Reproduction and Conception Flashcards
1
Q
when is differentiation of the external genitaliacomplete
A
12 weeks
2
Q
where does spermatogenesis occur
A
epididymis
3
Q
what do all glands in the male repro tract secrete and why
A
alkaline frutose colution
alkaline - urine is acidid
fructose - energy to swim
4
Q
what does the hypothalamus secrete
A
GnRH
5
Q
what does the anterior pituitary secrete
A
FSH and LH
6
Q
when are males capable of reproduction
A
13.5 y/o
7
Q
Tanner stages
A
measure of sexual maturation
8
Q
what tanner stage signals male puberty
A
Stage III
9
Q
when are women capable of reproduction
A
8-13 y/o
10
Q
what tanner stage signals female puberty
A
III or IV
11
Q
when does menarche occur
A
2-2.5 years after puberty
12
Q
what is menarche
A
1st menstrual period
13
Q
spinnkarkeit
A
elasticity of cervical mucus
14
Q
mittelschmerz
A
ovulation pains
15
Q
pregnancy after 50
A
uncommon
16
Q
when does fertility begin to decline
A
35-40
17
Q
most pregnancies over 35 y/o are
A
unintentional
18
Q
how long should contraception continue after LMP
A
12 months
19
Q
5 P’s of sexual health history
A
Partners in last 12 months Pregnancy status Protection from STI's Practices Past Hx of STI's
20
Q
consistency with contraception outweighs
A
absolute reliability
21
Q
abstinence
A
refraining from sexual intercourse
22
Q
abstinence pt Ed X3
A
- saying no
- yes to other sexual activities
- requires self control
23
Q
abstinence advantages
A
failure rate is 0%
effective if practiced perfectly
24
Q
abstinence disadvantages
A
not common amongst peers
unrealistic
25
abstinence risks
none if abstinence is maintained
26
lactational amenorrhea
exclusive breastfeeding for 6 months - avoid ovulation and menses
27
lactational amenorrhea pt ed
- effectiveness is enhanced by frequent feedings or use of barrier methods
- disruption of breastfeeding or supplementing increases r/o pregnancy
- alternate method once menses returns
28
lactational amenorrhea advantages
inexpensive
29
lactational amenorrhea disadvantages
failure rate high since 1st ovulation is unpredictable
30
lactational amenorrhea risks
unplanned pregnancy
31
coitus interruptus aka
withdrawal
32
withdrawal method
removal of the penis prior to ejaculation
33
withdrawl pted
preejaculate fluid may contain sperm and can leak prior to ejaculation
34
withdrawal advantages
choice for monogamous couple with religious conviction
35
withdrawal disadvantages
failure rate is 22%
no protection against STD's
require self control on males part
36
withdrawal risks
unplanned pregnancy
37
fertility awareness
awareness of fertile cycle
38
fertile days
sperm is 4-5 days and ovum is 24-48 hours
39
fertility awarness advantages
works best with regular menstrual cycles
acceptable to religions who prohibit birth control
40
fertility awareness disadvantages
interfere with sexual spontaneity
poor choice for irregular cycle, breast feeding, perimenopause
41
family planning calendar
based on ovulation - occurs approx. 14 days prior to menses
42
when should you avoid intercourse with family planning
days 8-19
43
calendar method advantages
inexpensive
no drug or hormones
combined with barrier method to improve effectiveness
44
calendar method disadvantages
failure rate 24%
no protection against STI's
unpredictable menstrual cycles/ovulation
compliance with abstinence during fertile period
45
calendar method risks
unplanned pregnancy
46
symptothermal method
assessment of BBT, cervical mucus and other symptoms near ovulation
47
symptothermal method pt ed
measure BBT same time each morning prior to getting out of bed
BBT decreases before ovulation and increases after ovulation
avoid intercourse until 3rd night after increased BBT
BBT will then decrease 2-4 days before menses or remain increased if pregnant
48
BBT advantages
inexpensive
| accepted by most religions
49
BBT disadvantages
failure rate 24%
stress, fatigue, illness, or environmental temp can affect
no protection against STI's
50
BBT risks
unplanned pregnancy
51
cervical mucus method
cervical mucus becomes thin, flexible and stretches between fingers at ovulatoin
52
cervical mucus pt ed
good hand hygiene
obtain mucus from vaginal introitus
examine for consistency start on last day of cycle
observing for thinning characteristic
53
cervical mucus advantages
women become knowledgable regarding mucus
self-evaluation diagnostically helpful in recognizing ovulation
54
cervical mucus disadvantages
failure rate - 24%
uncomfortable touching her own genitals and mcus
no protection against STI's
55
cervical mucus risks
inaccurate if mixed with blood, semen, contraceptive foam or discharge
unplanned pregnancy
56
spermicides
chemical gel, foam, cream or suppository inserted deep into vagina 15 minutes prior to intercourse to destroy sperm
57
spermicide pt ed
inserted into vagina prior to intercourse
must be reapplied for multiple acts
58
spermicide advantages
inexpensive, readily available and easy to use
59
spermicide disadvantages
failure rate 28%
irritation, allergic reaction
must be reapplied for multiple acts
no protection for STI's
60
spermicide risks
unplanned pregnancy
61
male condom
thin rubber sheath worn over the penis during intercourse
62
male condom pt ed
roll condom onto erect penis, leaving empty space in tip
used with spermicide increases effectiveness
following ejaculation - remove erect penis
heat accelerates deterioration - avoid storage in hot place
use water-soluble jelly, petroleum canc ause deterioration
63
male condom advantages
protects against STI's
involves male birth control
inexpensive and readily available
64
male condom disadvantages
failure rate 18%
reduces spontaneity and non-compliance
one time use do not reuse
65
male condom risks
allergic reaction, Ci if latex allergy
rupture or leak resulting in unwanted pregnancy
66
female condom
synthetic rubber sheath inserted into the vagina prior to intercourse which prevents sperms from entering the uterus
67
female condom pt ed
insert closed end of condom into vagina
push towards the back of the vagina
make sure the inner ring fits over cervix
open outer ring covers labia
following intercourse - twist outer ring, remove and discard
68
female condom advantages
non-latex, protects against STI's
79% effective
no rx is needed
69
female condom disadvantages
failure rate 21%
reduces spontaneity & non-compliance
more expensive than male condom
noisy during sex
on time use
70
female condom risks
allergic reaction
71
sponge
pillow soft, cup shaped, absorbent sponge which fits over the cervix containing spemicide
72
sponge pt ed
one size fit all
remain in place for 6 hours
73
insertion for sponge
empty bladder
hand hygiene
moistened with water prior to inserting vaginally
74
sponge advantages
available of the counter
one time use but may be used for multiple acts within 24 hours
75
sponge disadvantages
difficult to insert and remove
does not protect against STI's
76
sponge risks
failure rate 12% no prior birth and 24% prior birth
irritation and allergic reaction
absorbs vaginal secretions - vaginal dryness
TSS
77
diaphragm
dome shaped latex or silicone cup which fits over the cervix
78
cervical cap
soft cup which fits over cervix to prevent sperm from entering
79
diaphragm and cap pt ed
requires fitting and refitting every 2 years, after childbirth or a +/- 20% weight
requires proper insertion
remains in place for 6 hours after intercourse
clean with soap and water after removal
TSS
80
how do you insert diaphragms and caps
empty bladder
erform hand hygiene
apply spermicide and insert into vagina
81
diaphragm and cap advantages
can remain in place for multiple acts
82
diapragm and cap disadvantages
requires fitting and rx
inconvenient and inhibits spontaneity
spermicidal cream must be applied and reapplied
difficult to insert and remove
does not protect against STI's
83
diaphragm and cap risks
failure rate of 12%
irritation, latex allergic reactions
cap can be associated with cervical changes
TSS
84
BC pill
estrogen, progestin combo - suppresses ovulation and thickens cervical mucus
progestin only - less effective - causes thickened cervical mucus
85
other uses for the pill
regulate menstrual cycles
reducing dysmenorrhea, blood loss for excessive menstrual cycles and anemia
86
when does fertility return after BC pill cessation
3 months but use an alternate method still
87
BC pill advantages
improves:
- acne
- benign breast disease
- endometriosis
- fibroid bleeding
- premenstrual symptoms
- hirsutism
88
BC Pill disadvantages
SE:
- breakthrough bleeding
- breast tenderness
- excessive cervical mucus
- N/V
- HA
- HTN
89
BC pill risks
3% failure
no STI protection
alter blood sugar levels
90
what doe BC pills increase the incidence of X3
thromboembolic disease
HTN and strokes
migraines
91
what do BC pills interact with
decrease effectiveness of abx
avoid hepatotoxic meds
interfere with bromocriptine mesylate and anticoagulants
increase toxicity of tricyclic antidepressants
92
BC pill pt ed
consistent and proper use to be effective
93
what to do if you miss 1 BC pill
take asap
94
what to do if you miss 2-3 BC pills
back up method must be used
95
postpartum and lactation risks with BC pills
increased risk for DVT and decreased milk production
96
how does the mini pill stop pregnancy
thickens cervical mucus preventing sperm penetration
alters uterine lining preventing implantation
97
mini pill admin
same time daily
if taken 3 hours late must use back up method
98
mini pill and post partum/lactation
better choice for breast feeding women
99
transdermal contraceptive patch
releases continuous small amounts of estrogen and progestin to suppress ovulation and thicken cervical mucus
100
transdermal patch pt ed
requires Rx
apply patch to buttocks, abdomen, upper arm same day of week for 3 weeks
use alternate birth control fo 1st week
remove patch for 4th week
101
transdermal patch advantages
apply weekly as effective as oral contraceptives
102
transdermal patch disadvantages
skin irritation
103
transdermal patch risks
failure 9%
less effective for larger women
104
nuvaring
soft flexible vinyl ring which releases small amounts of estrogen and progestin continuously to prevent ovulation
105
nuvaring pted
rq rx
must be refrigerated
1st insertion use back-up method unless placed 1st 5 day of menses
48 hrs w/o ring in 1st 2 weeks rq back up method for 7 days
106
nuvaring advantages
fitting not required
can remove for 3 hours wihtout loss of effectiveness
107
nuvaring disadvantages
failure 9%
can remove for 3 hours without loss of effectiveness
108
nuvaring risk
expulsion resulting in unplanned pregnancy
109
IUD's
chemical/hormonal active device which is inserted into uterus, damages sperm and prevents fertilization
110
IUD pt ed
inserted by provider in office
check for string monthly to confirm placement
111
potential SE of IUD
menorrhagia
PID
ectopic pregnancy or spontaneous abortions
perforation of uterus
112
CI of IUD
diabetes
anemia
abnormal pap
hx of pelvic infections
113
IUD advantages
stays in place all the time
effective for 5-10 years
safe for breastfeeding mothers
decreases dysmenorrhea and menstrual blood loss
copper IUD - emergency contraceptoin if placed w/n 5 days of intercourse
114
IUD disadvantages
1% failure
no protection against STI's
increased cramping and bleeding in 1st few cycles which resolves
115
implant
a sustained release progestin only filled rod which is placed in upper inner arm and under a local anesthetic
116
implant pt ed
requires a minor surgical office procedure
must use alternate birth control for 7 days
increased risk of ectopic pregnancy
117
implant advantages
long acting (3 yr) contraception
fertility returns immediately
lactating - once breastfeeding is established for 4 weeks
118
implant disadvantages
1% failure
no STI protection
same SE as BC pill
removal required
119
depo shot
intramuscular hormone injeciton of progestin which prevents pregnancy for 15 weeks, repeat injection should be given every 13 weeks
120
dep pt ed
1st dose given during 1st 5 days of menstrual cycle
keep follow up appointments
decreased bone density
calcium and vit D for bone health
may take up to 1 yr after stopping to become pregnanct
121
CI in depo
hx of breast Ca, stroke, blood clots, liver disease
122
depo advantages
long term BC
does not impair lactation once breast feeding is established
decrease bleeding or absence of period
123
depo disadvantages
4% failure
no STI protection
amneorrhea, spotting, irregular bleeding
nervousness, dizziness, GI disturbances, HA, fatigue, weight gain
124
morning after pill
prevent pregnancy after unprotected intercourse
125
plan b and next choice
progestin levonorgestrel or progestin only
inhibits ovulation, thickens mucus and interferes with corpus luteum function
126
ella
ulipristal acetate
delays surge of LH, ovulation and implantation
requires pregnancy test as it can disrupt an early pregnancy
127
emergency pill pt ed
taken within 72 hours of unprotected sex
not to be used as regular birth control
128
emergency pill advantages
reduces risk of pregnancy for one time unprotected sex
OTC
129
emergency pill disadvantages
failure depends on time taken after unprotected sex
no protection against STI's
does not provide long term contraception
N/V/HA/fatigue
abdominal pain or cramping
possible pregnancy if cycle does not occur within 21 days
130
tubal ligation
fallopian tubes are surgically cute, tied, burned and or blocked
131
tubal ligation advantages
permanent contraception
sexual function is unaffected
132
tubal ligation disadvantages
failure - 1%
no protection against STI's
surgical procedure which requires anesthesia
should be considered irreversible if future pregnancies are desired
133
tubal ligation risks
surgical complications
risk for ectopic pregnancies
134
vasectomy
vas deferens is surgically severed and ligated
135
vasectomy pt ed
surgical office procedure
alt. contraception until 2 negative sperm counts
scrotal support
limit activity for a couple of days
136
vasectomy advantages
permanent contraception - difficult to reverse
short, safe, simple office procedure requiring local anesthesia only
sexual function is not impaired
137
vasectomy disadvantages
failure - 1%
discomfort for 2-3 days
considered irreversible
alternate contraception until 2 negative sperm counts
138
vasectomy risks
bleeding, infection and anesthesia reactions
