Gen Med 3 Flashcards
what is Hormonal contraception
- Suppress ovulation/prevent secretion of hypophyseal gonadotropic hormones.
- Causes thickening of cervical mucus which prevents sperm penetration and egg implantation
- Start in first 5 days of menstruation , use additional contraception for 1 week.
- 3 weeks after delivery if not breastfeeding, immediately or upto 5th day from abortion
Contraindications:
- 35yr+,
- smoker of 15+cig daily,
- upmto 6m after delivery if breastfeeding
- before 21st day post delivery of non breastfeeding
Advantages
- efficient,
- doesn’t interfere with sex,
- decreased blood,
- prevent ovarian cyst/cancer
Contraception examples
Vasectomy,
implants,
intrauterine pessary,
oral contraception pills
condoms,
spermicides,
natural family planning
Hormonal Contraception in men
- LH-RH agonist (chemical castration) and GnRH antagonists (both for prostate Ca tx also, ↓testosterone levels)
- Anti-androgens (cyproterone acetate), estrogens, androgens, combina E+A
- LH-RH agonist + antiandrogens
- CAB complete androgen blockade: LH-RHagnonist + antiandrogen + orchiectomy
Therapeutic contraception in men
1 Direct blockage of spermatogenesis by Gonadotoxic therapy (young male that w/ chemo/radiotherapy/ immunetherapy, preserve sperm before)
2 Indirect blockage of spermatogenesis in epididymis by means of androgens causing negative impact on sperm motility and maturation
Mechanical male contraception
Vasectomy
very effective, reversal method possible after microsurgical operation
Classical contraception
- condoms
- coitus interruptus (interrupted sex)
- period abstinence (no sex in ovulation days (day 1-17 of menstrual cycle)—
- sexsonian/saxonian intercourse: wiggling movements to throw male sperm out
- coitus hispanicus: squeezes base of penis b4 ejaculation semen is diverted to the bladder
Male infertility definition- inability for pregnancy within year after unprotected regular sex
Primary: characterises a man’s past and present failure to impregnate a woman
Secondary: man’s present inability to impregnate a woman with success in past
Dyspermia: quantitative and qualitative changes in sperm parameters.
OAT syndrome: oligo—astheno—terato—zoospermia
(↓number of spermatozoa, abnormalmotility and abnormal forms of spermatozoa)
Spermatogenesis- physiology, formation and stages
undifferentiated sex cells spermatogoni=mitosis=>spermatocytes==meiosis=>spermatids==spermatogenesis=> Spermatozoa==spermiation=> lumen of seminiferous tubules
Physiology/transport /storage of sperm
Production of sperm in germ epithelia in proximal seminiferous tubules
Transport by reti testis to the epididymis
Physiological role of epipidymis is storage and maturation of spermatozoa
Risks factor for SSD
Endogenous (within organism): inherited/ acquired, biological (age, sex, weight)
Exogenous (environmental factors) Social, Natural (mechanical ,physical, chemical)
Behavioural (lifestyle) : smoking, unhealthy diet, alcohol abuse, no sports, stress
SSD 5 stages of change
- Consideration for necessary change
- preparation for change
- carrying it out
- maintenance of change
- sustaining a stable and safe lifestyle
define Primary Prophylaxis
Compromises both the healthy individual and those at risk.
The GP’s role here is to prevent the occurrence of the disease
define Secondary prophylaxis
Directed at early detection of disease before clinical symptoms occurs
and early treatment to improve disease diagnosis and reduce its frequency
Tertiary prophylaxis definition
Dispensarization and follow up observation to prevent progression and complications of a disease in people already suffering from different diseases, prolonging their lives and exerting a positive effect on their quality of life.
Definition of screening
Systematic approach for discovering among groups of apparently healthy individuals pre-symptomatic conditions and diseases that people are n_ot aware of._
