Exam 2 Flashcards
(146 cards)
1
Q
The Pill general info
A
- combination est & progestin
- 21 days on, 7 off
- works by inhibiting ovulation, thickening cervical mucus, endometrium inhospitable for implantation
2
Q
Quick Start
A
- with the pill… start pill as soon as prescribed, regardless of day in cycle
3
Q
Health Risks of Pill
A
- no increased risks of cervical, uterine, or breast cancer
- protect against endometrial and ovarian cancer
- risk of thromboembolic disorders (blood clots)
- esp women over 35 who smoke - BP increase
- increased risk of STIs
4
Q
Why increased risk of STIs with pill?
A
- more likely to not use a condom
- makes vagina more vulnerable to infection
5
Q
Side effects of the pill
A
- increased vaginal discharge
- change in libido, up or down
- mood changes (20%)
- antibiotics can decrease effectiveness
- the pill can change dosage of antibiotic
6
Q
Risk on pill 5+ years
A
- increased risk of benign hepatic tumors (liver)
7
Q
The Patch
A
- Ortho evra
- 1 patch/week for 3 weeks
- estrogen & progestin
- lack of certainty about dosing, esp over 200lbs
- possibly higher or lower est levels
- slightly higher rates of blood clots
- more consistency with timing
8
Q
Nuva Ring
A
- mainly works by stopping ovulation
- insert ring like diaphragm, leave in for 3 weeks
- failure rate comparable to pill
- est & progestin
9
Q
Seasonale
A
- 84 days of pills, 7 off
- no additional side effects from normal
10
Q
Other pills (2)
A
- Triphasic ( steady est levels, increasing progestin levels in phases)
- Progestin-only
11
Q
Progestin-Only pills
A
- “mini pills”
- safest for breastfeeding mothers
- not to be used in first 6 weeks after birth
- not as effective)
12
Q
Depo-Provera Injections
A
- Progestin only
- inhibits ovulation
- thickens cervical mucus
- inhibits growth of endometrium
- every 3 months
- works slightly better than pill (no memory needed)
- possible lag of 6-12 months of fertility
- most no problems after that
13
Q
Emergency Contraception
A
- “morning after pill”
- 75-89% effective
- pregnancy rate .5-2%
- Plan-B one step
- Ella
- insertion of IUD within 5 days
- handful of BC pills
14
Q
Plan B One-Step (next choice one dose)
A
- OTC
- effectiveness decreases longer you wait
- high dose of synthetic progesterone
- most effective within 24 hours after intercourse
- must be within 120 hours (5 days)
- mode of action depends on what time in cycle
- prevent ovulation, prevent fertilization, inhibit sperm function, inhibit endometrial growth - not abortion, egg not implanted
15
Q
Ella
A
- non-hormonal (UPA) (Ulipristal acetate)
- by prescription only (antiprogestin)
16
Q
LARC
A
- long acting reversible contraception
- preferred methods, dont rely on user, have very low failure rates
- implants, IUDs
17
Q
- Implants
A
- Implanon/Nexplanon
- single rod, progestin-only
- lasts 3 years
- high cost
- effectiveness (99.95%)
- work like other progestin only birth controls
18
Q
IUDs and side effects
A
- paraguard- copper
- mirena and skyla - progesterone
- changes uterine lining making it lethal to sperm and eggs
- side effects:
- increased menstrual cramping, flow
- usually not covered by insurance
- does not affect tampon use or intercourse
- can get pregnant immediately after
19
Q
Copper T
A
- Paraguard
- changes enzymes in uterus so implantation unlikely
- up to 12 years
- more irregular bleeding
20
Q
Progestin IUDs
A
- disrupts ovulation, reduces endometrium
- Mirena 5 years
- reduced flow
- Skyla 3 years
- smaller
21
Q
Barrier Methods & Facts
A
- Diaphragm and Fem Cap
- metal rimmed, fits over cervix, place spermicide on rim and inner edge
- work by mechanical blockage of sperm, spermicide kills sperm
- may insert up to 6 hrs before intercourse
- needs to stay in 6 hours after, not more than 24
- one diaphragm can be used for ~2 yrs
- failure rate ~12%
- $75 + dr. visit + spermicide
22
Q
Barrier Method: Sponge
A
- polyurethane and spermicide
- not very effective
23
Q
External Condom
A
- Protection against STIs and pregnancy
- Latex - don’t use oil based lube
- lambskin - ineffective (STIs can get through)
- polyurethane- noisier
- leave 1/2 inch space at top
24
Q
External Condom + Spermicide
A
- not more effective
- may increase risk for STIs b/c of irritation
25
Dental Dam
- type of external condom
- rectangle of latex
- placed over anus/vagina during oral sex
- some flavored (keep flavoring out of vagina, irritation)
26
Internal Condom
- polyurethane (noisy)
- lube inside & outside
- STIs can be transmitted if it malfunctions/slips
- two rings, one at each end
- typical failure rate 21% (perfect 5%)
27
Spermicides
- foam, vaginal film etc
- Nonoxynd 9 (N-9)
- use along with diaphragm
- 28% failure rate
- must leave in 6 hours
- increased risk of STIs b/c of irritation
28
Douching/Withdrawal
- DONT DO THIS
- flushing out vagina can push sperm in
- pre-ejaculate contains sperm
- failure rate 22%
29
Rhythm
- Roman Catholic Church approved
- fertility awareness methods (abstain during ovulation)
- sperm can survive 5 days
- eggs can be fertilized 12-24 hours after ovulation
- Calendar, Standard Days, BBT, Cervical Mucus, Sympto-thermal
30
Calendar Method
- Rhythm method
- abstain 3 days before and 2 days after ovulation
- assume ovulation occurs on days 13-15
- need 6 months-1 year data to be effective
31
Standard days method
- Rhythm
- assume most menstrual cycles 26-32 days
- abstain days 8-19
- failure rate 12%
32
BBT Method
- Rhythm
- only tracks temp rise AFTER ovulation
- determine safe days after
33
Cervical mucus method
- Rhythm
- right after menstruation: relatively little mucus
- white & tacky: follicular phase
- thin: days shortly before ovulation
- determine safe days before
34
Sympto-Thermal Method
- mucus + BBT
| - best rhythm method
35
Irreversible Methods
- Sterilization
36
Irreversible Method: Men
- Vasectomy: cut vas deferens
- no effect on hormone production
- 20 mins local anesthetic
- use contraception 3 months after
37
Reconnecting Vas deferens
- vasovasectomy
38
Irreversible Methods: Women
- tubal ligation (laparotomy): cut and tie fallopian tubes
| - minilaparotomy: small incision usually immediately after giving birth
39
Failure Rate Definition
- "if 100 women use this method for 1 year, the % of whom become pregnant"
40
Effectiveness rate
- 1-failure rate
41
Perfect vs Typical user
- perfect: perfect
| - typical: human error involved
42
Best method for spacing of births
- rhythm
| - don't care as much
43
Psychological Aspects of BC
- 750,000 teen pregnancies in US/yr
- 29% abortion
- 57% live births
- 14% miscarriage
- often as a result of not using contraception
44
Medical Abortion
- RU-486 (mifepristone): antiprogesterone + prostaglandin (misopristol)
- within 7-9 wks of conception
- anti-progesterone sloughs off uterus, prostaglandin makes uterine contractions
- 92% effective
- 17% all abortions
- commonly done in physician's office
- shown little negative psychological effects of woman
45
Methotrexate
- used in medical abortions
| - also used as cancer treatment and ectopic pregnancies
46
New contraceptive methods for men (3)
- new condoms
- pill or injection to suppress sperm production
- "switch" on vas
47
New contraceptive methods for women (3)
- better microbicides: kill sperm and viruses and bacteria (bufferGel)
- vaginal ring with antiviral to protect against HIV
- SPRMs: selective progesterone receptor modulators
48
SPRMs
- selective progesterone receptor modulators (ella)
- useful for emergency contraception
- depending on time in cycle when used either prevent LH surge or prevent implantation
49
Surgical Abortion
- vacuum aspiration (suction and curretage)
- 1st trimester up to 14 weeks
- outpatient
- dilation of cervix and suction of fetus
- most common method early abortion
- 88% abortions (& in first 12 weeks)
- dilation and evacuation (D&E) 2nd trimester abortions
50
Ekiti Yoruba
- S.W. Nigeria
- 200,000-500,000 pregnancies aborted/yr
- 10,000 women die/yr
- believe "real child" isn't formed until 4th month
51
Turnaway study
- 3 groups: 1st trimester abortions, near limit abortions, & turnaways
- found good adjustment and mood of those who had abortion to those who didn't
52
How many partners knew about abortion?
- 82% knew
| - 80% of those were supportive
53
Masters & Johnson
- Masters: father of human sexual response
| - Johnson: recruited by Masters, later married
54
"Glass Penis"
- insertable EMG sensor
| - measured blood flow, muscle contractions, took pictures
55
Basic Phys Processes of sexual response
- Vasocongestion
| - Myotonia
56
Stages of Sexual Response
- excitement
- orgasm
- resolution
57
Male Excitement Phase
- testes elevated, penis elevates
58
Male Late Excitement Phase
- testes fully elevated, color of penis deepens, secretion of cowper's gland
59
Male Orgasm: Stage 1
- internal sphincter of bladder closes
- prostate and seminal vesicle contracts
- rectal sphincter closes
60
Male Orgasm: Stage 2
- ejaculation
| - urethral contractions
61
Male Resolution
- scrotum thins
- erection disappears
- testes descend
62
Refractory Period
- time after ejaculation where male cannot have another erection
- increases with age
63
Female Excitement Phase
- vaginal lubrication
- clitoris swells
- labia swell
- bladder shifts
64
Female Late Excitement
- expansion of upper 2/3 of vagina
- clitoris retracts
- color change in labia
- uterus elevates
- orgasmic platform forms (Front side of vagina)
65
Female Orgasm
- rhythmic contractions in uterus and orgasmic platform
| - rectal sphincter contracts
66
Female Resolution
- uterus lowers
- vagina to normal size
- orgasmic platform disappears
- semen pools under cervix
- no refractory period (multiple orgasms possible)
67
____% of women never experience an orgasm
- 10%
| - likely physiological problem
68
Breast Response (excitement, orgasm, resolution
- size increase
- nipples erect
* excitement
- areolar enlargement
- sex flush
- veins visible
* orgasm
- sex flush disappears v rapidly
* resolution
69
Extragenital Response; Excitement
- nipple erection
| - sex flush (late excitement --> orgasm)
70
Extragenital Response; Orgams
- carpopedal spasm
| - increased HR, BP
71
Extragenital Response; Resolution
- sweating, hyperventilation
72
Viagra
- 1998
| - developed originally for prevention of heart attacks
73
Erection: Spinal Reflex
- Psychogenic Stimulation (visual, auditory..)
| - Reflexogenic Stim (tactile stim)
74
Psychogenic Stim (Spinal Reflex)
- from brain through T11-L2
75
Reflexogenic Stim (Spinal Reflex)
- tactile stim of the genitals
- bowel or bladder stim
- sacral erection center (S2-S4)
76
Erection Mechanism
- smooth muscle relaxation lets blood flow in (parasymp), smooth muscle contraction at venules keeps blood there
- NO --> cGMP --> Muscle Relaxation
77
PDE5 and viagra
- viagra inhibits PDE5 which usually degrades cGMP... viagra keeps muscles relaxed to let blood flow in
78
If spinal cord is severed above S2 what can happen?
- can still get erection by tactile stim
79
Triphasic Model
- Kaplan
- Sexual Desire, Vasocongestion, Myotonia all need for sexual arousal
- "good sex needs good friction and good fantasy"
80
Sexual Excitation-Inhibiton Model
- "dual control model"
| - need balance between the two models
81
High excitation, low inhibition
- risky behavior
82
Low excitation, high inhibition
- sexual disorders
83
Study with emotions and arousal
- both extremes of mood correlated with higher arousal
84
G-Spot
- Grafenberg's Spot
- Skene's gland (female prostate)
- female ejaculation
- uterine orgasms "Freudian mature orgasm"
85
What does some female ejaculation have in it?
- PSA (prostate specific antigen
86
Phermones
- biochems secreted outside the body
- McClintock and Stern
- menstrual synchrony and pads
- mechanism: vomernasal cells have chemoreceptors
87
McClintock and Stern
- Menstrual Synchrony
| - Pad experiment (underarms and necklaces)
88
Endocrine Influences
- Organizing Effects
| - Activating Effects
89
Organizing Effects
- Prenatal Development hormones
- cause relatively permanent change of structures in nervous or repro systems
- critical period for these
90
Activating Effects
- Hormones that activate/deactivate certain behaviors
91
Sexual Behaviors influence _____, and _____ influences sexual behaviors
- testosterone levels
92
Antiandrogen drugs
- "chemical castration"
- tried on pedophiles, sexual assaulters
- should also have psychotherapy b/c sexual behavior of humans controlled by both hormones and brain
93
Women and Testosterone
- effects on desire
| - adrenal-ectomy: decreased sexual desire.. take T injections to return libido levels to normal
94
Components of a reflex
- Receptors
- Transmitters
- Effectors
95
Receptors (Reflex)
- sensory neurons that detect stim & transmit messages to brain or spinal cord
96
Transmitters (Reflex)
- centers in spinal cord or brain that receive the messages, interpret, and send out a message to produce a response
97
Effectors (Reflex)
- neurons or muscles that respond to stim.
98
Ejaculation Reflex
- muscular response (not vasocongestion)
99
Retrograde Ejaculation
- ejaculate empties into bladder
- creates "dry orgasm"
- can be caused by illness, psychoses drugs, and prostate surgery
- external sphincter closes, internal opens (backwards)
100
Brain Control of Sexual Response
- 3 phases
- anticipatory
- consummatory
- post-orgasmic
101
Anticipatory Phase
- Brain Control of Sexual Response
- sexual interest, desire, beginnings of arousal
- limbic system activation
102
Consummatory Phase
- Brain Control of Sexual Response
- corresponds roughly to excitement and late excitement
- motor and somatosensory cortex
- orgasm
- decreased prefrontal cortex
103
Post Orgasmic Phase
- Brain Control of Sexual Response
| - dearousal neural network
104
Anticipatory and Consummatory Phase of sexual response neurotransmitters
- dopamine, melanocortins, oxytocin, NE
105
Post Orgasmic Phase of sexual response neurotransmitters
- opioids, endocannabinoids, serotonin
106
Measuring Sex (4)
- Self-reports
- behavioral measures
- implicit measures
- biological measures
107
Self-Reports
- questionnaires
108
Behavioral Measures
- direct observation
- eye tracking
- police reports
109
Problem with police reports as behavioral measures
- have some wrongly accused, underreported
110
Implicit Measures
- measures nonconscious attitudes
| - ex) slow rxn time between gay and good
111
Biological Measures
- genital measure
- plethsmograph
- MRI and fMRI
- pupil dilation
112
Plethsmograph
- measures arousal in women (tampon-like camera to view vagina during arousal) and men (penialgage)
113
fMRI function
- measures relative blood flow in brain
114
Population vs. Sample
- population: everyone of interest
| - sample: small group of everyone of interest
115
Sampling: random vs probablity
- random: each member of population has an equal chance of being selected
- probability: target a group of people more than others.. known probability of being chosen
- both considered representative sample
116
Convenience sample
- when researchers fails to obtain a random or probability sample
- use who's around
117
volunteer bias
- those who volunteer for study have something different about them that makes them want to volunteer vs those who don't
118
Issues in sex research (3)
- accuracy of measurement of self reports
- accuracy w/ behavioral observations or biological measures
- ethics
119
Problems with Self Reports
- purposeful distortion
- memory
- ability to estimate
120
Ways to make self reports better
- increase anonymity
| - computer assisted self interviews (CASI)
121
CASI
- computer assisted self interviews
| - reads questions to participant
122
Ethics of sex research
- 3 pillars
- informed consent
- protection from harm
- justice
123
Ethics: Informed Consent
- participants need to be informed on what is expected and be able to give consent
124
Ethics: Protection from Harm
- minimize stress
| - protect anonymity
125
Ethics: Justice
- cost of research should be born equally
- benefits of research should be born equally
- ex) BC tested on low-income puertorican women.. not same effects as other women
- do costs outweigh risks?
126
Kinsey Report
- 1938-1949
- interviews with >11,000 people (over half interviewed by Kinsey himself)
- Indiana University
- Sampling: mostly well educated students, or people of interest to kinsey
- interviewing techniques: good
- nonjudgmental
127
Books By Kinsey
- 1948: Sexual behavior in the human male
| - 1953: Sexual behavior in the human female
128
NHSLS
- 1994
- National Health & Social Life Survey
- Laumann**
- U of Chicago
- probability sample of households
- 79% response rates
- 3,500 participants
- mostly face to face interviews
129
NSSHB
- 2009
- National Survey of Sexual Health & Behavior
- Indiana University
- Probability sample: random digit dialing
- Ages 14-94
- 53% response rate
- n=5865
- answered survey on website
- 69% white, 14% hispanic, 11% black, 7% other
130
British and Australian Surveys
- similar to NSSHB and NHSLS
- better funding
- larger samples
131
Ethnicity in US surveys
- interviewer same sex & ethnicity as participant: better response rate/honesty of response
- can be profoundly different cultural conceptualizations of same ideas
132
Magazine Surveys
- can reach large population
| - do not know who sample is.. hard to make conclusion
133
Web-Based Surveys (Strengths & Weaknesses)
- Strengths
- large samples at low cost
- access to hidden populations, recruited through specialty websites
- Weakness
- lose control of samplings
134
Snowball Sampling
- existing participants suggest names of future participants to recruit
135
Daily Diary Method of Sampling
- improved self reporting.. log every day
136
Media Content Analysis
- set of procedures to make valid interference about text
137
Intercoder Reliability
- multiple researchers measuring same thing, look @ their consistency
138
Masters and Johnson Experiment
- 1966
- Lab Study
- Biological Measures
- Behavioral Measures
- n=694
139
Quan vs. Qual Methods
- Quan: assign #s to attributes
- surveys, experiments
- Qual: "thick description" gain indepth understanding of behavior
- interviews, words, not #s
140
Participant-Observer Studies Examples
- Inis Beag, Mangaia
- Humphrey's Tearoom Trade
- Moser = S&M parties
141
Humphrey's Tearoom Trade
- 1970
| - followed those who left bathroom after sex to see what their lives were like
142
Moser Participant-Observer Study
- S/M parties
143
Meta-Analysis
- quantitative lit review
- method for combining results of numerous studies on a given question
- Effect Size: d=Mn-Mw/Sw
144
What we learn from meta-analyses
- whether there is an effect
- how big the effect is
- whether it replicates across many studies
145
What is the gold standard for conclusions in medicine, ed, and psych?
- meta-analyses
146
Measures of discrimination
- formal: permission to interview
| - informal: # words spoken
