, elevate the testes
2 tunicas
tunica vaginalis
outer layer
tunica albuginea
deepest layer
parts
seminiferous tubules
sperm factory
form of tubules
rete testis
connect seminiferous tubules and epididymis
accessory ducts
epididymis
where the sperm matures
sperm is there for total of 20 days
sperm can also be stored there form months
sperm is ejaculated from epididymis
ductus deferens
transport sperm during ejaculation
ejaculatory duct
ampulla of duct deferens join seminal gland
urethra
terminal portion of the male duct system
transport
urine
semen
regions
prostatic urethra
surrounds prostate
intermediate part
urogenital diaphragm
spongy urethra
runs through penis and opens to outside
accessory sex glands
seminal glands
70% of semen volume
yellowish viscous alkaline fluid containing fructose sugar, citric acid and coagulating enzymes, prostaglandins
prostate
gland size of peach pit, encircles urethra just inferior to bladder
contract during ejaculation, releasing prostatic secretions
fluid activates sperm
milky, acitic fluid
bulbo urethral glands
pea sized, located inferior to prostate in urogenital diaphragm
produce
thick, clear mucus
lubricates
semen
milky white, sticky mixture of accessory gland secretions and sperm
roles
prostagladins
cause viscosity of mucus guarding cervix
stimulate reverse peristalsis in uterus
relaxin and some enzymes
enhance sperm motility
ATP
provide energy
other ingredients
suppress immune response in female reproductive tract
antibiotics
destroy bacteria
penis
copulatory organ
delivers sperm into female reproductive tract
parts
glans penis
enlarged tip
prepuce (foreskin)
skin covering penis
tissue
spongy urethra
erectile tissue
spongy network of connective tissue and smooth muscles riddled with vascular spaces.
corpus spongiosum
surrounds the urethra
Female reproductive system
internal genitalia
ovaries
hormones
estrogen
progesterone
follicles
immature eggs (oocyte) develop
duct system
uterus
in pelvic cavity, anterior to rectum and posterosuperior to bladder
regions
body
major portion of the uterus
fundus
rounded region superior to the entrance
isthmus
near cervix
wall
layers
perimetrium
1 more item...
myometrium
1 more item...
endometrium
3 more items...
uterine tubes
receive the ovulated oocyte and site for fertilization
begins near ovary, empties in to uterus
regions
infundibulum
funnel shape region
ampulla
half the length of the uterine tube, where fertilization occurs
isthmus
narrow medial third of the uterine tube, empties into uterus
vagina
thin walled tube that lies between the bladder and the rectum
function
passageway for delivery of infant
menstrual flow
organ of copulation
3 coats
adventitia
outer fibroelastic
muscularis
smooth muscle
inner muosa
ridges or rugae
external genitalia
vulva
external genitalia
mons pubis
fatty rounded area overlying the pubic symphysis
labia majora
largest lips
labia minora
smaller folds
clitoris
protruding structure composed of erectile tissue
mammary glands
modified sweat glands
function
produce milk
nourish an infant
parts
areola
pigmented skin
nipple
middle part
Physiology
Function
Form Gametes ( sperm) and (Ova)
Bring gametes from male and female together in copulation
Combine genetic information in fertilization and form a zygote
support the development of fetus
HPG Axis
hormonal interaction that regulate the production of gametes and sex hormones
hormones
GnRH
indirectly stimulates testes and ovaries via FSH and LH
inhibin
exerts negative feedback on FSH
meiosis
nuclear division that occurs only in the gonads
events
meiosis 1
homologous chromosomes separate ( 2n to n)
forming haploid cells with replicated chromosomes
phases
prophase I
Homologous chromosomes form tetrads
nonsister chromatids trade segments during crossing over
metaphase I
tetrads line up in the equator
anaphase I
homologous chromosomes separate from each other
dyads move to opposite poles of cell
telophase I
nuclear membrane re-form, spindles break down, chromatin reappears
2 daughter cells (haploid) enter second interphase. no DNA replication
meiosis II
2 sister chormatids separate
forming 4 haploid cells with unreplicated chromosomes
repeate all phases
Prophase II
metaphase II
Anaphase II
Telophase II
product
4 haploid daughter cells
each genetically different form parent
interphase
pair of homologous chromosomes in diploid parent cell replicate
physiology of male reproductive
erection
allows penetration to female vagina
parasympathetic control
enlargement and stiffening of penis
NO relaxes smooth muscle in penile blood vessel walls
erectile bodies fill with blood
ejaculation
expels semen into the vagina
sypathetic control
ducts empty their contents in the prostatic urethra
spinal reflex accompanied by intense pleasure (orgasm)
spermatogenesis
process of forming male gametes in seminiferous tubules of testes
cells
sustentocytes
sperm formation
spermatogenic cells
cells that give rise to sperm
myoid cells
help squeeze sperm and testicular fluid through tubules
interstitial endocrine cells
produce androgens
testosterone
small amount of estrogen
sperm
mitosis
golgi packages the acrosomal enzymes
the acrosome forms at the anterior end of the nucleus and centrioles gather at opposite ends
microtubules form the flagellum
mitochondria multiply and cluster around the proximal portion of the flagellum
excess cytoplasm sloughs off
immature sperm released from sustentocyte
structure of fully develop sperm
physiology of female reproductive system
oogenesis
beginning of an egg
process
oogonia
diploid stem cells
primary oocytes
begins first biotic division
secondary oocytes
ova
ovarian follicles
Primordial follicles
Primary follicle
secondary follicle
early vesicular follicle
mature vesicular
follicle ruptures, secondary oocyte ovulates
corpus luteum ( forms from ruptured follicle)
ovarian cycle
maturation of an egg
phases
follicular phase
follicules secrete increasing amounts of estrogen
dominant follicle
1-14 days
luteal phase
days 14-28
corpus luteum is active
supplies high levels of progesterone and estrogen
degenerate in 10 days
ovulation
ovary wall ruptures and expels secondary oocyte
28 days
regulation of the ovarian
GnRH stimulates FSH and LH secretion
FSH and LH stmulate follicles to grow mature, and secrete sex hormones
3.negative feedback inhibits gonadotropin release
positive feedback stimulates gonadotropin release
Uterine (menstrual) Cycle
series of cyclic changes that uterine endometrium goes through each month
events
Days 0-4
menstrual phase
uterus sheds
ovarian hormones lowest normal levels
bleeding for 3-5 days
Days 5-14
Proliferative phase
endometrium rebuilts itself
endometrial cells synthesize progesterone receptors
thin cervical mucus
Days 15-28
endometrium prepares for an embryo to implant
rise levels of progesterone
endometrial glands secrete nutrients into uterine cavity
contraceptive methods
implant
IUD
LARC goes in Uterus
types
copper IUD
contains copper
longer heavier periods
Hormonal IUD
contains progestogen
spotting or no periods
up to 10 years
how does it work
stops sperm from reaching egg
stops egg from attaching to wall of uterus
removable
diadvantages
small risk of infection
allergic reactions
might come off by itself
the Rods
up to 5 years
bleeding may change
removable
rods go under skin
release progestogen
stop body from releasing an egg each month
thicken the mucus wall of cervix so sperm cannot reach egg
effectiveness
99%
hormonal contraception
pill
take very day
combination of estrogen and progestogen
stop eggs being made
ovary does not release an egg
effectiveness
99% if taken correctly
progestogen only
thickens mucus in cervix
sperm can't travel through it
disadvantages
irregular bleeding
Devo Provera
contraceptive injection with progestogen
every 12 weeks
how does it work
stop ovaries from releasing egg each month
change in endometrium
effectiveness
97%
disadvantage
irregular or prolonged bleeding
reduce bone density
gain weight
barrier method
condom
protect against sexually transmissible infections
barrier
stops sperm and infections from passing to sexual partner
disadvantage
condom can break
internal condoms
barrier and reduce STIs
how it works
collects and keeps sperm from entering the vagina
effectiveness
79%
permanent contraception
vasectomy
deferens tubes are cut and tied
sperm is not delivered to the outside of the body
it is absorbed by the body
advantages
will still have erections and orgasms
hormones do not change
sex drive do not change
permanent
ligation
close both fallopian tubes so sperm can not reach egg
tubes are cut or tied
permanent
Downstream
suggestions
Best Options
tube ligation
fallopian tubes are cut, tied or blocked permanently
how does it work
prevents egg from traveling from ovaries through fallopian tube
blocks sperm from traveling up fallopian tubes
why it is a good option
permanent birth control
effective
reduce risk of ovarian cancer
reduce pelvic inflammatory disease
does not affect hormones
won't change periods or bring on menopause
vasectomy
deferens tubes are cut and tied
how does it work
sperm is not delivered to the outside of the body
why it is a good option
99% effective
less expensive
permanent
hormones do not change
sex drive do not change
IUD
contraceptive implates
long acting
why it is a good option
forgettable contraception
very effective
good for a busy lifestyle
safe for woman all the way to menopause
how does it work
stops sperm from reaching egg
stops egg from attaching to wall of uterus
Worst options
hormonal contraception
Pill
how it works
stops egg from being made
why it is not a good option
increases blood pressure
bleeding or spotting in the first months
increase risk of blood clots
increase risk of breast cancer
Devo Provera
birth control shot
release medroprogesteron
how does it work
prevent ovulation
thickens cervical mucus
why its not a good option
remember to get the injection
bone density loss
irregular bleeding
skin reactions
weight gain
may cause depression
patches
why it is not a good option
less reliable for heavier woman
prone to blood clots
breast cancer
uterine cancer
higher concentration of estrogen
how does it work
hormones absorption
prevent eggs from being released from ovaries
thickens cervical mucus
prevent sperm from reaching the egg