Week 4 - Reproduction and Contraception Flashcards
What is reproduction?
The biological process by which new individual organisms (“offspring”) are produced from their “parents
How is reproduction related to genetics?
Essential in the creation of diversity
Supports natural selection as a probable mechanism of creating complexity and diversity of life
How is reproduction related to public health?
Central aspect of human life and health
Includes family issues, maternal and child health, STDs, etc.
What are sex hormones? What hormone/s are released by men and women? Give examples of others.
Chemical messengers that are
secreted directly into the blood, which carries them to organs and tissues of the body to exert their functions
Men: testosterone
Women: estrogen, progesterone
Examples: oxytocin, follicle stimulating hormone (FSH), and luteinizing hormone (LH)
How is sex hormone secretion regulated?
Hypothalamus increases production of gonadotropin-released hormone (GnRH)
GnRH: amino peptide acid that is synthesized and secreted from hypothalamic neuron and binds to receptors in the gonadotropes
GnRH triggers the anterior pituitary to release LH and FSH
FSH and LH trigger testosterone production in testes and estrogen production in ovaries
Main actions of testosterone: spermatogensis and development of secondary sex characterization (broad shoulders, facial hair growing, lowering voice, etc.)
Main actions of estrogen: growth and maturation of ovarian follicles and release of ovum from mature follicle (LH is primary hormone responsible for the release of egg from mature follicle) and development of secondary sex characteristics (pubic hair grows, breasts develop, and hips broaden)
What is the menstrual cycle?
Regular natural changes that occur in the uterus and ovaries that make pregnancy possible
Required for the production of ovum, and for the preparation of the uterus for pregnancy
How are hormones regulated during the menstrual cycle?
Hypothalamus produces GnRH which acts on the anterior pituitary which secretes FSH and LH
What two groups are not using the most effective methods of contraception? Why?
Women and teens
Women lack basic knowledge about contraception
What are the 5 reasons for why sharing responsibility in choosing a BC method in the interest of both partners?
Can enhance relationship trust
Can be a good way to practice personal and sexual topics
Women respect men who share consent
Men shouldn’t assume that a woman will take care of it
Dealing with an unplanned child is difficult
How can partners share responsibility in choosing a birth control method?
Ask about BC before intercourse
Read and discuss options together
Attend a class or clinic together
Share expenses
What are the 6 basic types of contraception?
Fertility awareness methods
Barrier methods
Spermicides
IUDs
Hormonal contraception
Operative sterilization
What are 8 details about fertility awareness methods?
Also known as Natural Family Planning
Based on understanding ovulatory cycle
Require periods of abstinence & careful recording of events throughout cycle
Cooperation very important
Free, safe, and acceptable to all
spiritual beliefs
Require extensive initial counseling
25% of women will experience unintended pregnancy in first year
Some women combine with barrier methods (use during fertile periods) and/or combine types of FAM
What are the pros (7) and cons (3) of fertility awareness method?
Pros: inexpensive, safe, can be used while breastfeeding, you can be pregnant as soon as you stop, no side effects, no effects of hormones, and no need for medication
Cons: needs a lot of discipline, support from all sexual participants, and unrelated medication can affect ability to apply FAM methods by inducing irregular periods
What is the calendar method used for?
Determining the “safest time” to have sex
What are 5 examples of barrier methods? What are barrier methods usually used with?
Male condom: thin sheet that covers penis to collect sperm and prevent it from entering woman’s body; reduce risk of STDs
Female condom: thin, flexible pouches; reduce risk of STDs
Diaphragm: shallow, flexible cup made of latex or soft rubber that is inserted into vagina before intercourse and blocks sperm from entering uterus
Cervical cap: smaller and more rigid forms of diaphragm
Vaginal sponge
Usually used with spermicides
What are 4 details about spermicides?
Available as creams, jellies, foams, film, suppositories
May require up to 30 minutes to become effective
Minimally effective if used alone
May cause skin/mucus membrane irritation, allergic reaction
What are 6 hormonal contraceptives?
Injected contraceptives
Progesterone-only oral contraceptives
Combined oral contraceptives
Implanted contraceptives
Vaginal ring
Contraceptive patch
What is the most common hormonal contraception? What is the new formulation?
Depo-Provera (DMPA-IM 150 mg/1 ml) most commonly used (medroxyprogesterone)
Given IM q 12 weeks
Depo-subQ provera 104 (DMPA SC 104 mg/0.65 ml) new formulation
Given SC q 12 weeks
What medical condition can depo-provera cause?
Osteoporosis
What are 5 details about combined oral contraceptives?
Birth control pills with both estrogen & progesterone
Most taken daily for 21 days, with 7 days of placebo or no pill
(exceptions: Seasonale, Seasonique, Yaz)
Many formulations- different strengths, different progesterones
Very effective if used correctly
No protection against STD
Who shouldn’t use combined oral contraceptives?
People who are sensitive to estrogen side effects
How do progestin-only contraceptives work? (5 details)
May or may not interfere with ovulation
Thins uterine lining
Lower levels of estrogen in pill prevent pituitary gland from releasing LH (luteinizing hormone)
With no LH, egg doesn’t mature and ovulation doesn’t occur
Progestin in the pill thickens cervical mucus, blocking passage of sperm into the uterus
How do combined oral contraceptives prevent pregnancy?
Suppress ovulation through negative feedback to hypothalamic-pituitary axis
Thickening of cervical mucus to prevent sperm entry
May also slow tubal motility, disrupt transport of ova, change function of endometrial vessels, cause endometrial atrophy, and inhibit implantation (not proven)
What are the 2 forms of intrauterine contraception (LARC)?
Paragard (copper T) and MIRENA (releases levonorgestrel)
How does intrauterine contraception prevent pregnancy?
Copper based IUD prevents sperm from fertilizing egg and may prevent egg from attaching to womb
If fertilization occurs, the physical presence of the device can prevent the fertilized egg from implanting into the uterine lining by causing inflammation of the uterine wall
What are 4 details about intrauterine contraception?
Provide long-term, highly effective contraception
Risks include perforation, dysmenorrhea, expulsion
Also may be used as emergency contraception (Paragard only)
Lasts from 3-6 years
What are 6 details about implanon (implanted contraception)?
Single rod implanted under skin of upper arm
Provides contraception for 3 years
Releases progestin continuously
Extremely effective
Like all progestin-only methods, causes irregular bleeding in many women
Must be inserted by health care provider & removed later
What are 6 details about emergency contraception?
Used after unprotected sex, contraceptive failure, or unsure
protection
Should be taken as soon as possible after incident
No medical contraindications except established pregnancy
Most effective in first 72 hours
Providing EC is the standard of care for women who request it
Copper IUD insertion (99% effective); can insert up to 7 days after coitus