A healthy, happily married couple in their early 40s has sought your advice on contraceptive strategies. The woman is concerned about the long-term effects of birth control pills and wants to stop taking
them. They have two kids in high school and are certain they do not want more children. They seek
your advice on what to do. What do you tell them?
Anatomy of the male reproductive system
Testes
produce male sex cells or spermatoza in the seminiferous tubules that are in each testes and hormones like testosterone.
Prostate gland
During ejaculation the muscular tissue in the prostate gland contracts to help the expulsion of the semen into the urethra
A donut shaped gland that produces an alkaline secretion that increases the sperm motility and neutralizes the acidity in the vagina
cowpers glands located under the prostate
Jobs: Secrete a mucus that serves as a lubricant for intercourse and alkaline fluid which decreases the acidity of urine the resides in the urethra
Scrotum
Is the sac suspended between the 2 thighs and this is where the testes are housed
Located outside the body, the temp is lower, which is a must for sperm production
epididymis
Where the Sperm go after they develop in the seminiferous tubules. It is a tightly coiled tube that is around 20 feet long
Its job is to store sperm while they mature and become motile
Produces a fluid that becomes part of the semen and connects with the next tube.
vas deferens
Receives sperm and fluid from the epididymis, It goes up into the abdominal cavity and cures behind the bladder and joins with the seminal vesicle
Job: Passageway and temporary storage area for perm
seminal vesicles
2 small pouch like tubes that have a glandular lining that produces a thick yellow fluid rich in sugar that provides nutrients for the sperm. This fluid is a large makeup of semen
ejaculatory ducts
2 short tubes that are formed from the union of the vas deferens and the seminal vesicles
Job: Carry sperm and fluids known collectively as semen though the prostate gland and into the urethra
Urethra carries both urine and semen
penis
External male organ that is responsible for depositing semen in the vagina, and the elimination of urine
Anatomy of women reproductive system
uterus
Job: Organ of menstruation, allows the development and growth of the fetus and contracts to aid in the expulsion of the fetus during birth
divided into three sections
cervix
narrow bottom section, which attaches to the vagina
fundus
the top portion
body (corpus)
middle section
inner layer
If fertilization doesn't occur, endometrium deteriorates and causes menstruation
Endometrium has a layer of specialized epithelium which provides for implantation of the fertilized ovum and helps aid in the development of the growing fetus
middle layer
Allows for the expansion of the uterus during pregnancy and contracts to expel baby
outer layer
serous membrane
Ovaries also produce hormones that help in the development of the reproductive organs and give rise to the secondary sexual characteristics
When an ovum matures the follicle enlarges and then ruptures to release the mature ovum
Ovaries the female gonads, small and almond shaped and are attached to the uterus by ligaments
Contains thousands of small sacs called follicles with each follicle containing an immature ovum
fallopian tubes
2 tubes that are 5 inches long and attached to the upper part of the uterus.
the ends have finger like projections which helps move the ovum
Job: Serves as a passageway for the ovum as the ovum moves down toward the uterus. this is where fertilization takes place
vagina
Lines with a mucous Membrane with a rugae that allows the vagina to expand for childbirth and intercourse
Vagina muscular tube that connects the cervix of the uterus to the outside of the body
Job: Serves as a passageway for the menses, receives sperm and semen from the males, and is the organ of copulation and acts as a birth canal
Barthdins glands each side of the vaginal openings
Secrets mucous for lubrication for intercourse
Menstrual cycle
uterine cycle
Menstrual Phase:
the spiral arteries rupture secondary to ischemia, releasing
blood into the uterus, and the apoptosed endometrium is sloughed off lasts four days
the functional is completely shed
Luteal Phase or secretory phase:
progesterone induces the endometrial glands to secretesubstances – they become tortuous and have large lumens
endometrium undergoes involution: days 25-26 of the menstrual cycle vasoconstriction of the spiral arteries
ischemia may cause some early menstrual cramps
Follicular Phase:
increasing levels of estrogen proliferation of the functionalis from stem cells of the basalis, proliferation of endometrial glands
--> proliferation of stromal connective tissue.
contraceptions:
oral contraceptives: birth control pill
Mechanism:
Suppresses ovulation
Thickens cervical mucus
Thins endometrium
Slows tubal motility
the patch:
Mechanism:
Prevents pregnancy in the same way that oral contraceptives
the ring:
Suppresses ovulation
Similar to combined pills
IUD
Mechanism: CopperT
Works by preventing fertilization
Works primarily as a spermicide,Copper ions inhibit sperm motility so they rarely reach the tube
condoms, etc
Happy couple in their 40s not wanting any more children
Have two children in high school (older kids)
Middle age couple not wanting more kids, but have concern of long term usage of birth control pills, wanting to get off of them.
I would advise them, to go ahead and stop with the contraceptives but they should go ahead and speak to their doctors before getting of anything. The woman should speak to her general physician or her gynecologist to make sure it would be okay to get of the pill.
The husband can start or continue to use condoms
long term oral contraceptives usage after 40 can cause some serious health problems due to the body maturing and aging; might be best to consult with an gynecologist to seek other appropriate contraceptives; ie: IUD