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BMS 300: Concepts in Human Anatomy and Physiology > Reproductive System III (Contraceptives, STD's, Sex Determinants) > Flashcards

Reproductive System III (Contraceptives, STD's, Sex Determinants) Flashcards

1
Q

What are the two major types of contraceptives?

A

Short-acting: Combination and progestin-only
Long-acting: Ex. IUD, Nexplanon

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2
Q

What hormones do combined hormonal contraceptives contain? What are some examples of these?

A

Estrogen and progesterone.
Ex. OCPs (the pill), patch, vaginal ring

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3
Q

What is the goal of combined hormonal contraceptives?

A

To replicate what happens naturally in the body between day 7 to day 28 (proliferative and secretory phase).

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4
Q

What is the role of progesterone as a contraceptive?

A

Progesterone is the major contraceptive hormone because it blocks GnRH, which prevents FSH and LH release. FSH is necessary for folliculogenesis and LH is released for ovulation. Thus, progesterone prevents follicular development and ovulation.

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5
Q

What is the role of estrogen as a contraceptive?

A

Exposure leads to development of the endometrial lining.
When estrogen exposure is removed, the corpus luteum will degrade, triggering menses, which could terminate a pregnancy if an embryo is present.

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6
Q

What is the failure rate of combined hormonal contraceptives? Why?

A

7% (highest failure rate) due to misuse (i.e. skipping a pill)

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7
Q

How do progestin-only contraceptives work? What are examples of these?

A

Similarly to combined contraceptives, but without estrogen. Also impacts the reproductive tract. Acts on the endometrial lining to thicken cervical mucus (harder for sperm to enter uterus). Impairs endometrial development so implantation cannot occur. Can variably prevent ovulation.
Ex. POPs (pill), injection (3 months),

Progestin is synthetic progesterone.

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8
Q

To what degree are hormonal contraceptives reversible?

A

Fully, rapidly reversible.

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9
Q

What is the failure rate of progestin-only contraceptives? Why?

A

4-9%. Less failure due to professional help (like with injections), but misuse can still occur with ones like the pill.

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10
Q

What is a downside of progestin-only contraceptives?

A

Can result in unpredictable bleeding.

Happens because the estrogen is not present to ensure appropriate development of lining.

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11
Q

How long can long-acting contraceptives work?

A

Up to 12 years (LARC)

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12
Q

How does the failure rate of long-acting contraceptives compare to short-acting?

A

Failure rate is much lower because it requires the oversight of healthcare professionals and is not prone to misuse.

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13
Q

How does a hormonal IUD work?

A

Releases progestin into the uterus.
- Thickens cervical mucus
- Thins uterine lining
- May prevent ovulation (depending on pt size).

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14
Q

How does a copper IUD work?

A

Creates a hostile environment for sperm and pregnancy.
Does not impact ovulation. Acts locally.

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15
Q

How do hormonal implants work?

A

Same as progestin-only.
Often placed in the arm, lasts around 3 years.

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16
Q

What is the most effective contraceptive?

A

IUDs.
Work to prevent pregnancy even if inserted up to 5 days after unprotected sex. Reduces chance of pregnancy by 99%.

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17
Q

How do morning after pills compare to IUD’s?

A

Can also be taken up to 5 days after unprotected sex (most effective within 3 days).
Acts like an IUD, but is less invasive.
However, it is not quite as effective. Reduces likelihood of pregnancy by 75-90%.
Variable pill types based on body weight.

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18
Q

Who is at risk for getting STD’s?

A

Anyone engaging in oral, anal, or vaginal sex.

19
Q

What is the cause and cure of Trichomoniasis?

A

Cause: protozoan parasite
Cure: antibiotic

20
Q

What is the cause and cure of Syphilis?

A

Cause: Bacteria
Cure: Antibiotics (though some damage can be irreversible)

21
Q

What is the cause and cure of Genital HPV?

A

Cause: Human Papilloma Virus
Cure: No cure, but symptoms (warts) can be treated.

22
Q

What is the cause and cure of Gonorrhea?

A

Cause: Bacteria
Cure: Antibiotics (though resistant strains are on the rise)

23
Q

What is the cause and cure of Chlamydia?

A

Cause: Bacteria
Cure: Antibiotics

24
Q

What is the cause and cure of HIV?

A

Cause: Human Immunodeficiency Virus
Cure: No cure, but can be treated (can progress to AIDS without treatment).

25
Q

What populations have a higher risk of STD’s?

A

College-aged students (especially chlamydia, gonorrhea, syphilis, and HPV).
The elderly (Viagra, no condom/screening, mid-life divorce rates, etc.)

26
Q

What are the three levels of differences between males and females?

A

Genetic
Gonadal
Phenotypic

27
Q

What are the different types of chromosomes?

A

Autosomal (22 pairs, “body” chromosomes)
Sex (1 pair, determines gonadal development)

28
Q

What is the major difference between the X and Y chromosomes?

A

X: larger, encodes for 900 genes (necessary for survival (00/0Y is fatal)).
Y: very small, encodes 55 genes (not necessary for survival).

29
Q

What is the SRY gene?

A

Sex-determining Region Y
Leads to the development of male, necessary for sperm development (but not the only necessary factor)

30
Q

How do chromosomes impact gonadal development?

A

Gonadal development SOLELY dependent upon genes.
1+ Y present: testes will develop
0 Y present: ovaries will develop

31
Q

What are bipotential gonads?

A

Undifferentiated gonads (can become ovaries or testes). Present until changes begin at 6 weeks of fetal development.

32
Q

What is the process of gonadal sex determination in the case of XY?

A

SRY gene (on Y) produces transcription factor SRY.
SRY activates Sox9, which inhibits Rspo1, B-catenin, and Wnt4 (autosomal signal proteins). Results in formation of testes.

33
Q

What is the process of gonadal sex determination in the case of XX?

A

No SRY gene present. Rspo1, B-catenin, and Wnt4 are activated, which suppresses Sox9. Results in ovary development.

34
Q

What duct is expressed in females?

A

Mullerian duct: Female reproductive tract progenitor.
Wolffian duct will degenerate.

Mullerian duct will differentiate into oviduct, uterus, cervix, and the upper part of the vagina.

35
Q

What duct is expressed in males?

A

Wolffian duct: male reproductive tract progenitor.
Mullerian ducts will degenerate.

Wolffian duct will differentiate into the epididymis, vas deferens, and seminal vesicle.

36
Q

What determines if a Mullerian/Wolffian duct will remain or regress?

A

Determined by hormones.

Mullerian remains:
Gonads not required to maintain Mullerian ducts.

Wolffian remains:
Testes (TESTOSTERONE! (Leydig)) maintains the Wolffian ducts and releases AMH (Nurse) for regression of Mullerian ducts.
WOLF must be fed with TESTOSTERONE lest it die!

37
Q

Sex phenotype is displayed in what structures?

A

Reproductive tracts (internal genitalia), and external genitalia.

38
Q

What determines phenotypic sex in females?

A

HORMONES: Estrogen

Estrogen affects breast development, matures the uterus and ovaries, and acts on the endometrial lining (thickens) and vagina (mucus secretion).

39
Q

What determines phenotypic sex in males?

A

HORMONES: Testosterone and AMH

AMH: regression of Mullerian duct.
DHT: formation of external genitalia.

40
Q

Why is estrogen required in males?

A

Regulates erections and libido. Plays a role in spermatogenesis. Without a low level of estrogen, males will be infertile.

41
Q

How does the genital tubercle differentiate for males and females?

A

Feminization: forms clitoris (default)

Masculinization: forms penis and urethra (requires DHT)

42
Q

How does the genital swelling differentiate for males and females?

A

Feminization: forms labia majora (default)

Masculinization: forms scrotum (requires DHT)

43
Q

Is feminization or masculinization the default for genital development?

A

Feminization.

44
Q

What can Testosterone be converted into? By what?

A

Dihydrotestosterone (DHT): converted by 5-alpha-reductase. More potent and can bind to receptors with greater affinity than testosterone.

Estradiol: converted by aromatase. Most potent form of estrogen.

BMS 300: Concepts in Human Anatomy and Physiology (10 decks)

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