Sexual Health & Reproductive Choices

1. Sexual Health & Reproductive Choices Chapter 12 & 13

2. Outline • Sexual Development • Puberty • Middle Age Hormones • Abstinence • Hormonal Contraceptive Methods • Barrier Methods • IUD • Fertility Awareness Methods • Emergency Contraception • Sterilization • Pregnancy • Fetal Development • Pregnancy & Complications • Labor and Delivery • Childbirth • Infertility

3. Sexual Development • Sexual and reproductive development is directed by hormones that begins during fetal development. • Androgens • Male sex hormones • Secreted by testes • Estrogens and progestins • Female sex hormones • Secreted by ovaries • Adrenal gland • Secrets androgens in both males and females • Pituitary gland and hypothalamus • Work to regulate levels and function of sex hormones

4. Puberty • Secondary sex characteristics appear • Growth spurt • Sex organs become larger • Increase in hair growth • Males • Voice deepens • Onset of ejaculation and nocturnal emissions • Testes start to produce sperm • Females (about two years ahead of males) • Breast development • Body fat increase • Onset of menstruation (menarche)

5. Female Menstrual Cycle (28 days) Days 9 – 18 highest probability of pregnancy if sperm are present

6. Middle Age Hormonal Changes Menopause Viropause • Gradual reduction in ovarian functioning • Symptoms: • Hot flashes • Night sweats • Irritability • Insomnia • Reduction in bone density • Increased cholesterol • Androgen decline • Symptoms: • Decreased sexual desire and/or functioning • Irritability • Sluggishness • Mild to moderate mood swings • Continue to produce viable sperm

7. Choosing a Contraceptive Method • Considerations • Effectiveness • Cost • Convenience • Permanence • Safety • Protection against STDs • Consistency with personal values • Types • Abstinence • Hormonal contraceptive methods • Barrier methods • IUD • Fertility awareness method • Emergency contraception • Sterilization

8. Abstinence • Not having sexual intercourse • Advantages: • Only way to ensure you do not get pregnant • Without contraception, 85% of sexually active women will become pregnant within one year. • Free • Available to all • Can start at anytime • Disadvantages: • Requires control and commitment • Not abstaining from other sexual activities can still lead to STD infection

9. Hormonal Contraceptive Methods

10. Barrier Methods (Condoms)

11. How to Buy and Use Condoms • Choose latex if you or your partner are not allergic • Check expiration date • Expired condoms are more likely to break • Buy condoms without spermicide • Do not remove it from wrapper until you are ready to use it • Don’t leave condoms in a place where they may be exposed to heat. • Wallets, glove compartments of a car, etc. • Do not use oil based lubricants with condoms • Use condoms correctly (see figure 13.2 & 13.3)

12. Barrier Methods

13. Intrauterine Device (IUD)

14. Fertility Awareness Method

16. Emergency Contraception • Reduces risk of pregnancy in cases of rape, unprotected sex, or failure of a barrier method • Available over the counter if you are > 18 years old • Most effective within 48 - 72 hours • Works by preventing ovulation and fertilization • Side effects: • Nausea • Vomiting • Altered menstrual cycle • Not the same as the abortion pill

17. Sterilization • A surgical procedure that permanently prevents any future pregnancies • Vasectomy • Small incision made in scrotum • Tie off and sever the vas deferens • Quick, simple procedure • Tubal ligation • Laparoscopic surgery through the abdomen • Sever and seal fallopian tubes • Invasive

18. Unintended Pregnancy • Carry the pregnancy to term and raise the child • How do you know you are ready? (almost impossible to ever be completely ready) • Long-term educational goals • Relationship with your partner • Emotional maturity • Financial situation • Social support system • Health status and age • Carry the pregnancy to term and place the child up for adoption • Open versus closed adoption • Terminate the pregnancy • Elective versus spontaneous abortion • Surgical (2 – 8 weeks of gestation) • Medical (early< 7 weeks or late > 15 weeks) • RU486 (pill) • Induce labor or perform surgery

19. Fetal Development

20. Pregnancy & Complications • Miscarriage • Approximately 15-20% of all pregnancies end in miscarriage • Gestational Diabetes • Preeclampsia: • Mother’s blood pressure becomes elevated and can be life threatening • Infant death: • Stillbirth • Low Birth Weight • Birth Defects • ~5% of babies born in the United States • Several tests have been developed to detect abnormalities in a fetus prior to birth • Alpha-Fetoprotein Measurement (AFP) • Ultrasound • Chromosomal Analysis • Chorionic Villus sampling • Amniocentesis

21. Labor and Delivery

22. Childbirth Delivery of head Crowning Baby after delivery Placenta after delivery

23. Delivery & The Postpartum Period • Cesarean-section • Surgical delivery of infant through the abdominal wall • Newborn screening • Apgar scale: 0-2 points for each major condition of baby to add up to 10 points • Postpartum period • First few months after childbirth • Issues for the newborn that deserve attention include: • Growth and nutrition, illness and vaccinations, adjustment and attachment

24. Infertility Causes of Infertility Treating Infertility • Low sperm count • Poor sperm motility • Lack of ovulation • Obstruction of fallopian tubes • Surgery • Intrauterine Insemination • Fertility drugs • IVF

25. For Next Time • Study for Exam #3