Reproductive Health Midterm

Unintended pregnancies

2.7 million unintended pregnancies

1.3 million due to failure to use contraception

1 million due to contraception non-adherence

0.4 million due to contraception failure

Consequences of unintended pregnancy

Higher incidence of:

Smoking, drinking, drug use during pregnancy

Low birth weight (LBW) babies

Infant mortality

Child abuse

Childhood depression

Women and children living in poverty

Forms of contraception

Combined estrogen and progestin

• oral contraceptive pills

• ortho evra patch

• nuva ring

• implanon

Progesterone only

• depo provera

• micronor

• mirena (IUD)

Non-hormonal methods

• diaphragm

• female condom

• sponge

• fem cap

• male condoms

• withdrawal before ejaculation

  natural family planning:

• abstinence

  permanent procedures

• vasectomy

• tubal ligation - tubes tied

• ensure - female sterilization

• IUD copper T-380

Pros and cons of male condoms

Pro’s:

• Does not require examination

• Inexpensive

• Wide variety of choice

• Protects from HIV and other STI’s

• When used correctly, prevents unplanned pregnancy

• Non hormonal

Con’s:

• Requires partner compliance

• Does not fully protect from HPV or HSV

Female condom efficacy rates

Perfect use: 95%

Typical use: 81%

Male condoms efficacy rates

Perfect use: 97%

Typical use: 86%

Pro’s and Con’s of female condoms

Pro’s:

• Female controlled

• Non-hormonal

• May provide increased protection from HPV and HSV

• Does not require examination or re-fitting

Con’s:

• Expensive

• Protrudes externally

• Noisy

• Partner satisfaction

• Can be dislodged

Oral contraceptives

Pills contain estrogen and progestin

One pill taken everyday of the month

OCP’s prevent pregnancy in three ways:

• inhibit ovulation

• alter cervical mucus

• alter endometrial lining

Efficacy:

Perfect use: 99.5%

Typical use: 98%

Side effects of taken OCP’s

• Nausea

• Altered menstrual cycle (BTB - break through bleeding)

• Amenorrhea

• Water weight gain

• Breast fullness/tenderness

  • Increased vaginal discharge

Symptoms to OCP use

• pregnancy/breastfeeding

• undiagnosed vaginal bleeding

• active liver disease/jaundice

• migraines with neurological symptoms

• estrogen dependent carcinoma

• uncontrolled hypertension

• has diabetes (>20 years duration)

• over 35 and smoker

• depression that worsens with OCP use

  • clotting disorders

A-C-H-E-S

Abdominal pain - severe

Chest pain- sharp, servere (SOB)

Headaches - severe, dizziness, unilateral

Eye problems - sudden change, blurred vision, blind spots

Severe leg pain - calf or thigh

Vagina has 2 reproductive functions

• encompass penis (or other objects) during vaginal intercourse/depository for sperm

• birth canal

• unstimulated - 3 to 5 inches long and walls are collapsed

  • aroused - upper 2/3 expand, opening narrows

Introitus

lower third of the vagina, the majority vaginal nerve endings

Hymen

thin membranes that partially covers the opening of the vagina

Grafenberg Spot (G spot)

a sensitive area on front wall of vagina, mid-way between pubic bone and cervix

Vaginal health

self-cleansing organ

acidic environment

musky odor

deodorant sprays and douches can cause disrupt of health vaginal flora as well as infection and odors

Ovaries

born with 300,000 - 400,000 (use about 400 eggs in a lifetime)

Sexual response cycle

Excitement, plateau, orgasm, resolution (EPOR)

1993 – Family & Medical Leave Act

Gives employees unpaid medical leave for themselves or for their care of a family member or newborn or adopted infant

1994 — Violence Against Women Act

VAWA mandated a unified judicial response to sexual crimes committed against women

VAWA legislation expired in 2012 for the first time since 1994

VAWA first passed in 1994 to support victims of sexual assault and violence

VAWA came together in the aftermath of the 1991 Anita Hill hearings, where Hill faced sexual harassment by Supreme court nominee Clarence Thomas

How many black transgender women were killed in 2024

32

Asexual

No sexual feelings or desires

Pansexual

Sexual, romantic, or emotional attraction towards people of all genders, or regardless of their sex or gender identity

Extra dyadic involvement

Sexual or romantic relationships outside of a primary or dating couple

Paraphilia (frequent, intense, sexually arousing fantasies or behaviors that involve inanimate objects, children or nonconsenting adults, or suffering or humiliation of the person or a partner)

coprophilia - aroused by feces

klismaphilia - aroused from having enemas

necrophilia - having sexual activity with a corpse

urophilia - aroused by sight or though of urine

nymphomania - referred to excessive sexual desire in women

satyriasis - referred to abnormal sexual desire in men

Autoerotic asphyxia

breath play

zoophilia

sexual act between human and non-human

voyuerism

becoming sexually aroused by watching an unsuspecting person who is disrobing, naked, or engaged in sexual activity

exhibitionism

getting sexual gratification from showing one's genitals or private areas to others

frotteurism

sexual arousal derived from rubbing one's genitals against another person without their consent

Functions of the placenta

• Produces Hormones

• Metabolic Functions

respiration

nutrition

excretion

storage

Amniotic fluid

“my water broke!”

maintains temperature

source of oral fluid

repository for waste

protects fetus from trauma

allows for movement - musculoskeletal development

Fraternal twins

2 ova produced at one time fertilized by separate sperm

may be same sex or opposite

not genetically alike

increased in AA women

Identical twins

1 fertilized ova that spilts

chance - 1:250 pregnancies

not familial - total fluke!

same sex

same genetic material

Amniocentesis

Amniotic fluid withdrawn with needle inserted through abdominal wall

Fluid to detect for

• down syndrome

• neural tube defects

• fetal lung maturity

performed after 14 weeks when uterus is abdominal organ and sufficient fluid available

Nuchal Translucency

early screening test for down syndrome

Human chorionic gonadotropin (hCG)

biologic marker for pregnancy

Cesarean birth

1:5 births in the US

Testes: epididymis

a coiled tube about 20 feet long, that carries sperm from the testicles for ejaculation

Spermatogenesis

several 100 million sperm produced daily

20 days for sperm to travel through epididymis

Penis size

Average size 3-4 inches

5-7 when erect

Smegma

under the foreskin and can become inflamed, have foul order