Reproductive Health PDF

Reproductive Health 1  Objectives ▪ Describe the various types of intimate and committed relationships ▪ Identify components of the male and female reproductive system ▪ Describe the menstrual cycle and human conception ▪ Compare and contrast the various types of birth con...

Reproductive Health 1  Objectives ▪ Describe the various types of intimate and committed relationships ▪ Identify components of the male and female reproductive system ▪ Describe the menstrual cycle and human conception ▪ Compare and contrast the various types of birth control 2  Relationships TIME As children, we first learn how to relate in our families Relationships change as we grow toward independence Relationships between friends change as they move or develop new interests Close relationships are tested and strengthened by time 3  Sex & Gender impact our experiences, relationships and health https://www.mdedge.com/psychiatry/article/2 https://orwh.od.nih.gov/sex-gender 62577/diversity-medicine/de-pathologizing- gender-identity-psychiatrys-role?reg=1 (biological) (cultural/personal) 4 https://orwh.od.nih.gov/sites/orwh/files/docs/ SexGenderInfographic_11x17_508.pdf 5  Sternberg’s Love Triangle: A Psychological View Consummate love has the 3 components of loving relationships Combinations of the 3 components give different types of relationships 6  Committed Relationships People yearn for an intense, supportive, exclusive relationship, based on mutual commitment that endures over time Types of relationships – Monogamy: commitment to a single partner – Open relationship: partners agree to sexual involvement with others outside – Polyamory: multiple individuals have intimate relationships with each other at the same time, with the knowledge and consent of everyone involved 7 Monogamy is a committed relationship with exclusive involvement between two partners. There are different ways of practicing monogamy: PHYSICAL EMOTIONAL SOCIAL an exclusive sets boundaries around the perception that being physical sexual emotional connections monogamous by others is experience with and affairs with others more important than one’s partner outside the primary actually practising relationship monogamous behaviour 8 Cohabitation is when two people live together as a couple, without official ties such as marriage. Legally assessed by: 1. Shelter, share accommodation 2. Behaviour, intimate interdependent relationship 3. Services, share traditionally functions of a family 4. Social, portray themselves as a couple to others 5. Societal, treated by others as a partnership 6. Children, interact parentally with each other’s children 9 Marriage is the lawful union of two persons to the exclusion of all others It is more common among Canadian adults than cohabitation (39% versus 9%, respectively) Crucial ingredients for commitment: ▪ shared values; ▪ a willingness to change in response to each other; ▪ a willingness to tolerate flaws; ▪ a match in religious beliefs and; ▪ the ability to communicate effectively 10  QUICK CHECK T/F: Romantic love involves commitment and passion T/F: In monogamous relationships two people have exclusive sexual relations with each other T/F: Sex refers to the roles and norms that are expected of people with XX and XY chromosomes 11  Female Reproductive System Functions to produce gametes (called eggs or ova) and required sex hormones, receive male gamete, maintain fertilized eggs as they develop into mature fetuses and deliver the fetus 12 Every menstrual cycle begins in the brain with the production of gonadotropin-releasing hormone (GnRH): 1. The hypothalamus causes the pituitary gland to release gonadotropins follicle stimulating hormone (FSH) and luteinizing hormone (LH) to stimulate the menstrual cycle. 2. FSH stimulates follicle development in the ovary; follicle produces estrogen while it matures; the high level of estrogen results in a surge of LH which causes the follicle to rupture, releasing an ovum (egg) into the fallopian tube (ovulation). 3. The ruptured follicle (corpus luteum) produces estrogen and progesterone which stimulates the lining of the uterus (endometrium) to become thicker in preparation for a fertilized egg. 4. If the egg is not fertilized, progesterone decreases and the endometrium is shed (menstruation); blood hormone levels drop and cycle begins again. 13 ovulation and menstrual cycle often called period|medical animationDandelionTeam #ovulation #period - YouTube Note that when blood levels of estrogen and progesterone are high, FSH and LH levels are low because these hormones inhibit the pituitary gland in the brain. Hormone contraceptions make use of this. 14  Male Reproductive System Functions to create, store, release and deliver the male sex cells for conception along with fluids to protect them and increase their chance surviving the female reproductive tract 15 Spermatogenesis (creation of sperm) starts at puberty. Sperm cells form in seminiferous tubules, stored in epididymis. 16 Conception= fertilization + implantation 1. Fertilization= Nuclei of sperm and egg cells merge forming a zygote; 2. Cleavage = zygote divides, fluid enters the ball of cells, and becomes known as a blastocyst. 3. Implantation = blastocyst burrows into the endometrium 17  QUICK CHECK T/F: Progesterone is responsible for maintaining the lining of the uterus. T/F: Conception is the fusion of the egg and sperm nuclei 18 Check out these videos Fertilization - YouTube from fertilization to childbirth | 3d medical animation | by Dandelion Team - YouTube 19 Birth Control Options 20  External condoms cover the erect penis and catch ejaculate; can be used for oral, vaginal, and anal sex. The three types include: LATEX POLYURETHANE NATURAL Most common type Used if one partner Protects against of condom used has a latex allergy pregnancy, not STIs Prevents pregnancy by keeping sperm away from vagina. 21  External condoms ▪ Easy to find and cheap to purchase ▪ Available over the counter without a prescription ADVANTAGES ▪ Can delay ejaculation, prolonging some kinds of sex ▪ Very effective at preventing STIs ▪ May break if improperly stored or used incorrectly DISADVANTAGES ▪ Applied before intercourse, reducing spontaneity ▪ May reduce sensitivity during intercourse ▪ Oil based products can cause condoms to break 22  Internal condoms are inserted into the vagina or rectum; can be used for oral, vaginal, and anal sex. Consist of two rings (one open and one closed) and a polyurethane sheath that loosely lines the vagina or rectum. One ring is anchored internally and the other rests externally at the vaginal or anal opening. Prevents pregnancy by keeping sperm away from vagina. 23  Internal condoms ▪ Available over the counter without a prescription ▪ One size condom can be used for all ADVANTAGES ▪ May be effective at preventing STIs ▪ Can be inserted up to 6 hours before intercourse ▪ Can be expensive and hard to find DISADVANTAGES ▪ May take time to get used to inserting and using 24  Combined hormonal birth control pills are oral contraceptive pills that are taken on a daily basis. Pills contain 2 hormones (estrogen and progestin); COMBINED take 21 days of active pills and 7 days of placebo pills. Monophasic: releases hormones at a constant level during cycle Multiphasic: releases hormones at different levels throughout the cycle Prevents pregnancy by thickening the cervical fluid, stopping the release of an egg, and thinning the lining of the uterus. https://www.youtube.com/watch?v=jIolmLbBiw0 25  Combined hormonal birth control pills ▪ Period may be more regular and lighter ▪ Can be used to skip or shorten periods ADVANTAGES ▪ Reduction in acne breakouts ▪ Decreased risk of ovarian and uterine cancer ▪ Must remember to take a pill every day DISADVANTAGES ▪ Rare but serious complications (e.g., blood clots) ▪ Not appropriate for those who cannot take estrogen ▪ Does not offer any protection against STIs 26  Progestin-only hormonal birth control pills are oral contraceptive pills that are taken on a daily basis. Pills contain 1 hormone (progestin); PROGESTIN-ONLY take 28 days of active pills and no placebo pills. Mini Pill: releases a lower dose of progestin during the cycle Prevents pregnancy by thickening the cervical fluid; may also stop the release of an egg in some users. 27  Progestin-only hormonal birth control pills ▪ Lighter or no periods (which is safe) ADVANTAGES ▪ Hormone related side-effects may be less ▪ A good choice for people who cannot use estrogen ▪ Must remember to take a pill every day DISADVANTAGES ▪ Irregular bleeding (spotting) is common ▪ Does not offer any protection against STIs 28  Vaginal ring is a clear, flexible, thin, plastic ring that is placed into the vagina for one cycle. Releases a low dose of the hormones estrogen and progestin into the surrounding tissue. Ring must be worn for at least 21 days, after that: ▪ take a ring-free break of no more than 7 days OR ▪ wear for 21 or 28 days and immediately insert a new ring Prevents pregnancy by thickening the cervical fluid, stopping the release of an egg, and thinning the lining of the uterus. https://www.youtube.com/watch?v=p_WkTKrYRD8 29  Vaginal ring ▪ Period may be more regular and lighter ▪ Can be used to skip or shorten periods ADVANTAGES ▪ Reduction in acne breakouts ▪ Decreased risk of ovarian and uterine cancer ▪ Must remember to remove and replace every month ▪ Rare but serious complications (e.g., blood clots) DISADVANTAGES ▪ Not appropriate for those who cannot take estrogen ▪ Does not offer any protection against STIs 30  Birth control patch sticks to clean, dry, lotion-free skin on lower belly, upper arm, buttocks, or back. Contains the hormones estrogen and progestin that are absorbed through the skin (transdermal). Each patch is worn for 7 days (total 21 days), after that: ▪ take a patch-free break of no more than 7 days OR ▪ remove and immediately apply a new patch Prevents pregnancy by thickening the cervical fluid, stopping the release of an egg, and thinning the lining of the uterus. 31  Birth control patch ▪ Period may be more regular and lighter ▪ Can be used to skip or shorten periods ADVANTAGES ▪ Reduction in acne breakouts ▪ Decreased risk of ovarian and uterine cancer ▪ Must remember to change the patch every week DISADVANTAGES ▪ Rare but serious complications (e.g., blood clots) ▪ Not appropriate for those who cannot take estrogen ▪ Does not offer any protection against STIs 32  Birth control shot is a long-acting injectable option; injection is repeated approximately every 3 months. One example is Depo-Provera Contains only the hormone progestin; no estrogen. Very effective method of birth control, but a person must visit the clinic every 11-14 weeks to get the next shot. Prevents pregnancy by thickening the cervical fluid; may also stop the release of an egg in some users. 33  Birth control shot ▪ Lighter or no periods (which is safe) ▪ Only need to remember to get the shot every 3 months ADVANTAGES ▪ No one can interfere with its effectiveness ▪ A good choice for people who cannot use estrogen ▪ Must plan to return to clinic every 3 months ▪ Irregular bleeding (spotting) is common in initial use DISADVANTAGES ▪ May be a delay (average 9 months) in fertility ▪ Does not offer any protection against STIs 34  Intrauterine Device (IUD) is a small piece of flexible plastic shaped like a T and inserted into the uterus. Inserted by a healthcare provider; can stay in IUD place for up to 3-10 years (depending on type). Copper IUD: wrapped with copper, does not contain hormones Progestin IUD: releases only progestin into the surrounding tissue Prevents pregnancy by thickening the cervical fluid; may also stop the release of an egg in some users (progestin IUD); natural spermicide (copper IUD). https://www.youtube.com/watch?v=Aomv80RexVo 35  Intrauterine Device (IUD) ▪ Stays in place, no need to remember anything ADVANTAGES ▪ No one can interfere with its effectiveness ▪ Fertility quickly returns after removal ▪ Requires a pelvic exam and procedure to insert/remove DISADVANTAGES ▪ Expensive if not covered by extended health insurance ▪ Does not offer any protection against STIs 36  Fertility Awareness Methods are a combination of practices used to determine when pregnancy is likely. The three types include: CERVICAL-MUCUS CALENDAR BASAL BODY METHOD METHOD TEMPERATURE Observe changes to the Count days after Measure change in vaginal mucus to period begins to body temperature to estimate ovulation. estimate ovulation. estimate ovulation. Prevents pregnancy by abstaining or using other methods during ovulation. How Do Fertility Awareness-Based Methods Prevent Pregnancy? - YouTube 37  Fertility Awareness Methods ▪ Inexpensive, no health risks ADVANTAGES ▪ Convenient (no devices or hormones) ▪ May fit with faith-based or cultural values ▪ High failure rate, difficult to predict ovulation DISADVANTAGES ▪ Decreases spontaneous sexual intercourse ▪ Does not offer any protection against STIs 38  Sterilization is a surgical procedure performed by a doctor to permanently prevent pregnancy. Meant to be permanent and will end a STERILIZATION person’s reproductive capability. Vasectomy: sperm stay in testicles and are absorbed by the body Tubal Ligation: sperm cannot reach the egg in the fallopian tube Prevents pregnancy by permanently closing or blocking the fallopian tubes (tubal ligation) or cutting or blocking the vas deference (vasectomy). 39  Sterilization ▪ Very effective and convenient ADVANTAGES ▪ No hormones involved ▪ Allows for spontaneity ▪ Is permanent DISADVANTAGES ▪ Pain and discomfort during and after procedure ▪ Does not offer any protection against STIs 40 Emergency Contraception can be used AFTER unprotected vaginal-penile intercourse to reduce chance of pregnancy. Examples: ▪ When sex occurred without a reliable birth control method ▪ If birth control fails (e.g., condom breaks, pills missed) Types of Emergency Contraception: Combined Copper IUD Plan B Ella Hormonal Pills https://www.youtube.com/watch?v=zN8fEakox5I 41 42