NURS 280

What is sexual health?

A state of physical, emotional, mental, and social well-being in relation to sexuality \n (it is not just an absence of disease, etc)

What are the 5 components of Dennis Dailey's Circles of Sexuality?

1) Reproduction
2) Identity
3) Intimacy
4) Sensuality
5) Sexuality

What is the Reproduction portion of your Sexual Self?

* often the foundation of sex education
* includes procreation, contraception, abortion, STI's, infertility

What is the Identity portion of your Sexual Self?

* one's sense of self as a sexual being
* includes gender identity, sexual orientation, gender/society roles

What is the Intimacy portion of your Sexual Self?

* the need and ability to experience emotional closeness to another person as well as it reciprocated
* the feeling of being seen and known

What is the Sensuality portion of your Sexual Self?

* the need and ability to accept one's body as a sexual entity \n - includes body image, attraction, skin to skin contact "hunger"

What groups of people are touch depried?

* Elderly: lack of contact with people
* Youth during puberty: people are told that they need to stay away

What is the Sexualization portion of your Sexual Self?

* the use of the body to influence, control or manipulate others
* sex as a "weapon"
* includes sexual teasing, flirting, sexual harassment, advertisements

What are the 3 main factors that lead to discomfort and anxiety about sexuality?

1) Ignorance:
2) Secrecy:
3) Trauma:

How does Ignorance play a factor in the discomfort/anxiety about sexuality?

* Lack of knowledge
* society believes that it is better to know less about sex (EX. drugs)
* leads to unsafe experimenting/decision making

How does Secrecy play a factor in the discomfort/anxiety about sexuality?

\
Keeping things secret

* topics that people aren't comfortable or allowed to talk about because of judgement
* society shames us about our pleasures, experiences, people we are interested in

How does Trauma play a factor in the discomfort/anxiety about sexuality?

Negative experiences

* the inability to process trauma
* usually due to ignorance, secrecy or shame

What is Sexology?

The study of sexuality \n - what people do when they have sex and how they feel about it

Do all cultures celebrate sexuality?

Not all

* Many cultures celebrate or normalized the exploration of sexuality (Come sutra, tantra, etc)
* During medieval era, the church had some sway of the de-sexualization

Who was the first person to study sexuality in North America?

Alfred Kinsey used ht escientific lense to explore sexuality.

* Was a bug guy that taught a marriage course that had o syllabus
* He used the Kinsey scale of 0-6 (and X for those with no sexual attration)

What did Masters and Johnson study?

In 1950's, they began looking into sexuailty and arousal

* invented machines to measure arousal (tenting, BP, lubrication, HR)
* people either masterbated or had sex and arousal was monitored
* in 1966 they wrote The Human Sexual Response (4 stage modle)

Is it the provincial or federal government that is in charge of sexual health education?

* sex ed is regulated by the province → varying quality across the country and schools

What is the sex education like in BC?

* BC has the most comprehensive system in Canada
* Sex ed is mandated in BC but delivery is hit or miss
* Teachers are not taught how to teach sex ed

Who are the gatekeepers for education?

Prevent knowledge transfer

* School boards: Vancouver has a policy for sex education
* Principles: are administrators and have the main voice, many are older and may not believe its important
* Community/parents: maybe connected to faith and some may shame sex ed
* Teachers: afraid they could get fired, dont have formal eduation, are embarrassed

What do children in elementary school learn in sex education?

* scientific names ofr body parts
* consent
* their body is their own
* puberty (emotional, physical & social changes)
* empathy
* human repreoduction

What do children in highschool learn in sex education?

* healthy sexual decision making
* STI's
* Healthy emotional, physical and social relationships
* sources of information

What are the 9 Core Principles of Comprehensive Sex Ed?

1) Accessible to all people
2) Promotes human rights
3) Scientifically accurate
4) Broadly range of topics
5) Inclusive
6) Promotes gender equality
7) Includes positive aspects of sexuality and relationships
8) Incorporates emerging issues
9) provided by educators who have the knowledge

What happend to sex education during the Cinton administration?

* only way to get federal fundign for sex ed. the school had to promote abstinence only before marriage education
* funding could be millions of dollars

What are the imacts of AOUM Programs?

* scientifically and ethically problematic
* people that use it as their only form of birth control only have it work 60% of the time
* research shows its not effective
* provide inaccurate and stigmatizing information
* threaten fundamental human right to health information and education

What are some sources of values and beliefs?

* family of origin
* formal and informal education
* peers
* media influences
* faith
* experiences

What are the 3 main ways we know our gender?

1. Our bodies (chromosomes, hormones, gonads, genitals)
2. Socialization (begins at birth, reinforced through social roles, overt and subtle)
3. Internal sense of self (overt or hidden, challenged or validated, solidifies between 18-36 months)

What are some of the gender options?

* female
* male
* trans
* gender fluid/nonbinary
* femme/masc
* two spirit

What is femme or masc?

An expression of gender

What is a two-sprit person?

Someone of who is indigenous to North America. Believe there is a range of genders and they are not male or female

What are some ways people can express their transition?

* social transition (dress, name, pronouns)
* clinical-affirning clinical care (hormones, upper surgery, lower surgery)

Are there changes noticed after taking hormones reversible?

Not all of them.

* body hair will return to normal if hormones are stopped
* voice dropping while taking testosterone is not reverible

Who first studied the arousal response cycle?

William Master & Virginia Johnson \n - divided the sexual response cycle into 4 phases (excitement, plateau, orgasm, resolution)

What is the Excitement stage?

The bodies natural physiological response (can't control) \n - it preps the body for sexual activity, doesn't have to mean anything

What occurs during the Excitement stage?

* rise in HR, BP, breathing
* skin flush (different for every person)
* vasocongestion and erection (clitoris, penis, nipples)
* testicles draw upwards
* vaginas lubricate

What is the Plateau stage?

pleasure phase

\

What occurs during the Plateau stage?

* pleasure
* increased muscle tension, rapid breathing and HR
* pre-ejaculate released
* clitoris very sensitive
* vagia lengthens (tenting)

What is pre-ejaculate?

\

What is the Orgasm stage?

Peak of plesure

What occurs during the Orgasm stage?

* quick muscle contractions & spams (near genitals, butt, feet, hands, faces)
* highest point of BP, HR, respiration peak
* Euporic sensations
* Ejaculation
* Feeling of release (sense of satisfaction, mood may improve, feeling of connection)

What is the Resolution stage?

The body returns to base line (heart rate, breathing rate, blood pressure)

What occurs during the Resolution stage?

* body slows, relaxes
* release of blood from engorged areas
* penis becoes flaccid (refractory period, lengthens as men age)
* clitoris extremely sensitive (aditional orgasms may be possible right away)

What did Helen Singer Kaplan add to the Sexual Response Cycle?

She added that there is two phases; psychological (sexual desire/emotions) and phyiological (excitement, orgasm, resolution)

What did Rosemary Basson add to the Sexual Response Cycle?

Looking at straight cis women who had issues with sexual drive

* she believes that arousal is circular rather then linear
* people can enter the circle at different points and make up for "passed levels"
* not to be used against people

What is the Dual Control Model?

Bancroft & Janssen believe that out brain looks for things that are sexually rBancroft & Janssen believe that out brain looks for things that are sexually relevant (there are things that trigger the "gas pedal" and things that trigger the "brake pedal") \n - your brain has the ability to give the gas context so you dont get fully aroused your NURS 280 class

What are examples of turn ons?

Sexual Excitation System

* partner smell
* partner appearance
* new love
* making up after a fight
* pleasant genital sensations

What are examples of turn offs?

Sexual Inhibition

Sexual Inhibition System

* body image (usually your own)
* trauma history
* reputation
* feeling obligated
* sleep deprivation
* depression or anxiety

What do Bancroft & Janssen say about desire?

Many people think that difficulties with desire and arousal can be solved by adding more stimulation to the "gas pedal" (toys, role play, erotica) but research has shown that it is more liekly less activation if the "brake pedal" (sleep, a good cry, physical activty, trust)

Where does conception take place?

High in the fallpoian tubes (24 hour period where fertilization can occur)

How much sperm is ejactuled? How many make it to the ovum?

Half a billion sperm are ejaculated
About 1000 sperm reach the ovum

How long can sperm live in the vagina?

5- 7 days

When is someone considered pregnant?

Medically someone is pregnant once implantation occurs

How many pregnancies are unplanned?

40 to 50%

How many couples face infertlity challenges?

About 15%

\- they are only considered infertile if they can't conceived after a year of trying or 6 months if over 35)

What are some alternatives for those facing fertility issues?

* IVF
* Surrgoacy
* Adoption

What are miscarriages?

When the egg is fertilized, implanted and the embryo doesn't survive. Could be due to many reasons.

What are ectopic pregnancies?

When pregnancies occur outside the uterus usually in the fallopian tubes

What may increase your risk for an ectopic pregnancy?

If the women has an undiagnosed STI that has caused scar tissue to form in the fallopian tubes

What is the typical gestation period?

280 days, 40 weeks or 10 lunar months

What happens during the first trimester?

* rapid development
* major organs form
* very vulnerable period

What happens during the second trimester?

* fetus reaches viability by the end

What happens during the third trimester?

* rapid growth (gets chubby)
* fetus turns head down
* drops lower in the pelvis before birth

What occurs during stage 1 of labour?

Usually takes 12-24 hours

* cervix dialates (opens) and effaces (thins)
* contractions vecome more frequent and stronger
* ends with baby's head moving into the vagina

What occurs during stage 2 of labour?

Usually takes minutes to hours

* contractions move the baby down the vagina
* baby crowns
* ends with baby emerging from the vagina

What occurs during stage 3 of labour?

Usually takes minutes to hours

* contractions move the baby down the vagina
* baby crowns
* ends with baby emerging from the vagina

What is an Apgar score?

Assess newborn's condition at birth. A \= appearance, P \= pulse, G\= grimace, A \= activity and R \= Respiratory effect.

What are the different birthing choices available in BC?

* Obstetrician or family physician and nurses (hospital)
* Mid-wife (hospital or at home)
* Doula (provides support to parents

What are the 4 main categories of birth control?

1. Hormonal
2. Barrier
3. Natural
4. Emergency

How does hormonal methods of birth control prevent pregnancy?

Stops ovulation to prevent an egg from being released

How does barrier methods of birth control prevent pregnancy?

Keeps the sperm away from the egg

How does natural methods of birth control prevent pregnancy?

Uses rule of conception and cycles to reduce odds of sperm and egg meeting

How does emergency methods of birth control prevent pregnancy?

Interrupts conception when it is likely to have happened

What are the 4 forms of hormonal birth control?

1. Pill
2. Ring
3. Patch
4. Depo

Facts about "the pill"

* most common form of hormonal birth control
* extremely low doses of extrogen/progesterone (not at risk for reproducitve issues)
* those with breast cancer, migraine with aura and bklood clotting disorders are not able to take

Do you get your period on the pill?

Not really. Scant lining is produce which wont allow for pregnancy to survive. Scant uterine lining just kinda falls out mimicking a period

Why is there only 28 days in a pill package?

The church \n - Women were hoping for it to be approved by the pope so they made it 28 days to match

Facts about "the patch"

* transdermal
* not placed on the breast because absorption isn't as good
* each patch lasts a week

Facts about "the ring"

* dosen't need to be placed anywhere specific in the vagina
* as long as its out for less then 3 hours its fine
* lasts about a month

Facts about Depo

* an injection every 3 months
* goes in glute or deltoid
* slow release formlua

What are some side effects of Depo?

* tends to thin bone density in young women (not permanently)
* causes weight gain (about 20% gain 5lbs)

Why is there controversy over Depo?

It used to be tested on women in developing countries without their consent

What are the 3 barrier methods of birth control?

1. External condoms
2. Internal condoms
3. IUD

Facts about external condoms

* there are a flare or dome styled condom
* made of latex

What are the important steps to take to increase effectiveness of condoms?

* make sure not expired
* make sure its isnt dried up
* make sure its on the right way (toque or sombrero)
* pinch and roll all the way down
* use lube to reduce friction and breakage
* DO NOT use oil based lubes
* hold condom on when removing from body crevasse

Facts about internal condoms

* has inner and outer ring
* about $3 each
* made out of mitral which is a good transmitter of heat

Facts about IUDs

* most effective reverible method of birth control
* goes in uterus
* copper kills sperm or hormones thicken cervical wall and makes a plug
* lasts 5-7 years

What are the 3 methods of emergency birth control?

1. Plan B (levonorgestrel)
2. Ella (ulipristal)
3. Copper IUD

Facts about plan B and Ella

* pills taken after unprotected sex
* stops ovulation temporarily

What are the 4 "natural" methods of birth control?

1. Abstinence
2. Withdrawal
3. Sympto-thermal
4. Lacational amenorrhea

Facts about abstinence

* keeping penis out of the vagina
* fails about 40-50% of the time

Facts about withdrawl

* pulling out
* pre-ejaculate may contain sperm
* very unreliable

Facts about sympto-thermal

* when people track their basal temp to know when ovulating
* good method to use when trying to get pregnant
* appeals to people who are religious

What is safer sex?

Pleasureable, consensual sex which minimizes transfer of STI's

What are some signs and symptoms of STI's?

* sores or bumps
* painful or burning urination
* discharge from the penis
* unnsual or odd smelling vaginal discharge
* rash over trunk, hands or feet

What are the 4 main bacterial infections?

1. Chlamydia
2. Gonorrhea
3. Syphilis
4. Pubic Lice

What bacterial infections are starting to become resistant?

Gonorrhea and syphilis

Facts about chlamydia

* sometimes there are no signs/symptoms
* scaring in the fallopian tubes may lead to infertility
* can be transfered to babies

What are the 4 main types of viral infections?

1. Herpes
2. Hepatitis B
3. HIV
4. HPV

Facts about herpes

* may already have the herpes virus if you have had chicken poxs
* can have herpes on genitals or mouth
* can be transfered sores to babies
* first outbreak is painful/extreme
* stress can cause outbreaks

Facts about hepatitis B

* transferred through musous membrane, blood, feces
* affects liver (and potentially immunity if liver is not 100%)
* immune if you have recieved the vaccine

Facts about HIV

* Human immunodeficency virus
* transferred through semen (not sperm) or blood
* can be controlled with medication