Reproductive Health Notes PDF

© www.bankofbiology.com All rights reserved. According to World Health Organisation (WHO), ▪ Educate people about birth control, care of pregnant mothers, Reproductive health is a total well-being in all aspects of post-natal care of mother and child, importance of b...

© www.bankofbiology.com All rights reserved. According to World Health Organisation (WHO), ▪ Educate people about birth control, care of pregnant mothers, Reproductive health is a total well-being in all aspects of post-natal care of mother and child, importance of breast reproduction i.e., physical, emotional, behavioural & social. feeding, equal opportunities for male & female child etc. REPRODUCTIVE HEALTH: PROBLEMS & STRATEGIES ▪ Awareness of problems due to population explosion, social evils like sex-abuse and sex-related crimes, etc. India initiated reproductive health programmes (family planning) in 1951. Aims and needs of sex education in schools Wider reproduction-related areas are in operation under the ▪ To provide right information about sex-related aspects. It Reproductive & Child Health Care (RCH) programmes. helps to avoid sex-related myths and misconceptions. Such programmes deal the following: ▪ To give proper information about reproductive organs, ▪ Give awareness about reproduction related aspects for adolescence and related changes, safe and hygienic sexual creating a reproductively healthy society. practices, sexually transmitted diseases (STD), AIDS etc. POPULATION STABILIZATION & BIRTH CONTROL In 1900, world population was about 2 billion. By 2000, it 2. Barriers rocketed to about 6 billion and 7.2 billion in 2011. They prevent physical meeting of sperm & ovum. E.g. In India, population was nearly 350 million at the time of ▪ Condoms (E.g. Nirodh): Made of rubber/latex sheath. independence. It reached 1 billion by 2000 and crossed 1.2 Condoms for male: Cover the penis. billion in May 2011. It means every sixth person in the Condoms for female: Cover the vagina & cervix. world is an Indian. Condoms are used just before coitus. They prevent the entry According to the 2011 census report, our population growth of semen into female reproductive tract. rate was less than 2% (i.e. 20/1000/year), a rate at which Condoms are very popular because: our population could increase rapidly. - It protects the user from STDs and AIDS. Reasons for population explosion - Easily available and disposable. o Increased health facilities and better living conditions. - It can be self-inserted and thereby give privacy to user. o Rapid decline in death rate, maternal mortality rate ▪ Diaphragms, cervical caps and vaults: (MMR) and infant mortality rate (IMR). - Made of rubber and are inserted into the female o Increase in number of people in reproducible age. reproductive tract to cover the cervix during coitus. - They block the entry of sperms through the cervix. Impacts of population explosion - They are reusable. Scarcity of basic requirements (e.g. food, shelter & clothing). - Spermicidal creams, jellies & foams are used along Control measures with these barriers to increase contraceptive efficiency. o Motivate smaller families by using contraceptive methods. 3. Intra Uterine Devices (IUDs) o Aware peoples about a slogan Hum Do Hamare Do (we two, These are inserted by doctors or nurses in the uterus through our two). Many couples have adopted a ‘one child norm’. vagina. They increase phagocytosis of sperms. o Statutory rising of marriageable age of females (18 years) IUDs are ideal method to delay pregnancy or space children. and males (21 years). Types of IUDs: Properties of an ideal contraceptive o Non-medicated IUDs: They retard sperm motility. Also o User-friendly, easily available, effective and reversible. have spermicidal effect. E.g. Lippes loop. o No or least side-effects. o Copper releasing IUDs: Cu ions suppress motility and o It should not interfere with sexual drive, desire & sexual act. fertilising capacity of sperms. E.g. CuT, Cu7, Multiload 375. CONTRACEPTIVE METHODS o Hormone releasing IUDs: They make the uterus unsuitable for implantation and the cervix hostile to the sperms. E.g. 1. Natural/Traditional methods Progestasert, LNG-20. Avoid chances of ovum and sperms meeting. It includes ▪ Periodic abstinence: Avoid coitus from day 10 to 17 of the 4. Oral contraceptives menstrual cycle (fertile period) to prevent conception. - Oral administration of progestogens or progestogen– ▪ Coitus interruptus (withdrawal): Withdraw penis from oestrogen combinations in the form of tablets (pills). the vagina just before ejaculation to avoid insemination. - Pills are taken daily for 21 days starting within the first five ▪ Lactational amenorrhea: It is the absence of menstrual days of menstrual cycle. After a gap of 7 days (menstruation cycle & ovulation due to intense lactation after parturition. period), it should be repeated in the same pattern till the Fully breastfeeding increases lactation. This method helps female desires to prevent conception. to prevent conception. This is effective up to 6 months - They inhibit ovulation and implantation and thicken following parturition. cervical mucus to prevent entry of sperms. It has no side effect. But chances of failure are high. - Pills are very effective with lesser side effects. 1 © www.bankofbiology.com All rights reserved. - Saheli: New oral contraceptive for the females. It is 6. Surgical methods (sterilization) developed by Central Drug Research Institute (CDRI) in - It helps to block gamete transport and thereby prevents Lucknow. It contains a non-steroidal preparation. It is a conception. It is very effective but reversibility is poor. ‘once a week’ pill with very few side effects and high - Vasectomy: Sterilization procedure in males. In this, a contraceptive value. small part of the vas deferens is removed or tied up through 5. Injectables a small incision on the scrotum. - Progestogens or Progestogens-oestrogen combination are - Tubectomy: Sterilization procedure in females. In this, a used by females as injections or implants under skin. small part of the fallopian tube is removed or tied up through - Their mode of action is like that of pills and their effective a small incision in the abdomen or through vagina. periods are much longer. Side effects of anti-natural contraceptives: Progestogens or progestogen-oestrogen combinations & IUDs are used as emergency contraceptives within 72 hours of coitus. Nausea, abdominal pain, breakthrough bleeding, irregular It avoids pregnancy due to rape or casual intercourse. menstrual bleeding, breast cancer etc. MEDICAL TERMINATION OF PREGNANCY (MTP) Intentional or voluntary termination of pregnancy before Problems related with MTPs full term is called MTP or induced abortion. ▪ Majority of the MTPs are performed illegally. 45 to 50 million MTPs are performed in a year all over the ▪ Misuse of amniocentesis test for foetal sex determination. world (i.e. 1/5th of total number of conceived pregnancies). If the foetus is female, it is followed by MTP. Such MTP helps to decrease the population. practices are dangerous for the young mother and foetus. Many countries have not legalised MTP due to emotional, ethical, religious and social issues. Amniocentesis: In this, some amniotic fluid of the foetus Government of India legalised MTP in 1971 with some is taken to analyse the foetal cells & dissolved substances. strict conditions to check illegal female foeticides. It is used to test the presence of genetic disorders, survivability of the foetus etc. Importance of MTP Government of India enacted The Medical Termination of o To avoid unwanted pregnancies due to casual intercourse Pregnancy (Amendment) Act, 2017 to reduce illegal or failure of the contraceptive used during coitus or rapes. abortion and consequent maternal mortality and morbidity. o It is essential in cases where continuation of pregnancy According to this Act, a pregnancy may be terminated within could be harmful to the mother or to the foetus or both. the first 12 weeks on the opinion of a registered medical MTPs are safe during the first trimester, (up to 12 weeks of practitioner. If the pregnancy is between 12 - 24 weeks, two registered medical practitioners must be of the opinion. pregnancy). 2nd trimester abortions are very risky. SEXUALLY TRANSMITTED DISEASES (STDs) Diseases or infections transmitted through sexual intercourse swellings, etc. in the genital region. are called Sexually transmitted diseases/infections (STDs Absence or less significant early symptoms and the social or STIs)/Venereal diseases (VD) or Reproductive tract stigma deter the infected persons to consult a doctor. This infections (RTI). E.g. Gonorrhoea, syphilis, genital herpes, leads to pelvic inflammatory diseases (PID), infertility, chlamydiasis, genital warts, trichomoniasis, hepatitis-B & ectopic pregnancies, abortions, still births, cancer of the HIV leading to AIDS. reproductive tract etc. Hepatitis-B & HIV are also transmitted All persons are vulnerable to STDs. These are very high o By sharing of injection needles, surgical instruments etc. among persons in the age group of 15-24 years. o By transfusion of blood. Prevention: o From infected mother to foetus. i. Avoid sex with unknown partners/multiple partners. Except hepatitis-B, genital herpes & HIV, other diseases are ii. Always use condoms during coitus. completely curable if detected early and treated properly. iii. In case of doubt, go to a qualified doctor for early Early symptoms: Itching, fluid discharge, slight pain, detection and get complete treatment. INFERTILITY It is the inability to conceive or produce children even after 1. In vitro fertilisation (IVF) or 2 years of unprotected sexual cohabitation. Test tube baby programme The reasons for this may be physical, congenital, diseases, In this method, ova from the wife/donor and sperms from the drugs, immunological or even psychological. husband/donor are collected and are induced to form zygote ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) under simulated conditions in the laboratory. This is followed These are the technologies used to correct the infertility by Embryo transfer (ET). problems. Some of them are given below: ET is 2 types: 2 © www.bankofbiology.com All rights reserved. Zygote Intra Fallopian Transfer (ZIFT): Transfer of partner). After fertilization, the embryo is implanted into the zygote or early embryo (with up to 8 blastomeres) into woman’s uterus. fallopian tube. 4. Artificial insemination (AI) technique Intra Uterine Transfer (IUT): Transfer of embryo with more than 8 blastomeres into the uterus. The semen collected from husband or a donor is artificially introduced into the vagina or the uterus of the female. Embryo formed by in vivo fertilisation (fertilisation within Artificial insemination into the uterus is known as intra- the female) is also used for such transfer to assist those uterine insemination (IUI). females who cannot conceive. This technique is useful for the male partner having inability 2. Gamete Intra Fallopian Transfer (GIFT) to inseminate female or low sperm counts etc. Transfer of an ovum from a donor into the fallopian tube of Problems of ART another female who cannot produce ovum, but can provide o It requires specialized professionals and expensive suitable environment for fertilization and development. instrumentation. Therefore, these facilities are available only in very few centres. 3. Intra cytoplasmic sperm injection (ICSI) o Emotional, religious and social problems. It is a laboratory procedure in which a single sperm (from male partner) is injected directly into an egg (from female Legal adoption is a good method for couples looking for parenthood. Visit: www.bankofbiology.com Bio Master YouTube channel MODEL QUESTIONS 1. Is sex education necessary in school? Justify your answer. 2. Removal of gonads cannot be considered as contraceptive method. Why? 3. Match the following A B C Lactational amenorrhea Vasectomy ‘Once a week’ IUD Saheli Breastfeeding Sterilization Natural method Lippes loop Oral contraceptive Inserts in uterus Reversibility is poor 4. Note the relationship between the first two words and fill up the fourth place a. Male: vasectomy Female: …………………… b. LNG-20: Hormone releasing IUD Multiload 375: ……………….. c. IUD: Intra-uterine device IUI: ………………. 5. Condoms are more popular than other contraceptive devices. Give reasons (any 4) 6. Consider the following contraceptive methods. Lactational amenorrhea, Condoms, Oral contraceptive pills a) Which method, in your opinion, is more desirable? Why? b) Mention 2 methods of contraception like Lactational amenorrhea. What is the advantage of these methods? 7. Match the following A B C ZIFT More than 8 blastomeres Direct injection of sperm into egg GIFT Very low sperm count Embryo to oviduct IUT Up to 8 blastomeres Ovum to oviduct ICSI Transfer of egg Uterus 8. Expand the following a) IVF b) ZIFT c) GIFT d) ICSI 9. “Female foeticide is very high in India. So MTP (Induced abortion) must be completely banned”. Do you agree with this statement? Why? 10. Anil said that IUD, IUT and IUI are the three methods of ART. a. Do you agree with this statement? Justify. b. Expand the above abbreviations. 11. A person is affected with itching, fluid discharge, swelling etc. in his genital region. But he did not consult a doctor. a. Mention the type of disorder affected him. b. Can you give any advice to him about the importance of consulting the doctor? c. How to prevent such type of diseases? 3