A healthy, happily married couple in their early 40s has sought your advice on contraceptive strategies. The woman is concerned about the long-term effects of birth control pills and wants to stop taking them. They have two kids in high school and are certain they do not want more children. They seek advice on what to do.
Important factors to consider when using birth control includes side effects such as weight gain, acne, mood changes, nausea, and headaches.
Downstream
Because they are a healthy, happily married couple in their early 40s , with two kids and have intentions of not having kids anymore they are available to consider many methods of contraceptives that are best suitable for them.
Background
Male Reproductive system
Female Reproductive system
Testes
Ducts
Ejaculatory duct
Vas Deferens
Urethra
Epididymis
Penis
Accessory glands
Seminal gland
Prostate
Bulbo-urethral gland
Ovaries
vagina
urethra
Fallopian tube
uterus
Cervix
oval shaped organs contained in the scrotom
cylindrical tissue suspended by the pubic arch
tube connecting the urinary bladder
pass through the prostate, and open into the urethra at the seminal colliculus.
long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder
ghtly-coiled tube connecting rear of the testicles to the deferent duct
pea shaped gland located beneath the prostate
pair of simple tubular glands posteroinferior to the urinary bladder
walnut-sized gland located between the bladder and the penis
inverted pear-shaped muscular organlocated in the female pelvis between the urinary bladder
tube connecting the unrinary bladder
ovary is a solid, ovoid structure about the size and shape of an almond
elastic tube that connects the uterus and cervix to the vulva
muscular organ extending from the uterus and ending next to the ovary
ervix is a cylinder-shaped neck of tissue that connects the vagina and uterus
Male reproductive system functions
Female reproductive system functions
vagina
ovaries
Fallopian tube
cervix
uterus
testes
penis
prostate
vas deferens
bulbs urethral gland
seminal gland
ejaculatory duct
produce gametes, or sperm, and they secrete hormones, primarily testosterone
secrete prostate fluid, one of the components of semen. The muscles of the prostate gland also help propel this seminal fluid into the urethra during ejaculation
add fluids to semen during the process of ejaculation
function to mix the sperm stored in the ampulla with fluids secreted by the seminal vesicles and to transport these substances to the prostate.
sexual and urinary function
transports mature sperm to the urethra, the tube that carries urine or sperm to outside of the body, in preparation for ejaculation
add extra fluid to the semen before it is sent down the urethra
It functions to nourish and house a fertilized egg until the fetus, or offspring, is ready to be delivered
transport sperm toward the egg, which is released by the ovary, and to then allow passage of the fertilized egg back to the uterus for implantation
it carries menstrual flow outside the body, it receives the male penis during sexual intercourse, and it serves as a birth canal during labor.
They produce oocytes (eggs) for fertilisation and they produce the reproductive hormones, oestrogen and progesterone.
allow flow of menstrual blood from the uterus into the vagina, and direct the sperms into the uterus during intercourse
The Ovarian Cycle
Follicular phase
Ovulation
Luteal phase
the first phase is called the follicular phase because many large vesicular follicles are growing in the ovary during this phase.
As FSH levels begin to drop in the middle of the follicular phase, that follicle outcompetes the other follicles for FSH, and so continues to escape from atresia. It becomes the dominant follicle.
As one of the final events of follicle maturation, the primary oocyte of the dominant follicle complete meiosis 1 to form the secondary oocyte and first polar body.
Occurs when the ballooning ovary wall ruptures and expels the secondary oocyte, still surrounded by its corona radiata, into the peritoneal cavity .
after ovulation, the ruptured follicle collapses and the antrum fills with clotted blood. This corpus hemorrhagicum is eventually absorbed.
The remaining granulose cells enlarge, and along with the internal theca cells they form a new, quite different endocrine structure, the corpus luteum which supplies the high levels of progesterone and estrogen that characterizes the luteal phase.
If pregnancy does not occur the corpus luteum starts degenerating. If the Oocyte is fertilized and pregnancy ensues , the corpus luteum persists until the placenta is ready to take over its hormone producing duties in about three months.
The Uterine cycle
Days 0-4 Menstrual Phase
Day 5-14 Proliferative Phase
Days 15-28 Secretory Phase
The uterine or menstrual cycle Is a series of cyclic changes that the uterine endometrium goes through each month as it responds to the waxing and waning of ovarian hormones in the blood. These endometrial changes are coordinated with the phases of the ovarian cycle, which are dictated by gonadotropins released by the anterior pituitary
The uterus sheds all but the deepest part of its endometrium. The thick hormone dependent functional layer of the endometrium detaches from the uterine wall, a process accompanied by bleeding for 3-5 days.
The detached tissue and blood pass out through the vagina as the menstrual flow. By day 4, the growing ovarian follicles start to produce more estrogens.
The endometrium rebuilds itself. Under the influence of rising blood levels of estrogens, the basal layer of the endometrium generates a new functional layer.
As this new layer thickens , its glands enlarge and its spiral arteries increase in number. The endometrium becomes well vascularized. Estrogens induce the endometrial cells to synthesize progesterone receptors , readying them for interaction with progesterone.
Ovulation occurs at the end of the proliferative stage (day 14) in response to the LH surge from the anterior pituitary
The endometrium prepares for an embryo to implant. Rising levels of progesterone from corpus luteum act on the estrogen primed endometrium, causing spiral arteries to elaborate and converting the functional layer to a secretory mucosa.
The endometrium glands enlarge, coil, and begin secreting nutrients into uterine cavity. These nutrients will sustain the embryo until it has implanted in the blood rich endometrial lining.
Major Contraceptive Methods
Birth control pill
male condom
Vasectomy
Emergency contraceptive
Tubal sterilization
IUD
Abstinence
released progesterone or copper creates changes in the cervical mucus and inside the uterus that kills sperm or makes them immobile. The IUD changes the lining of the uterus, preventing implantation should fertilization occur.
side effects -rregular bleeding for several months.
lighter or shorter periods or no periods at all.
symptoms of premenstrual syndrome (PMS), which include headaches, nausea, breast tenderness, and skin blemishes
Emergency contraception pills use hormones or medications that block pregnancy. Most use the same hormones that are in regular birth control pills. The emergency-use pills work mainly by delaying the release of an egg or ovulation.
side effects -Nausea or vomiting, dizziness, Fatigue, Headache,
Breast tenderness, Bleeding between periods or heavier menstrual bleeding, Lower abdominal pain or cramps.
Prevents semen from entering the vagina.
side effects - latex allergy, generally safe and effective.
Birth control pills work by emitting naturally-occurring hormones estrogen and progestin to prevent pregnancy. These hormones stop sperm from fertilizing an egg by stopping ovulation.The hormones in the pill also thicken cervix mucus, meaning it is more difficult for the sperm to get to the egg.
Side effects - Nausea or vomiting, dizziness, Fatigue, Headache,
Breast tenderness, Bleeding between periods or heavier menstrual bleeding, Lower abdominal pain or cramps.
It prevents sperm from being released during ejaculation. ... Sperm must travel from the testicles to the man's urethra for pregnancy to eventually occur. Sealing or cutting the vas deferens prevents sperm from reaching the urethra.
side effects -Bleeding or a blood clot (hematoma) inside the scrotum, Blood in your semen, Bruising of your scrotum, Infection of the surgery site, Mild pain or discomfort, Swelling.
During tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy. Tubal ligation prevents an egg from traveling from the ovaries through the fallopian tubes and blocks sperm from traveling up the fallopian tubes to the egg.
Side effects - damage of bowel, bladder, major blood vessels, procedure failure, pelvic abdominal pain, improper wound healing or infection.
Sexual abstinence or sexual restraint is the practice of refraining from some or all aspects of sexual activity
Side effects - sexual frustration
Best contraceptive methods
Worst contraceptive methods
Condoms - they are effective, have no side effects, easy to use, and do not require surgery or medications.
Oral Contraceptives - Easy to use, side effects are minimal after three months, very effective, require no surgery.
Contraceptive intramuscular injection - Very effective, easy to administer, no medication or surgery, injection good for 3 months.
Vasectomy - although 100 percent effective, they do have serious side effects, will need surgery, back up birth control in order to fully dispose of remaining sperm cells, no longer have children.
Fertility awareness - requires use of condoms during fertility days, Female cycle usually varies, sperm may stay alive after 6 days, failure rate is about 25%
Spermicide - does require condom to be more effective, effective only 70-80%, does not guarantee contraception.