married couple in their 40s, concerned about long term affects birth control pills, wants to stop. They don't want any more kids.
Female reproductive system
uterus
fallopian tube
fimbrae
ovarian ligament
ovaries
cervix
endometrium
vagina
Male reproductive system
ureter
vas deferens
seminal vesicle
prostate
bulbourethral gland
erectile tissue
epididymis
testicle
urethra
penile head
Functions of male reproductive organs
Vas Deferens : transports mature sperm to urethra, prep for ejaculation
Seminal Vesicles : produce fructose serving as energy source for sperm. Serves as majority of fluid in ejaculate
Prostate : contributes to fluid in ejaculate, serves as nourishment for sperm
bulbourethral gland : produce clear slippery fluid that empties into urethra. neutralizes acidity associated with residual urine
testes : produces male sperm
erectile tissue : tonically contracted, allowing small amount of arterial flow for nutritional purposes
epididymis : brings sperm to maturity
penile head : opening for urine and semen/fluids
functions of female reproductive organs
uterus : nurturing fertilized ovum that develops into fetus, holding it till baby is mature enough for birth
fallopian tubes: transport ova from ovary to uterus each month
fimbriae : finger like projections activated by hormones to catch released egg and move to fallopian tube
ovaries : produce eggs for fertilization, produce reproductive hormones , oestrogen, progesterone
cervix : allows menstrual blood to flow from uterus into vagina. directs sperm into uterus during intercourse
endometrium: prevent adhesions between opposed walls of myometrium, maintains patency of uterine cavity
events in ovarian cycle
follicular phase : day 1 -13
primodial follicles stimulated to mature by LH & FSH
primary oocyte finishes meiosis I
ovulation : release of secondary oocyte from mature follicle
occurs on day 14 of cycle
luteal phase: days 15-28 of cycle
corpus luteum : temporary endocrine gland, secretes progesterone and estrogen
regression causes shedding of uterine lining during menstruation , marking end of luteal phase
uterine cycle : cyclical changes in endometrial lining
menstrual phase : day 1-5 of cycle, last through period of menstrual bleeding
proliferative phase : days 6 - 14 cycle, development of new functional layer of endometrium,
overlaps time of follicle growth and ovary estrogen secretion
secretory phase : day 15-28, increased progesterone secretion
if fertilization doesn't occur, degeneration happens
Major contraceptive methods
abstinence : 100% way to prevent pregnancy
rhythm method : avoid sex during ovulation time
withdrawal method : pull out before ejaculation/high failure rate
barrier methods : prevent sperm from reaching uterine tubes - condoms, spermicidal gels
IUD: flexible plastic structure inserted into uterus , copper/synthetic progesterone prevents implantation
oral contraceptives or patches : prevent LH spike and ovulation
morning after pills : inhibits ovulation when taken 72 hours after unprotected sex
tubal ligation : surgically cutting uterine tubes and tying off ends. prevents sperm from reaching uterus
vasectomy : ductus deferens cut, segment removed, ends tied. sperm unable to leave testis
history of health before and after the end of birth control pills
health history of husband to see if he's good candidate for vasectomy
overall health of wife
vaginal ring
IUD
hormonal implant
condoms
withdrawal method
tubal litigation
average
good for women with no underlying health problems.
91% - 97% reliable
may make periods more regular, and lessen cramps
best
placed in woman's uterus, prevents sperm from reaching an egg, stops fertilized egg from implanting
99% reliable
may lighten or eliminate periods depending on the material chosen between hormone-free and progestin. may cause acne or ovarian cysts
can be used until they enter menopause
best
matchstick sized rod inserted under skin of upper arm , can remain in arm 3 years
99% reliable
may encounter irregular & unpredictable bleeding/spotting. or no more periods
don't require prescription, widely available. helps protect against STDs
79% - 95% reliable
worst
male withdrawals from the vaginal canal before ejaculation
may cause vaginal dryness, decreases sensation, can be difficult to use correctly
average
about 30% reliable
high chance of getting pregnant
best
most effective / female sterilization
99% reliable
permanent procedure, no reversion
vasectomy
male option
surgical cutting & sealing of part of vas deferens
99% reliable, after 3 months post surgery
overall health of husband