Reproductive health is about the reproductive systems of men and women. It also discusses sexuality, reproduction and childbearing. It also implies that people are able to have satisfying and safe sex life and that they have the capability to reproduce and freedom t decide if, when and how often to do so. The idea of procreation and reproduction f the men and women are some of the concerns of reproductive health education. It is the couple's right to exercise their responsibility, that is, they should decide when and how t practices their reproductive right. In reproductive health a woman is assured of access to appropriate health information and services t enable her to go through pregnancy and childbirth safely. It also provides protection from women from unwanted pregnancy by having access to safe and acceptable methods f family planning of their choice, protection from harmful reproductive practices and violence and lastly, access to information on sexuality.
What is Reproductive Health?
According to World Health Organization, Reproductive Health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system and t its functions and process.
It is the goal of reproductive health to assist individual and couples t:
• Achieve healthy sexual development and maturation
• Achieve their reproductive intention
• Avoid illness, injuries and disabilities related t sexuality and reproduction.
Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life.[1] Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. According to the WHO, "Reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men."
Dimensions of Reproductive Health
Male
Process of Ejaculation
In the male reproductive system the testes are the one producing the male sex cells called sperms. Which are about 50 Million every 24 hours in a young healthy man. The testes are located in the scrotum. If the sperms are aged enough , it is now stored at the epididymis. Before leaving the body, the sperm moves through the vas deferens to the prostate gland which releases fluids to nourish the sperms. Before passing to the urethra the seminal vesicle and ejaculatory duct releases fluids which empty the urethral canal f the penis. After this the sperm now travel through the urethra and out f the penis.
Female
Process of Ovulation
An ovary about to release an egg.
When the egg has nearly matured, the level of estradiol in the body has increased enough to trigger a sudden release of luteinizing hormone (LH) from the anterior pituitary gland.In the average cycle this LH surge starts around cycle day 12 and may last 48 hours. The release of LH matures the egg and weakens the wall of the follicle in the ovary, causing the fully developed follicle to release its secondary oocyte. The secondary oocyte promptly matures into an ootid and then becomes a mature ovum. The mature ovum is the largest cell of the body, with a diameter of between 0.1 and 0.2 mm. Which of the two ovaries--left or right--ovulates appears essentially random; no known left/right co-ordination exists. Occasionally, both ovaries will release an egg; if both eggs are fertilized, the result is fraternal twins. After being released from the ovary, the egg is swept into the fallopian tube by the fimbria, which is a fringe of tissue at the end of each fallopian tube. After about a day, an unfertilized egg will disintegrate or dissolve in the fallopian tube. Fertilization by a spermatozoon, when it occurs, usually takes place well inside the fallopian tubes. An egg that is fertilized immediately begins the process of embryogenesis, or development. The developing embryo takes about three days to reach the uterus and another three days to implant into the endometrium. It has usually reached the blastocyst stage at the time of implantation. In some women, ovulation features a characteristic pain called mittelschmerz (German term meaning middle pain), which may last a few hours. The sudden change in hormones at the time of ovulation also causes light mid-cycle blood flow from the vagina of some women.
Human fertilization is the union of a human egg and sperm, usually occurring in the ampulla of the fallopian tube. It is also the initiation of prenatal development. Fertilization constitutes the penetration of the oocyte (egg) which the sperm performs, fusion of the sperm and oocyte, succeeded by fusion of their genetic material
Penetration
Fertilization starts with a man and a woman initiating sexual intercourse. The man inserts the penis into the womans vagina, penetrating her vaginally. When the man experiences orgasm, a single sperm may penetrate the cell membrane of the oocyte. To reach the oocyte, the sperm must pass through the corona radiata and the zona pellucida; two layers covering and protecting the oocyte from fertilization by more than one sperm.
Corona radiata
The sperm passes through the corona radiata, a layer of follicle cells on the outside of the secondary oocyte.
Acrosome reaction
The acrosome reaction must occur to mobilise enzymes within the head of the spermatozoon to degrade the zona pellucida.
Zona pellucida
The sperm then reaches the zona pellucida, which is an extra-cellular matrix of glyco-proteins. A special complementary molecule on the surface of the sperm head then binds to a ZP3 glyco-protein in the zona pellucida. This binding triggers the acrosome to burst, releasing enzymes that help the sperm get through the zona pellucida.
Some sperm cells consume their acrosome prematurely on the surface of the egg cell, facilitating for surrounding, having on average 50% genome similarity, to penetrate the egg cell.[1] It may be regarded as a mechanism of kin selection.
Cortical reaction
When the sperm penetrates the zona pellucida, the cortical reaction occurs: cortical granules inside the secondary oocyte fuses with the plasma membrane of the cell, causing enzymes inside these granules to be expelled by exocytosis to the zona pellucida. This in turn causes the glyco-proteins in the zona pellucida to cross-link with each other, making the whole matrix hard and impermeable to sperm. This prevents fertilization of an egg by more than one sperm.
Fusion
The sperm fuses with the oocyte, enabling fusion of their genetic material, in turn.
Cell membranes
The cell membranes of the secondary oocyte and sperm fuse together.
Transformations
Both the oocyte and the sperm go through transformations, as a reaction to the fusion of cell membranes, preparing for the fusion of their genetic material.
The oocyte now completes its second meiotic division. This results in a mature ovum. The nucleus of the oocyte is called a pronucleus in this process, to distinguish it from the nuclei that are the result of fertilization.
The sperm's tail and mitochondria degenerate with the formation of the male pronucleus. This is why all mitochondria in humans are of maternal origin.
Replication
The pronuclei migrate toward the center of the oocyte, rapidly replicating their DNA as they do so to prepare the new human for its first mitotic division.
Mitosis
The male and female pronuclei don't fuse, although their genetic material do so. Instead, their membranes dissolve, leaving no barriers between the male and female chromosomes. During this dissolution, a mitotic spindle forms around them to catch the chromosomes before they get lost in the egg cytoplasm. By subsequently performing a mitosis (which includes pulling of chromatids towards centrosomes in anaphase) the cell gathers genetic material from the male and female together. Thus, the first mitosis of the union of sperm and oocyte is the actual fusion of their chromosomes.
Each of the two daughter cells resulting from that mitosis have one replica of each chromatid that was replicated in the previous stage. Thus, they are genetically identical.
In other words, the sperm and oocyte don't fuse into one cell, but into two identical cells.
Care and Issues of Reproductive Health
Family planning is frequently used to mean that people plan when to have children, using birth control and other techniques to implement that plan. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, preconception counseling[3] and management, and infertility management. Family planning is sometimes used as a synonym for the use of birth control, though it often includes more. It is most usually applied to the circumstance of a monogamous female-male couple who wish to limit the number of children they have and/or to control the timing of pregnancy (also known as spacing children)
Planning for Health
Waiting until mother is at least 18 years old before trying to have children improves maternal and child health. If additional children are desired, it is healthier for both the mother and child to wait at least 2 years after the previous birth before attempting to conceive (but not more than 5 years) After a miscarriage or abortion, it is healthier to wait at least 6 months.
Birth Control
Abstinence
Effectiveness (chances of NOT getting pregnant): 100%
What is Abstinence?
Refraining from vaginal, anal, or oral intercourse.
Advantages of Abstinence:
• No risk of unintended pregnancy.
• No risk of becoming infected with a sexually transmitted disease.
• Opportunities to express feelings and affection for another in other ways.
Disadvantages of Abstinence:
• Both partners must agree to honor this choice.
• Partners must have excellent communication skills; yes must mean yes and no must mean no.
• May need emergency contraceptive method if this method fails.
How do I decide?
• Are you comfortable expressing your feelings for another in nonsexual ways?
• Is your partner in agreement?
• Does this method fit with your religious or moral beliefs?
• Is abstinence the best decision for you?
• Do you want to discuss this method with your clinician, family planning clinic staff, husband, partner, friend, or family member?
Cervical Cap
Effectiveness (chances of NOT getting pregnant): 60-90 %
What is the cervical cap?
• It is a barrier contraceptive method.
• A soft rubber cup like device that fits snuggly around the base of the cervix.
• It is used with spermicide for prolonged and additional pregnancy prevention.
What are the advantages of the cervical cap?
• Simple to use.
• No serious side effects.
• Does not require partner involvement.
• Good for persons who do not have sex on a regular basis.
• May decrease risks of some sexually transmitted diseases.
• Provides contraceptive protection for up to 48 hours, no matter how many times
lovemaking occurs.
• Does not interrupt lovemaking.
• Does not interfere with breast-feeding.
What are the disadvantages of the cervical cap?
• Consistent and correct use is required to prevent pregnancy.
• Persons with allergies to latex or spermicides cannot use.
• Remains in vagina for at least 6 hours after intercourse.
• Possible risk of Toxic Shock Syndrome, if worn longer than 48 hours.
• May experience vaginal odor with prolonged use.
How Do I Decide?
• Are you comfortable inserting a medical device into your vagina?
• Do you have sex frequently (more than three times weekly)? If so, you may want to use another method.
• Are you sensitive or allergic to latex or spermicidal products?
• Does this method fit with your religious or moral beliefs?
• Is the cervical cap the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff, husband, partner, friend, or family member?
Condom (Male)
Effectiveness (chances of NOT getting pregnant): 86 - 97%
What is a male condom?
• Made out of latex (rubber), but polyurethane and tactylon (both plastic) are available.
• Over the counter barrier method of birth control.
Advantages of the male condom:
• Easy to get and relatively inexpensive.
• Can be discontinued at any time.
• Provides some protection from sexually transmitted diseases and HIV.
• Reliable method for people who cannot use hormonal birth control methods.
• Responsibility of both partners.
• Can be purchased without a prescription.
• Does not interfere with breast-feeding.
Disadvantages of the male condom; you may experience the following:
• Non-cooperative partner.
• Some irritation or sensitivity to latex.
• Difficulty using condoms correctly.
• Must use a new condom with every sex act.
• Some men say it reduces sexual feelings.
• Must be rolled onto an erect penis before sexual intercourse, can interrupt foreplay.
• Spillage or leaking of sperm is possible if condom is put on or removed incorrectly.
How Should I decide?
• Will you remember to use it every time you have sex?
• Will your partner be cooperative in the use of this method?
• Can you or your partner maintain an erection?
• Does this method fit with your religious or moral beliefs?
• Is the condom the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
partner, friend, or family member?
Depo-Provera ("The Shot")
Effectiveness (chances of NOT getting pregnant): More than 99%
What is Depo-Provera?
• It is an injection given every 3 months.
• It contains synthetic progesterone.
• It stops ovulation, and/or thickens the cervical mucus to prevent sperm from passing through.
• It is a reversible method of birth control given only by prescription.
Advantages of Depo-Provera:
• Does not interfere with sex.
• Only need to get a shot 4 times a year.
• May stop menses or make them very light.
• Excellent alternative for women 35 and older who smoke.
• Reduces the risk of ovarian and endometrial cancer.
Disadvantages of Depo-Provera:
• Irregular or unpredictable bleeding or spotting.
• Possible hair loss.
• Weight gain, especially right after pregnancy.
• It may delay your chances of getting pregnant after the shots are stopped. It can take between six and eighteen months for menstruation and ovulation to return consistently. This does not mean that you are protected from pregnancy during this time. Use alternate protection, such as condoms.
• Does not protect against sexually transmitted diseases (see warning below).
• You must go to the clinic or doctor's office 4 times a year.
How Do I Decide?
• Is getting a shot a problem for you?
• Do you have any medical problems that will prevent you from taking Depo-Provera?
• Do you have liver disease, breast cancer or blood clots in your arms, legs or lungs?
• Do you have sex frequently or not very often, if not very often do you want extra
hormones in your body all the time?
• Does this method fit with your religious, or moral beliefs?
• Is the Depo-Provera shot the best decision for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
Diaphragm
Effectiveness (chances of NOT getting pregnant): 80-94% (during first year of use and whether or not you have delivered a child)
What is a diaphragm?
• Barrier type birth control method prescribed by your family planning clinician.
• A dome shaped rubber cup with flexible rim that covers the cervix and is inserted into the vagina before intercourse.
• Used in combination with spermicidal jelly or cream.
Advantages of the diaphragm:
• Simple to use.
• No serious systemic side effects.
• Does not require partner involvement.
• Good for persons who do not have sex on a regular basis.
• Decreases risk of some sexually transmitted diseases.
• Does not interrupt lovemaking.
• Decreases risk of cervical cancer.
• Does not interfere with breast-feeding.
Disadvantages of the diaphragm:
• Consistent and correct use is required to prevent pregnancy.
• Persons with allergies to latex or spermicides cannot use.
• Increased risks for developing urinary tract infections (UTI's).
• Remains in vagina for at least 6 hours after intercourse.
• Repeated sexual intercourse requires additional spermicide.
• Must remove within 24 hours to avoid risk of toxic shock syndrome (TSS).
• Must replace diaphragm every two years.
How Do I Decide?
• Are you comfortable touching your vagina?
• Are you comfortable inserting a medical device into your vagina?
• Do you have sex frequently (more than three times weekly)? If so you may want to use another method.
• Are you sensitive or allergic to latex or spermicidal products?
• Does this method fit with your religious or moral beliefs?
• Is the diaphragm the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
ECP or Emergency Contraceptive Pills
Effectiveness (chance of NOT getting pregnant): 74 % - 89%
What is the ECP or Emergency Contraceptive Pills?
• An emergency contraceptive method used after sexual intercourse to prevent pregnancy.
• Is most effective when used within 12 hours of unprotected intercourse or contraceptive accident.
• ECP can be used up to 72 hours or three days after unprotected sex.
• ECP only works if a woman is not already pregnant.
• Interferes with egg development.
• Prevents or delays ovulation.
• Inhibits fertilization.
Advantages of ECP or Emergency Contraceptive Pills:
• Only method of contraception used to prevent pregnancy after unprotected sex.
• Only method used to prevent pregnancy after male condom slipped, broke, or leaked.
• Only method used to prevent pregnancy after a woman's diaphragm or cervical cap was inserted incorrectly, removed too early, or found to be torn.
• Only method used to prevent pregnancy after a woman has missed one or more of oral contraceptives.
• Only method used to prevent pregnancy when a female condom was inserted or
removed incorrectly.
• Method may be obtained ahead of time from a family planning clinician to be used when needed. Plan B, a brand name for ECP, is also available at a pharmacy. Women and men who are 18 or older can now purchase Plan B over the counter with proof of age. In most states, including Pennsylvania, women 17 or under will still need a prescription from a clinician for Plan B or other ECP methods.
Disadvantages of ECP or Emergency Contraceptive Pills:
• Does not work if already pregnant.
• Limited time frame (ECP must be used within 72 hours or three days after unprotected sex). Is not an ongoing method of contraception.
• Nausea occurs in 23% to 50 % of women who use this method (medications to prevent nausea are available).
• Vomiting occurs in 5 to 25% of women who use this method (medications to prevent vomiting are available).
• Ectopic (tubal) pregnancy may be a possible result.
• ECP changes the amount, duration, and timing of the next menstrual period in about 10 to 15% of women treated.
• There is still a chance of pregnancy. If menstrual cycle does not start in 7 days, consider pregnancy and contact your family planning clinician.
• Does not provide protection from sexually transmitted diseases.
How do I decide?
• Do you want to be pregnant?
• Do you understand that there is a possibility of pregnancy after taking ECP?
• Do you have unprotected sex frequently?
• Is 72 hours enough time for you to make a decision and get ECP?
• Does this method fit with your religious or moral beliefs?
• Do you want to discuss this method with your clinician, family planning clinic staff, husband, partner, friend, or family member?
Female Condom
Effectiveness (chances of NOT getting pregnant): 79% - 95%
What is the female condom?
• Over the counter barrier method of birth control.
• It is polyurethane (plastic) sheath with an inner ring that fits inside the vagina, around the cervix (like the diaphragm) and an outer ring that covers the outside labia.
• After the man ejaculates, you must twist the end closed and gently pull from the vagina.
Advantages of the female condoms:
• Can be inserted into the vagina up to eight hours before sexual intercourse.
• Can be used with spermicides to increase STD protection.
• Provides protection against some sexually transmitted diseases and HIV.
• Can be used by people allergic to latex or spermicides or by those who can't take
hormones.
• Made from polyurethane plastic, which conducts body heat.
• Erection unnecessary to keep female condom in place.
• Some women and men have an increased sensitivity or "natural" feel compared to
male condoms.
• Can be purchased without a prescription.
• Does not interfere with breast-feeding.
Disadvantages of the female condoms:
You may experience the following:
• Difficulty inserting and/or keeping in place.
• Cannot be combined with male condoms as they pull each other off.
• May be noisy (add more lubricant if this is a problem).
• May irritate vagina or penis.
• More expensive than male latex condoms.
• Must be used every time you have sex.
• After the man ejaculates, you must twist the end close and gently pull from the vagina.
How do I decide?
• Are you comfortable touching your vaginal area?
• Will you remember to use it every time you have sex?
• Does this method fit with your religious or moral beliefs?
• Is the female condom the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff, husband, partner, friend, or family member?
Female Sterilization
Effectiveness (chances of NOT getting pregnant): More than 99%
What is female sterilization?
A surgical intervention that mechanically blocks the fallopian tube to prevent the sperm
and egg from uniting.
Advantages of female sterilization:
• Very reliable and effective method of contraception.
• Permanent method.
• No long term side effects.
• Does not interrupt lovemaking.
• Does not require partner involvement.
• Nothing to remember or buy.
• Does not interfere with breast-feeding.
Disadvantages of female sterilization:
• Permanent method.
• Difficult and expensive to reverse surgical procedure.
• Requires skilled surgeon to perform procedure.
• Expensive procedure.
• Possible ectopic (tubal) pregnancy if method fails.
• No protection against sexually transmitted diseases.
How do I decide?
• Are you sure you do not want any more children?
• Are you willing to have an operation to prevent pregnancy?
• Have you considered other methods?
• Does this method fit with your religious or moral beliefs?
• Your decision for female sterilization should be what is best for you.
• Do you want to discuss this method with your clinician, family planning clinic staff, husband, partner, friend, or family member?
Intrauterine Device ("IUD")
Effectiveness (chances of NOT getting pregnant): 98% - 99%
What is an IUD?
• Small plastic device which is placed in the uterus by a clinician.
• Prevents sperm from fertilizing egg.
• Some contain synthetic progesterone others have copper on them.
• It is a reversible method of birth control given only by prescription.
Advantages of the IUD:
• Easy to use, low maintenance method.
• Easily inserted and removed in a clinic or doctor's office.
• Has no systemic side effects.
• Depending on the type they can be left in place 1, 5, or 10 years.
• Reduces the risk of tubal pregnancy.
• Does not interfere with breast-feeding.
Disadvantages of the IUD:
• Must be inserted and removed in a clinic or doctor's office.
• Easily inserted and removed in a clinic or doctor's office.
• May be some cramping or pain at the time of insertion.
• May experience increased bleeding or cramping during periods.
• May experience spotting between periods.
• Should not be used by women with multiple sex partners because this increases
exposure to STD's, which significantly increases the risk of pelvic inflammatory
disease (PID).
How do I decide?
• Does this method fit with your religious or moral beliefs?
• Do you have sex frequently? (The IUD functions 24 hours a day.)
• Decide if it fits your birth control needs.
• Is the IUD the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
Norplant
Effectiveness (chances of NOT getting pregnant): More than 99%
What is Norplant?
• Six capsules containing synthetic hormones inserted under the skin of your upper arm.
• Capsules slowly release hormones into the bloodstream over a 5-year period.
• These hormones stop the ovaries from releasing an egg each month.
• Hormones also thicken mucus in the cervix (opening to the uterus), stopping sperm from entering it.
• Reversible method of birth control.
Advantages of Norplant:
• Long term method can stay in for 5 years.
• After 12 to 18 months of using this method, periods usually stop.
• Can be removed anytime, and the woman can become pregnant right away.
• Does not interfere with sex.
• Reduces risk of ovarian or endometrial cancer.
Disadvantages of Norplant:
• You may experience spotting between periods, light periods, longer periods, or no
periods.
• You may experience weight gain and hair loss.
• It is expensive anywhere between $500 and $700 depending on where you go (at a Title X Federally supported family planning clinic fees are based on family size and income, so fees could range from $0 to $700).
• It requires minor surgery for insertion and removal of the capsules (done in the clinic or doctor's office).
• Effectiveness is lowered by most antiseizure medications.
How do I decide?
• Is having a small scar and having the capsules in your body a problem for you?
• Do you have any medical problems such as breast cancer, liver, or heart disease that will prevent you from using this method?
• Does this method fit with your religious or moral beliefs?
• Do you have sex frequently or not very often? If not very often, do you want extrahormones in your body all the time?
• Is the Norplant method best for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
NuvaRing ("The Ring")
Effectiveness
• 99% chance of NOT getting pregnant
• Less than 1 per 1000 woman may become pregnant if method is not used as prescribed.
What is the NuvaRing?
• The NuvaRing is a comfortable, flexible contraceptive ring that is about two inches in diameter and contains synthetic low dose hormones (progestin and estrogen); these hormones are similar to those produced by a women's body.
• The NuvaRing is placed directly into the vagina; hormones are released from the ring and are directly absorbed through the walls of the vagina then distributed into the bloodstream.
• Pregnancy is prevented because the ring prevents the ovaries from producing mature eggs.
• The ring is a reversible method of birth control available only by prescription.
Advantages of NuvaRing
• Does not interfere with sex. Ability to remove the ring at leisure.
• No need to remember to put it on daily/weekly. Month long protection (3 weeks in, 1 week out)
• Exact positioning of the NuvaRing is not critical; however the ring should be placed high in the vault of the vagina.
• Muscles within the vagina allow the ring to stay in place during sex and/or exercise.
• Reduces menstrual flow and cramping.
• Decreases acne outbreaks.
• Reduces the risk of ovarian and endometrial cancer.
• Ability to become pregnant immediately after discontinued use, if seeking pregnancy.
Disadvantages of NuvaRing
• Not a good choice if patient is uncomfortable with touching herself.
• Increased risk of heart attack, stroke, or blood clots (in lungs, legs, or arms), especially if you smoke more than 15 cigarettes a day, or are over 35 and smoke.
• Patient may experience vagina discomfort and discharge.
• If the ring is kept out of the vagina longer than 3 hours on any day during the 21 day period (3weeks) pregnancy can occur; therefore a back-up method (condoms) is recommended for 7 days.
• Does not prevent sexually transmitted diseases (see warning below).
How Do I Decide?
• Are you comfortable touching your genitalia to place and remove the ring?
• Are you smoking more than 15 cigarettes a day? If yes this method may not be good for you.
• Do you have liver disease, breast cancer and/or blood clots in lungs, legs, or arms?
• Are you taking any medications that may interfere with the effectiveness of the ring? (Consult with a clinician)
• Does this method fit with your religious or moral beliefs?
Ortho Evra ("The Patch")
Effectiveness
• 95% - 99% chance of NOT getting pregnant
• Between 1 and 5 per 100 women may become pregnant if method is not used as prescribed.
What is the Patch?
• The Patch contains synthetic hormones (progesterone and estrogen); these hormones are similar to those produced by a women's body.
• The patch is placed directly on the skin; these hormones are released from the patch directly through the skin into the bloodstream.
• Pregnancy is prevented because the patch stops ovulation and/or thickens the cervical mucus and stops sperm from passing through.
• The patch is a reversible method of birth control available only by prescription.
• The patch is less effective in women weighting more than 198lbs.
Advantages of the Patch
• Does not interfere with sex.
• No need to remember to put it on daily. Apply a new patch once a week.
• Reduces menstrual flow and cramping.
• Decreases acne outbreaks.
• Reduces the risk of ovarian and endometrial cancer.
• Ability to become pregnant immediately after discontinued use, if seeking pregnancy.
Disadvantages of the Patch
• May cause slight skin irritation at the patch site.
• Increased risk of heart attack, stroke, or blood clots (in lungs, legs, or arms), especially if you smoke more than 15 cigarettes a day, or are over 35 and smoke.
• Possible mood swings or depression.
• Women are encouraged not to use creams, lotions, or oils near the patch site these agents may cause the patch to detach.
• Does not prevent sexually transmitted diseases (see warning below).
"Recent news stories overstate the blood clot risk from the Ortho Evra contraceptive patch, experts tell WebMD."
How Do I Decide?
• Can you remember to put on a new patch once a week?
• Are you smoking more than 15 cigarettes a day? If yes this method may not be good for you.
• Do you have liver disease, breast cancer and/or blood clots in lungs, legs, or arms?
• Does this method fit with your religious or moral beliefs?
Oral Contraceptives ("The Pill")
Effectiveness (chances of NOT getting pregnant): 95% - 99% (1-5 in 1000 women become pregnant during their first year of using the pill)
What is the Pill?
• Synthetic hormones (progesterone and/or estrogen) like those produced by the body to regulate the menstrual cycle.
• Pregnancy is prevented because the pill stops ovulation and/or thickens the cervical
mucus by stopping sperm from passing through.
• Reversible method of birth control given only by prescription.
Advantages of the Pill:
• Doesn't interfere with sex.
• Regulates the menstrual cycle.
• Reduces menstrual flow and cramping.
• Decreases acne outbreaks.
• Reduces the risk of ovarian and endometrial cancer.
• Most popular method used.
Disadvantages of the Pill:
• Must be taken every day at the same time each day.
• Increased risk of heart attack, stroke, or blood clots (in lungs, legs, or arms), especially if you smoke more than 10 cigarettes a day, or are over 35 and smoke.
• Possible mood swings or depression.
• May decrease sexual desire.
• Can not be used if you are 35 or older and smoke.
• Does not prevent sexually transmitted diseases (see warning below).
How do I decide?
• Can you remember to take a pill every day?
• Do you have sex frequently or not very often?If not very often, do you want to take a pill every day?
• Are there some medical problems that prevent you from taking the pill?
• Do you have liver disease, breast cancer and/or blood clots in lungs, legs, or arms?
• Does this method fit with your religious or moral beliefs?
• Is the pill the best method for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
Vaginal Spermicides
Effectiveness (chances of NOT getting pregnant): 50-95% (among typical users in the first year of use)
What are vaginal spermicides?
• A chemical birth control method that kills sperm and prevents pregnancy.
• Comes in the form of gel, foam, cream, film, suppository, or tablet.
Advantages of vaginal spermicides:
• A relatively safe contraceptive method when combined with the use of a barrier method (condom, diaphragm, cervical cap).
• May lower the chance of becoming infected with a bacterial sexually transmitted disease.
• Can be purchased without prescription.
• Depending on the amount purchased is relatively inexpensive.
• Immediate protection is available.
• Good method for persons who have sexual intercourse infrequently or not very often.
• Simple back up method for women waiting to start the pill or have an IUD inserted, or for forgetting to take pill or running out of pills.
• Provides lubrication during intercourse especially with condom use.
• Male partner does not need to be involved in decision to use product.
• Does not interfere with breast feeding.
Disadvantages of vaginal spermicides:
• Allergic reactions or hypersensitivity to ingredients may occur.
• Some persons may have difficulty inserting properly.
• Abnormal vaginal anatomy (e.g. prolapsed uterus) may interfere with proper insertion.
• Poor protection from HIV exposure.
How do I decide?
• Are you sensitive or allergic to ingredients in product?
• Do you have sexual intercourse infrequently? This may a good choice for you.
• Are you comfortable touching your vagina?
• Do you want to use vaginal spermicides as a backup?
• Does this method fit with your religious or moral beliefs?
• Your decision should be what is best for you.
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member?
Vasectomy (Male Sterilization)
Effectiveness (chances of NOT getting pregnant): 99% or more
What is a Vasectomy?
A surgical procedure that prevents pregnancy by blocking the passage of sperm into the
ejaculated seminal fluid (cum).
Advantages of Vasectomy:
• Permanent method of contraceptive.
• Highly effective method.
• Very safe surgical procedure.
• Removes the responsibility of contraception from the woman.
• No significant long term side effects.
• Does not interrupt lovemaking.
• Highly acceptable method.
• A no scalpel Vasectomy is also available.
Disadvantages of Vasectomy:
• Protection for the male only (females are at risk for pregnancy).
• Usually irreversible.
• Requires skilled medical personnel.
• Lack of protection from sexually transmitted diseases and infections, including HIV.
• Initial cost may be expensive, some times considered an elective procedure, and
requires self-pay. However, the long term cost benefits are great.
• Although unproven, serious long-term effects are possible.
How do I decide?
• Are you sure you do not want any more children?
• Can you tolerate a surgical procedure?
• Can you afford the procedure?
• Have other methods been considered?
• Does this method fit your religious or moral beliefs?
• Is a Vasectomy the best decision for you?
• Do you want to discuss this method with your clinician, family planning clinic staff,
partner, friend, or family member?
Withdrawal (Coitus Interruptus)
Effectiveness (chance of NOT getting pregnant): 4% to 19%
What is Withdrawal?
• A contraceptive method that prevents fertilization by preventing the contact between the sperm and egg.
• Couple engages in penile-vaginal intercourse until ejaculation is about to occur.
• The male partner withdraws his penis from the vagina and away from the external
genitalia of the female partner.
Advantages of Withdrawal:
• Costs nothing.
• Requires no devices.
• Involves no chemicals.
• Available in any situation.
Disadvantages of Withdrawal:
• Chances of getting pregnant with this method are much higher than with any other
method.
• Some men have difficulty telling when they will ejaculate.
• Some men may not withdraw in sufficient time.
• Interruption of the excitement or plateau phase of the sexual response cycle may
decrease pleasurable experience.
• High risk of contracting sexually transmitted diseases and infections.
How do I decide?
• Is the risk of getting pregnant too large?
• What about the risk of contracting a sexually transmitted disease?
• Does the method fit with your religious or moral beliefs?
• Do you want to discuss this method with your clinician, family planning clinic staff,
husband, partner, friend, or family member
Sexually transmitted disease (STD) or venereal disease (VD), is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal intercourse, oral sex, and anal sex. Increasingly, the term sexually transmitted infection (STI) is used, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via use of an IV drug needle after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of years.
Sexual abuse, also referred to as molestation, is the forcing of undesired sexual acts by one person upon another. The offender is referred to as a molester/molestor/abuser/sexual abuser. When the victim is younger than the age of consent, it is referred to as child sexual abuse. Types of sexual abuse include:
• Non-consensual, forced physical sexual behavior such as rape or sexual assault
• The use of a position of trust to compel non-consensual sexual behavior without physical force
• Incest, when it is coerced by force or emotional manipulation; the euphemism "bad touch" is sometimes used to describe such abuse. [
Spousal abuse is the term applied to the specific form of domestic violence, where physical or sexual abuse is perpetrated by one spouse upon another. Frequently this involves forced sex (spousal rape) upon a spouse without his or her consent. Spousal abuse is inclusive of sexual abuse toward spouses (spousal sexual abuse).
Occupational misconduct
Sexual misconduct in occupational and educational settings can occur where one person makes use of their position of authority in order to compel compliance. A university student may feel compelled to comply with a professor's sexual advances for fear of being given a failing grade. Or an employee may likewise be coerced in exchange for not being terminated.
Sexual abuse of children/minors
Child sexual abuse refers to sexual abuse of a child (see also: minor) by an adult, or some other person significantly older or in a position of power or control over the child, where the child is used for sexual stimulation of another person. Studies of the effects of child sexual abuse often define it as including invitations or requests in addition to actual actions, with regard to any sexual interactions between adult and child, from kissing or hugging to completed intercourse, and all other related activities.
Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that can lead to acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV). Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unprotected sexual intercourse, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth. Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world. HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. It is estimated that about 0.6 percent of the world's population is infected with HIV.[3][dated info] In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty.[4] According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries. HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. Eventually most HIV-infected individuals develop AIDS (Acquired Immunodeficiency Syndrome). These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. Without treatment, about 9 out of every 10 persons with HIV will progress to AIDS after 10-15 years. Many progress much sooner. Treatment with anti-retrovirals increases the life expectancy of people infected with HIV. Even after HIV has progressed to diagnosable AIDS, the average survival time with antiretroviral therapy (as of 2005) is estimated to be more than 5 years. Without antiretroviral therapy, death normally occurs within a year. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of the general public.
Adolescent sexuality refers to sexual feelings, behavior and development in adolescents and is a stage of human sexuality. Sexuality is a vital aspect of teens' lives.[1] The sexual behavior of adolescents is, in most cases, influenced by their culture's norms and mores, their sexual orientation, and the issues of social control such as age of consent laws. In humans, mature sexual desire usually begins to appear with the onset of puberty. Sexual expression can take the form of masturbation or sex with a partner. Sexual interests among adolescents, like adults, can vary greatly. Sexual activity in general is associated with a number of risks, including sexually transmitted diseases (including HIV/AIDS) and unwanted pregnancy. This is particularly true for adolescents as most are not emotion.
Homosexuality refers to sexual behavior with or attraction to people of the same sex, or to a homosexual orientation. As a sexual orientation, homosexuality refers to "having sexual and romantic attraction primarily or exclusively to members of one's own sex"; "it also refers to an individual's sense of personal and social identity based on those attractions, behaviors expressing them, and membership in a community of others who share them." Homosexuality, bisexuality, and heterosexuality together make up the three main classifications of sexual orientation and are the factors in the Heterosexual-homosexual continuum. The exact proportion of the population that is homosexual is difficult to estimate reliably, but most recent studies place it at 2–7%Sexual orientation is also distinguished from other aspects of sexuality, "including biological sex (the anatomical, physiological, and genetic characteristics associated with being male or female), gender identity (the psychological sense of being male, female or other), and social gender role (adherence to cultural norms defining feminine and masculine behavior)."Etymologically, the word homosexual is a Greek and Latin hybrid with homos (sometimes confused with the later Latin meaning of "man", as in Homo sapiens) deriving from the Greek word for same, thus connoting sexual acts and affections between members of the same sex, including lesbianism.[13][14] The word gay generally refers to male homosexuality, but is sometimes used in a broader sense, especially in the mediato refer to homosexuality in general. In the context of sexuality, the word lesbian always denotes female homosexuality. There is much evidence of both acceptance and repression of homosexual behavior throughout recorded history. During the last several decades, there has been a trend towards increased visibility, recognition, and legal rights for homosexuals, including marriage and civil unions, parenting rights, and equal access to health care.
Abortion is the removal or expulsion of a mammalian embryo or fetus from the uterus, resulting in or caused by its death. An abortion can occur spontaneously due to complications during pregnancy or can be induced. Abortion as a term most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed a miscarriage. The term abortion may also refer to the aborted embryo or fetus. Abortion has a long history and has been induced by various methods including herbal abortifacients, the use of sharpened tools, abdominal pressure, and other traditional methods. Modern medicine utilizes medications and surgical procedures to induce abortion. The legality, prevalence, and cultural views on abortion vary substantially around the world. In many parts of the world there is intense public debate over the ethical and legal aspects of abortion. The approximate number of induced abortions performed worldwide in 2003 was 42 million, which declined from nearly 46 million in 1995.
Teen Pregnancy
Few teenagers have the experience or resources it takes to start a family. But that doesn't keep them from doing so. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, each year about 900,000 teenage girls become pregnant. The rate of pregnancy among American teenagers has dropped steadily in recent years, but it's still tops among industrialized nations.
While some teenagers make great parents, many others struggle with the staggering task of raising a child at such a young age. Trouble comes in many shapes: poverty and loneliness, health problems for the mother and baby, missed opportunities for a good education, and sadness and resentment at missing out on proms and other exciting teen activities, just to name a few.
What are the health problems associated with teen pregnancy?
According to the March of Dimes, pregnant teenagers are especially vulnerable to complications, such as high blood pressure, anemia, and, most troubling, premature delivery. Their babies are more likely to be too small at birth and often have underdeveloped lungs, vision problems, or a host of other ailments.
Most of these problems could be prevented. As reported by the March of Dimes, teenage girls are usually biologically ready to have healthy babies. If they receive proper prenatal care, get a healthy diet, and stay away from cigarettes and alcohol, they have an excellent chance for a healthy pregnancy. Unfortunately, many girls fail to take these basic steps.
What are the lasting consequences of teenage pregnancy?
In many cases, teenage pregnancy isn't just a temporary inconvenience. It's a setback that can affect the lives of the parents and the child for many years to come. For one thing, an early pregnancy can keep a woman -- and sometimes the father -- from getting a good education. As reported by the National Campaign to Prevent Teen and Unplanned Pregnancy, only 41 percent of mothers who have children before the age of 18 ever complete high school. Unqualified for a good-paying job, the mothers have a very hard time making ends meet. Almost half of all teenage mothers go on welfare within five years.
The children of teenage mothers are also at a distinct disadvantage. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, they are 50 percent more likely to repeat a grade and are also less likely to finish high school. The sons of teenage mothers are more likely than sons of older moms to do a stint in prison, and daughters are more likely to become teenage mothers themselves.
Why do so many teenagers become pregnant?
Most teenage pregnancies can be chalked up to carelessness. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, about 80 percent of teen pregnancies are unplanned. That still leaves 180,000 young girls who get pregnant on purpose. As stated by human sexuality expert Andrea Parrot in a Cornell University press release, "Many teenage pregnancies aren't accidental but intentional because of girls who see no life goals other than being a mother as realistically within their reach. " For these girls, a simple sex education class or abstinence lecture probably won't be enough to keep them from becoming pregnant before they are truly ready.
What can be done to lower the rates of teen pregnancy?
Sex education classes, easy access to contraceptives, and personal choices to remain abstinent all play a role in preventing teenagers from becoming pregnant. But according to the National Campaign to Prevent Teen and Unplanned Pregnancy, parents of teenagers may be the most valuable resource of all. When parents talk openly with their children about sexuality and responsibility starting at a young age, the children are less likely to rush ahead into parenthood.
What about the fathers?
For many years, reproductive policy in the United States focused only on females; something that almost everyone now acknowledges was a mistake.
"Why males were ever excluded from the way we think about pregnancy prevention is puzzling," write the authors of the recent report Involving Males in Preventing Teen Pregnancy. "Sexual behavior involves two partners." Relegating fertility and family to the world of women, the authors write, "has kept us from acknowledging what should have been obvious -- that males must be involved in any policy solution to unintended pregnancies among teenagers."
The report continues that it is well known that adolescent boys initiate sex earlier than girls. But "contrary to stereotypes about males' disregard for contraception," the authors say, overwhelming evidence shows that for many years teenage boys have played a key role in providing contraception. In addition, this pattern has improved over the last two decades: between 1979 and 1988 condom use doubled, and since then this trend has increased. These shifts in behavior, the researchers conclude, suggests that pregnancy prevention efforts that include young men are crucial and "will not necessarily fall on deaf ears."
Finally, when parents explain the risks of early sex and the realities of raising children, their kids will listen. In the end, the facts are clear: A family is worth the wait.
-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive and was a staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education.
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