Reproductive Health Flashcards
intro
Definition of Reproductive Health
According to WHO, reproductive health refers to total well-being in all aspects of reproduction: physical, emotional, behavioral, and social health.
A reproductively healthy society consists of individuals with normal reproductive functions and socially responsible sexual behavior.
2. India’s Initiatives for Reproductive Health
India launched Family Planning Programs in 1951, one of the first national-level initiatives in the world.
Later, these programs expanded into Reproductive and Child Health Care (RCH) programs to address wider reproductive health issues.
wareness and Education and Infrastructure and Medical Support
Awareness and Education
Government and non-government agencies use media (audio-visual, print, and digital) to spread awareness about reproductive health.
Sex education in schools is encouraged to prevent misconceptions and myths related to reproduction.
Key topics covered in awareness programs:
Safe and hygienic sexual practices
Adolescence and bodily changes
Contraceptive methods and birth control
Sexually transmitted diseases (STDs), including AIDS
Care for pregnant women and newborns
Equal rights for male and female children
Control of population growth and prevention of sex crimes
Infrastructure and medical support
Infrastructure and Medical Support
Strong healthcare infrastructure, trained professionals, and material resources are needed to address:
Pregnancy, childbirth, and post-natal care
Abortions and infertility treatments
Menstrual disorders and reproductive diseases
Sexually transmitted diseases (STDs)
Governmental policies
5.Governmental Policies and Legal Measures
Ban on amniocentesis for sex determination to curb female foeticide.
Mass child immunization programs to improve child health and reduce infant mortality.
6. Research and Contraceptive Development
Scientific research has led to new contraceptive methods like ‘Saheli’, a non-steroidal oral contraceptive developed by CDRI-central drug reseqarch institute, Lucknow, India.
7. Improvements in Reproductive Healthcare Indicators
Reduced maternal and infant mortality rates.
Increased use of contraceptives and family planning methods.
Better detection, prevention, and treatment of STDs.
More medically assisted deliveries and post-natal care.
Overall improvement in reproductive healthcare facilities.
Population Stabilization and Birth Control
- Rapid Population Growth: - The world population increased from 2 billion (1900) to 7.2 billion (2011). - India’s population grew from 350 million (1947) to over 1.2 billion (2011). - Reasons for Population Explosion: 1. Decline in death rate, maternal mortality rate (MMR), and infant mortality rate (IMR). 2. Better healthcare and living conditions. 3. Increase in the number of people in reproductive age. - Concerns: - Rapid population growth can lead to scarcity of basic resources (food, shelter, clothing). - Government Measures to Control Population Growth: 1. Reproductive Child Health (RCH) Programme to reduce birth rates. 2. Raising the legal marriage age to 18 years (females) and 21 years (males). 3. Encouraging small families through advertisements (e.g., Hum Do Hamare Do slogan). 4. Incentives for couples following family planning norms. - Contraceptive Methods for Birth Control: - An ideal contraceptive should be: User-friendly, effective, reversible, safe, and not interfere with sexual activity. - Types of Contraceptives: 1. Natural/Traditional Methods (e.g., rhythm method, withdrawal method). 2. Barrier Methods (e.g., condoms, diaphragms). 3. Intrauterine Devices (IUDs) (e.g., copper-T, hormone-releasing IUDs). 4. Oral Contraceptives (Pills) (e.g., hormonal pills to prevent ovulation). 5. Injectables and Implants (e.g., hormonal injections, subdermal implants). 6. Surgical Methods (e.g., vasectomy in males, tubectomy in females). - Conclusion: - Population stabilization is crucial for sustainable development. - Family planning and contraception help control population growth while ensuring reproductive health.
Medical Termination of Pregnancy (MTP)
- Definition: Intentional or voluntary termination of pregnancy before full term is called Medical Termination of Pregnancy (MTP) or induced abortion. - Statistics: - Nearly 45-50 million MTPs are performed annually worldwide (~1/5th of all conceived pregnancies). - Legal and Ethical Issues: - Many countries debate legalization of MTP due to ethical, religious, and social concerns. - In India, MTP was legalized in 1971 under strict conditions to prevent misuse (e.g., illegal female foeticide). - Reasons for MTP: 1. Unwanted pregnancies due to unprotected intercourse, contraceptive failure, or rape. 2. To protect the mother or fetus if pregnancy continuation is dangerous or fatal. - Safety of MTP: - MTPs are relatively safe in the first trimester (up to 12 weeks). - Second-trimester MTPs (12-24 weeks) are riskier and require special medical attention. - Illegal MTPs and Associated Risks: 1. Unqualified practitioners (quacks) performing unsafe abortions → leads to severe health risks or death. 2. Misuse of Amniocentesis: - Used for sex determination → leads to illegal female foeticide. - This is a major social issue in India and is strictly prohibited by law. - Medical Termination of Pregnancy (Amendment) Act, 2017: - Purpose: Reduce illegal abortions and maternal mortality/morbidity. - Regulations: 1. Up to 12 weeks: MTP allowed on the opinion of one registered medical practitioner. 2. 12 to 24 weeks: Requires opinion of two registered medical practitioners. - Grounds for MTP: 1. Risk to the mother’s life or severe physical/mental health complications. 2. Fetal abnormalities that would result in serious physical/mental disabilities. - Preventing Illegal and Unsafe MTPs: - Counseling on contraception and risks of unprotected intercourse. - Strict enforcement of laws against illegal abortions and female foeticide. - Improved healthcare facilities to ensure safe and legal abortions.
Sexually Transmitted Infections (STIs)
- Definition: Infections or diseases transmitted through sexual contact are called Sexually Transmitted Infections (STIs), also known as Venereal Diseases (VD) or Reproductive Tract Infections (RTIs). - Common STIs: 1. Bacterial STIs: Gonorrhoea, Syphilis, Chlamydiasis 2. Viral STIs: Genital Herpes, Genital Warts, Hepatitis-B, HIV/AIDS 3. Parasitic STIs: Trichomoniasis - Modes of Transmission: - Primarily through sexual intercourse with an infected person. - Some STIs (e.g., Hepatitis-B, HIV) can also spread through: 1. Sharing injection needles or surgical instruments with infected persons. 2. Blood transfusions from infected donors. 3. From infected mother to foetus during pregnancy or childbirth. - Curability of STIs: - Completely curable if detected early: Gonorrhoea, Syphilis, Chlamydiasis, Trichomoniasis. - Non-curable but manageable: Hepatitis-B, Genital Herpes, HIV/AIDS. - Symptoms of STIs: - Often mild or unnoticed in early stages, making early detection difficult. - Common early symptoms: - Itching, fluid discharge, slight pain, swelling in genital areas. - Asymptomatic cases (especially in females) can lead to undetected infections. - Long-Term Complications of Untreated STIs: 1. Pelvic Inflammatory Disease (PID) in females. 2. Abortions, stillbirths, ectopic pregnancies. 3. Infertility in both males and females. 4. Cancer of the reproductive tract. - Prevention and Control of STIs: 1. Avoid multiple or unknown sexual partners. 2. Use condoms during sexual intercourse. 3. Seek early medical attention for timely detection and treatment. - STIs in Adolescents and Youth: - The 15-24 age group is most vulnerable to STIs. - Social stigma prevents people from seeking medical help, leading to severe complications. - Government reproductive health programs focus on early detection, treatment, and awareness to control STIs.
infertility
Infertility
📌 Definition:
Infertility refers to the inability of a couple to conceive or produce children even after 2 years of unprotected sexual cohabitation.
📌 Causes:
Physical factors – Congenital abnormalities, injuries, or structural issues in reproductive organs.
Diseases – Infections, sexually transmitted infections (STIs), and hormonal imbalances.
Drugs – Certain medications affecting fertility.
Immunological factors – Autoimmune responses affecting sperm or egg viability.
Psychological factors – Stress, anxiety, or mental health conditions impacting reproductive health.
📌 Diagnosis & Treatment:
Infertility clinics help in diagnosis and corrective treatments for some conditions.
Assisted Reproductive Technologies (ART): Specialized techniques to aid conception.
📌 ART Techniques:
1️⃣ In Vitro Fertilisation (IVF) & Embryo Transfer (ET) – Fertilisation outside the body, followed by embryo transfer.
ZIFT (Zygote Intra-Fallopian Transfer) – Zygote with ≤8 blastomeres transferred to the fallopian tube.
IUT (Intra-Uterine Transfer) – Embryo with >8 blastomeres transferred to the uterus.
2️⃣ GIFT (Gamete Intra-Fallopian Transfer) – Transfer of an ovum from a donor to another female’s fallopian tube.
3️⃣ ICSI (Intra-Cytoplasmic Sperm Injection) – Direct injection of a sperm into an ovum in the lab to form an embryo.
4️⃣ Artificial Insemination (AI) –
IUI (Intra-Uterine Insemination) – Semen from the husband/donor is artificially introduced into the uterus.
📌 Limitations & Challenges:
Requires high precision handling & advanced technology—available only in specialized centers.
High cost makes these techniques inaccessible to many.
Emotional, religious, and social factors influence adoption of ART methods.
📌 Alternative Option:
Legal Adoption – A socially and ethically viable option for couples desiring parenthood, especially in a country with many orphaned and destitute children.
natural methods of contraception
Natural Methods of Contraception
Natural methods work by preventing the meeting of sperm and ovum without the use of any external devices or medications.
- Periodic Abstinence
Couples avoid coitus from day 10 to 17 of the menstrual cycle.
This is the fertile period when ovulation is expected, and chances of fertilization are high.
By abstaining during this time, conception is prevented. - Withdrawal Method (Coitus Interruptus)
The male partner withdraws his penis from the vagina just before ejaculation.
This prevents sperm from entering the female reproductive tract and reduces the risk of fertilization. - Lactational Amenorrhea
Based on the principle that intense lactation inhibits ovulation and menstrual cycles after childbirth.
Effective only for about six months postpartum, provided the mother is exclusively breastfeeding.
Advantages
No use of chemicals or devices.
No side effects associated with hormonal or barrier methods.
Disadvantages
High failure rate due to the uncertainty of ovulation timing.
Requires strict discipline and awareness of the menstrual cycle.
barrier methods of contraception
Barrier methods prevent fertilization by physically blocking the meeting of sperm and ovum. These methods are available for both males and females.
- Condoms
Thin rubber/latex sheaths worn over the penis (male condom) or inserted into the vagina and cervix (female condom) before coitus.
Prevents sperm from entering the female reproductive tract.
Example: Nirodh is a popular brand of male condoms in India.
Additional Benefits:
Protects against Sexually Transmitted Infections (STIs) and AIDS.
Disposable and provides privacy since it can be self-inserted. - Diaphragms, Cervical Caps, and Vaults
Rubber barriers inserted into the female reproductive tract to cover the cervix during coitus.
Prevent sperm entry into the uterus, thus preventing fertilization.
Reusable after cleaning. - Spermicidal Creams, Jellies, and Foams
Used along with diaphragms and cervical caps to increase contraceptive efficiency.
These substances kill or immobilize sperm, reducing the chances of fertilization.
Advantages of Barrier Methods
✅ No hormonal side effects.
✅ Protects against STIs and AIDS (especially condoms).
✅ Easy to use and widely available.
Disadvantages of Barrier Methods
❌ Risk of slippage or tearing (especially condoms).
❌ Diaphragms and cervical caps require proper insertion and fitting.
❌ May reduce spontaneity during intercourse.
pills contraception
- Intrauterine Devices (IUDs)
IUDs are devices inserted into the uterus through the vagina by doctors or trained nurses. They are one of the most widely used contraceptive methods in India.
Types of IUDs:
Non-medicated IUDs: Example: Lippes Loop.
Copper-releasing IUDs: Examples: CuT, Cu7, Multiload 375.
Copper ions suppress sperm motility and reduce fertilizing ability.
Hormone-releasing IUDs: Examples: Progestasert, LNG-20.
These make the uterus unsuitable for implantation and thicken cervical mucus, making it hostile to sperm.
✅ Highly effective for delaying pregnancy & spacing children.
✅ One of the most widely accepted contraceptive methods in India.
- Oral Contraceptives (Pills)
Oral administration of progestogens or progestogen-estrogen combinations is a widely used contraceptive method in females.
Taken daily for 21 days, starting within the first five days of the menstrual cycle.
After a 7-day gap (during which menstruation occurs), the cycle repeats.
Mode of Action:
Prevents ovulation & implantation.
Alters cervical mucus to block sperm entry.
Example:
Saheli – A non-steroidal once-a-week pill with fewer side effects and high contraceptive efficacy.
3. Injectable & Implant Contraceptives
Progestogens (alone or combined with estrogen) can be administered as injections or implants under the skin.
Long-lasting effect compared to oral pills.
Mode of Action: Similar to oral pills—inhibits ovulation, implantation, and alters cervical mucus.
4. Emergency Contraception
Progestogen-estrogen pills or IUDs can be used within 72 hours of unprotected intercourse to prevent pregnancy.
Effective in cases of rape or casual unprotected intercourse.
✅ Prevents pregnancy after unprotected sex.
- Surgical Methods (Sterilization)
These permanent contraceptive methods involve surgical intervention to block gamete transport and prevent conception.
Vasectomy (Male Sterilization):
A small portion of the vas deferens is removed or tied through a small incision in the scrotum.
Tubectomy (Female Sterilization):
A small part of the fallopian tube is removed or tied through an incision in the abdomen or vagina.
✅ Highly effective but ❌ poor reversibility.
surgical methods for contraception
- Injectable & Implant Contraceptives
Progestogens (alone or combined with estrogen) can be administered as injections or implants under the skin.
Long-lasting effect compared to oral pills.
Mode of Action: Similar to oral pills—inhibits ovulation, implantation, and alters cervical mucus. - Emergency Contraception
Progestogen-estrogen pills or IUDs can be used within 72 hours of unprotected intercourse to prevent pregnancy.
Effective in cases of rape or casual unprotected intercourse.
✅ Prevents pregnancy after unprotected sex. - Surgical Methods (Sterilization)
These permanent contraceptive methods involve surgical intervention to block gamete transport and prevent conception.
Vasectomy (Male Sterilization):
A small portion of the vas deferens is removed or tied through a small incision in the scrotum.
Tubectomy (Female Sterilization):
A small part of the fallopian tube is removed or tied through an incision in the abdomen or vagina.
✅ Highly effective but ❌ poor reversibility.
