Reproductive Health :Reproductive Health


Reproductive Health :Reproductive Health Male Reproductive System


Male Reproductive System (continued) :Male Reproductive System (continued) The male reproductive system is structured for the development and maturation of sperm and for delivering sperm to the vagina. Testes contain seminiferous tubules where sperm are made. Sperm mature in the epididymis on the back of each testis. When mature, sperm move through the epididymis to the vas deferens via rhythmic muscular contractions. Sperm are stored in the vas deferens until released during ejaculation.


Male Reproductive System (continued) :Semen is composed of sperm and secretions from the seminal vesicles and the prostate gland. The penis is composed of three columns of spongy tissue that become engorged with blood during sexual arousal, causing the penis to enlarge and become firm. Male Reproductive System (continued)


Reproductive Health :Reproductive Health Female Reproductive System


Female Reproductive System (continued) :Female Reproductive System (continued) The female reproductive system is structured for the development and maturation of ova (eggs), for receiving sperm, for providing an environment in which the fertilized ovum (egg) can develop, and for giving birth to the developed fetus. Ova are produced in follicles located within the ovaries.


Female Reproductive System (continued) :Each month during ovulation, an ovum matures and bursts from the ovary. If sperm are present, the ovum is usually fertilized in the uterine tube. The fertilized egg implants in the uterus, a hollow, muscular, pear-shaped organ. The uterus opens into the vagina at the cervix, the narrow neck of the uterus. Female Reproductive System (continued)


Female Reproductive System (continued) :Female Reproductive System (continued) The female external genitals are collectively known as the vulva and include the clitoris, labia minora, labia majora, and mons pubis. Breasts consist of fat and glandular tissue. Major purpose: production of milk to sustain an infant after birth


The Menstrual Cycle :The Menstrual Cycle Levels of female hormones estrogen and progesterone change during the menstrual cycle. The cycle averages 28 days in length. The cycle begins on the first day of the menses (menstrual bleeding). The inner lining of the uterus, the endometrium, develops gradually during the first half of the cycle, preparing for implantation of a fertilized egg.


The Menstrual Cycle (continued) :The Menstrual Cycle (continued) Ovulation usually occurs mid-cycle. If the ovum is not fertilized, a decline in female hormones causes the endometrium to be shed. If the ovum is fertilized, female hormone production continues, maintaining the uterine lining.


Premenstrual Syndrome :Premenstrual Syndrome Approximately 70% to 90% of American women who are in their childbearing years report mild to moderate discomfort during the week prior to menstruation. Up to 40% of these women report that premenstrual symptoms interfere with daily life. PMS symptoms include depression, anxiety, irritability, mood swings, headaches, and bloating. Approximately 3% to 8% of women report severe PMS, referred to as premenstrual dysphoric disorder (PMDD).


Premenstrual Syndrome(continued) :Premenstrual Syndrome(continued) Most women are helped by one or more of the following: Counseling Lifestyle modification including daily exercise Medications to reduce symptoms of depression and anxiety Low-dose oral contraceptives Nutritional treatments include calcium supplements and diets low in salt, fat, caffeine, and sugar.


Toxic Shock Syndrome (TSS) :Toxic Shock Syndrome (TSS) Staphylococcal bacteria grow in blood-soaked tampon and vaginal tissues. These bacteria produce a toxin that can enter the woman’s bloodstream and produce a serious infection. TSS can also occur with the use of contraceptive diaphragms and sponges, but this is rare. Signs and symptoms of TSS include fever, muscle pain, headache, dizziness, diarrhea, vomiting, and a sunburn-like rash. Reduce the risk of TSS by changing tampons often and alternating use of tampons with pads.


Pre-pregnancy and Prenatal Care :Pre-pregnancy and Prenatal Care Pre-pregnancy (preparing for pregnancy) Have blood tests for: Antibodies against rubella Sexually transmitted infections, including HIV infection Avoid changing cat’s litter box to protect against toxoplasmosis. Eat a nutritious diet. Avoid drinking alcohol, smoking cigarettes, or taking any drugs, unless prescribed. Consider having genetic counseling if concerned about risks for inherited conditions.


Pregnancy Signs :Pregnancy Signs Missed menstrual period. There may be slight bleeding one week before the normal time of menses. Sore and swollen breasts. Nausea, tiredness, and mood changes. If pregnancy is suspected, see a physician for testing. A home pregnancy test is generally valid and reliable when used correctly.


Stages of Pregnancy and Development :Stages of Pregnancy and Development Pregnancy usually last 38–40 weeks from beginning of last menstrual period. Three trimesters of pregnancy are each approximately 3 months in length. Pre-embryo—first 2 weeks of development Embryo—week 3 through week 8 Fetus—week 9 through week 38


The Birth Process :The Birth Process Some women experience Braxton-Hicks contractions (false labor), which are irregular contractions that do not increase in strength. True labor is characterized by regular contractions that increase in strength and the interval between contractions shortens over time. Three stages of labor: First stage: Cervical dilation Second stage: Fetal delivery Third stage: Placental delivery


The Birth Process (continued) :The Birth Process (continued) First stage Rhythmic uterine contractions cause the cervix to soften, dilate (widen), and efface (thin out). The fluid-containing amniotic sac that surrounds fetus usually breaks during this stage (the “water breaks”). During transition into the second stage, contractions occur every 1 to 2 minutes.


The Birth Process (continued) :The Birth Process (continued) Second stage Contractions continue until baby is born. Usually lasts 30 to 60 minutes. Normally, the baby is delivered “head first.” Breech birth (feet or buttocks first). Surgery (cesarean section) may be needed to deliver the baby. Episiotomy—cut made by physician in tissue surrounding the vaginal opening to prevent it from tearing.


The Birth Process (continued) :Third stage This is 15 to 30 minutes after delivery of baby. Placenta separates from uterine wall and is expelled from the uterus. The Birth Process (continued)


Circumcision :Circumcision Circumcision is a surgical procedure to remove the foreskin of the penis from a male infant’s penis. Has potential medical benefits: Reduces risk of urinary tract infections during infancy Reduces risk of certain sexually transmitted infections Complications are rare.


The Postpartum Period :The Postpartum Period This period is the 6-week period after childbirth during which mother’s body returns to pre-pregnant state. Many women (40% to 85%) experience postpartum depression, especially in the week after delivery. This type of mild depression, referred to as “baby blues,” includes: Mood swings Periods of crying Sleep disturbances Loss of appetite Confusion


Infertility :Infertility Infertility is the inability to conceive a child after one year of unprotected sex. Approximately 9% of the U.S. population is infertile. Male infertility may be caused by: Low sperm count and sperm mobility High percentage of abnormally shaped sperm Environmental factors: Smoking Chronic alcoholism Medications Infections Erectile dysfunction


Infertility (continued) :Infertility (continued) Female infertility may be caused by: Structural defects of the female reproductive tract (vagina, ovaries) Use of lubricants that kill sperm Endometriosis Hormonal imbalances Infections Radiation/chemotherapy Age Smoking Obesity


Treatments for Infertility :Treatments for Infertility Surgical procedures Hormone therapy Medication Lifestyle changes In vitro fertilization and assisted reproductive technology


Contraception :Contraception Abstinence Natural family planning methods: Basal Body Temperature method Mucothermal method Calendar method Coitus interruptus or withdrawal


Chemical Methods :Chemical Methods Spermicides—chemicals that kill sperm Most spermicides contain nonoxynol-9. Shortly before vaginal sex, foams, creams, and jellies, are placed high in the vagina, near the cervix using an applicator. Spermicidal films are placed near the cervix. Suppositories or tablets are placed in vagina and need time to dissolve. Correct placement and timing are critical to effectiveness.


Chemical Methods (continued) :Chemical Methods (continued) Advantages Easy to obtain (over-the-counter). Side effects are minimal. Disadvantages Low rates of effectiveness. Nonoxynol-9 can cause genital sores that increase risk of contracting sexually transmitted infections.


Douching :Douching The use of specially prepared solutions to cleanse the vagina Not effective for contraception Renders spermicides inactive if they have been use as contraceptive


Barrier Methods :Barrier Methods Block the path of sperm Methods include: Male and female condoms Diaphragm Cervical cap (Femcap) Sponge (Today Sponge) Lea’s Shield Correct use is critical to effectiveness.


Hormonal Methods :Hormonal Methods Prevent pregnancy by suppressing ovulation Combined oral contraceptives (COCs) Combination of two hormones—estrogen and progestin Available in pill, patch, vaginal ring, or monthly injection form


Hormonal Methods (continued) :Hormonal Methods (continued) Progestin-only Contraception Implanon and Depo-Provera Use progestin to suppress ovulation. Implanon is a matchstick-sized contraceptive implant that has to be surgically inserted under the skin of the upper arm—lasts 3 years. Depo-Provera is an injection—lasts 3 months. Mini-pills Progestin-only pills that are taken continuously


Hormonal Methods (continued) :Hormonal Methods (continued) Advantages of hormonal methods: Highly effective Reversible Decreases menstrual cramps Decreases length of menses and amount of blood loss Protects against pelvic inflammatory disease Reduces risk of ovarian and endometrial cancers Reduces risk of benign breast disease Helps prevent osteoporosis


Hormonal Methods (continued) :Hormonal Methods (continued) Disadvantages of combination hormonal methods: Increased risk of cardiovascular disease, especially in women over 50 or those over 35 who smoke cigarettes Increased risk of cervical cancer Disadvantages of progestin-only contraceptive: Changes in menstrual cycle Amenorrhea Breath-through bleeding Thinning of the bones


Intrauterine Devices :Intrauterine Devices A small device inserted into uterus where it remains in place Inhibits the ability of sperm to reach and fertilize egg May think the uterine lining May prevent ovulation Active ingredient in the IUD is either copper or progestin Among the safest, most effective, and least expensive reversible contraceptives available


Sterilization :Sterilization Permanent form of birth control Highly effective Female sterilization Tubal ligation (surgical method) Essure (nonsurgical method) Male sterilization Vasectomy Surgical procedures can be reversed, but pregnancy rates vary depending on several factors.


Slide 43:Tubal Ligation


Slide 44:Vasectomy


Abortion :Abortion Removal of the embryo or fetus from the uterus Spontaneous abortion Also known as miscarriage Body expels the embryo Generally occurs during first trimester of pregnancy Ten to twenty percent of pregnancies end in spontaneous abortion Cause may be serious genetic defects to the embryo or other causes


Abortion (continued) :Abortion (continued) Induced abortion Caused by the taking of certain drugs or via surgical procedure Method used will depend on stage of pregnancy Medical abortion Conducted between weeks 7–9 of pregnancy Involves use of medications that cause changes in the pregnant woman’s body so that it cannot sustain the pregnancy, followed by expulsion of the contents of the uterus


Abortion (continued) :Abortion (continued) Surgical abortion Removal of the contents of the uterus through surgical procedures Vacuum aspiration (suction curettage) Dilation and evacuation (D&E) Induction Intact dilation and evacuation


Across the Life Span :Across the Life Span Puberty On average, puberty begins at age 10 or 11; girls usually begin 2 years earlier than boys. Puberty ends about 5 or 6 years later. Average age of first menstruation is about 12 (range is 8 to 15 years of age). A significant developmental event for pubertal boys is nocturnal emission, semen emission during sleep. Initially, sperm are not present in semen


Across the Life Span (continued) :Across the Life Span (continued) Menopause Most ova have matured, and remainder are old. Normal cyclic secretion of estrogen and progesterone does not occur. Menses become irregular, then stop. Physicians may prescribe hormone replacement therapy and recommend lifestyle modifications to reduce symptoms.


Across the Life Span (continued) :Across the Life Span (continued) Men Middle-aged men remain fertile but experience a decline in testosterone and the number of healthy, active sperm. Ejaculation has less force and volume. Regaining an erection after orgasm takes longer than at a younger age. Prostate gland usually enlarges.