CPH’Lec: M6_Sexual and Reproductive Health

Sexual Health

Fundamental to the overall health and well-being of individuals, couples and families.

Sexual Health

Affects the social and economic development of communities and countries.

Sexual Health

Pleasurable and safe sexual experiences, free from coercion, discrimination and violence.

• Access to comprehensive and quality information about sex and sexuality

• Knowledge about risk and vulnerability of unprotected sex

• Ability to access sexual care

• Living in an environment that affirms and promotes sexual health

Achieving Positive Sexual Health

• STI's and their outcomes

• Unintended pregnancy and abortions

• Sexual dysfunction

• Sexual violence

• Harmful practices (female genital mutilation)

Sexual Health Related Issues

Reproductive Health

When people are able to have satisfying and safe sex life.

Reproductive Health

Have capability to reproduce.

Reproductive Health

Freedom to decide if, when and how often to do so.

Family Planning

Utilization of modern and effective methods to determine the number of children and the spacing of children between one another.

3-5 years

Ideal year interval of children according to DOH.

• Family planning means advocating for abortion

• Harmful adverse effects

• Reduces libido

• Laborious and expensive

Misconceptions about Family Planning

• Halts population growth

• Promote economic well-being

• Reduce maternal morbidity and mortality

• Empowerment and education

• Preventing STDs

Benefits of Family Planning

Republic Act 10354

The Responsible Parenthood and Reproductive Act of 2012

30 Sections

How many sections does Republic Act 10354 have?

December 21, 2012

When was the Republic Act 10354 signed into law?

Pres. Benigno S. Aquino III

Who was the president who signed Republic Act 10354 into law?

Definition of Terms

What is the title of Section 4 of the Republic Act 10354?

• Abortifacient

• Family Planning

• Responsible Parenting

• Reproductive Health

• Reproductive Health Care

What are the definitions from Section 4 of Republic Act 10354?

Abortifacient

Any drug or device that induces abortion or the destruction of a fetus inside the mother's womb.

Family Planning

Access to a full range of safe, affordable, effective, non-abortifacient modem natural and artificial methods of planning pregnancy.

Responsible Parenting

Will and ability of parent(s) to respond to the needs and aspirations of the family and children.

Responsible Parenting

Shared responsibility to achieve desired number and timing according to their own aspirations.

Reproductive Health

Refers to the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its function and processes.

Reproductive Health Care

Refers to the access to a full range of methods, facilities, services and supplies that contribute to reproductive health and well-being by addressing reproductive health-related problems.

Access to Family Planning

What is the title of Section 7 of the Republic Act 10354?

• Accredited Health Facilities

• Right to medical information

• Parental consent: age below 18

What are the informations under Republic Act 10354 Section 7?

Prohibited Acts

What is the title of Section 23 of the Republic Act 10354?

Healthcare Professionals:

• Withholding Information

• Refusal to perform procedures

What are the informations under Republic Act 10354 Section 23?

• Calendar Method

• Contraceptive Beans

Natural Family Planning Method

Calendar Method

Predict fertile days of a woman.

Calendar Method

Track menstrual cycle for at least 6 periods (26-32 days).

Calendar Method

Identify shortest and longest cycle.

Calendar Method

Fertile days will be determined.

• Cons

• Irregular cycle

• Recently had a baby

• Breastfeeding

• Used a hormonal method

• Extreme discipline

Calendar Method

• Menstruation (day 1-5)

• Follicular Phase (day 6-14)

• Ovulation Phase (day 15-19)

• Luteal Phase (day 20-28)

Stages of the Menstrual Cycle

• Jan 20 (29 days)

• Feb 18 (29 days)

• March 18 (29 days)

• April 16 (29 days)

• May 12 (26 days)

• June 9 (28 days)

• July 9 (30 days)

• Aug 5 (27 days)

Enumerate the dates of first day periods and their corresponding number of days in cycle

1. Identify the shortest cycle.

2. Subtract 18 days from the shortest cycle.

3. Count (X) days starting from the first day of current cycle.

4. (X) days starting will be the first fertile day.

How to determine the first fertile days?

1. Identify the longest cycle.

2. Subtract 11 days from the longest cycle (N).

3. Count (X) days starting from the first day of current cycle.

4. (N) day will be the last fertile day.

How to determine the last fertile days?

• Same principle with calendar method

• Non-fertile and fertile days

• Color varies (manufacturer: cycle beads)

What are the informations about Contraceptive Beads?

• Red bead (first day of your period)

• Dark brown bead (tells you if your cycle is shorter than 26 days

• Brown beads (pregnancy is very unlikely)

• White beads (pregnancy is most likely)

• Movable rubber ring

Enumerate the contraceptive beads' elements

• BBT Method

• Cervical Mucus Method

• Coitus Interruptus

What are the Other Natural Methods of Family Planning?

Lactation Amenorrhea

Temporary postnatal infertility occurring when a woman is not menstruating and fully breastfeeding.

• <6 Months

• No Monthly Periods

• Fully Breastfed Every 4 hours, <6 hr/24 hours

Enumerate the conditions of Lactation Amenorrhea

1. Intrauterine Device (IUD)

2. Barrier Methods

3. Surgical Sterilization

4. Hormonal Methods

Enumerate the Artificial Family Planning Methods

• Hormonal: (13.5mg) Kyleena IUD (19.5mg), Mirena IUD (52mg)

• Copper: Paragard IUD

Enumerate the Intrauterine Device (IUD) and their brand names of Artificial Family Planning

Hormonal Intrauterine Device (IUD)

Progestin or Levonorgestrel

Copper Intrauterine Device (IUD)

Damages sperm cells.

• Male Condom

• Female Condom

Enumerate the Barrier Methods of Artificial Family Planning

• No-Scalpel Vasectomy

• Tubal Ligation

Enumerate the Surgical Sterilization of Artificial Family Planning

No-Scalpel Vasectomy

Permanent blockage or cutting of the vas deferens.

No-Scalpel Vasectomy

Keeps sperm out of ejaculated semen.

Female Sterilization

Tubal Ligation is also known as?

Tubal Ligation

Permanent blockage or cutting of the fallopian tubes

Hormonal Methods

Constant release of progesterone and levonorgestrel.

• Contraceptive Patches

• Vaginal Rings

• Birth Control Pills

• Implant

• Emergency Contraception

Enumerate the Hormonal Methods of Artificial Family Planning

Contraceptive Patches

Releases hormones, thinning of uterine lining, and thickens cervical mucus.

5x5 cm

What is the size of Contraceptive Patches?

Vaginal Rings

Releases hormones, thickens cervical mucus, and can prevent pregnancy for up to 3 weeks.

• Combined Oral Contraceptives

• Progestin-Only Pills

Enumerate the Birth Control Pills of Hormonal Methods

Combined Oral Contraceptives

Estrogen & Progesterone; prevent release of eggs.

Progestin-Only Pills

Progestin; thickens cervical mucus.

Implant

It is a small, flexible rod about the size of a matchstick that is inserted under the skin of the upper arm.

Low dose of Progestin

What does an Implant have?

3 years

How long is the effectivity of an Implant?

Plan B Pill or Morning After Pill

Emergency contraception is also known as?

Emergency Contraception

It is the increased dose of Levonorgestrel Effectivity

Within 24 hours

How long is the increased dose of Levonorgestrel Effectivity?

72 hours

How long is the decreased dose of Levonorgestrel Effectivity?

Abortion Pill

Emergency Contraception is not an?

• Syphilis

• Trichomoniasis

• Gonorrhea

• Human papillomavirus (HPV)

• Hepatitis B

• Chlamydia

• Human herpesvirus 8 (HHV-8)

• Human immunodeficiency virus (HIV)

• Herpes

Enumerate the Sexually Transmitted Infections (STIs)

Treponema pallidum subsp. pallidum (bacteria-spirochete)

What is the causative agent of Syphilis?

French dse., great imitator

Syphilis is also known as?

• Inoculation: No symptoms

• Primary Stage: Chancre (painless sore)

• Secondary Stage: Skin rashes, swollen lymph nodes

• Latent: Rashes

• Tertiary Stage: Systemic infection, gumma of skin

Enumerate Syphilis' stages and its symptoms

Lymph and blood

Syphilis' organisms spreads by?

• Hepatitis

• Meningitis

• Glomerulonephritis

Rashes from secondary syphilis may be accompanied by?

Up to 24 weeks

How long does Syphilis' asymptomatic period last?

3 weeks

What is the average incubation of Syphilis?

3-30 years

How long does Syphilis' latent period last?

• Venereal Disease Research Laboratory (VDRL)

• Rapid Plasma Reagin (RPR)

• RDT

• CMIA

• FTA-ABS (Fluorescent Treponemal Antibody Absorption)

• TP-MHA (Treponema Pallidum Microhemagglutination Assay)

• Dark Field Microscopy

Enumerate the diagnosis of Syphilis

Penicillin/Doxycycline

What is the treatment for Syphilis?

Trichomonas Vaginalis (Flagellated protozoan)

What is the causative agent of Trichomoniasis?

Strawberry cervix

Trichomoniasis is also known as?

Strawberry cervix

Inflamed and malodorous and yellow green pus.

Flagellated, motile trichomonads on wet mount Papsmear

What is the diagnosis of Trichomoniasis?

Metronidazole/Tinidazole

What is the treatment for Trichomoniasis?

Neisseria gonorrhoeae

What is the causative agent of Gonorrhea?

Clap

Gonorrhea is also known as the?

• Vaginal discharge

• Abnormal uterine bleeding

• Dysuria

• Mucopurulent cervicitis

• Lower abdominal pain

Enumerate the signs and symptoms of Gonorrhea

Gonorrhea

Most women are asymptomatic.

• Polymerase chain reaction

• Gram stain

• Culture

Enumerate the diagnosis of Gonorrhea

Gram stain

Polymorphonucleocytes with gram negative intracellular diplococci.

Ceftriaxone + Azithromycin

What is the treatment for Gonorrhea?

Chlamydia trachomatis

What is the causative agent of Chlamydia?

Clam

Chlamydia is also known as the?

• Mucopurulent cervicitis/vaginal discharge

• Dysuria

• Lower abdominal pain

• Urethritis, prostatitis

• Postcoital bleeding (friable cervix)

Enumerate the symptoms of Chlamydia

• Direct immunofluorescence assay

• PCR

• ELISA

• Cell Culture

Enumerate the diagnosis of Chlamydia

• Azithromycin

• Doxycycline

• Erythromycin

• Levofloxacin

Enumerate the treatment of Chlamydia

• HSV-1

• HSV-2

What are the causative agents of Herpes simplex?

• Cold sores on face and mouth, genitals and hands

• HSV-1 is the most common

Enumerate the symptoms of Herpes simplex

• PCR

• Culture

• ELISA

Enumerate the diagnosis of Herpes simplex