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105 Cards in this Set
- Front
- Back
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What is menstrual synchrony and what is the cause?
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Menstrual synchrony is the tendency for women to begin cycling at the same time when they live together and is apparently a response to pheromonal secretions (like those found in underarm perspiration)
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Who first described menstrual synchrony and when?
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McClintock, 1971
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Stern and McClintock (1998) found that women exposed to underarm secretions from women in their late follicular phase (post menses to the day before LH surge) resulted in what?
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Earlier LH surge (ovulation) and shortening of the cycle
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Stern and McClintock (1998) found that women exposed to underarm secretions from women who had just ovulated resulted in what?
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Delayed LH surge and lengthened cycle in recipient
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Do all cohabitating women become synchronous?
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No, factors leading to menstrual synchrony are not fully clear, but a greater number of shared activities may result in greater likelihood of synchrony
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Did McClintock (1971) suggest that cycle length may be increased, decreased or become more regular when a woman has contact with males at least 3 times per week?
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Decreased
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Did Burleson suggest that cycle length may be increased, decreased or become more regular with intercourse at least once a week?
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Cycle length becomes more regular
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Extreme stress during the preovulatory phase results in what?
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Increased cycle length and delayed ovulation
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Extreme stress during the postovulatory phase results in what
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Decreased cycle length and earlier menses
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What is the most commonly used form of contraception overall in the US?
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sterilization
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What is the most commonly used form of contraception by women in the US who desire more children?
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hormonal contraceptives
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What hormones are contained in hormonal contraceptives?
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estrogen & progestin or progestin only
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What are the ways in which hormonal contraceptives are administered?
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pills, injections, implantable capsules, intrauterine devices (IUD), vaginal ring, and patch
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What is the effect of estrogen in the contraceptive?
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the synthetic estrogen inhibits GnRH, effectively shutting down the ovary (because GnRH is inhibited, FSH and LH are inhibited) so that it produces very little of its own estrogen (no FSH = no follicle growth; no LH=no estrogen)
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What are the two actions of estrogen in contraceptives?
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inhibits ovulation through inhibiting production of GnRH.
increases the rate of ovum transport through the oviduct |
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What is the effect of estrogen in the contraceptive?
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the synthetic estrogen inhibits GnRH, effectively shutting down the ovary (because GnRH is inhibited, FSH and LH are inhibited) so that it produces very little of its own estrogen (no FSH = no follicle growth; no LH=no estrogen)
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What are the five actions of progestin in contraceptives?
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prevents ovulation by inhibiting LH ad FSH production in the anterior pituitary
stimulates the production of a thick, pasty cervical mucus. inhibits capacitation of sperm slows the rate of ovum transport through the oviduct prevents adequate build-up of the endometrium such that implantation is unlikely. |
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What is capacitation?
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An enzyme-initiated change in sperm that typically occurs inside the woman’s body and is required before fertilization can occur
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If a contraceptive contains both estrogen and progestin, what is the net effect of the rate of ovum transport through the oviduct?
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it is usually slower
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Which is more effective: a contraceptive containing only progestin or one containing both progestin and estrogen?
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both are extremely effective in the 98-100% range
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What are the risks of estrogen in contraceptives?
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increased risk of blood clots, stroke, and heart attack;
the effect on risk of breast cancer is unclear |
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What are the risks of progestin-containing contraceptives
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increased risk of cardiovascular disease due to increase plasma lipids
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What is Yasmin
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a combination oral contraception that uses a different progestin that has an anti-androgenic and anti-mineralocorticoid effect
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What is a risk associated with Yasmin?
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the new progestin used can result in elevated potassium levels, which can have adverse effects in someone who already has high potassium levels or who has kidney or liver problems
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What are the advantages of hormonal contraceptives?
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may reduce the risk of ovarian cancer
non-intrusive; it doesn’t interrupt sex easy to use highly effective reduction of menstrual blood loss reduced dysmenorrhea |
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What are the disadvantages of hormonal contraceptives?
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no protection from STDs
may cause irregular menses or amenorrhea [particularly progestin-only contraceptives] reduced estrogen levels may reduce bone density |
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What are the two forms of emergency contraception?
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hormonal and IUD
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When must emergency contraception pills be taken in order to be effective?
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within 72-120 hours of unprotected sex
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When must an IUD be inserted to be effective as an emergency contraceptive?
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within 5 days of unprotected sex
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What is involved in the hormonal form of emergency contraception?
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taking several doses of certain oral contraceptives or higher doses of specific contraceptive hormones
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How does hormonal emergency contraception work?
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prevents ovulation
changes the rate of ovum or sperm transport reduces endometrial buildup, making the endometrium unsuitable for implantation |
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If a fertilized ovum has already implanted, will emergency contraception work?
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no – it only works before implantation
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What is the primary side effect of emergency contraception?
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can result in severe nausea
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How is an intra-uterine device (IUD) inserted into the uterus?
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it is inserted through the cervical os during menses by a medical professional
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What is an IUD made of?
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flexible plastic; some have a metal coating and some contain progestin
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How does the sponge work as contraception?
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It is made of polyurethane foam and impregnated with spermicide, and placed near the cervix to kill sperm as they enter the cervix.
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Why has there been a renewed interest in the male condom in recent years?
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Prevents transmission of STIs, including HIV.
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How effective is the male condom
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85-90%
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What is the difference between a male condom and a female condom?
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Female condom- only made out of polyurethane, vs. male condom made out of primarily latex
Female- worn inside vagina by woman Female Effectiveness- 70-85%, vs. 85-90% with male condom (harder to use) Female- less well known than male. |
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What is monitored on a daily basis when using Natural Family Planning or Fertility Awareness?
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Basal body Temp
Cervical changes |
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When during the cycle does basal body temp increase?
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just after ovulation as progesterone increases
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What does SHOW mean and when does it happen?
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SHOW happens before and during ovulation when the woman is fertile
S- Soft- the cervix softens H- High- the cervix rises in the body (estrogen causes the uterus to move forward) O- Open- the cervical os widens W- Wet- cervical mucus becomes slippery and wet |
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When using NFP or FA as a birth control method, is it OK to skip one day of monitoring?
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NO!
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What is necessary to use NFP and FA effectively?
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patience
assertiveness and self-control special training |
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How is male sterilization performed?
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By cutting and clamping, tying, or burning the vas deferens
Doctor’s office procedure with local anesthetic |
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How is female sterilization performed?
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By cutting and clamping, tying, or burning the oviducts
Requires general or local anesthesia in a hospital or surgical clinic |
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In what group is regret the highest after sterilization?
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Young women who were uncertain about being sterilized, or who are not committed to having no additional children.
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Approximately how many unintended pregnancies end in abortion?
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Approximately half of all unintended pregnancies end in abortion
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Is the risk of death from childbirth more or less than from early abortion?
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Is the risk of death from childbirth more or less than from early abortion?
The risk of death from childbirth is higher- 1 death per 5,800 births vs. early abortion versus 1 death for every 530,000 abortions. |
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What are the 2 main types of abortion?
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Medical and surgical
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How long after the start of the last menses can a medical abortion be performed?
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The first 49 days from the start of the last menses.
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What are the two drugs involved in a medical abortion and how are they administered?
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Mefepristone (RU 486)
Misoprostol (prostaglandin) These are administered in pill form |
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Describe how the 2 drugs work in a medical abortion.
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Mefepristone- anti-progesterone which results in the deterioration of the endometrium
Misoprostol- causes contractions of the uterus to expel contents |
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What must the patient agree to before undergoing a medical abortion and why?
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to have a surgical abortion if the medical abortion is not effective, because a medical abortion will induce a complete abortion 92-99% of the time.
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What are the three types of surgical abortions and when are they performed?
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-Manual Vacuum aspiration- up to ten weeks after start of last menses
-Vacuum Aspiration- 6-14 weeks after start of last menses -Dilation and Evacuation- used after 14 weeks. Abortion is not used after 24 weeks except when there are serious health risks for the woman |
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What is the difference between manual vacuum aspiration and vacuum aspiration abortions?
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Manual uses a manual device to gently suck out the uterine contents, while a vacuum aspiration uses machine based aspiration with gentle scraping of the uterine walls with a curette
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Dilation and Evacuation abortion involved more use of _______ and _______ to remove contents from the uterus.
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instruments
suction |
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What are the most common psychological reactions of women who have voluntary abortions?
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mild reaction overall, more distress before than after, relief afterwards
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How are psychological reactions different for abortions for medical or eugenic reasons?
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-medical (health of mother)- often followed by guilt
-eugenic (health/ development problems with fetus)- often followed by depression |
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What factors have been found to be associated with increased risk of negative outcomes after voluntary abortion:
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Previous psychiatric problems, mid-trimester abortion, low self esteem, poor prior knowledge of contraception, ambivalence about decision, pregnancy highly meaningful to woman, not making own decision
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What do women do if they are denied an abortion and what are the frequencies of each?
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Seek abortion elsewhere (most)
Continue pregnancy and keep the baby (6-19%), very few relinquish baby for adoption Spontaneous abortion/ miscarriage (4-18%) this is very high, and at a point in pregnancy when miscarriage rates are very low. |
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Define open adoption and closed adoption.
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Open adoptions the woman relinquishing is involved in selecting the family in some way and may receive news of the child via letters or face to face contact after birth.
A closed adoption is done anonymously through an agency and the woman usually has little contact with the child post birth and does not know anything about the family she is relinquishing to. |
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What are two similarities between women relinquishing in an open versus a closed adoption (Lauderdale and Boyle study)?
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Both report avoiding developing attachment during pregnancy.
Most relinquish their child due to pressure from others or due to financial problems. |
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Women relinquishing in closed adoptions are more likely to ____________ than women relinquishing in open adoptions.
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Have been pressured by others
Have less contact with the infant after birth Have poorer pre-natal care Initiate the search for the child years later. |
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Women relinquishing in open adoptions are more likely to _____________ than women relinquishing in closed adoptions.
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More likely to admit pregnancy to others.
Desire child to contact them but don’t initiate search. |
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In interviews with women who had relinquished their child what were some things they desired to make the adoption process better?
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The women preferred moderately open adoptions. Of the women who relinquished in a closed adoption most wanted to receive information about their child through the agency.
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In current, typically open, adoptions what are the psychological effects of relinquishing a child?
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Mainly positive, most have no grief and feel relieved
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What hormone is measured in pregnancy tests and why are pregnancy tests uncertain in early pregnancy?
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HCG is measured and is similar to LH so the test is uncertain until HCG levels are higher than LH levels would ever be in a cycling woman
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What makes Human Chorionic Gonadotropin (HCG)?
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The fertilized ovum and later the placenta
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What does HCG do?
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Keeps the corpus luteum alive
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Where does the placenta come from?
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The trophoblast of the fertilized ovum and is genetically similar to the fetus not the mother.
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How are nutrients/waste transferred across the placenta?
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Diffusion across a concentration gradient
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What major hormones does the placenta produce?
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Estrogen (estrial)
progesterone Human Placental Lactogen (and a number of other hormones similar to those produced by the anterior pituitary) |
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What is unique about how the placenta produces estrial?
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It can not make estrial from cholesterol so it makes it from androstenedione provided by the fetal adrenal gland.
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What does HPL do?
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increase number of alveoli in mammary glands
make alveoli functional |
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What comes from the ectoderm?
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Central nervous system, peripheral nervous system, and epidermis
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What comes from the mesoderm?
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Skeletal system, musculature, vasculature
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What comes from the endoderm?
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Gut, lungs, liver
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During which stage of fetal development is the fetus most sensitive to damage from drugs and other problems?
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Organogenesis – during the first trimester
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What happens to the uterus during pregnancy?
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Increases in size, increase in size and number of muscle cells, increase in number and size of blood vessels
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What is Goodell’s Sign?
the softening of the cervix early in pregnancy due to engorgement with blood What happens to the cervix during labor? |
It effaces (shortens) and the os dilates
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What is morning sickness?
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Nausea associated with hunger pains (not just in the morning) that is typically worst in first trimester.
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What can happen if a woman has high blood pressure during pregnancy?
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High blood pressure is a condition called toxemia that can develop into pre-eclampsia.
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What can result from eclampsia?
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Softens ligament letting joints widen which reduces the risk of broken bones during labor and delivery
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What produces relaxin?
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Corpus luteum and placenta
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What is one theory about the cause of labor onset?
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The aging placenta can no longer produce enough estrogen and progesterone to maintain the pregnancy (drop in progesterone enables coordinated contractions of the uterus).
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What are three common signs that labor has begun?
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release of a small amount of blood with mucus from the vagina (cervical plug)
uterine contractions at intervals less than 10 minutes rupture of amniotic sac (water breaking) |
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What is the longest stage of labor, and what occurs during this stage?
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The first stage is the longest (includes three different phases). During this stage the cervix effaces and dilates to about 10 cm, and contractions increase in frequency and intensity.
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What happens during the third stage of labor?
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The placenta is delivered.
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What are the three phases of the first stage of labor?
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Latent phase (contractions 5-20 min. apart, cervix 3-5 cm.)
Active phase (contractions 3-4 min. apart, cervix 4-7 cm.) Transition (contractions every few minutes, cervix 8-10 cm.) |
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True or false: Immediately after birth, the mother produces mature breast milk.
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False. The breasts produce colostrum, making a transition to mature breast milk after about 30 days.
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Is breastfeeding typically an effective form of birth control in the United States?
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No. A woman only remain non-cyclic and anovulatory during breastfeeding if she feeds the infant on-demand, every day, round the clock, which is very rare in the U.S.
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the infant on-demand, every day, round the clock, which is very rare in the U.S.
How can a woman tell whether she has gone through menopause? |
Menopause has occurred if the woman has had no menses for 12 consecutive months.
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What happens to women’s estrogen and progesterone levels during menopause?
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Estrogen and progesterone production from the ovaries is dramatically reduced.
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What happens to a woman’s GnRH, FSH and LH levels during menopause?
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GnRH, FSH, and LH levels become very high.
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What happens to sex steroid production by the adrenal cortex after menopause?
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Hormone production by the adrenal cortex is unchanged. Androstenedione from the adrenal cortex is converted to estrone in fat.
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In what way are a woman’s reproductive hormones after menopause the same as they were before puberty?
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estrogen and progesterone are similarly both prior to puberty and after menopause
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In what way are a woman’s reproductive hormones after menopause different than they were before puberty?
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GnRH, FSH and LH are very low pre-puberty and very high post-menopause
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How is body fat level related to a woman’s estrogen level after menopause?
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High body fat is associated with higher post-menopause estrogen levels since androstenedione from the adrenal cortex is converted to estrogen (estrone) in fat
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What are the benefits and risks of Estrogen Replacement Therapy (ERT)?
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Benefits: can reduce estrogen-related symptoms of menopause such as hot flashes, genital changes, loss of sex drive, loss of calcium from bones, and risk of cardiovascular disease
Risks: increases risk of endometrial cancer (so is rarely used for women with an intact uterus) |
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What are the benefits and risks of Hormone Replacement Therapy (HRT), which includes both estrogen and progesterone?
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Benefits: can reduce symptoms of menopause listed for ERT, except for risk of cardiovascular disease
Risks: increases the likelihood of developing Alzheimer’s, and may increase plasma lipids which increase the risk of cardiovascular disease |
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What is the most common symptom that menopausal women experience in the US?
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hot flashes
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What groups of women are at highest risk for developing osteoporosis? …lowest risk?
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highest risk – Caucasian or Asian
Lowest risk – African American or Hispanic |
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What are some factors that a woman can control to reduce her risk of osteoporosis?
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Have an active lifestyle (including weight-bearing exercise).
Avoid taking thyroid hormones. Don’t smoke. ERT/HRT stops calcium loss (but see risks listed above). Non-estrogen treatments, such as Fosomax and Boniva, increase bone density. Consume adequate calcium. |
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What are some uncontrollable factors that affect women’s risk of osteoporosis?
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Being Caucasian or Asian.
Being tall and thin (small-boned). Having early menopause (in your 20’s or 30’s) or surgical menopause (removal of ovaries) |
