Chapter 27
The Reproductive
System
G.R. Pitts, J.R. Schiller, and
James F. Thompson, Ph.D.
The Reproductive Systems
 Reproductive
organs are grouped by function
 Gonads - testes and ovaries
 produce
gametes and secrete hormones
 produce gametes and fluid; then discharge into
duct system indicates exocrine function
 production of hormones indicates endocrine
function
 Ducts
– receive, store, transport gametes
 Accessory sex glands – support gametes
 Supporting structures - various reproductive
functions
Males
Male Reproductive System

Testes, a system of ducts, accessory sex glands, and
several supporting structures (including the penis)
Male Reproductive System

Scrotum
2 fibrous sacs
which support and
protect the testes
 Muscle

 cremaster muscle
 dartos muscle

Location and
temperature due to
muscle contraction
 sperm production
requires temp 3 C
below body temp
 involuntary muscle
contraction raises
the testes
Male Reproductive System

Testes - testicles
paired oval
glands 5 cm x
2.5 cm
 development
influenced by Y
sex chromosome
and by maternal
hormonal levels
 develop in
abdomen
 begin descent
during the 7th
month of
development

Male Reproductive System

Surrounded by
dense connective
tissue
covered by tunica
vaginalis (serous
membrane) from
peritoneum
 internal fibrous
capsule = tunica
albuginea

 also forms septa
creating lobules
 200-300
lobules/testicle
tunica albuginea
tunica vaginalis
Male Reproductive System
3 seminiferous tubules in each lobule (typical)
 Each seminiferous tubule is lined with spermatogenic
cells in various developmental stages

Male Reproductive System


Blood-Testis Barrier prevents
immune system response to
sperm antigens
Sustentacular (Sertoli) cells
 create blood-testis
barrier with tight
junctions
 respond to FSH and
testosterone
 phagocytize shed excess
spermatid cytoplasm
 control sperm movement
and release into the
tubule lumen
 secrete some nutrients
for sperm
 secrete some fluid for
sperm transport
Male Reproductive System

Interstitial
endocrinocytes
(interstitial cells of
Leydig)
located between
tubules
 secrete testosterone
in response to LH (=
ICTH)


Spermatogonia
undergo meiosis to
give rise to
spermatazoa
Male Reproductive System

Spermatogenesis




meiosis occurs in the
seminiferous tubules
produces haploid
spermatozoa
64-72 days in humans
Spermatogonia



Diploid stem cells
by mitosis, some remain
as viable stem cells
through out life
others undergo
developmental changes
to become primary
spermatocytes and
undergo meiosis
Male Reproductive System

Reduction division



primary spermatocytes
undergo meiosis I to
become secondary
spermatocytes (haploid)
secondary spermatocytes
undergo meiosis II to
become immature
spermatids (haploid)
Spermatids mature
morphologically into
spermatozoa = sperm cells
 spermatid do not separate
their cytoplasm completely
 they maintain cytoplasmic
bridges until released into
the tubule lumen
Male Reproductive System

Spermatogenesis





spermatids mature
physiologically into
spermatozoa
Requires 10-14 days for
migration to and 3-4
days for maturation in
the ductus epididymus
Older sperms are
removed gradually by
phagocytes within the
epididymus
Many sperms are
abnormal, either
morpholically,
physiologically, or
genetically
30% abnormal is
considered “normal”
Male Reproductive System

Spermatozoa
300 million/day mature
 survive about 48 hrs
following ejaculation in the
female reproductive tract
 structure

 head
• nuclear material
• acrosome - enzymes for
penetration into egg
 midpiece - site of ATP
production to power tail
 tail - flagellum
Male Reproductive
System

Hormones of braintesticular axis

anterior pituitary drives
changes during puberty
 controlled by GnRH from
hypothalamus
 begins to secrete FSH, LH

LH – targets Interstitial
endocrinocytes
 testosterone
 dihydrotestosterone (DHT)

FSH - Sustentacular cells
 Androgen-Binding Protein
(ABP) concentrates
androgens for spermatids
 Inhibin – negative feedback
to the pituitary and
hypothalamus
Male Reproductive
System

Development
testosterone stimulates
pattern development before
birth (internal ducts)
 DHT  external genitals
 estrogens from testes 
brain development


Puberty – testosterone &
DHT stimulate enlargement
of male sex organs and
secondary sexual
characteristics
Male Reproductive System
 Testosterone
 secondary
-
sex characteristics:
muscular, skeletal growth
• heavier, thicker muscles and bones in men than in women
• also triggers epiphyseal closure
pubic, axillary, facial and chest hair
oil gland secretion
larynx enlargement  deepening the voice
 sexual
functions
male sexual behavior and aggressive behaviors
spermatogenesis
sex drive in both male and female
 metabolism
- stimulates protein synthesis
“anabolic steroids” are often misused and abused
Male Reproductive System

Ducts
sperm move slowly
from the lumen of
seminiferous tubules
 straight tubules
 rete testis 
epididymis
 continuous sperm
and testicular fluid
production move
sperms along
 fluid contains: H2O,
androgens,
estrogens, K+,
glutamic acid,
aspartic acid

Male Reproductive System

Epididymis

posterior border of testes
 tightly coiled tube - head,
body, tail
 6 m long if uncoiled

pseudostratified
columnar epithelium
 microvilli provide nutrients
 reabsorb testicular fluid
 phagocytize degenerating
older sperm

ductus epididymis
 site of sperm maturation
(10-14 days) -  motility
 may remain in storage for
a month, then reabsorbed
Male Reproductive System

Ductus (vas) deferens
less convoluted with a larger diameter
 ascends, enters pelvic cavity through inguinal canal
 loops up, over urinary bladder to end in the ampulla

Male Reproductive System

Ductus (vas)
deferens
pseudostratified
columnar
epithelium with
thick muscularis
 transports sperm
from epididymis
to urethra by
peristalsis during
ejaculation

Male Reproductive System
Posterior View
Male Reproductive System
Spermatic cord:
testicular artery,
veins, lymphatic
vessels, autonomic
nerves, vas deferens,
cremaster muscle
descend with the
testes
 Exit the abdominal
cavity through the
inguinal canal
 Vasectomy – a
portion of each duct
is removed

Male Reproductive System

Ejaculatory Ducts
formed by ducts from seminal vesicle and ductus deferens
 move sperm into prostatic urethra before ejaculation

Male Reproductive System

Urethra


terminal tract for
urinary and
reproductive
systems
3 regions:
 prostatic urethra
 membranous
urethra
 spongy
(cavernous)
urethra

Ends at external
urethral orifice at
the bulb/glans of
the penis
Male Reproductive System
Accessory sex glands: seminal vesicles,
prostate, and bulbourethral glands
Male Reproductive System

1)
Accessory sex glands
secrete the fluid
portion of the semen
Seminal vesicles



base of urinary bladder
 60% of semen
volume
secrete alkaline viscous
fluid containing:
fructose, ascorbic acid
 prostaglandins
 vesiculase
(coagulating enzyme)
keeps semen near
cervix while sperm
swim into cervix via
flagellar movements

Male Reproductive System
2)
Prostate


below bladder, around
urethra
secretes milky, slightly acidic
fluid with:
 citrate
 enzymes
• phosphatase
• fibrinolysin
 prostate specific antigen
(PSA)
3)
Bulbourethral (Cowper's)
glands
 beneath prostate gland at
membranous urethra
 secrete:
•
•
alkaline fluid
mucus
 neutralize acidic urine
Male Reproductive System

Semen - mixture of sperms and secretions

Average volume = 2.5 – 5.0 mL
 50-150 million sperm/mL
 below 20 million/mL infertility
Large numbers needed for successful fertilization
 Slightly alkaline (pH 7.2-7.6), milky and mucoid

 decreases acidity of vagina
 fructose is the nutrient for sperm metabolism
 prostaglandins decrease mucous viscosity and stimulate reverse
peristalsis
Contains natural antibiotic = seminalplasmin
 Coagulates after ejaculation into vagina

 somewhat different mechanism than blood clotting
 breaks down in 5-20 minutes
Male Reproductive System

Penis



root (attachment)
body (shaft)
glans penis (head)
Male Reproductive System

Root of penis - bulb
(base of corpus
spongiosum)

Glans penis with
outer corona
Terminal slitlike
opening (external
urethral orifice)
 Covering is prepuce
(foreskin)

 circumcised in a
variety of societies
globally
Male Reproductive System

Body
3 cylindrical tissue masses surrounded by tunica albuginea
 Dorsolateral pair, the corpora cavernosa penis
 midventral corpus spongiosum penis with spongy urethra
 All surrounded by fascia and skin
 Each section has blood sinuses = erectile tissue

Male Reproductive System

Erection
Arteries dilate with
sexual stimulation, a
parasympathetic reflex
 Large quantities of
blood enter the
sinuses

 compress superficial
veins from sinuses
 trapped blood 
erection

Close bladder
sphincter
 prevent urine flow
 prevent semen
backflow

Ejaculation
Sympathetic reflex
 Peristalsis
 Arteries constrict, capillary
sinuses empty

Females
Female Reproductive System

Ovaries, uterine (Fallopian) tubes, uterus, vagina,
vulva, mammary glands
Female Reproductive System

Ovaries
Paired, small (pecan-sized) oval organs in the
pelvic cavity
 Supported by several complex fibrous ligaments
 Homologous in embryological development to the
testes

Female Reproductive System

Ovary Histology
Germinal epithelium
 Tunica albuginea connective tissue
 Ovarian follicles
 Stroma – fibrous
connective tissue

 cortex - outer dense
layer with ovarian
follicles containing
eggs = oocytes
 medulla - inner
loose fibrous
connective tissue
layer containing
blood vessels
Female Reproductive System

Ovary Histology
Germinal epithelium
 Primordial follicles
 Ovarian follicles

 Primary follicles
 Secondary follicles
with antrum
formation
 Vesicular (Graafian)
follicles with large
antrums
After Ovulation:
 Corpus luteum
(“yellow body”)

Corpus albicans
(“white body”)
Female Reproductive System

Oogenesis


Formation of haploid
ova in the ovary
Steps
Reduction division meiosis I (haploid)
 Equatorial division meiosis II
 Maturation –
potential for
fertilization

Female Reproductive System

Uterine (Fallopian) tubes = oviducts
Extend laterally from uterus to transport ova by peristalsis
and cilia-generated current from the ovaries to the uterus
 Structure

 (1) infundibulum with fimbriae
 (2) ampulla
 (3) isthmus
2
1
3
Female Reproductive System

Once a month an ovarian follicle ruptures releasing
a secondary oocyte (ovulation)
Oocyte drawn into the oviduct by cilia-generated current
on the fimbriae and within the tube by cilia and peristalsis
 Fertilization can occur at any time (ideally in 24 hours)

 ideally in the ampulla – upper third of oviduct
 becomes a zygote and then begins mitotic divisions

Unfertilized oocytes disintegrate and are swept out
Female Reproductive System


zygote 
morula 
blastocyst
with
trophoblast
membrane

implantation
more details
on the
stages of
embryonic
development
in the next
chapter
Female Reproductive System

Uterus
Site of menstruation, implantation, fetal development, labor
 Between the urinary bladder and the rectum
 Size and shape of an inverted pear

Female Reproductive System

3 parts of Uterus
1) Fundus 2) Body with 3) Isthmus
fundus
body
isthmus
Female Reproductive System

3 parts of Uterus
(cont.)
3)
Cervix
 narrow portion that
opens into vagina
 produces cervical
mucus; (20-60
mL/day)
•
•
more receptive to
spermatazoa at or
near ovulation
otherwise  the
mucus plug keeps
microbes out
 cervix, mucus
•
•
•
protect
spermatazoa
provide nutrients
role in capacitation

Cervical canal in cervix
internal os
 external os

Female Reproductive System
Uterus bends between its
body and cervix
 Uterus joins with the
vagina at a right angle

Female Reproductive System

Ligaments provide stability – important
especially during labor
broad ligaments
 uterosacral ligaments
 cardinal ligaments
 round ligaments

Female Reproductive System

3 uterine layers
1)
Perimetrium
 = visceral peritoneum
2)
Myometrium
 3 layers of smooth muscle
•
•
thickest in fundus
thinnest in cervix
 for expulsion at labor
Female Reproductive System

3 uterine layers
3)
Endometrium
 highly vascular
 surface layer
•
•
simple columnar
epithelium
ciliated, secretory cells
 uterine (endometrial)
glands
Female Reproductive System

3 layers
3)
Endometrium
 stroma (lamina
propria) of
glandular and
connective tissues
 divided into 2
layers:
•
•
stratum
functionalis
(functional layer)
- shed during
menstruation
stratum
basalis (basal
layer) - gives rise
to stratum
functionalis
Female Reproductive System

Blood supply from
uterine arteries
arcuate arteries - circular
around the myometrium
 radial arteries penetrate
into the myometrium with
smaller branches:

spiral
 straight arterioles
• terminate in basilis
• supply materials to
regenerate functionalis
straight
 spiral arterioles
• penetrate functionalis
• change during menstruation

drained by uterine veins
Female Reproductive System
Fetal expulsion =
labor and delivery
 Oxytocin and
prostaglandins
regulate labor
 ANS controls
contractions

Female Reproductive System

Vagina
Tubular,
fibromuscular
organ with
mucous
membrane
 Between
bladder,
rectum

fornix
 superiorly
attached to
uterus
 recess (fornix)
forms around
the attachment
to the cervix

Several functions
 passage for menstrual flow,
childbirth
 receives penis and semen
Female Reproductive System
 Vagina
histology
 Mucosa
continuous with the uterus
non-keratinized stratified squamous epithelium and
connective tissue in folds (rugae)
• mucosal cells have large stores of glycogen
• upon decomposition produce organic acids  lowers pH
dendritic (APC) cells – (source for HIV attachment --
AIDS?)
 Muscularis
smooth muscle - outer circular, inner longitudinal layers
stretches to receive penis and for accommodating
childbirth
 Adventitia
 Vaginal
- areolar connective tissue
orifice - hymen – thin membrane
Female Reproductive System

Vulva - pudendum

Female external genitalia
this is a test
Mons pubis - anterior, adipose tissue
 Labia majora

lateral skin folds with sebaceous and sudoriferous glands
 homologous to scrotum


Labia minora - medial folds with sebaceous glands
Female Reproductive System

Clitoris
Anterior junction of labia majora
 Small cylindrical mass of erectile tissue and nerves
 Plays a role in sexual excitement
 Homologous to penis; has prepuce and glans

Female Reproductive System

Vestibule
Region between
labia minora
 Mostly the
vaginal orifice


Bulb of vestibule
 2 elongated masses of tissue
 fill with blood during sexual arousal
• narrows vaginal orifice
• increases pressure on penis
 homologous to corpora spongiosum and bulb of penis
Female Reproductive System

External urethral orifice
Anterior to vaginal orifice, posterior to clitoris
 Exterior opening of the urinary tract
 Proximity to vagina and anus increase risk of UTI

Female Reproductive System
 Accessory
glands
 Paraurethral
(Skene's) glands
On either side of external urethral orifice in the vulva
Secrete mucus
Homologous to prostate gland
 Greater
vestibular (Bartholin's) glands
Open in the area between hymen and labia minora
Mucus secretion during sexual intercourse
Some lesser vestibular mucous glands also present
Homologous to bulbourethral (Cowper's) gland
General Reproductive System

Perineum
Diamond
shaped area
between
thighs,
buttocks
 Contains
external
genitals,
anus

Urogenital triangle
Anal triangle
 anterior -
pubic
symphysis
 posterior coccyx
Anterior - urogenital triangle
 Posterior - anal triangle


Episiotomy – to ease labor
Female Reproductive System

Mammary Glands
Modified sudoriferous
(sweat) glands that
produce milk
 Anatomy

 over pectoralis major
and serratus anterior
muscles
 attached to the deep
fascia
 surrounded by adipose
and fibrous tissue
 suspensory ligament
of breast
• runs between skin
and deep fascia
• supports breast
Female Reproductive System

Mammary Glands

Nipple
 exterior pigmented projection
 many closely spaced openings -
lactiferous ducts

Areola
 surrounding pigmented area
 sebaceous (oil) glands
Female Reproductive System

Mammary Glands
15 - 20 lobes internally
separated by adipose
tissue (which determines
breast size and shape)
 separated into lobules
with milk-secreting
glands = alveoli

 milk (when being
produced) passes from
alveoli  secondary
ducts  mammary ducts
 approaching the nipple,
the mammary ducts
expand to form lactiferous
sinuses (for storage)
 sinuses continue to nipple
Female Reproductive System
 Mammary
 Develop
Gland Development
at puberty due to estrogen, progesterone
 Ducts develop, fat deposition occurs
 Areola and nipple enlarge; become pigmented
 Further development occurs following ovulation and
corpus luteum formation in menstrual cycle or
pregnancy
Female Reproductive System
 Mammary
Gland Physiology
 Primary
function is milk synthesis
 Secretion and ejection together = lactation
 Primary stimulus for milk production is prolactin
from the anterior pituitary
 Stimuli for milk release (letdown) in response to
suckling:
 oxytocin from posterior pituitary
 ANS reflexes
Female Reproductive System

Breast Cancer
12% of women will have breast cancer
 3.5% will die of breast cancer
 Early detection is the most important aspect
 Each month after a menstrual period, the breasts should be
examined for lumps, puckering of skin or nipple retraction or
discharge
 Genes BRCA1 and BRCA2 linked to the 10% of hereditary
breast cancers
 BR-1 is a new marker (2003), esp. for black women
 But >70% of breast cancers are not associated with known
risks
 http://www.time.com/time/photoessays/breast_cancer/

Female Reproductive System
 Breast
 Risk
Cancer
factors
family history
early onset menses and late menopause
no child or first child after age 34
previous breast cancer
exposure to ionizing radiation (x-rays)
obesity, alcohol intake, cigarette smoking
 Detection
- mammogram, flattening is the key to a
sharp image
 Treatment
lumpectomy (removal of tumor and surrounding tissue)
radical mastectomy (breast, pectoral muscles, axillary
lymph nodes)
Female Reproductive Cycle
 Two
parts in two different areas
 Ovarian
cycle - events in ovary leading to
ovulation
 Menstrual (uterine) cycle - endometrial changes
 Controlled
by varying levels of several
hormones from several glands
 Anterior
Pituitary
 Ovarian follicles
 Corpus luteum
 Hormones
 Ovaries
target several organs
– Uterus – Breasts – CNS
Female Reproductive Cycle - Hormones
Female Reproductive Cycle

Reproductive
cycle
Normally 2435 days in
length
 Anterior
Pituitary
hormones
target ovary
 Ovarian
hormones
target uterus
(and breasts)

Female Reproductive Cycle

3 Phases of
Reproductive
cycle
1. Day 1-4 -
menstrual
phase
2. Day 5-14 -
preovulatory
(proliferative)
phase
3. Day 15-28 postovulatory
(secretory)
phase
1.
2.
Proliferative
3.
Secretory
Female Reproductive Cycle

Menstrual Phase
50-150 ml of discharge: tissue fluid, mucus, epithelial cells
and a small quantity of blood from the endometrium
  levels of estrogen/progesterone - negative feedback

 uterine spiral arteries constrict  creates ischemic tissue
 entire stratum functionalis sloughs off

Ovaries
 FSH levels rise (from day 25 of cycle) to stimulate a few primordial
follicles to develop into primary follicles
 All follicles release low levels of estrogen
 By day four, ~20 develop into primary and then secondary (growing)
follicles
• granulosa cells surround oocyte
• zona pellucida forms between oocyte and the granulosa (follicular cells)
– cells secretes watery follicular fluid into antrum
– fluid forces oocyte to the follicle’s edge and fills follicular cavity
Female Reproductive Cycle
 Preovulatory
Phase - lasts 6-13 days
 Menstrual
and Preovulatory phase together are
known as the Follicular phase
 By day 6 of the cycle, one follicle outgrows others
dominant follicle secretes & inhibin
estrogen & inhibin reduce FSH secretion • all other follicles stop growing and degenerate = atresia
estrogen levels increase due to this single follicle
 Dominant
follicle matures
vesicular ovarian (Graafian) follicle (mature follicle)
forms a blister-like bulge on the surface of the ovary
Female Reproductive Cycle

Preovulatory Phase

Follicle continues to
secrete estrogen
 FSH is dominant early
 Close to ovulation, LH
becomes important

Estrogen stimulates
endometrial
regrowth
 stratum basalis
• mitosis creates a
new stratum
functionalis
 endometrial glands
redevelop
 arterioles coil and
lengthen
Female Reproductive Cycle
 Ovulation
 LH
pulse causes rupture of vesicular = Graafian
follicle and release of oocyte into the pelvic
cavity; occurs approximately day 14
 Secondary oocyte
surrounded by follicular cells, corona radiata
secondary oocyte in metaphase II
 Fimbriae
become more active; cilia create
currents in peritoneal fluid to carry oocyte into
uterine tube
 Estrogen causes changes in body temperature
and cervical mucus becomes less gelatinous
Female Reproductive Cycle

Ovulation

Prior to ovulation
 high estrogen exerts
positive feedback on FSH,
LH
 sudden surge of LH causes
release of oocyte
 LH surge is measurable

Following ovulation
 follicle collapses becoming
corpus hemorrhagicum
 follicular cells then
enlarge, change character,
form the corpus luteum
 follicular cells respond to
LH by secreting estrogen
and now progesterone
Female Reproductive Cycle
 Postovulatory
Phase
 Most
constant in duration, lasts for 14 days, from
ovulation to the next menses
 LH stimulates corpus luteum development (luteal
phase); corpus luteum secretes increased levels
of estrogen and progesterone
 Progesterone prepares endometrium to receive an
embryo (if it has developed sufficiently)
growth and coiling of endometrial glands
vascularization of surface endometrium
endometrial thickening
increased tissue fluid
secretory phase for the endometrial glands
Female Reproductive Cycle
 Postovulatory
 If
Phase
no fertilization
 estrogen and progesterone inhibit GnRH and LH
corpus luteum degenerates (no LH)  corpus albicans
 levels of estrogen and progesterone
• stop endometrial development
• stimulate next menstruation
• stimulate anterior pituitary hormones to begin next cycle
 If
fertilization occurs
corpus luteum maintained until the placenta takes over
maintained by hCG (human chorionic gonadotropin)
• produced by chorion (outer embryonic membrane which
becomes the bulk of the placenta)
• home pregnancy test detects hCG
placenta produces estrogen, progesterone
Female Reproductive Cycle -- Review
Female Reproductive Cycle -- Review
Physiology of Sexual Intercourse

Male Reproductive Act
 Erection
may be initiated by anticipation, memory, visual
stimulation or as a reflex from physical stimulation
Parasympathetic stimulation causes vasodilation of
capillary sinuses, compression of veins  erection
 Lubrication
Parasympathetic impulses stimulate bulbourethral and
urethral glands
glands secrete mucus for lubrication
Physiology of Sexual Intercourse

Male Reproductive Act (cont.)
 Orgasm
tactile stimulation causes ejaculation
• intense stimulation causes rhythmic sympathetic impulses
causing peristaltic contractions of ducts propelling
spermatazoa into ductus (vas) deferens  urethra
• simultaneous stimulation of seminal vesicles, prostate and
bulbourethral glands add seminal fluid to the spermatazoa
• stimulation of skeletal muscle at the base of the penis triggers
rhythmic contractions to help expel semen  ejaculation
sensory input including  HR,  BP,  RR, pleasurable
sensations, along with ejaculation, define male orgasm
followed by a refractory period
Physiology of Sexual Intercourse

Female Reproductive Act

Arousal – mediated by Parasympathetic Division of ANS
 stimulation of breasts, genitalia, especially the clitoris, generates
arousal
 clitoris, vaginal mucosa and breasts engorge with blood
 lubrication - secretion of mucus from epithelium of the cervical
mucosa

Orgasm (climax) - maximal tactile stimulation of genitalia
results in orgasm, mediated by Sympathetic Division
(ANS)
 perineal muscles contract rhythmically; general increase in muscle
tension; rhythmic contractions of the uterus
 engorgement of clitoris, breasts
  HR,  RR,  BP
 intense pleasurable sensations
Birth Control = Contraception
 Sterilization
 vasectomy
in males and tubal ligation in females
(tubes cut and sealed)
 Hormonal
methods
 Intrauterine devices
 Barrier methods
 Chemical methods
 Physiological methods
 Abortions
Birth Control = Contraception
 Hormonal
 Oral
methods
contraception – simulate “pregnant state”
generally higher in progesterone and lower in estrogen
• negative feedback inhibition of FSH, LH and GnRH
• prevents follicular development and ovulation
• also alter cervical mucous and make endometrium less
receptive to implantation
allows for regulation of length of menstrual cycles,
menstrual flow, and prevention of ovarian cysts
not good for women with clotting problems, cerebral
blood vessel damage, hypertension, liver malfunction
or heart disease
an increased risk for heart attack and stroke in women
who smoke and drink
Birth Control = Contraception
 Hormonal
methods
 Norplant
surgical implants under skin of progestin
prevents ovulation and thickens cervical mucus
 No
male oral contraceptive currently available –
research underway
 Intrauterine
 Small
devices
plastic, copper or stainless steel device
inserted into uterine cavity to prevent
implantation
 Danger of pelvic inflammatory disease, infertility,
and excessive menstrual bleeding and pain
Birth Control = Contraception
 Barrier
methods
 Condom
nonporous materials (e.g., latex) provide mechanical
barrier to sperm deposition
reliable when used correctly
both male and female versions
The only method likely to prevent STD's and reliable
when used correctly
 Diaphragm
rubber dome-shaped device is placed over cervix to
stop sperm passage; often used with spermicide
toxic shock syndrome and frequent urinary tract
infections are possible with incorrect use
Birth Control = Contraception
 Chemical
methods - spermicidal agents, make
vagina more inhospitable to sperm and may
prevent sperm flagellar motility
 Physiological
 Coitus
methods – not too reliable
interruptus (withdrawal)
 Rhythm method - abstention for 3 days before
and after ovulation (estimated)
 Sympto-thermal method - abstention when signs
of ovulation are present
Birth Control = Contraception
 Induced
 RU486
abortion
(mifepristone) – drug blocks progesterone
preventing proper endometrial development 
menstruation occurs
 Various surgical procedures
End Chapter 27