Sexuality , Reproduction & Contraceptives

1. Sexuality , Reproduction & Contraceptives PPL 1OM/F

3. Sex Versus Gender • Sex: the qualities by which people are categorized by their reproductive organs and functions • Gender: the condition of being female or male as defined by society • Gender roles: sets of behaviours that project an image of femininity or masculinity

4. Gender, Sex, and the Media • “The media”: any form of communication that distributes information • Television, radio, music, movies, newspapers, magazines, billboards, the Internet • Sex as a Sales Tool • Double Standards in Sexuality (stereotypes) • Looking Good: Beauty Myths

5. Sexual Orientation • People vary in terms of their sexual attraction towards others • Heterosexual: woman to man, man to woman • Homosexual: woman to woman, man to man • Lesbian/Gay • Bisexual • Transsexual/Transgender • Questioning ones sexuality/ self identification • Canadian Human Rights Code: - Strictly prohibits discrimination or harassment on the basis of sexual orientation.

6. Sexuality and Childhood Development:Puberty Visible Changes: Breast development Height and weight increases Hair growth Boys only- Adam’s apple will begin to show Shoulders and chest will grow bigger Muscles will become bigger Voice changes for some boys Testicles gradually grow a little larger Penis will grow longer and wider as the rest of the body grows

7. Sexuality and Childhood Development:Puberty Visible Changes: Girls Only- • One breast often develops before the other breast • It can take 3-5 years before breasts are fully grown • Breasts are often unequal in size • Hips broaden to prepare for the delivery of a baby Chemical and Emotional Changes: • “wet dreams” • Feelings of sexual attraction emerge • Sudden mood changes occur • Weight gain before growth spurt

8. Sexuality and Childhood Development:Puberty Social/Relationship Changes: • Dating (i.e., going with) • Physical intimacy (kissing, petting) • Preoccupation with sexuality (e.g., frequently makes references to sexuality) CONCERNS!!! • Premature initiation of adult sexual activity • Difficulty adjusting to homosexual or bisexual orientation • Difficulty with body image • Difficulty with social skills

9. REVIEW- Female Reproductive Organs

10. The Female Reproductive System The External System (outside the body): Vulva • Consists of labia majora and labia minora (outer and inner folds of skin) Clitoris • Small, sensitive organ located above the opening to the vagina • Function is one of sexual pleasure Three openings • Urethra, vagina, anus

11. Internal (inside the body)Reproductive Organs Vagina • Leads to the other internal reproductive organs • Menstruation, intercourse, childbirth A thin membrane (the hymen) surrounds the vaginal opening, may not be noticeable in some Uterus • where the baby grows • nowhere near the stomach, about the size of a fist

12. Internal (inside the body)Reproductive Organs Fallopian tubes • A tube on either side of the uterus • Passageway from the uterus to ovary (ies) Ovaries • Females have 1-2 ovaries • Reproductive glands • Start producing hormones at puberty • Hold about 250,000 ova (eggs) until puberty when they start being released –one released per month

13. Internal (inside the body)Reproductive Organs Ovum • Also called egg cell • Cellwhich, when united with male sperm cell, can create a baby – this is called fertilization

14. Path of an Egg • Ovary • Fallopian tube (where it waits to meet a sperm) • Uterus • Cervix • Vagina

15. Male Reproductive Organs

16. Male Reproductive Organs The External System: Penis • Tube-like organ of spongy tissue • Urethra runs lengthwise through centre of penis • Head of penis is called the glans which is a source of sexual pleasure Testicles • Male sex glands (1-2) held in a sac called the scrotum • On outside of body to keep temperature cooler than body temperature for healthy sperm production • One hangs lower – this is normal • Very sensitive area – easily damaged – important to protect e.g. During sports activities • Only need one testicle to be fertile (able to reproduce)

17. The External System Sperm • Special cells produced in testicle at puberty • Very small (over 300 million in 15 ml of semen) • Millions are made every day • Mix with fluid in glands to form a white sticky fluid called semen • Swim up vagina, through uterus to fallopian tube to fertilize an egg • Sperm can last in the female body for 5-7 days

18. The External System Urethra • Tube which is located in penis • 2 branches – one to bladder, one to vas deferens • Two substances which come out of the urethra are urine and semen, they cannot come out at the same time • When penis is ready to release semen, a valve blocks off branch to the bladder so urine cannot escape

19. Internal (inside) Organs Vas Deferens • Tube which carries sperm out of testicles Prostate Gland • Starts producing a fluid at puberty in which sperm are kept alive • Sperm + fluid = substance called semen Seminal Vesicles • Two small pouches behind the bladder that produce fluid • This fluid mixes with sperm and other fluid to produce semen

20. Path of a Sperm • Testicle • Epididymis • Vas Deferens • Seminal Vesicle • Prostate Gland • Bladder • Urethra

21. Caring for the Reproductive Systems Shower or bathe daily with soap and water. Shower after all physical activity. Wash hair. Wash clothes often. Wear fresh undergarments daily. Change pad/tampon frequently. Wear deodorant.

22. Caring for the Reproductive Systems Dangers of un-cleanliness for males and females: Examples: Yeast Infections, Vulvovaginitis, Open sores, odour, bacterial infections, discharge, and jock itch.

23. Changes In The Reproductive Organs: Girls Ovulation • once a month an egg is released from one ovary • If egg is not fertilized (united with a sperm) in a day or so, it dissolves. Menstruation • Hormones from ovaries send message to uterus to grow a thick, soft lining of tissue and blood every month. • This lining contains nutrients that would be needed to nourish the egg and sperm if fertilization occurred • If the egg is not fertilized in the fallopian tube, the lining is not needed to nourish a baby, so the uterus sheds the lining, takes 5-7 days to shed lining – this is called menstruation(having a period). • Usually menstruation occurs once a month – bloody discharge drips out of the body through the vagina

24. Changes In The Reproductive Organs: Girls • This continues to happen over and over again. That is why we call it the menstrual cycle. • Some women experience menstrual cramps which can be relieved with anti-inflammatory pills, exercise, decreasing salt intake, or hot water bottles. • Menstruation is a normal change of puberty. Women can continue to participate in regular daily activities (e.g. physical education classes, gymnastics, swimming, etc.), and do EVERYDAY! • Personal hygiene (i.e. bathing) is even more important at this time as oil secretion from hair and skin may increase and menstrual blood may get dried in pubic hair.

26. Tampons and Pads Feminine Hygeine • Sanitary pads or tampons are used to absorb menstrual fluid • Always wipe from front to back to help prevent infection Pads and Tampons • Various sizes of pads available, as the flow varies • Must change pads frequently, approximately every 3-4 hours • Dispose of pads/tampon applicator in wastebasket rather than toilet. Don’t leave them on the floor!

27. Male Reproductive System • Testicles produce sperm • Sperm move from testicles to the epididymis • During ejaculation, sperm from the epididymis move through the vas deferens to collect semen • Penis must be erect for ejaculation to occur • Semen is ejaculated through the urethra

28. Male Reproductive System How Do Erections Happen? • Sexual thoughts send message to penis – thickens and sticks out from the body • Spongy tissue fills up with extra blood • Happens for physical reasons even before puberty • Can happen when you least expect it or want it (e.g. First thing in the morning, during sleep, vibrations e.g. Riding a bus, not always related to sexual thoughts.) • Can be frightening and embarrassing • Important to realize that it is a normal process of growing up • An erection does not mean an ejaculation must occur – erection will go away on its own • Size of penis varies – all sizes work well – less of a difference when erect

29. Male Reproductive System Ejaculation • The release of semen from penis occurs during an erection • Millions of sperm in one ejaculation • Usually has to be some extra stimulation of the penis for this to happen e.g. During sexual intercourse or masturbation – this is an orgasm

30. Sexual Relationship? Know your Options • Abstinence • Contraceptive Methods and Barriers Against Disease: • condoms (male/female) • sponges and spermicides Hormonal Methods of Contraception: • the Pill • the Patch • contraceptive injections • intrauterine system • Natural Methods of Contraception: • fertility awareness • Surgical Methods • intrauterine device • female sterilization • male sterilization

31. Barrier Methods Types: • condoms (male/female) How does it work? Acts as a physical barrier preventing direct genital contact and the exchange of genital fluids, so the sperm does not enter the uterus and fertilize the egg • A new barrier is used for each repeated act of intercourse • Types: • -spermicide/sponge How do they work? Sponge • Fits over the cervix • Traps and absorbs sperm • Spermicide in the sponge disables the sperm • Effective for up to 12 hours Spermicides • Contain an ingredient that disables sperm

32. Hormonal Methods Types: Birth Control Pill Prescription tablets taken once a day, at the same time everyday! How does it work? Stop the release of a mature egg • Thicken the cervical mucus making it difficult for sperm to get to the egg • Change the lining of the uterus making implantation difficult Types: Hormonal Injections (Depo-Provera) What is it? • It contains a hormone called progesterone; it does not contain estrogen • The injection is given in the upper arm or buttocks every 12 to13 weeks (four times a year) How does it work? • Prevents the ovary from releasing an egg • Thickens the cervical mucus making it difficult for sperm to get to the egg • Changes the lining of the uterus making implantation difficult

33. Hormonal Methods Types: The Patch How does it work? A patch that releases hormones through the skin • Can be placed on the buttocks, upper outer arms, lower abdomen, or upper torso excluding the breast • A new patch is applied once a week for three weeks followed by one week without a patch • Types: IUS What is it? • A T-shaped device that contains a hormone called levonorgestrel • The hormone is released slowly over time and acts on the lining of the uterus • It is inserted into the uterus by your physician in the doctor’s office How does it work? • Thickens the cervical mucus making it difficult for sperm to reach the egg • Causes changes in the lining of the uterus that helps to prevent implantation • In some women, it may prevent the ovary from releasing an egg

34. Hormonal Methods Types: Vaginal Ring What is it? • A flexible, nearly transparent ring • The ring releases a continuous dose of hormones for three weeks while it is in the vagina How does it work? • Prevents the ovary from releasing an egg • Thickens the cervical mucus making it difficult for sperm to reach the egg • Changes the lining of the uterus making implantation difficult Myths and Misconceptions about Hormonal Contraception • Causes weight gain • Causes acne • Causes infertility • Causes birth defects • Shouldtake a break from time to time • Smokers should not be taking it • Women over age 35 should not take the Pill • No need for condoms if you’re on the Pill

35. Side-Effects of Hormonal Contraception Sideeffects that may occur during the first few months on hormonal contraception include : • irregular bleeding, spotting • nausea • mood swings • bloating • breast tenderness • headaches

36. S t e r i l i z a t i o n Female Sterilization Tubal ligation What is it? • A surgical procedure to close or block the fallopian tubes • A clip or a ring • Cautery (an electric current) • Removing a small piece of each tube Male Sterilization Vasectomy What is it? • A surgical procedure to close or block the vas deferens (the tubes that carry sperm to the penis)

37. Chances of Catching an STI • Having unprotected sex • You have a new partner • Your partner has sex with others • You or your partner uses injection drugs • Sharing needles for drugs, piercing, tattoos • Some can be transferred through sharing razors, toothbrushes, skin contact • Pregnancy

38. When Should I Go to the Dr.? • Are you sexually active? • Are you thinking about becoming sexually active? • Do you want to get some form of birth control? • Are you experiencing any sort of physical discomfort- abdomen, penis, vagina, lower back, unexplained fever, excessive discharge, burning when urinating, blood in urine, warts or blisters on genitalia, etc.

39. Reproductive concerns YOU need to be aware of! • Endometriosis: • When tissue normally found within the uterus starts to grow on the ovaries, fallopian tubes, cervix, vagina, vulva, or other parts of the pelvic cavity • Can lead to sterility if left untreated • Ovarian cysts: • Non-cancerous sacs filled with fluid or semi-solid material • Cervical Cancer • Ovarian Cancer • Breast Cancer • Testicular Cancer • Prostate Cancer

40. Breast Self-Examination

41. Surviving the Sexual Health Exam • You should feel comfortable with your doctor • It’s okay to ask questions • You don’t have to go alone • Relax • You will need to ask for specific tests • Trust your instincts Testicular examination video: what to expect http://www.youtube.com/watch?v=JJzrqp-S-_0 Annual pap smear examination video: what to expect • http://www.youtube.com/watch?v=LjXKi-STk5E