Reproductive System

Reproductive System Basics

• Human reproduction results from the union of a male sex cell and a female sex cell.
• Male and female reproductive systems differ, enabling reproduction.

Male Reproductive System Anatomy

• Key components consist of:
  • Penis
  • Urethra
  • Vas Deferens
  • Bladder
  • Prostate
  • Seminal Vesicle
  • Testicle
  • Epididymis
  • Colon

Female Reproductive System Anatomy

• Key components consist of:
  • Ovary
  • Fallopian Tubes
  • Uterus
  • Cervix
  • Vagina

Vulva Anatomy

• The vulva is the external female genitalia.
• The mons pubis is a rounded, fatty pad over the symphysis pubis bone.
• The labia majora and labia minora are two folds on each side of the vaginal opening.
• The clitoris is a small, erectile tissue organ which becomes hard when sexually stimulated.

Fertilization and Menstruation

• Fertilization is the union of sperm and ovum into one cell.
• During intercourse, millions of sperm are deposited into the vagina.
• Fertilization results if a sperm and ovum unite in a fallopian tube.
• The fertilized cell travels down the fallopian tube to the uterus.
• The fertilized cell implants in the thick endometrium and develops during pregnancy.
• During menstruation, if pregnancy does not occur, the endometrium (blood-rich uterine lining) breaks up and is discharged through the vagina.

Physical Changes to the Male Reproductive System

• Men experience declines in testosterone levels.
• Decreased testosterone impacts strength, sperm production and reproductive tissues.
• Erections take longer to achieve.
• The phase between erection and orgasm is longer.
• Orgasms become less forceful than when younger.
• Erections are losed quickly.
• The time between erections is longer.

Physical Changes to the Female Reproductive System

• Menopause begins.
• Menstruation stops.
• A woman can no longer have children.
• Female hormones (estrogen and progesterone) decrease.
• The uterus, vagina, and genitalia atrophy.
• Vaginal walls thin, leading to vaginal dryness.
• Arousal takes longer.
• Orgasms become less intense.
• The pre-excitement state returns more quickly.

Key Definitions

• Sex refers to physical or physiological differences between males and females, including primary characteristics (the reproductive system) and secondary characteristics like height and muscularity.
• Gender is a term for social or cultural distinctions associated with being male or female.
  • Gender identity is the extent to which one identifies as being either masculine or feminine.
  • Gender expression is how a person expresses their gender identity, typically through appearance, dress, and behavior
• Sexuality is a person's sexual orientation or preference, in relation to the gender to which they are attracted.

Sex: Biological Assignment

• Sex is a label, male or female, assigned by a doctor at birth based on genitals and chromosomes, recorded on the birth certificate.
• Intersex describes individuals with sexual and reproductive anatomy that does not fit typical female or male definitions.
  • Intersex people have variations in sex characteristics, according to the UN Office of the High Commissioner for Human Rights, that "do not fit the typical definitions for male or female bodies.”

Gender: Societal Expectations

• Gender: A social and legal status, and set of expectations from society, including behaviors, characteristics, and thoughts.
• Gender roles are based on societal norms or standards created.
• Gender is something a person figures out and expresses themselves.
• The two most common types of gender are male and female.

Gender Identity vs. Gender Expression

• Gender identity is each person's internal, individual experience of gender, i.e. being a woman, a man, both, neither, or anywhere along the gender spectrum.
  • A person's gender identity may or may not be the same as their birth-assigned sex.
• Gender expression is how a person publicly presents their gender: outward appearance, dress, hair, make-up, body language, voice.
  • Choice of name and pronoun are also common ways of expressing gender

Gender Identity Terminology

• Binary: Viewing gender solely as two identities/sexes (man and woman or male and female).
• Non-binary: Any gender outside the binary system of male/female or man/woman, including:
  • Gender Non Conforming
  • Genderqueer
• Cisgender: A term for someone whose gender identity aligns with their sex assigned at birth.
• Bigender: Encompassing both man and woman, possibly with one side stronger.
• Agender: Identity/expression does not align with man, woman, or any other gender; sometimes termed gender-neutral.
• Gender Fluid: Not identifying with a single fixed gender, expressing a fluid/unfixed gender identity that shifts/changes depending on context.
• Transgender: An umbrella term for people whose gender identity and/or expression is different from any cultural and social expectations based on the sex they were assigned at birth.
  • Trans Woman is someone who is assigned as a male at birth, but identifies as a woman
  • Trans Man is Someone who is assigned as a female at birth, but identifies as a man
• Transitioning: A legal/and social/or medical process a person may go through to live outwardly as the gender with which they identify, rather than the gender they were assigned at birth.
  • Transitioning can include: telling loved ones , using a different name and pronouns, dressing , legally changing name and/or sex, hormone therapy, and / or surgery.
• Transsexual person: (Generational term) People whose gender identity is different from their assigned sex at birth, and seek to transition from male to female or female to male.
  • The term is no longer preferred by many people, as it is often seen as overly clinical, and associated with psychological disorders in the past.
• Dead name: How some transgender people refer to their given name at birth.
• Gender questioning: Processing, questioning, or exploring their gender identity.
• Gender dysphoria: Clinically defined as significant and durational distress when a person's assigned birth gender is not the same as the one with which they identify
• Passing: Perceived by others as the gender with which they self-identify.
• Two-Spirit: Modern, pan-Indian, umbrella term which describes Native people who fulfill a traditional third-gender (or other gender-variant) ceremonial role in their cultures.

Sex vs Gender Distinctions

• A person's sex, as determined by their biology, does not always correspond with his or her gender.
• The terms sex and gender are not interchangeable.
• Characteristics of biology refers to physical distinctions, characteristics of sex will not vary significantly between different human societies.
• Characteristics of gender may vary greatly between different societies.

Sexuality Vocabulary

• Sexual orientation: Who you are emotionally, mentally and physically attracted to based on their sex/gender in relation to your own, possibly same-sex, male-female, or a bisexual
• Heterosexuality is the attraction to individuals of the opposite sex.
• Homosexuality, or Gay, is the attraction to individuals of one's own sex.
• Bisexuality is the attraction to individuals of either sex.
• Asexuality is no attraction to either sex.
• Demisexuality where people only experience sexual attraction to folks that they have close emotional connections with.
• Pansexual is where a person experiences sexual, romantic and/or physical attraction to people of all gender/sexual identities or expressions.

The Older Adult and Sexuality

• Love, affection, and intimacy do not disappear between adults in elder care.
• It is normal for older adults to remain sexual.
• Promote ways to meet the client's sexual needs.

STI Prevention

• Sex can still be satisfying but will be different from younger years, and might need to be adapted for current age, disability, illness, or surgery- induced body changes.
• Older adults are more vulnerable to STIs. Everyone should use safe sex practices.
• All sex can spread STIs; talk about sexual histories, past STIs, test results, drug use.
• HIV/AIDS can also be acquired by sharing syringe needles.
• Before sex, check for sores, abnormal discharges, or odors.
• Use condoms and lubricant every time during foreplay until you know your partner's sexual history!

Chlamydia

• Most infected people are asymptomatic, and symptoms may not arise until weeks after exposure.
• Asymptomatic or not, chlamydia can damage the reproductive system.
• Women may experience abnormal vaginal discharge or burning during urination.
• Men may experience discharge from the penis, burning during urination, or testicular pain and swelling (though less common).

Gonorrhea

• May be asymptomatic (particularly in women).
• Men may experience burning during urination, a white/yellow/green discharge from the penis, or painful/swollen testicles (less common)..
• Women may experience painful/burning urination, increased vaginal discharge, or vaginal bleeding between periods Women are at risk of complications

Genital Warts Symptoms and Locations

• In women, warts can grow on the vulva, vaginal walls, area between external genitals and anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus.
• Symptoms include small, flesh-colored, brown/pink swellings, a cauliflower-like shape from clustered warts, itching, or discomfort.

Genital Herpes Characteristics

• Many people are asymptomatic or have mild symptoms, which are often mistaken for skin conditions.
• Sores typically appear as one or more blisters around the genitals, rectum, or mouth.
• Blisters break and cause painful sores that heal in a week or more.
• Initial outbreaks may include flu-like symptoms.

Pubic Lice

• Infestation leads to intense itching in the genital region.
• It is spread to other areas with coarse body hair including Legs, Chest, Armpits, Beard or mustache and Eyelashes or eyebrows.

HIV Basics

• HIV damages the immune system by infecting and killing CD4 cells (T cells).
• HIV can lead to infections and cancers.
• HIV is transmitted through bodily fluids:
  • Blood
  • Semen;
  • Vaginal and rectal fluids
  • Breast milk
• HIV doesn't spread in water or by casual contact.
• HIV is a lifelong condition with medical treatment available to manage the virus.
• HIV is a sexually transmitted infection (STI.)

Progression to AIDS

• Untreated HIV can develop into AIDS when the immune system is weak.
• Life expectancy with AIDS is 3 years without treatment.
• AIDS is the most advanced stage of HIV.

Safe Sex

• Practice "Don't be silly, wrap your willy", "If you go into heat, package your meat!", "Don't be a fool, cover your tool!" or “No glove, no love!"

Definition of Elder Sexual Abuse

• Involves contact with an elderly person without their consent.
• The act can involve physically or emotionally forcing them to be sexual against their will.

Forms of Abuse

• Showing an elderly person pornographic material
• Forcing the elder to undress
• Abuse by confused seniors in care facilities with dementia being approached, spouses/partners, or caregivers.
• Abuse of senior’s/spouses, partners, family members, or trusted people.

Range of Sexual Abuse

• Includes using sexual or degrading jokes in her of his presence. Treating senior like sex object and withholding of sex/affection. Forcing uncomfortable sex or wanting sex from a senior.

Reporting Abuse

• Abuse is always a crime
• Candian law states anyone must report when a suspect a child/ mental or physicaly disabled adult is being abused.
• Listen attentively, reassure the person
• You are protected from the authorities if the report is made witout malice

Reporting Process

• Suspect older-adult abuse in provinces and territories.
• All provinces and territories have laws for healthcare workers to report an abuse.
• Write down specific observations and details.
• Know employer's policies.
• When reporting name/address/phone number/age/gender and contact of the abuse of both parties.
• Have descriptions based suspicions and all evidence obtained only reporting facts and not opinions of statements.

Sources Reporting

• Call SAIL - Seniors Abuse and Information Line 604-437-1940 .
• Toll Free: 1-866-437-1940 available all week from 8am-8pm. Language interpreters available.
• All province-wide a confidential Abuse and Information Line (SAIL) of care workers available.

Abuse of Health Care Workers

• Abuse of health care workers comes from family, clients/dementia and employers.
• All abuse should me negated and rejected at will.
• Report to supervisors and authorities keeping written records.

Sexual Harassment in Workplace

• Could present itself off of sexual comments, gestures, threats, or suggestions and you should report it immediately to authorities.
• Report is no one offends, makes you uncomfortable form family and clients being harassed.
• Respond assertively, be polite, and tell them harassment is inappropriate. Be respectful.
• Documentation is needed, contact supervisors.
• Workplace sexual harassment is illegal: All employers require this policy

Aggressive Client Sexual Behaviours

• Are sexually explicit which may or may not be sexual, and the patient needs supervision.
• Client touch, masturbate, expose their selves without permission.
• Be professional-ask person not to touch you.
• Inform person you will not do what they want.
• Tell them those behaviours are unacceptable and uncomfortable.
• If you feel unsafe, leave the room or house.
• Discuss situation with nurse in charge

Dementia-Related Sexual Aggression Management

• • Inappropriate is behavior of all: management starts when and what is happening.
• Explain behaviours of others.
• Document as triggers and how it prevents inappropriate behaviours.
• Do not tempt any clothing removal.
• Contact physicians, or medical professionals.
• Connect with family members for support.