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55 Cards in this Set
- Front
- Back
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Actions of Estrogens in Hormonal Contraceptive
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Inhibits GnRH and therefore ovulation. Speeds up ovum transport
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Actions of Progesterone in Hormonal Contraceptive
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1. prevents endometrial buildup
2. slows ovum transport 3. inhibits FSH and LH 4. Thick cervical mucus 5. inhibits capacitation of sperm |
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Risks of estrogen containing contraceptives
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1. heart attack, blood clots, stroke over 35
2. under 35 if smoking 3. unknown effects on breast cancer |
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Progestin containing hormonal contraceptive risks
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1. plasma lipid increase can lead to cardiovascular disease
2. all "yaz" birth control contains drospirenone, which is an anti-mineralocorticoid. Can lead to high potassium levels and heart failure |
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Advantages of hormonal contraceptive
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1. easy
2. effective 3. non-invasive 4. reduced risk of various cancers 5. lighter periods 6. reduces dysmenorrhea 7. Beyaz and folate |
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Disadvantages of hormonal contraceptive
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1. no STD protection
2. Potential bone loss 3. irregular menses/ ammenorrheic |
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How do Plan B and Next Choice work?
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1. reduces endometrial buildup
2. slows ovum transport 3. Inhibits FSH and LH production (possibly GnRH) |
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How does Ella work?
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1. ulipristal acutate - progestin agonist and antagonist
2. inhibits actions of progesterone at the uterus. Will even destroy endometrial wall 3. Will terminate pregnancy |
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Mirena
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1. effective for 5 years
2. progestin only plus irritation effect. 3. can't be at the top of the uterus |
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Paraguard
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1. effective 12 years
2. copper, which causes the uterus to become more inflamed, decreases sperm viability, inhibits natural estrogen (and therefore build-up of endometrium) and slows ovum transport through the oviduct. 3. placed at top of uterus with arms down. |
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Advantages of an IUD
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highly effective, long term, non intrusive
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Disadvantages of an IUD
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1. risk of vaginal infections
2. increased risk of fertility from inflammation 3. increased risk of PID 4. Perforation risk when being inserted and removed 5. No STD protection 6. Will increase suseptibility to STDs for 3 months 7. Paraguard will cause dysmenorrhea and heavier blood loss during menses |
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Diaphragm Effectiveness
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80%-90%
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Diaphragm Advantages
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Easily reversible.
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Diaphragm Disadvantages
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1. invasive
2. must be fitted 3. spermicide risk 4. does not protect against stds 5. increased bladder infection risk 6. suction/ development of abnormal cervical cells |
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Uterus during pregnancy
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increase in size and muscle
increased vasculature Braxton-Hix contractions |
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Cervix during pregnancy
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Goodell's sign
cervical mucus form plug effaces during labor |
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Vagina during pregnancy
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walls thicken
increased blood flow |
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Breasts during pregnancy
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increased vasculature
maximum development breast tenderness Montgomery glands more pronounced darkened areolas colostrum by end of tenth week |
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Gastrointestinal Changes during pregnancy
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morning sickness, heartburn, excessive salvation
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morning sickness
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experienced by 50-80% of women, first trimester, empty stomach, thought to be estrogen effect
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heartburn during pregnancy
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common later, uterus pushes food up into esophagus from stomach, progesterone relaxes sphincter between the stomach and the esophagus
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Cardiovascular Changes during pregnancy
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declines first 22 weeks, then returns back to normal. Toxemia (1/600 pregnancies). Can develop into pre-eclampsia. Very serious. Eclampsia can lead to convulsions, coma, and death. Low sodium prevents water retention, which lowers blood pressure. High blood pressure makes it difficult for organs to function fully.
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Skeletal Changes during Pregnancy
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•General softening of the ligaments of the sacroiliac and pelvis
•Allows joints to widen •Reduces risk of broken bones during labor •Induced by Relaxin |
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Relaxin
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produced by C.L. and placenta. Rates highest in the third trimester. Relaxes ligaments so they do not break during child birth. Shuffling
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Right before labor
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1. progesterone levels drop
2. oxytocin and prostaglandin cause contractions to begin. 3. mucus plug 4. Rupture of the amniotic sack |
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Latent Phase (stage one)
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longest, minimal discomfort, cervix dialates 3-5 cm
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Active Phase (phase 2)
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more frequent, stronger contractions. 4-7 cm cervix
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Transition Phase (phase 3)
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strongest, longest contractinos; cervix 8-10 cm. contractions long and close together
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Stage 2 of Labor
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pushing, baby born. Average of 20-30 minutes for first birth
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Stage 3 of labor
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placenta expelled, only a few minutes, can be dangerous if it does not come all the way out in one piece.
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Labor Management: Pain - Pharmacological Options
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•Local anesthesia (typically for pre/post episiotomy)
•IV narcotics (reduce transmission of pain messages to brain, affect whole body) •Neuraxial Medication (in spinal column: epidural -> most common in US/spinal block -> doesn’t last as long) •General anesthesia (rarely used today) |
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Non-pharmacological labor coping methods
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stress reduction, relaxation techniques, rhythmic movement, calm environment
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Breast Feeding
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1. colostrum to mature milk takes up to thirty days
2. prolactin and oxytocin 3. Associated with improved heath and growth Breast feeding may result in slower growth, which may result in less obese people. |
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Human Chorionic Gonadotropin
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1. produced by fertilized ovum
2. tells C.L. not to die 3. tested for in pregnancy tests 4. transition hormone - C.L. until placenta |
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Placenta produces...
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Estrogen, progesterone, HCG, Human placental lactogen
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Human Placental Lactogen
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HPL
the placenta's version of prolactin. Works with estrogen and progesterone to increase alveoli in mammary glands and increase functionality |
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Estrial
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-Made by placenta
-Placenta cannot make estrial from cholesterol. -Produces estrial from androstenedione from by fetal adrenal gland (not mom). -Level of estrogen in mom’s blood is a measure of viability to the fetus. |
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Functions of estrogen in the pregnant woman
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1. builds up uterine muscle. Proliferation of cells
2. builds up mammary gland tissue |
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Functions of Progesterone in the pregnant woman
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Inhibits coordinated contractions of the uterus
works with HPL and estrogen to build up mammary gland tissue |
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Ectoderm
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central nervous system, peripheral nervous system, and epidermis
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Average age for menopause
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45-55
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What is menopause?
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rapid decrease in the number of ovarian follicles, and the follicles still around are not very responsive to FSH and LH. End result of being insensitive to tehse is low estrogen. Eventually too low to stimulate the growth of the endometrium.
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How do you know if you are going through menopause?
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No menses for 12 months
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Is menopause the same for all women?
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no, some have very irregular or heavy periods before menopause. The cessation of menstruation is just one part of a 5-15 year changing process
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Endocronological changes of menopause
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1. relative cessation of estrogen and progesterone production from ovaries (some estrogen production can continue for up to ten years)
2. Relationship between hormones DOES NOT CHANGE. therefore, excess of LH and FSH because the ovary simply is not functioning now. |
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Adrenal Cortex during menopause
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1. no decrease in sex steroids
2. estrone converted from androstenedione in body fat 3. Like puberty - the more body fat, the more estrogen. This leads to overweight people feeling fewer effects of menopause |
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Hormone Replacement Therapy Effects
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increases risk of death if you develop lung cancer, risk of cardiovascular problems (with added progesterone like in hormonal contraception), may increase chances of developing alzheimers.
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Hot flashes
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1. experienced by 80%.
2. cardiovascular system trying to adapt to low estrogen 3. happens anytime the cardiovascular system is trying to adapt to a hormone. Not just women and not just menopause. 4. HRT will subside, but won't stop - body must adapt 5. diets in high soy and sesame; black cohosh |
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Fixing genital changes of Menopause
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•ERT/HRT can reverse all genital changes
•Localized treatment with an estrogen containing cream can reverse vaginal symptoms •Use of a water soluble lube (KY Jelly) at the time of intercourse can provide the needed lube •Replens, a non hormonal vaginal cream, draws water into the vagina -> decreasing vaginal dryness. Can reduce pain of intercourse/exams •Drink lots of water -> needed to lubricate the vagina |
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Sex Drive after Menopause
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Increased Sex drive -> reduced fear of prego/children out of homeDecreased Sex Drive: •Testosterone patch designed to increase sex drive recently sent back for further testing
•ERT/HRT may work |
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Osteoperosis and menopause
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most common for light skinned women. Risk factors: sedentary lifestyle, white or Asian, taking thyroid hormones, smoking, early menopause or surgical menopause, being small-boned. Can be treated with HRT
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Cardiovascular system and menopause
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stroke, heart attack, clotting all risks after menopause.
ERT can help HRT increases risk of CVD low fat diet and exercise |
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Skin and muscle effects of menopause
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Decrease of skin thickness and loss of muscle tissue
NOT due to estrogen loss, so ERT/HRT cannot help |
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Psychological symptoms of aging
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increased depression for women 45-55. Not due to menopause. Possibly the loss of a social role/ aging.
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