Healthy couple in early 40's seeking advice on contraceptive strategies. Woman wants to stop taking birth control pills. Have two kids in high school and do not want more.
Downstream effects
Upstream causes
Background information
Anatomy of Female Reproductive system
Anatomy of Male Reproductive system
Prostate
Scrotum
Seminal Vesicle
Testicle
Urethra
Penis
Vas Deferens
Contains the urethra
Produces & stores sperm
Where the testicles are located (held), regulates the temperature of the testicles
Produce liquid that form part of semen
Produces liquid that form part of semen
Sperm travels throughout the urethra to the outside of the body; expels urine
Sperm travels through two tubes named Vas Deferentia, to the seminal vesicles
Uterus
Fallopian Tubes
Ovaries
Vagina
Produce cells called ova
The baby grows here
Connects the ovaries to the uterus
Connects the uterus to the outside of the body
Contraception Methods
Rhythm method: avoid sex during ovulation time
Abstinence: only 100% way to prevent pregnancy
Withdrawal method: pull out before ejaculation; high failure rate
Barrier methods: prevent sperm from reaching uterine tubes; condoms, spermicidal gels, diaphragms
Intrauterine devices (IUD): flexible plastic structures inserted into uterus; copper or synthetic progesterone to help prevent implantation
Oral contraceptive or Estrogen/progestin patches: prevent LH spike and ovulation
Morning after pills: inhibit ovulation; take within 72 hours of unprotected intercourse
Tubal ligation: Surgically cutting uterine tubes and tying off ends; prevents sperm from reaching uterus
Vasectomy: Outpatient procedure; ductus deferens cut, segment removed, ends tied; sperm unable to leave testis
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Events of uterine/ovarian cycles
Uterine cycle: cyclical changes in endometrial lining; Influenced by estrogen and progesterone; Timeline based on 28-day uterine cycle, but varies (21-35 day)
Menstrual phase: Days 1-5 of cycle; Sloughing off of the functional layer; Lasts through period of menstrual bleeding
Proliferative phase: Days 6-14 of cycle; Development of new functional layer of endometrium; Overlaps time of follicle growth and ovary estrogen secretion
Secretory Phase: Days 15-28 of cycle; Increased progesterone secretion from corpus luteum; Increases vascularization and uterine gland development; If fertilization does not occur, Degeneration of corpus luteum and dramatic drop of progesterone, without progesterone, sloughs off functional layer
Ovarian cycle and uterine cycle phases: Menstrual phase during ovarian follicular phase; Proliferative phase during ovarian follicular phase and ovulation; Secretory phase during ovarian luteal phase
Factors for this couple not seen in others
Older woman
Higher chance of still birth
Limited methods due to age
3 best options
3 worst options
Morning after pills, dependent on sexual activity this could result in a lot of pills
Withdrawal method, high failure rate
Oral contraceptive, do not want to take pills
Tubal ligation, Surgically cutting uterine tubes and tying off, prevents sperm from reaching uterus
Barrier methods, condoms, spermicidal gels along with withdrawal and rhythm methods would be safe if surgery is out of question
Vasectomy, Outpatient procedure, sperm unable to leave testis