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34 Cards in this Set

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Mechanisms of contraception
- prevention fertilization

- disruption of preembryo transportation

- disruption of implantation
Percentages unintended pregnancies
55% unmarried women
30% married women
Most common contraceptives in US:
- oral contraceptives for unmarried

- female tied tubes/male vasectomy for married couples
Contraceptives in world:
Developed countries: oral, condom, female tube tying

Developing countries: female tube tying, UID, pill
Oral contraceptives
- Minipill

- Combination pill
Progresterone - Estrogen pill mechanism
1. Ovulation prevented

2. Cervical mucus thick -> sperm transportation difficult

3. Changes endometrium -> problems w/ implantation
How does it prevent ovulation?
Mimicks negative feeback ->
< GnRH = like luteal phase

Inhibits 3rd follicle growth ->
- prevention est peak
- postive feeback of est
- GnRH, FSH, LH surge
- OVULATION
Types of administration
- oral
- transdermal (patch)
- injectable
- intradermal
Differences monophasic + diphasic combination pill?
Diphasic: different levels, more accuratly mimic of human body
Efficacy combination pill?
99%

1% might be due to wrong intake.
Minor side effects combi. pill?
- Weight gain
- Mood changes
- Breast tenderness
- Dysmenorrhea
Major side effects combi pill?
- small increased risk of breast cancer
- women at risk (smoking/history/etc): > cardiovascular
- however, also studies that slow lower cardiovascular diseases for other women.
Beneficial effects combi pill?
- < ovarian cancer risk
- < endometrial cancer risk
- alliviate: acne, heavy menstruation, PMS
Minipill vs. combi pill?
- Lower dosis
- Fewer side effects
- Taken if women can't take est

- Higher failure rate: 0.5-10%
What is the morning after pill and what does it do?
Pro and/or Est: soon as possible after unproteceted sex.

2 types approven: Plan B and Preven

Dose 1: asap, 2nd: 12 hours later

Effectiveness (within 72 h taken): Plan B: 89%, Preven: 75%
Hormonal patches
Transdermal Pro/est for a week and then replacing.

(also ring = transdermal)
Injectable hormones
high efficacy rate

- 90 days
- monthly shot
- larger side effects
What is the dioscoreap spp.?
Yams from which progesterone is derived.
What does IUD stand for?
Intrauterine devises.

T shaped and flexible. Copper and progesterone.
IUD mechanism (3)
1. < sperm motility (lower sperm counts in uterus and cervix)

2. interfere with ovum development/maturation

3. cause inflammation + attracts wbcs
What is the efficacy rate of IUDs?
copper: 96-99% for 10 years

progesterone: 94-98% for 5 years
Side effects of IUDs
- abdominal cramping
- > menstrual bleeding
- pelvic infection (though not any more with modern ones)

NOT POPULAR IN US
What do spermicides do?
1. barrier for sperm transport
2. kill sperm cells

By disrupting structure sperm
How and efficacy of spermicides?
Applied in various forms in vagina next to cervix.

Very HIGH failure rate if used alone (3-21%)
Diagpram for women?
thin rubber cap over flixible wire ring that is placed in upper vagina to block external os.

Failure rate: 3-18%

Efficacy > with spermacides
Cervical cap for women?
Over cervix, difficult to insert + irritate cervix.

Together with spermiced > efficacy.
Coitus interruptus is?
Withdrawal penis before ejaculation.

Pre-ejaculatory fluid

High failure rate (4-18%)
Coitus reservatus/obstructus?
Reservatus: Loss of erection w/o ejaculation while in the vagina.

Obstructus: pressure prevents ejaculation during orgasm -> retroejaculation.
- > chance bladder infection


BOTH: HIGH FAILURE RATE
When is the fertile period?
8 days.

- sperm: survive 7 days.
- ovum: upto 1 day after ovulation
What are natural rhytm methods?
Aim at preventing pregnancy by calculating fertile periods.
- Calender
- Temperature
- Mucus
- Sympto-Thermo

ALL HIGH FAILURE RATE!
More permanent contraceptives
- Female tubal tying (50% reversal). Oviducts tied back.
By Laparotomy, Laparoscopy, Hysteroscopic tubal sterilization: soft metal
coils are inserted through the vagina, uterus, and
into the proximal oviduct where it induces scar
tissue formation, which closes the tubes)

- Male vasectomy (50% reversal) Excision and tying of each vas deferens -> blocks the transport of newly
formed sperm
Condoms
Male/female

- barrier
- also prevent many STDs
Male contraceptives (6)
1. Condom
2. Abstinence
3. Vasectomy
4. Spermicides
5. Coitus interuptus
(6. pill?)
Medicinal plants used as male
contraceptive?
Tripterygium wolfordii is a medicinal
plant from China.
inhibit sperm
production in human males without
effects on testosterone, LH, FSH,
sex drive, or ability to achieve and
erection