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40 y/o couple seeks advice for contraceptive strategies - Coggle Diagram
40 y/o couple seeks advice for contraceptive strategies
important factors:
Age: 40's
childbearing goals: none
sexual relationship: Married/one sexual partner
concern for long term use
no interest in further pregnancies,
worst options:
fertility awareness/planning: often ineffective for preventing pregnancies
hormonal contraception
emergency contraception: long term effects of
Reproductive anatomy
Female reproductive anatomy
clitoris is very sensitive to stimulation and can become erect.
vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body
also referred to as birth canal
uterus is a hollow, pear-shaped organ that is the home to a developing fetus, or sheds its lining during menstruation
cervix: lower part that opens into the vagina,
main body of the uterus: corpus
ovaries are small, oval-shaped glands that are located on either side of the uterus.
produce eggs and hormones.
Fallopian tubes: narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova
Male reproductive anatomy:
Most of males reproductive system is external
penis: the male organ for sexual intercourse
Semen, which contains sperm, is expelled (ejaculated) through the end of the penis when the man reaches sexual climax (orgasm).
The opening of the urethra, the tube that transports semen and urine, is at the tip of the glans penis.
ejaculatory ducts empty into the urethra.
scrotum: the loose pouch-like sac of skin that hangs behind the penis
contains the testicles:
testes must be at a temperature slightly cooler than the body temperature for sperm production
also responsible for making producing testosterone
epididymis is a long, coiled tube that rests on the backside of each testicle
functions in the carrying and storage of the sperm cells that are produced in the testes, brings sperm to maturity
protective function and acts as a climate control system for the testes
vas deferens transports mature sperm to the urethra in preparation for ejaculation.
seminal vesicles produce a sugar-rich fluid that provides sperm with a source of energy and helps with the sperms’ motility
prostate gland contributes additional fluid to the ejaculate.
FSH is necessary for sperm production (spermatogenesis), and LH stimulates the production of testosterone, which is necessary to continue the process of spermatogenesis.
events of the uterine/ovarian cycles,
The average menstrual cycle takes about 28 days and occurs in phases: the follicular phase, the ovulatory phase (ovulation), and the luteal phase
Follicular stage: LH and FSH are released and stimulate growth of 15-20 eggs, increased estrogen, one follicle becomes dominant and matures
ovulatory phase is the midpoint of the menstrual cycle: 14 days after follicular cycle. surge of LH promotes release of egg
increase in the amount and thickness of mucus produced by the cervix to capture sperm
Luteal phase: empty follicle develops into a new structure called the corpus luteum.
Progesterone prepares the uterus for a fertilized egg to implant.
If intercourse has taken place and a man's sperm has fertilized the egg
fertilized egg (embryo) will travel through the fallopian tube to implant in the uterus
If the egg is not fertilized, it passes through the uterus
lining of the uterus breaks down and sheds, and the next menstrual period begins
contraceptive methods
long-acting reversible contraception, such as the implant or intra uterine device (IUD)
hormonal contraception, such the pill or the Depo Provera injection
barrier methods, such as condoms
emergency contraception
permanent contraception, such as vasectomy and tubal ligation
fertility awareness/planning
best options:
IUD: minimal side effects, most effective non-hormonal option
tubal ligation: no further risk of pregnancies, low likelihood of long term effects
vasectomy: no further risk of pregnancies, low likelihood of long term effects