Chapter 8: Healthy Sexuality Quiz

Chapter 8: Healthy Sexuality - Preventing Unintended Pregnancy and STDs

• This chapter covers healthy sexuality, focusing on preventing unintended pregnancies and sexually transmitted diseases (STDs).
• Learning objectives include listing reasons for fertility control, defining failure rates for various methods, describing combination hormonal contraception and progestin-only contraception, and explaining IUD use.
• Additional objectives cover barrier methods, fertility-awareness methods, reasons for not using fertility control, and the five most common STDs in North America.
• Further objectives involve identifying risk factors for STDs, safer sex practices, and treatments for specific STDs (trichomoniasis, gonorrhea, chlamydia, genital herpes, and anogenital warts).

Healthy Sexuality Definition

• The World Health Organization (WHO) defines healthy sexuality as a state of physical, mental, and social well-being in relation to sexuality.
• It's more than just the absence of disease, dysfunction, or infirmity.
• A positive and respectful approach, pleasurable and safe experiences, and freedom from coercion, discrimination, and violence are crucial aspects of healthy sexuality.
• Personal health perspective represents aspects of life individuals control, emphasizing the importance of responsible sexuality for overall well-being.

Preventing Unintended Pregnancy

• Ancient methods included using acacia bark, dates, honey, douching, and forcing the woman to jump or sneeze after intercourse.
• Modern methods still in use include coitus reservatus and coitus interruptus ("pulling out").
• Approximately 65 million women in the US are in their most fertile stage; about 65% of these women use contraception.

How Pregnancy Occurs

• Pregnancy begins with fertilization.
• Sperm are continually produced in the testes, taking about 73 days to mature.
• Sperm mix with seminal fluids.
• Females produce a fertilizable ovum (released from the ovary about every 28 days), maintaining fertility for about 24 hours after release.
• Fertilization takes place in the fallopian tubes.
• The fertilized ovum travels to the uterus, where it implants and develops into a fetus.
• The cervix acts as a barrier to sperm and microorganisms.
• Most ejaculated sperm becomes trapped and dies
• The majority of ejaculated sperm moves through the cervix & into fallopian tubes
• Only one sperm penetrates the ovum's outer covering
• The zygote travels to uterus for implantation

The Menstrual Cycle

• Menstruation is the process of uterine lining and blood vessels sloughing off and exiting the vagina if fertilization doesn't occur.
• The menstrual cycle involves near-monthly periods of ovum production; cycle lengths typically range from 24 to 35 days, though irregularities are common.
• Symptoms like cramps, headaches, and backache can accompany the cycle.

Methods for Preventing Unintended Pregnancy

• Choosing a method depends on weighing the benefits and drawbacks of each method.
• Couples choosing a method must ensure both partners are comfortable with its use.
• Key factors include typical user failure rate (TFR) (percentage of women likely to get pregnant during the first year of use) and lowest user failure rate (most consistent).
• Also, typical user failure rate (TFR) estimates how well a method performs when all errors and problems encountered during use are taken into account.

Ineffective Methods

• Vaginal douching is ineffective as thousands of sperm enter the uterus and are not impacted by the process.
• Douching can actually push sperm further up into the uterus.

Minimally Effective Methods

• Includes fertility awareness methods, which attempt to determine the days in a woman's menstrual cycle when ovulation is most likely to occur.
• Safer days are the days in the menstrual cycle when a woman is least likely to be fertile, though fertilization is still possible due to natural variations in reproductive processes.

Barrier Methods

• Barrier methods aim to block sperm movement or prevent sperm from contacting spermicide.
• Common barrier methods: male condoms, female condoms, diaphragms, cervical caps, contraceptive sponges, and spermicidal contraceptives.

Highly Effective Methods

• Hormonal contraceptives are convenient, low-cost, reversible, and effective.
• Combination estrogen/progesterone methods (like birth control pills, skin patches, and vaginal rings) exist, along with progestin-only methods (like the minipill, injectables, and implants).
• Hormonal contraceptives may cause unpleasant side effects like nausea, breast tenderness, fluid retention, headaches, weight gain, depression, decreased sex drive, and acne.
• Side effects can include the disappearance of menstrual cramps, reduction in menstruation, lower risks of PID, benign breast disease, ovarian cysts, ectopic pregnancy, and anemia.

Extremely Effective Methods

• Intrauterine devices (IUDs) are small, T-shaped plastic objects placed inside the uterus; these prevent pregnancy by killing or weakening sperm, altering ovum/embryo timing, or inhibiting embryo implantation in the uterine lining.
• The IUD and various IUD types remain in place as long as the user desires.
• Injectable hormonal implants ("the shot") provide a 3-month supply of synthetic progestin hormone; these are gradually released into the body over time.
• Injectable hormonal methods are replaced every 12 weeks. These are reversible by ceasing use.

Surgical Sterilization Methods

• Includes tubal ligation and hysterectomy (for females) and vasectomy (for males).
• Surgical methods permanently prevent the possibility of having children.
• A hysterectomy removes the uterus and may also involve removal of the cervix, ovaries, tubes, and lymph nodes.

Emergency Contraception

• Used for situations such as unprotected intercourse or contraceptive misuse.
• Hormonal emergency contraception involves estrogen and progestin types taken in two large doses 12 hours apart within 72 hours of unprotected intercourse.
• Alternative options like Plan B (levonorgestrel) or EllaOne (ulipristal) may be taken within various time frames after unprotected intercourse.
• Emergency contraception reduces pregnancy risk by ~90% by blocking ovulation.

Abortion

• Intentional, premature termination of pregnancy has several safe, medically administered methods.
• These methods include taking medication or undergoing surgical procedures; these methods may differ depending on the week of pregnancy.

Aftereffects of Abortion

• Feelings of anxiety, depression, or disappointment around the time of abortion are common.
• Most women experience relief.
• Some women may still experience trouble or find the experience too upsetting months later.

Preventing Sexually Transmitted Diseases (STDs)

• Eleven common STDs are found in North America.
• Half of STDs occur in people under 25.
• STDs are prevalent throughout history.
• STDs are caused by vectors including bacteria, viruses, parasites, protozoa, etc.

STD Risk Factors

• Multiple partners
• False sense of safety
• Absence of symptoms
• Untreated conditions
• Impaired judgment
• Lack of immunity
• Body piercing
• Value judgements
• Denial

Preventing STDs

• Vaccines for hepatitis B (HBV) and human papillomavirus (HPV) are available, though other STDs require consistent public health programs.
• Infected individuals must seek treatment, take responsibility for not infecting others, practice safer sex, use condoms, and disclose any previous exposure to their partners.

Specific STD Information (Examples)

• Trichomoniasis: Caused by protozoan Trichomonas vaginalis; symptoms typically occur in women and are diagnosed by vaginal fluid testing and treated with medication.
• Bacterial vaginosis (BV): Caused by the overgrowth of certain bacteria; characterized by a fishy vaginal discharge, especially after intercourse; treated with metronidazole.
• Chlamydia: Caused by Chlamydia trachomatis; symptoms can include pain on urination, whitish discharge from the genitals; untreated, it can lead to pelvic inflammatory disease (PID); treated with antibiotics.
• Gonorrhea: Caused by Neisseria gonorrhoeae; symptoms are similar to chlamydia; treated with antibiotics.
• Syphilis: Caused by Treponema pallidum; initial symptom is a painless sore; if left untreated, it advances to secondary and tertiary stages, leading to organ damage; treated with antibiotics.
• Herpes simplex virus type 2 (HSV-2): Caused by herpes simplex virus; organism remains in the body; treated with antiviral medications; symptoms may relapse.
• Human papillomaviruses (HPVs) & anogenital warts: Includes various types; some are non-cancerous, while others are linked to cervical cancer; treated with self-applied medications or by healthcare providers, who may also use cryosurgery, electrocautery, laser exposure, or other methods.
• Hepatitis B: Caused by hepatitis B virus; can cause liver disease, fever, fatigue, headache, loss of appetite, and jaundice. Treatment may not be required.