NORMAL OB

Only contraceptive method that is 100% effective

Abstinence

Only contraceptive method that prevents STIs and HIV

Condoms

Major disadvantage of natural family planning

High failure rate (~25%).

Why are natural methods less reliable in adolescents?

• Irregular cycles

• anovulatory cycles

• difficulty abstaining.

Requirements for LAM effectiveness

• Less than 6 months

• Amenorrhea

• Breastfeeding mainly every 4 hours during the daytime or every 6 hours at nighttime

When does LAM become unreliable?

• After 6 months

• Supplemental feeding begins

• Menses returns

What is coitus interruptus?

Withdrawal of penis before ejaculation

Why is withdrawal unreliable?

Pre-ejaculatory fluid may contain sperm

Most critical fertile period for conception to occur

5 days before ovulation to 1 day after

how long does ovum survive

24 hours

sperm lifespan in female reproductive tract

3 days (3-5 days)

hormone that increases BBT during ovulation

progesterone

how long should intercourse be avoided after ovulation

3 days

Fertile cervical mucus characteristics

• thin

• watery

• stretchy

• egg-white consistency

stretchy cervical mucus

spinnbarkeit

hormone responsible for fertile cervical mucus

estrogen

ovulation signs

• breast tenderness

• cervix softening

• mittelschmerz

hormone detected by ovulation kits

LH

Mechanism of spermicides

Kill sperm and create acidic vaginal environment

Contraindication to spermicides

Acute cervicitis

Major advantage of condoms

Protection against STIs including HIV.

When must a condom be applied

Before penile-vulvar contact.

Female condom structure

Inner ring → covers cervix

Outer ring → remains outside vagina

Important instruction for female condoms

Do NOT use with male condom

Diaphragm

Rubber dome placed over cervix to block sperm

Diaphragm must remain in place for?

At least 6 hours after intercourse

Maximum time diaphragm can remain

24 hours

Common complication of diaphragm

UTI

Cervical cap shape

Thimble-shaped rubber cap

How long can cervical cap remain?

Up to 48 hours

Components of combined oral contraceptives

Estrogen + Progestin

Component of combined oral contraceptives that causes blood clots

Estrogen

Mechanism of estrogen in oral contraceptives

Suppresses FSH: preventing follicular maturation.

Mechanism of progesterone in oral contraceptives

Suppresses LH to prevent ovulation +

• thickens cervical mucus

• inhibits implantation

• alters tubal transport.

COC effectiveness with perfect use

98-99.9%.

Non-contraceptive benefits of Oral Contraceptives (OCs)

• Reduced dysmenorrhea

• decreased ovarian cancer risk

• decreased endometrial cancer risk

• decreased anemia.

Common OC side effects

• Nausea

• weight gain

• breast tenderness

• headache

• breakthrough bleeding.

Danger signs of oral contraceptives (OCs)

• Chest pain

• severe headache

• shortness of breath

• leg pain

• vision changes

• thromboembolic disease

• migraine with aura.

• Major contraindications to OCs

• thromboembolic disease

• migraine with aura

• smokers >35

• cardiovascular disease

• stroke

Only STI-preventing contraceptive

Condom

What happens after LH surge?

Ovulation within 12-24 hours

Barrier contraceptives

• Condom

• diaphragm

• cervical cap

Hormonal contraception prevents pregnancy mainly by?

Suppressing ovulation

Vaccine that prevents cervical cancer

HPV Vaccine

At what age can HPV vaccine be started

11-12 years old

Earliest age to start HPV vaccine

9 years old

At what elementary level is HPV vaccine usually given

grade 5

Which ducts form male reproductive organs

Mesonephric ducts / Wolffian ducts

Which ducts form female reproductive organs

Paramesonephric ducts / Mullerian ducts

Which hormone causes male reproductive organ development

Testosterone

Which hormone is elevated in PCOS

LH and Androgens

If testosterone is absent during fetal life, what develops?

Female reproductive organs

What hormone triggers puberty and initiates menstruation

GnRH

GnRH stimulates the release of two hormones?

FSH and LH

thelarche

breast development

sequence of female pubertal development

thelarche, adrenarche, menarche, ovulation

average age of menarche

12.4

menarche age range

9-17

why are menstrual cycles irregular in early adolescence

ovulation is not yet regular

critical body weight to trigger puberty

95 lbs (43kg)

function of the scrotum

regulate temperature of sperm

why are testes located outside the body

sperm requires temperature lower than body temperature

undescended testes

cryptochidism

cells in men that produce testosterone

leydig cells

where are sperms produced

semeniferous tubules

where do sperm mature

epididymis

how long does sperm maturation take

65 - 75 days

function of vas deferens

transport sperm from epididymis

what structure is cut during vasectomy

vas deferens

which gland produces 60% of the semen

prostate gland

function of seminal vesicles

secrete alkaline fluid that nourishes the sperm

function of bulbourethral glands

produce lubricating alkaline fluid

main organ of sexual arousal in females

clitoris

function of bartholin glands

lubrication during intercourse

fourchette

posterior junction of the labia

function of the ovaries

produce ova

secrete estrogen

secrete progesterone

how many oocytes exist at birth

~2 million

Where does fertilization usually occur

ampulla

mcs of ectopic pregnancy

ampulla

mcs being cut during BTL

isthmus

function of fimbriae

guide ovum into fallopian tube

function of fallopian tube

transport ovum to uterus

function of uterus

implantation

nourishment of fetus

expulsion of fetus at birth

3 layers of the uterus

endometrium

myometrium

perimetrium

uterine layer that sheds during menses

endometrium (stratum functionale)

uterine layer that contracts

myometrium

opening between cervix and uterus

internal os

opening between cervix and vagine

external os

why is squamocolumnar junction in the cervix important

it is the mcs of cervical cancer

posterior fornix formation

collects semen after intercourse

bladder herniates into vagina

cystocele

rectum protrudes into vaginal wall

rectocele

hormone that triggers ovulation

LH

bicornate uterus

uterus with 2 horns

hormone that triggers ovum or follicular maturation

FSH

hormone responsible for secondary female characteristics

estrogen

hormone responsible for secondary male characteristics

testosterone

most important hormone in pregnancy

progesterone

Dominant gene

A gene that expresses its trait even if only one copy is present.

Recessive gene

A gene expressed only when copies are present.