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A woman is concerned about the long-term effects of birth control pills…

- - - - Testis
      - Scrotum
      - Ducts
      - Accessory Glands
      - Penis
    - - Ovaries
      - Uterine tubes
      - Uterus
      - Vagina
      - Mammary glands
  - - - Hormones involved
        
        Testosterone
        
        Source: interstitial cells
        
        Effect: stimulates sex drive and the development of male secondary sex characteristics
        
        Inhibin
        
        Source: sustentacular cells
        
        Effect: sustentacular cells respond to rising sperm count by secreting inhibin; inhibits the secretion of FSH; negative feedback mechanism to control sperm production
        
        ABP (androgen binding protein)
        
        Source: sustentacular cells
        
        Effect: binds androgens
        
        FSH
        
        Source: anterior pituitary
        
        Effect: stimulates sustentacular cells to secrete ABP; ensure high testosterone levels in testis
        
        LH
        
        Source: anterior pituitary
        
        Effect: stimulates interstitial cells in testis to secrete testosterone; ensure high testosterone levels in testis
        
        GnRH
        
        Source: hypothalamus
        
        Effect: initiates spermatogenesis by causing anterior pituitary to secrete FSH and LH
      - Function
        
        Testis
        
        Contains interstitial cells that produce androgens, the most common being testosterone
        
        Has lobules containing seminiferous tubules
        
        Sustentacular cells act as supporting cells for developing sperm cells and produce inhibin, which inhibits FSH secretion, thus reducing sperm production; form the blood-testis barrier
        
        Scrotum
        
        Contains the testis and keeps them at optimal temperature for sperm development using the darts muscle and cremaster muscle
        
        Ducts
        
        Rete testis
        
        Receive sperm from seminiferous tubules and dump it into the efferent ductules
        
        Efferent ductules
        
        Receive sperm from rete testis and dump it into the epididymus
        
        Epididymus
        
        Stores sperm until they are fully mature and capable of moving
        
        Vas deferens
        
        Receives sperm from the epididymus and contracts its middle muscularis to propel sperm through the vas deferens
        
        Enlarges at the superoposterior edge of the prostate gland to form the ampulla of the vas deferens
        
        Ejaculatory duct
        
        Uniting of the ampulla of the vas deferens with the proximal region of the seminal vesicle forms the ejaculatory duct
        
        Conducts sperm and seminal fluid into the prostatic urethra
        
        Urethra
        
        Carries urine and semen out of the body
        
        Accessory glands
        
        Secrete substances that form seminal fluid
        
        Seminal vesicles
        
        Secretes alkaline fluid containing fructose and prostaglandins
        
        Prostate gland
        
        Secretes weakly acidic fluid rich in citric acid, seminal plasmin, and prostate-specific antigen (PSA)
        
        Bulbourethral gland
        
        Secretes mucin to form mucus to lubricate urethra
        
        Penis
        
        Reproductive function
        
        Erectile and ejaculatory traits that contribute to sexual intercourse
        
        Urinary function
        
        Contains urethra for passage of urine
    - - uterine cycle
        
        Phase 1: Menstrual Phase
        
        Days 1-5: sloughing of the functional layer of the endometrium and lasts through the period of menstrual bleeding
        
        Phase 2: Proliferative Phase
        
        Days 6-14: does not vary time wise despite the length of the menstrual period; initial development of the new stratum functional is occurs, which overlaps the time of the follicle growth and estrogen secretion by the ovary
        
        Phase 3: Secretory Phase
        
        Days 15-28: progesterone secretion from the corpus luteum results in increased vascular inaction and development of uterine glands
      - ovarian cycle
        
        Phase 1: Follicular Phase
        
        Days 1-13: GnRH stimulates the secretion of FSH and LH; FSH and LH stimulate follicles to grow and mature and stimulate sex hormones; Negative feedback inhibits gonadotropin release; Positive feedback stimulates gonadotropin release
        
        Phase 2: Ovulation
        
        Day 14: there is a peak in LH (LH surge) which causes and increase in formation of antrum fluid; increased pressure forces the secondary oocyte out of the follicle——> I.e. the expulsion of the oocyte = ovulation
        
        Phase 3: Luteal Phase
        
        Day 15-28: If secondary oocyte is not fertilized the corpus luteum becomes the corpus albicans (white connective tissue); corpus luteum will regress and stop producing estrogen and progesterone; uterine lining sheds I.e menstration
      - Hormones involved
        
        Estrogen
        
        Source: ovarian follicles. (Before ovulation), corpus luteum (after ovulation), or placenta (during pregnancy)
        
        Effects: initiates and maintains growth of the functional layer of the endometrium
        
        Progesterone
        
        Source: corpus luteum or placenta (during pregnancy)
        
        Effects: primary hormone responsible for functional layer growth after ovulation; causes increase in the uterine blood vessel distribution, uterine gland size, and nutrient production
        
        Inhibin
        
        Source: ovarian follicles
        
        Effects: inhibits FSH secretion so as to prevent excessive follicular development
        
        Leutinizing hormone (LH)
        
        Source: anterior pituitary
        
        Effect: stimulates ovulation (when there is a peak in LH)
        
        follicle stimulating hormone (FSH)
        
        Source: anterior pituitary
        
        Effects: stimulates. Development and maturation of ovarian follicles
        
        Gonadotropin-releasing hormone (GnRH)
        
        Source: Hypothalamus
        
        Effects: stimulates anterior pituitary to produce and secrete FSH and LH
      - Function:
        
        Ovaries
        
        Stores primary follicles that secrete estrogen until ovulation when it releases secondary follicle; after ovulation vesicular follicles secrete progesterone; the corpus luteum also aids in progesterone secretion and maintains pregnancy
        
        Uterine tube
        
        Has fimbriae that catch the oocyte during ovulation and channels the released egg to the infundibulum until it reaches the ampulla where fertilization can occur
        
        Uterus
        
        Nurturing the fertilized ovum that develops into a fetus and holds it until the baby is mature enough for birth; fertilized ovum is implanted into the endometrium until it is mature and the myometrium contracts for menstruation and giving birth; the body of the cervix holds the baby and is supported by the round ligament; the cervix permits or denies entry of the sperm and is sealed by a mucus plug during pregnancy
        
        Vagina
        
        Passage for mensuration, intercourse, and child birth
        
        Mammary glands
        
        Responsible for milk production, transportation, and secretion (aka lactation) for the purpose of feeding the offspring; glandular tissue begins develop after puberty in response to estrogen release
  - - - inhibits ovulation by synthetic secretion of estrogen and progesterone
    - - Contains only progesterone-like substances; thins endometrium; thickens cervical mucus; may inhibit ovulation
    - - Stops implantation of blastocyst by secretion of synthetic progesterone
    - - Prevents egg and sperm from meeting
- - - - A surgical cutting and sealing of part of each vas deferens as a means of sterilization prevents any sperm from being released during ejaculation and is over 99% effective
    - - A surgical procedure for female sterilization which involves severing and tying the Fallopian tubes stops the release of ovum with contraceptive effectiveness at over 99%
    - - A substance that kills sperm combined with a barrier to prevent any sperm from reaching the egg raises contraceptive effectiveness to 97%
  - - - Implant placed in uterus that blocks entry of sperm into the uterus and makes the endometrium inhospitable for implantation
      - Still contains synthetic hormones like the birth control pill which the patient wants to avoid
    - - Removing penis from the vagina before ejaculation
      - HIGH FAILURE RATE
      - Pre-ejaculate contains small amounts of sperm
      - Still at risk for pregnancy
    - - Avoiding intercourse during ovulation
      - Menstrual cycle may be irregular
      - Easy to lose track of cycles