A woman is concerned about the long-term effects of birth control pills and wants to stop taking them. Her and her husband do not want more children.
background
downstream effects
upstream causes
anatomy
physiology
male reproductive system
female reproductive system
male reproductive system
female reproductive system
uterine cycle
ovarian cycle
major contraceptive methods
Combination pill
age
they do not want more kids
how long she's been taking birth control
3 best options
3 worst options
vascectomy
tubal ligation
Spermicide with condom
Hormones involved
Estrogen
Progesterone
Inhibin
Leutinizing hormone (LH)
Source: anterior pituitary
follicle stimulating hormone (FSH)
Effect: stimulates ovulation (when there is a peak in LH)
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
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
Source: ovarian follicles
Effects: inhibits FSH secretion so as to prevent excessive follicular development
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
Phase 1: Menstrual Phase
Phase 2: Proliferative Phase
Phase 3: Secretory Phase
Days 1-5: sloughing of the functional layer of the endometrium and lasts through the period of menstrual bleeding
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
Days 15-28: progesterone secretion from the corpus luteum results in increased vascular inaction and development of uterine glands
Phase 1: Follicular Phase
Phase 2: Ovulation
Phase 3: Luteal 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
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
click to edit
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
Function:
Ovaries
Uterine tube
Uterus
Vagina
Mammary glands
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
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
Passage for mensuration, intercourse, and child birth
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
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
Hormones involved
Function
Testis
Scrotum
Ducts
Accessory glands
Penis
Testosterone
Inhibin
ABP (androgen binding protein)
Contains the testis and keeps them at optimal temperature for sperm development using the darts muscle and cremaster muscle
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
Rete testis
Efferent ductules
Epididymus
Vas deferens
Ejaculatory duct
Urethra
Receive sperm from seminiferous tubules and dump it into the efferent ductules
Receive sperm from rete testis and dump it into the epididymus
Stores sperm until they are fully mature and capable of moving
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
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
Carries urine and semen out of the body
Secrete substances that form seminal fluid
Seminal vesicles
Prostate gland
Bulbourethral gland
Secretes alkaline fluid containing fructose and prostaglandins
Secretes weakly acidic fluid rich in citric acid, seminal plasmin, and prostate-specific antigen (PSA)
Secretes mucin to form mucus to lubricate urethra
Reproductive function
Urinary function
Contains urethra for passage of urine
Erectile and ejaculatory traits that contribute to sexual intercourse
IUD
Withdrawal method
Rhythm method
Having kids when older increases the risk in offspring abnormalities
Estrogen and progesterone intake for long periods of time increase chances of breast cancer, blood clots, and cervical cancer
Mini-pill
IUD
Stops implantation of blastocyst by secretion of synthetic progesterone
Condom
inhibits ovulation by synthetic secretion of estrogen and progesterone
Contains only progesterone-like substances; thins endometrium; thickens cervical mucus; may inhibit ovulation
Prevents egg and sperm from meeting
FSH
LH
GnRH
Source: hypothalamus
Effect: initiates spermatogenesis by causing anterior pituitary to secrete FSH and LH
Source: anterior pituitary
Effect: stimulates interstitial cells in testis to secrete testosterone; ensure high testosterone levels in testis
Source: anterior pituitary
Effect: stimulates sustentacular cells to secrete ABP; ensure high testosterone levels in testis
Source: sustentacular cells
Effect: binds androgens
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
Source: interstitial cells
Effect: stimulates sex drive and the development of male secondary sex characteristics
Testis
Scrotum
Ducts
Accessory Glands
Penis
Ovaries
Uterine tubes
Uterus
Vagina
Mammary glands
A substance that kills sperm combined with a barrier to prevent any sperm from reaching the egg raises contraceptive effectiveness to 97%
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%
Avoiding intercourse during ovulation
Menstrual cycle may be irregular
Easy to lose track of cycles
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