SEXUAL AND REPRODUCTIVE HEALTH

Learning Outcomes

• Explore effective teaching and learning strategies for:

• Prevention of unwanted pregnancies

• Prevention of sexually transmitted diseases (STDs)

• Identify ways to control/manage said diseases

Sexual Health

• Definition and Importance:

  • Fundamental for the overall health and well-being of individuals and families.

  • Impact on community and national social and economic development.

  • Promotes pleasurable and safe sexual experiences free from coercion, discrimination, and violence.

Achieving Positive Sexual Health

• Key Components:

  • Access to comprehensive and quality information about sex and sexuality.

  • Understanding the risks and vulnerabilities of unprotected sex.

  • Ability to access sexual care and services.

  • Living in a supportive environment that promotes sexual health.

Sexual Health Related Issues

• Common issues include:

  • Sexually transmitted infections (STIs), with various outcomes.

  • Unintended pregnancies and abortion.

  • Sexual dysfunction.

  • Sexual violence.

  • Harmful practices (e.g., female genital mutilation).

Reproductive Health

• Definition:

  • The ability to have a satisfying and safe sex life.

  • Capability to reproduce with autonomy regarding the timing and frequency of reproduction.

Family Planning

• Definition: Utilization of modern methods to manage:

• Number of children.

• Spacing of children (recommended spacing: 3-5 years as per DOH).

Misconceptions about Family Planning

• Family planning is often misunderstood as:

• Advocacy for abortion.

• Having harmful adverse effects.

• Reducing libido.

• Being laborious and expensive.

Benefits of Family Planning

• Family planning leads to:

• Halting population growth.

• Economic well-being.

• Reduction in maternal morbidity and mortality.

• Empowerment and education for individuals.

• Prevention of STDs.

Republic Act 10354

• Responsible Parenthood and Reproductive Act of 2012:

• Enacted on December 21, 2012.

• Implemented under President Benigno S. Aquino III.

Section 4: Definition of Key Terms

• Abortifacient: Drug/device that induces abortion or destroys a fetus.

• Family Planning: Access to a range of non-abortifacient methods of pregnancy planning.

• Responsible Parenting: Parental ability to meet the family's needs and aspirations.

• Reproductive Health: Complete well-being relating to the reproductive system, beyond mere absence of disease.

• Reproductive Health Care: Access to necessary methods and services for reproductive health.

Section 7: Access to Family Planning

• Conditions:

• Use of accredited health facilities.

• Right to medical information.

• Parental consent required for individuals below 18.

Section 23: Prohibited Acts

• Responsibilities of Healthcare Professionals:

• Withholding information or refusal to perform procedures is prohibited.

Natural Family Planning Method (Calendar Method)

• Identification of Fertile Days:

• Track menstrual cycle across several months to determine shortest and longest cycles.

• Calculate fertile days by adjusting cycle lengths according to the method.

Considerations

• Factors like irregular cycles, recent childbirth, and hormonal methods can affect accuracy.

Stages of Menstrual Cycle

1. Menstrual Phase: Shedding of the uterine lining, lasting about 3-7 days.

2. Follicular Phase: Start Date 1st day of menstruation; pituitary gland secretes FSH, leading to follicle growth and estrogen production.

3. Ovulation: Triggered by a surge in LH; usually occurs around day 14, when a matured egg is released from the ovary.

4. Luteal Phase: After ovulation, the remaining follicle transforms into corpus luteum, producing progesterone. If no fertilization occurs, hormone levels drop, leading back to the menstrual phase.

Determining First Fertile Day

1. Identify the Shortest Cycle.

2. Subtract 18 Days from the Shortest Cycle.

3. Count (X) Days starting from the First Day of the Current Cycle.

4. (X) Day will be the First Fertile Day.

Determining Last Fertile Day

1. Identify the Longest Cycle.

2. Subtract 11 Days from the Longest Cycle (N).

3. Count (X) Days starting from the First Day of the Current Cycle.

4. (N) Day will be the Last Fertile Day.

Contraceptive Beads

• Operates on the same principle as the Calendar Method.

• Distinguishes Non-Fertile from Fertile Days.

• Color coding

  • Color Coding:

  • Red: Menstrual Days

  • Brown: Non-Fertile Days

  • White: Fertile Days

  • Transparent: Post-Ovulation Days

  • Color variations may differ depending on the manufacturer (Cycle Beads).

Other Natural Methods

• BBT Method: Involves tracking body temperature.

• Cervical Mucus Method: Observes changes in cervical mucus.

• Coitus Interruptus: Withdrawal method before ejaculation.

Lactation Amenorrhea

• Temporary postnatal infertility when breastfeeding is exclusive and menstruation has not resumed:

• Lasts for up to 6 months and requires specific breastfeeding conditions.

Artificial Family Planning Methods

• Intrauterine Device (IUD):

  • Types:

  • Hormonal – Progestin Or Levonorgestrel

    • Brand Names: Liletta Iud (52mg), Skyla Iud

      (13.5mg) Kyleena Iud (19.5mg), Mirena Iud (52mg)

  • Copper – Damages Sperm Cells

    • Brand Names: Paraguard Iud

  • Function: Prevents sperm function and fertilization.

• Barrier Methods:

  • Male and female condoms.

• Surgical Sterilization:

  • No scalpel vasectomy: A minimally invasive technique for male sterilization.

  • Tubal ligation: A surgical procedure for female sterilization, blocking or sealing the fallopian tubes.

• Hormonal Methods:

  • Birth Control Patches: Deliver hormones transdermally to prevent ovulation and regulate menstrual cycles—5×5 cm in size.

  • Vaginal Rings: Releases hormones locally to inhibit ovulation and reduce menstrual symptoms for up to 3 weeks.

  • Pills:

    • Combination Oral Pills: Contain both estrogen and progestin, preventing ovulation and regulating menstrual cycles.

    • Progestin-Only Pills: Contains only progestin, primarily used by those who cannot take estrogen..

• Emergency Contraception:

  • Plan B Pill/Morning After Pill: taken within specific hours after unprotected sex. It's not an abortion pill.

• Implant

• 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

• 3 years effectivity

Sexually Transmitted Infections (STIs)

• Common STI types include

• Syphilis

• Trichomoniasis

• Gonorrhea

• Chlamydia

• Herpes

• Human papillomavirus (HPV)

Syphilis

• Ca: Treponema pallidum.

• Stages: Primary (chancre), Secondary (rashes), Latent, Tertiary (systemic).

• Diagnosis: Involves various tests like RPR and dark field microscopy.

• Treatment: Penicillin or doxycycline.

Trichomoniasis

• Symptoms: Strawberry cervix and yellow-green discharge.

• Diagnosis: Trichomonads on wet mount.

• Treatment: Metronidazole or tinidazole.

Gonorrhea

• Symptoms: Discharge, bleeding, dysuria.

• Diagnosis: PCR, culture methods.

• Treatment: Ceftriaxone and azithromycin.

Chlamydia

• Symptoms: Similar to gonorrhea, with discharge and pain.

• Diagnosis: Includes PCR and ELISA.

• Treatment: Azithromycin or doxycycline.

Herpes Simplex

• Symptoms: Cold sores.

• Diagnosis: PCR or culture tests.

• Treatment: Acyclovir and other antivirals.

Human Papillomavirus (HPV)

• Symptoms: Warts; can lead to cancer.

• Vaccine available for prevention.

References

• McKenzie, James, et al. An Introduction to Community Health, 2nd Edition, Jones and Bartlett Learning, LLC.

• Tulchinsky, Varavikova, The New Public Health, 2nd Edition, Elsevier Academic Press.