Fertility and contraception

• Fertility


  In relation to coitus
• Fertility regulation


  Demonstrate how
• Contraception


  Understand concepts of
• Methods of contraception available

  • Withdrawal
  • Basal body temperature
  • Barrier methods
  • Condoms: Male, Female
  • Vaginal diaphragm
  • Cervical cap
  • Long-Acting Reversible Contraceptives (LARCs)
  • Copper ParaGard IUD
  • Hormonal (progesterone) Mirena IUD
  • Hormonal contraceptive implant
  • Natural family planning
  • Lactation amenorrhea method
  • Spermicides
  • Long term surgical: Tubal ligation, Vasectomy
  • Hormonal: Oral, Progestins, Combined, Emergency, Injectables, Implants
• Human Sexual Response


  • Willingness
  • Desire
  • Excitement
  • Plateau
  • Orgasm
  • Resolution

  
• Phase 1: Excitement


  1. Duration: few minutes to several hours

  2. Muscle tension increases

  3. Heart rate quickens and breathing is accelerated

  4. Skin may become flushed

  5. Nipples become hardened or erect

  6. Blood flow to the genitals increases

  7. Vaginal lubrication begins

  8. The woman's breasts become fuller

  9. Vaginal walls begin to swell

  10. The man's testicles swell, his scrotum tightens

  11. He begins secreting a lubricating liquid
• Antimicrobial peptides
• Phase 2: Plateau


  1. Changes begun in phase 1 are intensified

  2. Vagina continues to swell from increased blood flow, walls turn a dark purple

  3. The woman's clitoris becomes highly sensitive (may even be painful to touch)

  4. Clitoris retracts under the clitoral hood to avoid direct stimulation from the penis

  5. The man's testicles are withdrawn up into the scrotum

  6. Breathing, heart rate, and blood pressure continue to increase

  7. Muscle spasms may begin in the feet, face, and hands

  8. Muscle tension increases
• Phase 3: Orgasm


  1. Involuntary muscle contractions begin

  2. Blood pressure, heart rate, and breathing are at their highest rates, with a rapid intake of oxygen

  3. Muscles in the feet spasm

  4. Sudden, forceful release of sexual tension

  5. In women, the muscles of the vagina contract

  6. Uterus also undergoes rhythmic contractions

  7. In men, rhythmic contractions of the muscles at the base of the penis result in the ejaculation of semen

  8. A rash, or "sex flush" may appear over the entire body
• Phase 4: Resolution


  1. Swelled and erect body parts return to their previous size and color

  2. Phase marked by a general sense of well-being, enhanced intimacy and, often, fatigue

  3. Some women capable of a rapid return to the orgasm phase with further sexual stimulation and may experience multiple orgasms

  4. Men need recovery time after orgasm, called a refractory period, during which they cannot reach orgasm again
• Basal body temperature chart


  Used for fertility regulation
• Basal body temperature
• Ovarian Cycle
• Concurrent changes
• Billings method: Spinbarkitte


  Used for fertility regulation
• Stretch cervical mucus


  Used for fertility regulation
• Billings Ovulation Method


  Used for fertility regulation
• Phases of the menstrual cycle

  • Menstrual phase (Day 1 -5)
  • Follicular phase (Day 1 - 13)
  • Ovulation phase (Day 14)
  • Luteal phase (Day 15 to 28)
• Long-Acting Reversible Contraceptives (LARCs)

  Copper ParaGard IUD, Hormonal (progesterone) Mirena IUD, Hormonal contraceptive implant
• Implants


  Hormonal contraceptive implant
• Other methods of contraception

  • Natural family planning
  • Lactation amenorrhea method
  • Spermicides
  • Long term surgical: Tubal ligation, Vasectomy
• Hormonal contraception


  • Oral, Progestins, Combined, Emergency, Injectables, Implants
• Hormonal control
• Injectables


  Hormonal contraception method