Republic of the Philippines

Surigao del Sur State University

Rosario, Tandag City, Surigao del Sur 8300
Telefax No. 086-214-4221
Website: www.sdssu.edu.ph
_____________________________________________________________________________________

Chapter 2
Unpacking the Self

“Don’t belittle yourself, Be Big

yourself “
-Corita Kent

Introduction

We are living in a world where the material and immaterial self are both
represented. How is that possible? Thanks to advances in technology, we not only live
in a physical world, we also have virtual reality. How do you view yourself in both
worlds?

Society shapes us in many ways, possibly more than we realize it. This involves:

 Ho we perceive our bodies visually

 How we feel about our physical appearance
 How we think and talk to ourselves about our bodies; and
 Our sense of how the other people view our bodies.

The current embedded idea of what is attractive, beautiful, or handsome is an

unrealistic image, which is genetically impossible for many of us to emulate. This
unrealistic image is continually driven into our minds by the media through ads, movies,
and TV shows. The media is a very powerful tool in reinforcing cultural beliefs and
values. Although it is not fully responsible for determining the standards for physical
attractiveness, it makes escaping the barrage of images and attitudes almost impossible
to escape.

A positive view of “self” involves understanding that healthy, attractive bodies come
in many shapes and sizes, and that physical appearance says very little about our
character or value as a person.

Lesson 1 – Physical and Sexual Self

 “ Beauty is when you can appreciate yourself. When you love
yourself, that’s when you’re most beautiful. “

-Zoe Kravitz

Chapter Overview

In this chapter, the student will explore some of the various aspects that make up the
self, such as the biological and materials to the spiritual and political, including the more
recent digital self. Moreover, the student will also reflect on a concrete experience on a
holistic point of view.

I. Objective
At the end of the chapter, the students will be able to unpack the self in
various aspects.
II. Learning outcomes
1. Discuss the developmental aspect of the reproductive system;
2. Describe the erogenous zones;
3. Explain human sexual behavior;
4. Characterize the diversity of sexual behavior;
5. Describe sexually transmitted diseases; and
6. Differentiate natural and artificial methods of contraception.

INTRODUCTION

It has been believed that the sex chromosomes of humans define the sex (female
or male) and their secondary sexual characteristics. From childhood, we are controlled
by our genetic makeup. It influences the way we treat ourselves and others. However,
there are individuals who do not accept their innate sexual characteristics and they tend
to change their sexual organs through medications and surgery. Aside from our genes,
our society or the external environment helps shape our selves. This lesson helps us
better understand ourselves through a discussion on the development of our sexual
characteristics and behavior.

ABSTRACTION

Marieb, E.N. (2001) explains that the gonads (reproductive glands that produce
the gametes; testis or ovary) begin to form until about the eighth week of embryonic
development. During the early stages of human development, the embryonic
reproductive structures of males and females are alike and are said to be in the
indifferent stage. When the primary reproductive structures are formed, development of
the accessory structures and external genitalia begins. The formation of male or female
structures depends on the presence of testosterone. Usually, once formed, the
embryonic testes release testosterone, and the formation of the duct system and
external genitalia follows. In the case of female embryos that form ovaries, it will cause
the development of the female ducts and external genitalia since testosterone hormone
is not produced.

Any intervention with the normal pattern of sex hormone production in the embryo
results in strange abnormalities. For instance, a genetic male develops the female
accessory structures and external genitalia if the embryonic testes fail to produce
testosterone. On the other hand, if a genetic female is exposed to testosterone (as in the
case of a mother with androgen-producing tumor of her adrenal gland), the embryo has
ovaries but may develop male accessory ducts and glands, as well as a male
reproductive organ and an empty scrotum. As a result, pseudohermaphrodites are
formed who are individuals having accessory reproductive structures that do not “match”
their gonads while true hermaphrodites are individuals who possess both ovarian and
testicular tissues but this condition is rare in nature. Nowadays, many
pseudhermaphrodites undergo sex change operations to have their outer selves
(external genitalia) fit with their inner selves (gonads).

A critical event for the development of reproductive organs takes place about one
month before birth wherein the male testes formed in the abdominal cavity at
approximately the same location as the female ovaries, descend to enter the scrotum. If
this normal event fails, it may lead to cryptorchidism. This condition usually occurs in
young males and causes sterility (which is also risk factor for cancer of the testes) that is
why surgery is usually performed during childhood to solve this problem.

Moreover, abnormal separation of chromosomes during meiosis can lead o

congenital defects of the reproductive system. For instance, males who possess extra
female sex chromosome have the normal male accessory structures, but atrophy (to
shrink) of their testes causes them to be sterile. Other abnormalities results when a child
has only one sex chromosome. An XO female appears normal but lacks ovaries. YO
males die during development. Other much less serious conditions also affect males
primarily such as phimosis, which is due to narrowing of the foreskin of the male
reproductive structure and misplaced urethral openings.

Puberty is the period of life, generally between the ages of 10 and 15 years old,
when the reproductive organs grow to their adult size and become functional under the
influence of rising levels of gonadal hormones (testosterone in males and estrogen in
females). After this time, reproductive capability continues until old age in males and
menopause in females.

The changes that occur during puberty is similar in sequence in all individuals but
the age which they occur differs among individuals. In males, as they reach the age of
13, puberty is characterized by the increase in the size of the reproductive organs
followed by the appearance of the hair in the pubic area, axillary, and face. The
reproductive organs continue to grow for two years until sexual maturation marked by
the presence of mature semen in the testes.

In females, the budding of their breasts usually occurring at the age of 11 signals
their puberty stage. Menarche is the first menstrual period of females which happens
two years after the start of puberty. Hormones play an important role in the regulation of
ovulation and fertility of females.

Diseases Associated with the Reproductive System

Infections are the most common problems associated with the reproductive
system in adults. Vaginal infections are more common in young and elderly women and
in those whose resistance to diseases is low. The usual infections include those caused
by Escherichia coli which spread through the digestive tract; the sexually transmitted
microorganisms such as syphilis, gonorrhea, and herpes virus; and yeast (a type of
fungus). Vaginal infections that are left untreated may spread throughout the female
reproductive tract and may cause pelvic inflammatory disease and sterility. Problems
that involve painful or abnormal menses may also be due to infection or hormone
imbalance.

In males, the most common inflammatory condition are prostatitis, urethritis, and
epididymitis, all of which may follow sexual contacts in which sexually transmitted
disease (STD) microorganisms are transmitted. Orchiditis, or inflammation of the testes,
is rather uncommon but is serious because it can cause sterility. Orchiditis most
commonly follows mumps in an adult male.

Neoplasms are a major threat to reproductive organs. Tumors of the breast and
cervix are the most common reproductive cancers in adult females, and prostate cancer
(a common sequel to prostatic hypertrophy) is a widespread problem in adult males.

Most women hit the highest point of their reproductive abilities in their late 20’s. A
natural decrease in ovarian function usually follows characterized by reduce estrogen
production that caused irregular ovulation and shorter menstrual periods. Consequently,
ovulation and menses stop entirely, ending childbearing ability. This event is called as
menopause, which occurs when females no longer experience menstruation.

The production of estrogen may still continue after menopause but the ovaries
finally stop functioning as endocrine organs. The reproductive organs and breast begin
to atrophy or shrink if estrogen is no longer released from the body. The vagina
becomes dry that causes intercourse to become painful (particularly if frequent), and
vaginal infections become increasingly common. Other consequences of estrogen
deficiency may also be observed including irritability and other mood changes
(depression in some); intense vasodilation of the skin’s blood vessels, which causes
uncomfortable sweat – drenching “hot flashes”; gradual thinning of the skin and loss of
bone mass; and slowly rising blood cholesterol levels, which place postmenopausal
women at risk for cardiovascular disorders. Some physicians prescribe low-dose
estrogen-progestin preparations to help women through this usually difficult period and
to prevent skeletal and cardiovascular complications.
 There is no counterpart for menopause in males. Although aging men show a
steady decline in testosterone secretion, their reproductive capability seems unending.
Healthy men are still able to father offspring well into their 80’s and beyond.

Erogenous Zones

Erogenous zones refer to parts of the body that are primarily receptive and
increase sexual arousal when touched in a sexual manner. Some of the commonly
known erogenous zones are the mouth, breast, genitals, and anus. Erogenous zones
may vary from one person to another. Some people may enjoy being touched in a
certain area more than the other areas. Other common area of the body that can be
aroused easily may include the neck, thighs, abdomen, and feet.

Human Sexual Behavior

Human sexual behavior is defined as any activity – solitary, between two

persons, or in a group – that induces sexual arousal (Gebhard, P.H. 2017). There are
two major factors that determine human sexual behavior: the inherited sexual response
patterns that have evolved as a means of ensuring reproduction and that become part of
each individual’s genetic inheritance, and the degree of restraint or other types of
influence exerted on the individual by society in the expression of his sexuality.

Types of Behavior

The various types of human sexual behavior are usually classified according to
the gender and number of participants. There is solitary behavior involving only one
individual, and there is sociosexual behavior involving more than one person.
Sociosexual behavior is generally divided into heterosexual behavior (male with female)
and homosexual behavior (male with male or female with female). If three or more
individual are involved, it is, possible to have heterosexual and homosexual activity
simultaneously (Gebhard, P.H. 2017).

1. Solitary Behavior
Self – gratification means self – stimulation that leads to sexual arousal
and generally, sexual climax. Usually, most self- gratification takes place in
private as an end in itself, but can also be done in sociosexual relationship.
Self – gratification, generally beginning at or before puberty, is very
common among young males, but becomes less frequent or is abandoned
when sociosexual activity is available. Consequently, self – gratification is
most frequent among the unmarried. There are more males who perform
acts of self – gratification than females. The frequency greatly varies
among individuals and it usually decreases as soon as they develop
sociosexual relationships.
Majority of males and females have fantasies of some sociosexual activity
while they gratify themselves. The fantasy frequently involves idealized
sexual partners and activities that the individual has not experienced and
might avoid in real life.
 Nowadays, humans are frequently being exposed to sexual stimuli
especially from advertising and social media. Some adolescents become
aggressive when they respond to such stimuli. The rate of teenage
pregnancy is increasing in our time. The challenge is to develop self –
control in order to balance suppression and free expression. Adolescents
need to control their sexual response in order to prevent premarital sex
and acquire sexually transmitted diseases.
2. Sociosexual Behavior
Heterosexual behavior is the greatest amount of sociosexual behavior that
occurs between only one male and one female. It usually begins in
childhood and may be motivated by curiosity, such as showing or
examining genitalia. There is varying degree of sexual impulse and
responsiveness among children. Physical contact involving necking or
petting is considered as an ingredient of the learning process and
eventually of courtship and the selection of a marriage partner.
Petting differs from hugging, kissing, and generalize caresses of the
clothed body to practice involving stimulation of the genitals. Petting may
be done as an expression of affection and a source of pleasure,
preliminary to coitus. Petting has been regarded by others as a near –
universal human experience and is important not only in selecting the
partner but as a way of learning how to interact with another person
sexually.
Coitus, the insertion of the male reproductive structure into the female
reproductive organ, is viewed by society quite differently depending upon
the marital status of the individuals. Majority of human societies allow
premarital coitus, at least under certain circumstances. In modern western
society, premarital coitus is more likely to be tolerated but not encouraged
if the individuals intend marriage. Moreover, in most societies, marital
coitus is considered as an obligation. Extramarital coitus involving wives is
generally condemned and, if permitted, is allowed only under exceptional
conditions or with specified persons. Societies are becoming more
considerate toward males than females who engage in extramarital coitus.
This double standard of morality is also evident in premarital life.
Postmarital coitus (i.e., coitus by separated, divorced or widowed persons)
is almost always ignored.

There is a difficulty in enforcing abstinence among sexually experienced

and usually older people for societies that try to confine coitus in married
couples.
A behavior may be interpreted by society or the individual as erotic (i.e.,
capable of engendering sexual response) depending on the context in
which the behavior occurs. For instance, a kiss may be interpreted as a
gesture of expression or intimacy between couples while the others may
interpret is as a form of respect or reverence, like when kissing the hand of
an elder or someone in authority. Examination and touching someone’s
genitalia is not interpreted as a sexual act especially when done for
 medical purposes. Consequently, the apparent motivation of the behavior
greatly determines its interpretation.

Physiology of Human Sexual Response

Sexual response follows a pattern of sequential stages or phases when sexual

activity is continued.

1. Excitement phase – it is caused by increase in pulse and blood pressure; a

sudden rise of blood supply to the surface of the body resulting in increased skin
temperature, flushing, and swelling of all distensible body parts (particularly
noticeable in the male reproductive structure and female breasts), more rapid
breathing, the secretion of genital fluids, vaginal expansion, and a general
increase in muscle tension. These symptoms of arousal eventually increase to a
near maximal physiological level that leads to the next stage.
2. Plateau phase – it is generally of brief duration. If stimulation is continued,
orgasm usually occurs.
3. Sexual climax – it is marked by a feeling of abrupt, intense pleasure, a rapid
increase in pulse rate and blood pressure, and spasms of the pelvic muscles
causing contractions of the female reproductive organ and ejaculation by the
male. It is also characterized by involuntary vocalizations. Sexual climax may last
for a few seconds (normally not over ten), after which the individual enters the
resolution phase.
4. Resolution phase – it is the last stage that refers to the return to a normal or
subnormal physiologic state. Males and females are similar in their response
sequence. Whereas males return to normal even if stimulation continues, but
continued stimulation can produce additional orgasms in females. Females are
physically capable of repeated orgasms without the intervening “rest period”
required by males.

Nervous System Factors

The entire nervous system plays a significant role during sexual response. The
autonomic system is involved in controlling the involuntary responses. In the
presence of a stimulus capable enough of initiating a sexual response, the efferent
cerebrospinal nerves transmit the sensory messages to the brain. The brain will
interpret the sensory message and dictate what will be the immediate and
appropriate response of the body. After interpretation and integration of sensory
input, the efferent cerebrospinal nerves receive commands from the brain and send
them to the muscles;

And the spinal cord serves as a great transmission cable. The muscle contract in
response to the signal coming from the motor nerve fibers while glands secrete their
respective products. Hence, sexual response is dependent on the activity of the
nervous system.
 The hypothalamus and the limbic system are the parts of the brain believed to be
responsible for regulating the sexual response, but there is no specialized “sex
center” that has been located in the human brain. Animal experiments show that
each individual has coded in its brain two sexual response patterns, one for
mounting (masculine) behavior and one for mounted (feminine) behavior. Sex
hormones can intensify the mounting behavior of individuals. Normally, one response
pattern is dominant and the other latent can still be initiated when suitable
circumstances occur. The degree to which such innate pattering exists in humans is
still unknown.

Apart from brain – controlled sexual responses, there is some reflex (i.e., not
brain – controlled) sexual response. This reflex is mediated by the lower spinal cord and
leads to erection and ejaculation for male, vaginal discharges and lubrication for female
when the genital and perineal areas are stimulated. But still, the brain can overrule and
suppress such reflex activity – as it does when an individual decides that a sexual
response is socially inappropriate.

Sexual Problems

Sexual problems may be classified as physiological, psychological, and social in

origin. Any given problem may involve all the three categories.Sexual problems may be
classified as physiological, psychological, and social in origin. Any given problem may
involve all the three categories.

Physiological problems are the least among the three categories. Only a small
number of people suffer from diseases that are due to abnormal development of the
genitalia or that part of the neurophysiology controlling sexual response. Some common
physiologic conditions that can disturb sexual response include vaginal infections,
retroverted uteri, prostatitis, adrenal tumors, diabetes, senile changes of the vagina, and
cardiovascular problems. Fortunately, the majority of physiological sexual problems can
be resolved through medication or surgery while problems of the nervous system that
can affect sexual response are more difficult to treat.

Psychological problems comprise by far the largest category. They are usually
caused by socially induced inhibitions, maladaptive attitudes, ignorance, and sexual
myths held by society. An example of the later is the belief that good, mature sex must
involve rapid erection, prolonged coitus, and simultaneous orgasm. Magazines,
marriage books, and general sexual folklore often strengthen these demanding ideals,
which are not always achieved therefore, can give rise to feelings of inadequacy anxiety
and guilt. Such resulting negative emotions can definitely affect the behavior of an
individual.

Premature emission of semen is a common problem, especially for young males.

Sometimes this is not the consequence of any psychological problem but the natural
result of excessive tension in a male who has been sexually deprived. Erectile
impotence is almost always of psychological origin in males under 40; in older males,
physical causes are more often involved. Fear of being impotent frequently causes
impotence, and, in many cases, the afflicted male is simply caught up in a self –
perpetuating problem that can be solved only by achieving a successful act of coitus. In
other cases, the impotence may be result of disinterest in the sexual partner, fatigue and
distraction because of nonsexual worries, intoxication, or other causes – such occasion
impotency is common and requires no therapy.

Ejaculatory impotence, which results from the inability to ejaculate in coitus, is

uncommon and is usually of psychogenic origin. It appears to be associated with ideas
of contamination or with memories of traumatic experiences. Occasional ejaculatory
inability can be possibly expected in older men or in any male who has exceeded his
sexual capacity.

Vaginismus is a strong spasm of the pelvic musculature constricting the female

reproductive organ so that penetration is painful or impossible. It can be due to anti –
sexual conditioning or psychological trauma that serves as an unconscious defense
against coitus. It can be treated by psychotherapy and by gradually dilating the female
reproductive organ with increasingly large cylinders.

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) are infections transmitted from an infected

person to an uninfected person through sexual contact. STDs can be caused by
bacteria, viruses, or parasites. Examples include gonorrhea, genital herpes, human
papillomavirus infection. Human Immunodeficiency Virus (HIV), Acquired
Immunodeficiency Syndrome (AIDS), chlamydia, and syphilis (National Institute of
Allergy and Infectious Diseases of the National Institute of Health of the united States
2017).

STDs are a significant global health priority because of their overwhelming impact
on women and infants and their inter – relationships with HIV and AIDS. STDs and HIV
are associated with biological interactions because both infections may occur in the
same populations. Infection with certain STDs can increase the risk of getting and
transmitting HIV as well as modify the way the disease develops. Moreover, STDs can
lead to long-term health problems, usually in women and infants. Among the health
complications that arise from STDs are pelvic inflammatory disease, infertility, tubal or
ectopic pregnancy, cervical cancer, and perinatal or congenital infections in infants born
to infected mothers. One of the leading STDs worldwide is AIDS, which is caused by
HIV or Human Immunodeficiency Virus. The virus attacks the immune system making
the individual more prone to infections and other diseases. The virus usually targets the
T – cells (CD4 cells) of the immune system, which serve as the regulators of the immune
system. The virus survives throughout the body but may be transmitted via body fluids
such as blood, semen, vaginal fluids and breast milk. AIDS occur in the advanced stage
of HIV infection.

Aside from HIV and AIDS, there are other sexually transmitted diseases in
humans. The following list of diseases is based on Sexually Transmitted Disease
Surveillance 2016 of the U.S Department of Health and Human Services Centers for
Disease Control and Prevention.
1. Chlamydia
In 2016, a total of 1,598,354 cases of Chlamydia Trachomatis infection
were reported to the Centers for Disease Control and Prevention (CDC),
making it the most common notifiable condition in the United States. This
case count corresponds to a rate of 497.3 cases per 100,000 population,
an increase of 4.7% compared with the rate in 2015. During 2015 to 2016,
rates of reported chlamydia increased in all regions of the United States.
Rates of chlamydia are highest among adolescent and young adult
females, the population targeted for routine chlamydia screening. Among
young women attending family planning clinics participating in as sentinel
surveillance program who were tested for chlamydia, 9.2% of 15 to 19
years old and 8.0% of 20 to 24 years old were positive. Rates of reported
cases among men are generally lower than rates among women.
2. Gonorrhea

In 2016, 468,514 gonorrhea cases were reported for a rate of 145.8 cases
per 100,000 population, an increase of 18.5% from 2015. During 2015 to
2016, the rate of reported gonorrhea increased 22.2% among men and
13.8% among women. The magnitude of the increase among men suggest
either increased transmission or increased case ascertainment (e.g.,
through increased extra-genital screening) among MSM (men who have
sex with men) or both
The concurrent increases among cases reported among women suggest
parallel increases in heterosexual transmission, increased screening
among women, or both. In 2016, the rate of reported cases of gonorrhea
remained highest among African Americans (481.2 cases per 100,000
population) and among American Indians/Alaska Natives (242.9 cases per
100,000 population). During 2012 to 2016, rates increased among all racial
and ethnic groups. Antimicrobial resistance remains an important
consideration in the treatment of gonorrhea.
3. Syphilis
In 2016, 27,814 Primary and Secondary (P&S) syphilis cases were
reported, representing a national rate of 8.7 cases per 100,000 population
and a 17.6% increase from 2015. From 2015 to 2016, the P&S syphilis
rate increase among both men and women in every region of the country;
overall the rate increased 14.7% among men and 35.7% among women.
During 2012 to 2016, P&S syphilis rates were consistently highest among
persons aged 20 to 29 years old, but rates increased on every 5-year age
group among those aged 15 to 64 years. In 2016, rates were highest
among African Americans (23.3 per 100,000 population) and Native
Hawaiian/Other Pacific Islanders (13.9 per 100,000 population); however,
rates increased among all racial and ethnic groups in 2012 to 2016.
4. Chancroid

Chancroid is caused by infection with the bacterium Haemophilus ducreyi.

Clinical manifestations include genital ulcers and inguinal
 lymphadenopathy or buboes. Reported cases of chancoid declined
steadily between 1987 and 2001. Since then, the number of reported
cases has fluctuated somewhat, while still appearing to decline overall. In
2016, a total of 7 cases of chancroid were reported in the United States.

5. Human Papillomavirus

Human papillomavirus (HPV) is the most common sexually transmitted

infection in the United States. Over40 distinct HPV types can infect the genital
tract; although most infections are asymptomatic and appear to resolve
spontaneously within a few years,

the prevalence of genital infection with any HPV type was 42.5% among United
States adults aged 18 to 59 years during 2013 to 2014. Persistent infection with
some HPV types can cause cancer and genital warts. HPV types 16 and 18
account for approximately 66% of cervical cancers in the United States, and
approximately 25% of low-grade and 50% of high-grade cervical intraepithelial
lesions, or dysplasia. HPV types 6 and 11 are responsible for approximately 90%
of genital warts.
6. Herpes Simplex Virus
Herpes simplex virus (HSV) is among the most prevalent of sexually
transmitted infections. Although most infections are subclinical, clinical
manifestations are characterized by recurrent, painful genital and/or anal lesions.
Most genital HSV infections in the United States are caused by HSV type 2 (HSV-
2), while HSV type 1 (HSV-1) infections are typically orolabial and acquired
during childhood.
7. Trichomonas Vaginalis
Trichomonas vaginalis is a common sexualy transmitted protozoal infection
associated with adverse health outcomes such as preterm birth and symptomatic
vaginitis. It is not a nationally reported condition, and trend data are limited to
estimates of initial physician office visits for this condition. Visits appear to be
fairly stable since 1990s; the number of initial visits for Trichomonas vaginalis
infection in 2015 was 139,000.

Natural and Artificial Methods of Contraception

Natural method

The natural family planning methods do not involve any chemical or foreign body
introduction into the human body. People who are very conscious of their religious
beliefs are more inclined to use the natural way of birth control and others follow such
natural methods because they are more cost-effective (www.nurseslabs.com 2016).

a. Abstinence
This natural method involves refraining from sexual intercourse and is the
most effective natural birth control method with ideally 0% fail rate. It is
 considered to be the most effective way to avoid STIs (Sexual Transmitted
Infections). However, most people find it difficult to comply with abstinence,
so only a few use this method.

b. Calendar Method
This method is also called as the rhythm method. It entails withholding
from coitus during the days that the woman is fertile. According to the
menstrual cycle, the woman is likely to conceive three or four days before and
three or four days after ovulation. The woman needs to record her menstrual
cycle for six months in order to calculate the woman’s safe days to prevent
conception.
c. Basal Body Temperature
The basal body temperature (BBT) indicates the woman’s temperature at
rest. Before the day of ovulation and during the ovulation, BBT falls at
0.50F; it increases to a full degree because of progesterone and maintains
its level throughout the menstrual cycle. This serves as the basis for the
method. The woman must record her temperature every morning before
any activity. A slight decrease in the basal body temperature followed by a
gradual increase in the basal body temperature can be a sign that a
woman has ovulated.
d. Cervical Mucus Method
The change in the cervical mucus during ovulation is the basis for this
method. During ovulation, the cervical mucus is copious, thin, and watery.
It also exhibits the property of spinnbarkeit, wherein it can be stretched up
until at least 1 inch and is slippery. The woman is said to be fertile as long
as the cervical mucus is copious and watery. Therefore, she must avoid
coitus during those days to prevent conception.
e. Symptothermal Method
The symptothermal method is basically a combination of the BBT method
and the cervical mucus method. The woman records her temperature
every morning and also takes note of the changes in her cervical mucus.
She should abstain from coitus three days after a rise in her temperature
or on the fourth day after the peak of a mucus change.
f. Ovulation Detection
The ovulation detection method uses an over-the-counter kit that requires
the urine sample of the woman. The kit can predict ovulation through the
surge of luteinizing hormone (LH) that happens 12 to 24 hours before
ovulation.
g. Coitus Interruptus
 Coitus Interruptus is one of the oldest methods that prevents conception. A
couple still goes on with coitus, but the man withdraws the moment he
ejaculates to emit the spermatozoa outside of the female reproductive
organ. A disadvantage of this method is the pre-ejaculation fluid that
contains a few spermatozoa that may cause fertilization.

Artificial Methods

a. Oral Contraceptives
Also known as the pill, oral contraceptives contain synthetic estrogen and
progesterone. Estrogen suppresses the Follicle Stimulating Hormone
(FSH) and LH to prevent ovulation. Moreover, progesterone decreases the
permeability of the cervical mucus to limit the sperm’s access to the ova. It
is suggested that the woman takes the first pill on the first Sunday after the
beginning of a menstrual flow, or as soon as it is prescribed by the doctor.
b. Transdermal Patch

The transdermal patch contains both estrogen and progesterone. The

woman should apply one patch every week for three weeks on the
following areas: upper outer arm, upper torso, abdomen, or buttocks. At
the fourth week, no patch is applied because the menstrual flow would
then occur. The area where the patch is applied should be clean, dry, and
free of irration.

c. Vaginal Ring
The vaginal ring releases a combination of estrogen and progesterone and
it sorrounds the cervix. This silicon ring is inserted into the female reproductive
organ and remains there for three weeks and then removed on the fourth
week, as menstrual flow would occur. The woman becomes fertile as soon as
the ring removed.
d. Subdermal Implants
Subdermal implants are two rod-like implants inserted under the skin of the
female during her menses or on the seventh day of her menstrual to make
sure that she will not get pregnant. The implants are made with etonogestrel,
desogestrel, and progestin and can be helpful for three to five years.
e. Hormonal Injections
A hormonal injection contains medroxyprogesterone, a progesterone, and
is usually given once every 12 weeks intramuscularly. The injection causes
changes in the endometrium and cervical mucus and can help prevent
ovulation.
f. Intrauterine Device
An Intrauterine device (IUD) is a small, T-shaped object containing
progesterone that is inserted into the uterus via the female reproductive
organ.
 It prevents fertilization by creating a local sterile inflammatory condition to
prevent implantation of the zygote. The IUD is fitted only by the physician and
inserted after the woman’s menstrual flow. The device can be effective for five
to seven years.
g. Chemical Barriers
Chemical barriers such as spermicides, vaginal gels and creams, and
glycerin films are used to cause the death of sperms before they can enter the
cervix and to lower the pH level of the female reproductive organ so it will not
become conductive for the sperm. On the other hand, these chemical barriers
cannot prevent sexually transmitted infections.

h. Diaphragm

It is circular, rubber disk that fits the cervix and should be placed before
coitus. Diaphragm works by inhibiting the entrance of the sperm into the
female reproductive organ and it works better when used together with the
spermicide. The diaphragm should be fitted only by the physician, and should
remain in place for six hours after coitus.
i. Cervical Cap
The cervical cap is made of soft rubber and fitted on the rim of the cervix. It
is shaped like a thimble with a thin rim, and could stay in place for not more
than 48 hours.
j. Male Condoms
The male condom is a latex or synthetic rubber sheath that is placed on
the erect male reproductive organ before penetration into the female
reproductive organ to trap the sperm during ejaculation. It can prevent STIs
(Sexually Transmitted Infections) and can be bought over-the-counter. Male
condoms have an ideal fail rate of 2% and a typical fail rate of 15% due to a
break in the sheath’s integrity or spilling of semen.
k. Female Condoms
Female condoms are made of latex rubber sheaths that are pre-lubricated
with spermicide. They are usually bound by two rings. The outer ring is first
inserted against the opening of the female reproductive organ and the inner
ring covers the cervix. It is used to prevent fertilization of the egg by the sperm
cells.
l. Surgical Methods
During vasectomy, a small incision is made on each side of the scrotum.
The vas deferens is then tied, cauterized, cut, or plugged to block the passage
of the sperm. The patient is advised to use a backup contraceptive method
until two negative sperm count results are recorded because the sperm could
remain viable in the vas deferens for six months.
In women, tubal ligation is performed after menstruation and before
ovulation. The procedure is done through a small incision under the woman’s
umbilicus that targets the fallopian tube for cutting, cauterizing, or blocking to
inhibit the passage of both the sperm and the ova.
Lesson 2: To Buy or Not to Buy? That is the Question!