Puberty, Menstruation and Infertility

Males and females respond differently when their bodies reach puberty. 

Males:

• testosterone levels increase - stimulates sperm production 
• Underarm, facial and pubic hair grow 
• Voice deepens 

Females:

• oestrogen levels rise and triggers the menstrual cycle (periods)
• underarm and pubic hair grow 
• breasts enlarge 

The menstrual cycle is a monthly cycle which involves the maturing and release of an egg (if sexual intercorse occurs it can lead to pregnancy)

Divided into 4 stages (depending on the level of horomones)

Controlled by 4 hormones: 

• Follicle Stimuating Hormone (FSH)
• Oestrogen 
• Luteinising Hormone (LH) 
• Progesterone

A female is born with all of her eggs ready but only one will mature each month (once the female reaches puberty)

FSH (Follicle Stimulating Hormone) 

• Released by the pituitary gland 
• Causes an egg in the ovary to mature 
• Encourages the production of oestrogen 

Oestrogen 

• Produced by the ovaries 
• Causes the development of the uterus lining
• Stimulates the production of LH (Luteinising Hormone) 
• Stops the production of FSH

LH (Luteinising Hormone) 

• Produced by the pituitary gland 
• Stimulates the release of a mature egg (on day 14)
• The release is called ovulation

Progesterone 

• Produced in the ovaries after ovulation 
• Maintains the lining of the uterus (during days 14-28)
• Stops the release of LH and FSH

• Stage 1 (days 1 - 4): uterus lining breaks down resulting in a 'period'

• Stage 2 (days 4 - 14): uterus lining starts to build up again into a layer full of blood vessels 

• Stage 3 (day 14): ovulation happens, an egg is released from the ovaries 

• Stage 4 (days 15 - 28): uterus lining is maintained and is now ready for the arrival of a fertilised egg but if no fertilised egg is attacked to the uterus lining the lining breaks down and the cycle begins again

Two main types of contraceptive pills (to reduce a woman's fertility to reduce the risk of pregnancy) 

Progesterone-only pill

• Stimulates the production of thick, sticky mucus, which is very difficult for any sperm to penetrate 
• Stops the release of FSH (so eggs don't mature) 
• Fewer side affects

 Combined pill

• Contains both oestrogen and progesterone 
• Have to take it every day 
• Builds up oestrogen in the body to stop the production of FSH (so eggs don't mature)

These don't have to be taken daily 

Contraceptive Implant 

• Can last up to 3 years 
• Is inserted under the skin and continuosly releases a small amount of progesterone 

Contraceptive Patch 

• Change once a week
• Put on the skin and steadily releases progesterone 

Contraceptive Injection

• Contains progesterone 
• Lasts up to 3 months 

Some contraceptive methods work by being inserted into the woman's body. 

Intrauterie devices (IUDs) 

• Can be known as the 'coil' 
• Small t-shaped devices that are inserted into the uterus 
• Prevent implatation of an embryo (fertilised egg)
• Some also release progesterone 

Diaphragm 

• A shallow plastic cup which is inserted into the vagina prior to sex and sits at the entrance to the uterus 
• Desgined to prevent the sperm reaching the egg 
• Can also be coverd in spermicide to kill sperm 

Condoms 

• Protect against sexually transmitted infections (STIs) e.g. chlamydia, gonorrhoea and HIV
• Often contain a spermicide which kills sperm on release 
• Prevent the sperm from entering the female during ***********
• Worn on the penis during sexual intercourse 

Sterilisation

• A permanent procedure to remove any chances of getting pregnant 
• Both male and female 
• Male - The sperm ducts are cut so sperm is not released on ***********
• Female - The falloopian tubes are cut so that an egg cannot reach the uterus 

Timing 

• Some women choose to avoid sex on days when they know (or feel) that they are ovulating 
• Sperm can last up to 6 days inside the womans body 
• Not a very reliable or effective method of contraception

Abstinece 

• Only truly effective way (apart from sterlisation) to avoid pregnanct is abstinence 
• This is when a couple chooses to not have sex unless to procreate

Some women do not have high enough levels of FSH to stimulate the maturation of their eggs. 

Fertility Drugs 

• A drug that contains a mixture of FSH and LH (can be prescribed by a doctor) 
• The mixture can cause an egg to be released in the ovaries 

IVF (In Vitro Fertilisation) 

• FSH and LH are given to stimulate the growth of lots of eggs 
• Eggs are collected before being fertilised in a dish using sperm from the father 
• Fertilised eggs grow into embryos and are implanted into the womans uterus (sometimes two eggs are implanted to increase the chance of pregnancy) 

These methods offer hope to couples who are unable to concieve naturally but they do have disadvanteges too such as 

Mutiple Pregnancies 

• Typically twins or triplets if more embryos are implanted 
• Can put both the mother and children at risk

Expensive 

• Are not guaranteed to work (success rates are not very high and may need multiple attempts) and can be very expensive 

 Stress

• Can place high levels of emotional and physical stress on patients and their families