1.Abstinence no sex (Abstinence only education has been proven ineffective in preventing unwanted pregnancies)

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1 REPRODUCTIVE SYSTEM Objectives: 1. Contraception 2. STDs 1. Ovary Transplants 2. Freezing Eggs 3. Choosing Gender 4. The Male Pill, parts 1&2 5. Male Birth Control: RISUG 6. Birth Control. 1.Abstinence no sex (Abstinence only education has been proven ineffective in preventing unwanted pregnancies) 2. Avoidance (avoid sex during fertile time ) 3. Permanent methods 4. Barrier methods 5. Hormonal methods 6. Other /abstinence-failures-charts/ 1

2 2. Avoidance FR = typical failure rate Rhythm method only having sex when not in fertile period (days 8-18). Depends on regular cycles. (FR = 20%) Coitus interruptus pull out penis before ejaculation. Depends on self control. (FR = 30%) 3. Permanent methods = irreversable FR = <1% Vasectomy = cut vas deferens Tubaligation = cut fallopian tubes 2

3 5. Barrier Methods FR = 3-18% Male condom Female condom Cervical cap Diagphragm Male condom Female condom Diaphragm 5. Hormonal FR = 1-3% usually in 1 st few months The Pill PREVENTS OVULATION. Delivers synthetic estrogen & progesterone which inhibits pituitary LH & FSH by negative feedback. - Estrogen & progesterone inhibit pituitary LH & FSH - Low LH & FSH inhibits egg development and prevents ovulation. - Also reduces endometrial growth (good for people w/endometriosis) - Also thickens cervical mucus (barrier to sperm) Typical hormonal pill has 21 days of active (contains hormones) pill and 7 days of placebo (hormone-free) pill. During 21 days of active pill, endometrium thickens but no egg develops. During 7 days of hormone-free, endometrium breaks down & have period. 3

4 Seasonale = low dose estrogen & progesterone. Take 84 days active pill followed by 7 days placebo. Repeat. Result = have only 4 periods / year. Good for people w/endometriosis or ovarian polycystic ovarian syndrome or immediate family history of ovarian cancer.. Lybrel (Anya) = take active pill 365 days/year (no placebo = no periods) Great for people w/endometriosis, polycystic ovarian syndrome, or immediate family history of ovarian cancer. Antibiotics known to interfere with birth control pill: Tetracycline Ampicillin Rifampin 4

5 New slide! Vaginal Contraceptive Film ( Strip ): FR =?% = Thin spermicide-embedded sheet place into vagina before sex, dissolves w/vaginal fluids. > New strip applied with each sexual encounter. > NOT reliable as sole form of contraception. > Does NOT protect against STDs. Also available as Contraceptive Spermicidal Suppositories (tablet or pellet inserted into vagina before sex) Hormone Injections: FR = 0.3% Lunelle monthly injection of combo of estrogen & progesterone. (Distributed in vials only. Pre-filled syringes no longer sold in US.) Depo-Provera injection once every 3 months, contains only progesterone. 5

6 Hormone Implants: FR = 0.05% Norplant contains progesterone. Implants last 5 years. Hormonal Patch: Ortho Evra FR = <1% Contains estrogen & progesterone. 6

7 Intrauterine device (IUD): FR = <2% > Small T-shaped device inserted into uterus by doctor. > More expensive than other forms but can last yrs. > Contains progesterone (and some might contain small amt copper. > Works by: preventing ovulation, thickening cervical mucus, and inhibiting sperm movement. Cervical Ring (NuvaRing): FR = <1% > small ring containing estrogen and progesterone placed over the cervix. > Put fresh ring in once a week. Go without ring for 1 week (no hormone, have period). > depends on proper placement. 7

8 Emergency Contraception: chance pregnancy by 75% Plan B (contains Levanorgestrel) -After unprotected sex, it can take up to 6 days for sperm to meet an egg. If a woman hasn t ovulated yet, emergency contraception prevents her from ovulating by delivering high dose of progesterone. -If already ovulated at time of sex, can still get pregnant. -IS NOT AN ABORTIFACIENT!! abortifacient = substance that induces abortion. Available for free at FMU student health center. RU486 (Mifepristone) this is an abortifacient. Clinical App Pg Mifepristone can be used in lower doses as emergency contraception. - At higher doses is abortifacient. - Taken after pregnant, causes abortion during first 2 months of pregnancy (< 8wks) by blocking progesterone receptors. - 2 days after taking mifepristone, need injection of misoprostol labor inducer to expel embryo & placenta. If retained can become septic. 8

9 Male Hormonal Birth Control? Pill combo of testosterone and progestin to inhibit sperm development (by inhibiting pituitary LH & FSH). Injection (2003) 100% effective in clinical trials in Australia (55 men, for 1 year). Hormone injection of progestin turns off normal production of sperm (by inhibiting pituitary LH & FSH). Implant testosterone implant inhibits sperm production by inhibiting pituitary LH & FSH. Gel - testosterone & progestin gel that inhibits sperm production by inhibiting pituitary LH & FSH. 6. Other Intra-Vas Device (IVD) Implant in vas deferens blocks sperm transport. Downside: can irritate the vas deferens. 9

10 6. Other Reversible Inhibition of Sperm Under Guidance (RISUG) Vasalgel - Reversible and non-hormonal - QUICK (10 15 min procedure in office) - Cheap. - Long-term effectiveness (10 yrs) - Inject gel into vas deferens (blocks sperm transport) - Remove when want be getting injection that dissolves gel. - Studies show quick return to normal fertility. - In USA, clinical trials beginning in 2014, for possible introduction to market in FMU's Student Health Services Monday - Friday Hours: 8:30 a.m.- 12:30 p.m. & 1:30 p.m.- 4:30 p.m. Students are strongly encouraged to make an appointment to be seen. Education Foundation Building swalters@fmarion.edu (843) Office Birth Control Options available: Birth Control Pills Ortho Evra Patch Nuva Ring Depo-Provera Injections Administration of Plan B ($15) as indicated Screening available: Chlamydia and Gonorrhea screening $60 Pregnancy Tests are free Bacterial Vaginosis, Yeast Infections screening is free Pap Smear $40 10

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13 Review Contraceptive methods: - Abstinence - Avoidance - Permanent - Barrier (male/female condoms, cervical cap, diaphragm) - Spermicidal agents - Hormonal (pill, injections, implants, patches, IUD, cervical ring, emergency contraception) - Male pill, implant, injection - Other methods (ex. IVD, RISUG) Sexually Transmitted Diseases (STDs) 2/3 of the people in the US infected with STDs are <25 years old Can result in mild disease, infertility, severe disease, and death Many can have few or no symptoms, so are passed unknowingly to partners Some STDs can also be passed to infants during birth 13

14 Sexual Behavior in College Students Approximately 80% of college students are sexually active <30% of those surveyed reported consistent use of condoms 35% have had 6 or more partners But I have only had unprotected sex with a few different people my risk is low.. unprotected sex exposes you to every person your partner has had unprotected sex with as well if you assume that every person you have had sex with had the same number of previous partners as you did - for example, you were the first partner of your first partner you were the second partner for your second partner..your overall exposure looks like this: 14

15 Some common STDs Bacterial STDs > Chlamydia the most frequently reported infectious disease in the U.S. highly contagious and often without noticeable symptoms (Chlamydia trachomatis) < new info added! > Gonorrhea -caused by the bacterium Neisseria gonorrhoeae. See painful urination, discharge, or no symptoms at all. Is becoming resistant to most antibiotics! > Syphillis caused by Treponema pallidum. 15

16 Some common STDs Bacterial STDs > Chlamydia the most frequently reported infectious disease in the U.S. highly contagious and often without noticeable symptoms (Chlamydia trachomatis) < new info added! > Gonorrhea -caused by the bacterium Neisseria gonorrhoeae. See painful urination, discharge, or no symptoms at all. Is becoming resistant to most antibiotics! > Syphillis caused by Treponema pallidum. Viral STDs > herpes simplex virus simplex 1 causes cold sores simples 2 causes gentital herpes > HIV (human immunodeficiency virus) can be latent for many years, may lead to AIDS (acquired immunodeficiency syndrome). > HPV (human papilloma virus) Bacterial STDs New slide added! > Chlamydia the most frequently reported infectious disease in the U.S. highly contagious and often without noticeable symptoms. May cause vaginal / penile discharge, pelvic pain, or no symptoms at all. More risk of permanent damage (sterility) in females than males. 16

17 Chlamydia & gonorrhea may cause discharge, pelvic pain, or no symptoms at all. Cervical discharge in female w/ gonorrhea Penile discharge in male w/ gonorrhea Occular discharge in babyw/ gonorrhea 17

18 Syphilis Herpes Simplex Virus (HSV) HSV can be latent, and then reactivate into painful blisters no cure; treatment is to minimize outbreak severity 18

19 HPV over 40 strains! - most will be asymptomatic and may be cleared within 2 years - some can develop into genital warts, cervical cancer, and sometimes other genital cancers (including men) - HPV vaccine HIV statistics -nearly 35 million people are infected worldwide - approximately 1.4 million people in North America are infected 19

20 Infection Rates of Diseases in the U.S. (per year) Most are STDs American Sexual Health Association. Sexually Transmitted Diseases in America: How Many Cases and at What Cost? December STD causes by protozoan parasite For more info. see 20

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