Imagine yourself working in a program with teenage individuals. What are some ways to discuss healthy relationships while being aware of the risks of sexually transmitted diseases, pregnan

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1. Imagine yourself working in a program with teenage individuals. What are some ways to discuss healthy relationships while being aware of the risks of sexually transmitted diseases, pregnancy, and rape?

references:
1 : https://www.youtube.com/watch?v=C63Xn–i13o&t=8s
2: https://www.youtube.com/watch?v=RFDatCchpus&t=2s
3: https://www.youtube.com/watch?v=ZtrynEEffMw
4: https://www.youtube.com/watch?v=IEffOROmkbQ
5: Reproductive Health
Birth Control vs. Contraception
Percentage of U.S. Women Ages 15-44
Using Contraception and Reasons
Figure 5-1 Percentage distribution of women aged 15 to 49 years, by current
contraceptive status: United States, 2015-2017.
Data from Daniels, K., Abma, J.C. (2018). Current contraceptive status among women aged 15-49: United States, 2015-2017. NCHS Data Brief, no 327.
Hyattsville, MD: National Center for Health Statistics. Available at: https://www.cdc.gov/nchs/data/databriefs/db327-H.pdf
Legal Perspectives of Birth
Control Griswold v. Connecticut (1965)
Mandated coverage for contraception for
federal employees via an act of Congress
(1998)
All new health insurance plans must cover all
FDA-approved methods of birth control,
sterilization, and related education and
counseling without cost sharing (2010).
Race and Religion Also Influence
Contraception Use
Figure 5-3 Percentage of all women
aged 15-49 who were currently using
female sterilization, oral contraceptive
pill, male condom, or LARCs, by
Hispanic origin and race: United
States, 2015-2017.
Data from National Health Statistics Reports. National Survey of Family
Growth, 2015-2017. Available at: https://www.cdc.gov/nchs/products/
databriefs/db327.htm
Fertility Awareness Methods
“Free, no equipment necessary, but not
reliable”
Calendar method
Avoidance of intercourse during fertile time of month by
calculating time of ovulation
Basal body temperature
Fertility cycle related to changes in basal body
temperature
Cervical mucus or ovulation method
Fertility cycle related to variations in type of cervical
mucus
Pros vs. Cons of Fertility
Awareness Methods
Pros Cons
? No side effects
? Used by anyone
? Cost-effective
? Limited effectiveness
? Need to abstain from
sexual intercourse
certain days/month
? No protection from
STIs
Birth Control Pills
Most commonly used
form of contraceptive
99% effective
Suppresses a
woman’s
reproductive
hormone cycle
One type of birth control pills.
© Christy Thompson/Shutterstock
Oral Contraceptives
Used by 16% of women aged 15-44 years
Pros Cons
? Lighter and less painful
periods
? Reduced PMS
symptoms
? Improved skin
? Protection against
ovarian and endometrial
cancers, ovarian cysts,
benign breast disease,
and PID
? Mood changes
? Spotting
? Weight changes
? Drug interactions
? Decreased libido
? Headaches
? Fluid retention
? Health risks for some
women
Hormone Delivery Methods
Depo-Provera
Injectable progestin every 3 months
Contraceptive patch (Xulane)
Patch worn on skin for 1-week intervals; fourth week is
patch-free
NuvaRing
Flexible, plastic ring inserted into the upper vagina and
worn for 3 weeks; removed during week of
menstruation
Barrier Methods (1 of 5)
Spermicides
Figure 5-4 Spermicidal agents.
Barrier Methods (2 of 5)
Diaphragm, cervical cap
Dome-shaped latex cup sealing cervix
Figure 5-5 Diaphragm Figure 5-6 Cervical cap.
Barrier Methods (3 of 5)
Condoms
Figure 5-7 Condom use
Barrier Methods (4 of 5)
Female condoms
Polyurethane sheath lining entire vagina and external
genitals
Figure 5-8 The internal condom.
Barrier Methods (5 of 5)
Pros Cons
Condoms offer protection
from STIs.
Can be used as backup
for pill users (or with other
methods)
Can be used for the short
or long term
Small risk of bacterial
infection or toxic shock
syndrome for diaphragm,
sponge, and cervical cap
Must be used properly
May have higher long-
term costs
Intrauterine Device (IUD)
Small object inserted
by clinician into a
woman’s uterus
Effectiveness is
superior to that of pills,
patch, or ring
An IUD is a small object placed in the
uterus through the cervix by a
clinician.
© Spike Mafford/Photodisc/Thinkstock
Permanent Methods
Female sterilization
Tubal ligation = fallopian tubes cut and tied
– Laparoscopic sterilization
– Minilaparotomy
– Essure
Male sterilization
Vasectomy = vas deferens cut and tied
Other Forms of Contraception
Abstinence
No penis-in-vagina intercourse
Withdrawal
Coitus interruptus
Breastfeeding
Lactational amenorrhea method (LAM)
Emergency Contraception (EC)
NOT the same as RU-486, otherwise known as
“the abortion pill”
Use of high-dose birth control pills taken within
72 hours of unprotected sex
Plan B = progestin-only form of emergency
contraception
ella = another form of emergency contraception
available by prescription
Failure Rates
A failure rate is the chance that the average
couple using a given birth control method will
become pregnant in a given year.
Failure rates can be either for “perfect use” (ideal
conditions) or “actual use” (failure rate in the real world)
Failure rates range from less than 1% to 30%.
Condoms, sponges, and diaphragms have the largest
difference between these rates.
Contraceptive Failure
High rates of effectiveness—oral
contraceptives, hormone injectables and
implants, IUDs, condoms, vaginal hormonal
ring, hormone patch, sterilization
Lower rates of effectiveness—diaphragms,
cervical caps, sponges, spermicidal agents,
fertility awareness methods, rhythm method,
withdrawal
Handling an Unplanned
Pregnancy
Adoption—can be “open” or “closed”; private
or public
Abortion
Abortion
A controversial issue of debate or a very common
medical procedure?
…both, actually
Abortion continues to be one of the greatest
debates in American society.
© Rena Schild/Shutterstock
Perspectives on Abortion (1 of 2)
Why do women choose abortions?
Pregnancy would reduce a woman’s ability to work,
finish school, or care for others.
Cannot afford a(nother) baby
Relationship issues or not wanting to be a single
mother
Completed childbearing
Not ready for a(nother) child
Did not want people to know she was pregnant or had
sex
Perspectives on Abortion (2 of 2)
Characteristics of U.S. abortion patients
More than half are in their 20s; women ages 20 to 24
have the highest rates.
36% are non-Hispanic White, 30% are non-Hispanic
Black, 25% are Hispanic, and 9% are other races.
Six in ten already have one child.
Three in ten have two or more children.
Women in poverty have more abortions than wealthy
women.
Abortion Procedures
Surgical abortion
Vacuum curettage
Dilation and curettage (D&C)
Dilation and evacuation (D&E)
Medical abortion (“abortion with pills”)
Mifepristone, misoprostol (RU-486)
Global Perspectives
Motherhood continues to be a major risk to life and
health in the developing world (most of Asia, Africa,
and Latin America)
Informed Decision Making
If you want to prevent pregnancy
Review your and your partner’s needs
Personal medical history
Review failure rates
Risks and benefits of method
Reevaluate periodically
6: Sexual Health
Sexual Health Defined:
“A state of physical, emotional, mental and social well-
being related to sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual health requires a
positive and respectful approach to sexuality and sexualelationships, as well as the possibility of having
pleasurable and safe sexual experiences, free of
coercion, discrimination, and violence. For sexual health
to be attained and maintained, the sexual rights of all
persons must be respected, protected, and fulfilled.”
World Health Organization [WHO]. (2006). Defining Sexual Health. Report of a technical consultation on sexual health 28-31 January
2002, Geneva, Switzerland: WHO. Available at: http://www.who.int/reproductivehealth/publications/en/
Perspectives on Sexual Health
and Sexuality (1 of 4)
Cultural and religious dimensions
“Marriage” is universal theme in all cultures
sanctioning sexual privileges and obligations.
Sexual behavior is often defined by cultural values.
– Normative sex roles
– Acceptable types of sexual activity
– Sanctions/prohibitions on sexual behavior
– Premarital sex
– Sexual restraint for females
– Same-sex relationships
– Contraception decision making
Perspectives on Sexual Health
and Sexuality (2 of 4)
Economic dimensions
Daughter in marriage = dowry
Value of bride = virginity
Sexual aggression = power and economic
dynamics
Commercial sex industry/prostitution
Perspectives on Sexual Health
and Sexuality (3 of 4)
Legal dimensions
Laws prohibiting certain types of sexual
behavior/intimacy—cohabitation, fornication,
sodomy
Same-sex partners
Marriage, annulment, separation, divorce, child
custody, child support
Perspectives on Sexual Health
and Sexuality (4 of 4)
Political dimensions
Sex education in schools
– Abstinence-only until marriage programs
– Comprehensive or abstinence-plus programs
Class Discussion
What are some current national or international
news items related to:
The commercial sex industry or prostitution?
Marriages between same-sex partners?
Sex education curricula in schools?
Sexual Behavior among
Youth in the United States
Figure 4-1 Sexual behaviors among U.S. youth, 2017.
Data from Centers for Disease Control and Prevention. (2018). Youth risk behavior surveillance—United States 2017. Surveillance Summaries. Morbidity and Mortality
Weekly Report 67(SS-8):1-114
Sex, Gender, and Gender Identity
Sex: An individual’s biological status (male, female,
intersex): anatomy, chromosomes, and biological
characteristics
Gender: The economic, social, and cultural attributes
and opportunities associated with being masculine,
feminine, or a combination of both
Gender identity: An individual’s personal subjective
sense of being male, female, or somewhere in between
Homologous Sex Structures
Figure 4-3 External genital differentiation-male and female.
Definitions (1 of 2)
Intersex
A person who is born with sex chromosomes, external
genitalia, or internal reproductive organs not
considered “standard” as male or female
Gender expression
The way a person acts to communicate gender within
a given culture, such as clothing and interests
Androgyny
Having characteristics of both sexes, but appearing
gender neutral
Definitions (2 of 2)
Transgender
Umbrella term for anyone whose biological sex is not
aligned with the person’s sense of self or gender
identity
Gender dysphoria
Psychological term used to describe a strong and
persistent cross-gender identification
Transitioning
Process in which transgender people work to change
their appearance and societal identity to match their
gender identity
Class Discussion (1)
What are some of the challenges faced by
transgender people? As individuals? In
school? In social situations? In various public
places?
What are some possible solutions to these
challenges?
Sexual Stereotypes: Discussion
Women are undersexed and men are oversexed.
Women are inexperienced and men are experts.
Women are recipients and men are initiators.
Women are controllers and men are movers.
Women are nurturing and supportive, and men are
strong and unemotional.
Women are sensitive and men are insensitive.
Women are dependent and men are independent.
Women are passive and men are aggressive.
Sexual Orientation
Sexual orientation refers to one’s sexual and
romantic attraction to other people, whether the
attraction is to members of the opposite sex, the
same sex, or both sexes.
Opposite sex = heterosexual
Same sex = gay, lesbian, homosexual
Both sexes = bisexual
Issues
Homophobia
Profiling
Discrimination in medical care
External Female Sexual Anatomy
Figure 4-4 External female sexual anatomy.
Internal Female Sexual Anatomy
Figure 4-6 Internal female sexual anatomy.
Common Problems Related with
Menstruation
Dysmenorrhea
– Painful menstrual flow
Premenstrual syndrome (PMS)
– Group of symptoms linked to menstrual cycle
Premenstrual dysphoric disorder (PMDD)
– Severe form of PMS
Amenorrhea
– Lack of menstrual flow
Physical Health and the Well-
Woman Exam
Exam steps
Medical history
General physical examination
– Breast examination and pelvic examination
Pelvic examination
– Phase I = external examination
– Phase II = use of speculum; collection of
specimens
– Phase III = bimanual examination
Sexual Arousal
and Sexual Response
Masters and Johnson: Female Sexual
Response Cycle
Four Phases
1. Excitement
2. Plateau
3. Orgasm
4. Resolution
Figure 4-7 Masters and Johnson’s model lists three
variations among women in the sexual response cycle.
Forms of Sexual Expression
Traditional heterosexual positions
Masturbation
Petting
Oral-genital stimulation (cunnilingus, fellatio)
Anal intercourse
Use of sex toys and accessories
Sexuality Through the Life Span (1 of 4)
Childhood
Self-genital
stimulation
Engage in play that
may be viewed as
sexual in nature
Curious about
secondary sex
characteristics
Children are innately interested in their bodies.
© Asiaselects/Getty Images
Sexuality Through the Life Span (2 of 4)
Adolescence
Puberty
– Secondary sex characteristics
o Hair growth, breast budding, vaginal walls
thicken, uterus enlarges, vaginal pH
increases in acidity
– Menarche
o About 2 years after breasts start to develop
and by the age of 15
Sexuality Through the Life Span (3 of 4)
Young to middle adulthood
Increasing number of single, sexually active adults
Marriage at later age
Increase in the number of women who never marry
Placing career goals and advanced education
before marriage
Increased divorce rate
Increase in cohabitating adults
Increase in the number of women who no longer
depend on marriage to ensure economic stability
Sexuality Through the Life Span(4 of 4)
Older adulthood
Climacteric—physiological changes that occur
during period from female fertility to infertility
Menopause—cessation of menstruation
– Vaginal dryness and thinning, delayed
lubrication, hot flashes
Decline in frequency and intensity of sexual
activity
Quality vs. quantity of sexual expression
Sexual Dysfunction
Prevalence
– About 44% of U.S. women report sexual problems,
with low desire being the most commons sexual
problem (38.7%).
Historically called “frigidity”
Areas of dysfunction
– Sexual desire disorders
– Sexual arousal disorders
– Orgasmic disorders
– Sexual pain disorders
Sex Research
Well-known studies
Kinsey Report (1948 and 1953)
– Factors affecting sexual behavior in males/females
Masters and Johnson (1966)
– Sexual response cycle phases
Redbook Survey (1977)
– Sexual behavior and attitudes of American women
Hite Report (1976)
– Sexual practices of American women
Blumstein and Schwartz (1983)
– Sexual and nonsexual components of relationships
ABC Primetime Poll (2004)
– Found most Americans were monogamous and happy about it
Class Discussion (2)
How do definitions of terms like “virginity” or “premarital”
complicate sexual health research?
Communication contributes
greatly to the satisfaction of
an intimate relationship.
© Iofoto/Dreamstime.com
Sexual Violence as a
Public Health Problem
Types of sexual violence Sexual assault and rape
Female genital mutilation (FGM)
Forced sterilization
Informed Decision Making
Gynecological checkup
Understanding personal feelings, thoughts
about sexual well-being
Understanding the medical language
associated with sexual health
Understanding responsible sexual behavior
Understanding myth vs. fact
Communication between parents and children
Knowledge of healthcare resources

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