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A healthy, happily married couple in their early 40s has sought your…
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.
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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
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Ducts
Ejaculatory duct
pass through the prostate, and open into the urethra at the seminal colliculus.
Vas Deferens
long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder
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The Ovarian Cycle
Follicular 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.
Ovulation
Occurs when the ballooning ovary wall ruptures and expels the secondary oocyte, still surrounded by its corona radiata, into the peritoneal cavity .
Luteal phase
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
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.
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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
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