OVERVIEW

Understanding and experiencing the self includes a discussion on the biological

factors and sexual behavior that includes the reproductive system and the sex
characteristics that differentiate between man and woman. The reproductive system is
designed for reproduction and sexual functions which does not only affect how
individuals view themselves but also their sexuality and sexual relationships.

This module also includes discussion on sexual behaviors which include early
pregnancy and sexually transmitted infections and the recommended strategies on how
the occurrence of such.

THE SEXUAL SELF

INTRODUCTION

Talking about sex should not be considered as a taboo, but instead be deemed
normal for there is a need for people to learn more about their sexuality. Too many
young people receive confusing and conflicting information about relationships and sex,
as they make the transition from childhood to adulthood. This has led to an increasing
demand from young people for reliable information, which prepares them for a safe,
productive and fulfilling life. Sexuality education responds to this demand, empowering
young people to make informed decisions about relationships and sexuality and
navigate a world where gender-based violence, gender inequality, early and unintended
pregnancies, HIV and other sexually transmitted infections (STIs) still pose serious risks
to their health and well-being. Equally, a lack of high-quality, age and developmentally-
appropriate sexuality and relationship education may leave children and young people
vulnerable to harmful sexual behaviors and sexual exploitation.

Sexuality is an essential component of healthy development for young people.

U.S. Surgeon General David Satcher echoed these sentiments, stating that, “sexuality is
an integral part of human life,” and “sexual health is inextricably bound to both physical
and mental health.”

THE DEVELOPMENT OF SEX CHARACTERISTICS

PRIMARY SEXUAL CHARACTERISTICS

Primary sexual characteristics refer to the reproductive organs themselves; e.g.,

the ovaries and testes. Secondary sexual characteristics refer to other characteristic
indicators of adult male and female bodies (e.g., body hair). The development of
primary sexual characteristics indicates youth have become capable of adult
reproductive functioning (i.e., the ability to make babies). The development of both
primary and secondary sexual characteristics begins during late childhood and

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INSTRUCTOR: JAYSON B. BENEDICTO
continues throughout early adolescence. However, it is important to remember youth
experience these changes at different rates and times. For more information about the
biological and hormonal changes that trigger these changes, and for suggestions about
guiding young teens through this process, please refer to the article on Puberty in the
Middle Childhood series.

For females, the most significant primary sexual characteristic is the first
menarche, or first menstrual period. The first menarche indicates girls have begun to
ovulate; i.e., to release mature eggs that can become fertilized by male sperm through
sexual intercourse. The average age for the first menstrual period is 12 years, but girls
can reach menarche at any age from 10 to 15 years old and still be considered "normal."

For males, the primary sexual characteristics include an enlargement of the penis
and testes, and the first spermarche; i.e., the first ejaculation of mature sperm capable of
fertilizing female eggs through sexual intercourse. The average age of first spermarche is
13 years, but it can occur anytime between the ages of 12 and 16 years. On average, the
testes will begin to enlarge at about 11 years of age, but this growth can occur anytime
between 9 and 13 years. On average, the penis begins to enlarge around age 12, but this
growth can begin at any age between 10 and 14 years. The penis reaches its adult size at
about age 14, but this can occur anytime between the ages 12 and 16.

SECONDARY SEXUAL CHARACTERISTICS

Secondary characteristics are the result of hormonal changes in the body during
puberty. These changes are faster in girls than in boys. Some changes are common in
both boys and girls while others are specific to each gender. This is due to the different
hormones released by them. Growth of pubic hair, facial hair and under the armpit,
increase in height, sweating, etc. are some of the secondary sexual characteristics.

 Change in height: Most prominent change that occurs in adolescents is the

change in their heights. Growth hormone secretion and bone growth are much
higher during this time.

 Sweat and Sebaceous glands: The pimples and acne in adolescents are mostly due
to the increased activities of sweat and sebaceous glands

 Hair growth: Another observable change is rapid hair growth under the armpit
and pubic area.

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INSTRUCTOR: JAYSON B. BENEDICTO
FEMALES

In females, breasts are a manifestation of higher levels of estrogen; estrogen also

widens the pelvis and increases the amount of body fat in hips, thighs, buttocks, and
breasts. Estrogen also induces growth of the uterus, proliferation of the endometrium,
and menstruation. Female secondary sex characteristics include:

 Enlargement of breasts and erection of nipples.

 Growth of body hair, most prominently underarm and pubic hair

 Widening of hips; lower waist to hi« ratio than adult males.

 Elbows that h hyperextend 5—8° more than male adults.

 Upper arms approximately 2 cm longer, on average, for a given height.

 Labia minora, the inner lips of the vulva, may grow more prominent and undergo
changes in color with the increased stimulation related to higher levels of
estrogen.

MALES

The increased secretion of testosterone from the testes during puberty causes the
male secondary sexual characteristics to be manifested. In males, testosterone directly
increases size and mass of muscles, vocal cords, and bones, deepening the voice, and
changing the shape of the face and skeleton. Converted into dihydrotestosterone in the
skin, it accelerates growth of androgen-responsive facial and body hair but may slow
and eventually stop the growth of head hair. Taller stature is largely a result of later
puberty. Male secondary sex characteristics include:

 Growth of body hair, including underarm, abdominal, chest hair and pubic hair.
Growth of facial hair.

 Enlargement of larynx (Adam's apple) and deepening of voice.

 Increased stature; adult males are taller than adult females, on average. Heavier
skull and bone structure.

 Increased muscle mass and strength.

 Broadening of shoulders and chest; shoulders wider than hips.

 Increased secretions of oil and sweat glands.

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INSTRUCTOR: JAYSON B. BENEDICTO
THE EROGENOUS ZONES

An erogenous zone is any area of the body that is pleasurable to touch. Most
people report that erogenous zones produce sexual pleasure when a partner touches
them, especially if they are already experiencing arousal.

Most people consider the genitals and breasts to be erogenous zones, though many other
areas of the body can also lead to sexual pleasure. Every person is different. An erogenous
zone in one person may be neutral in another, or it may even be unpleasant to touch. Talking to
a partner and experimenting with what works can help couples find one another’s erogenous
zones.

Additionally, some people report experiencing sexual pleasure from touching

certain erogenous zones on another person. This suggests that a person’s erogenous
zones may extend to another person’s body.

This article will discuss different areas of the body that people may consider to be
erogenous zones and how to stimulate them.

Erogenous zones are sexually pleasurable to touch. A person might derive

pleasure from touching these areas themselves, but many people get the most pleasure
when another person touches them.

Scientists have proposed a number of theories about erogenous zones and why they lead
to such pleasure, but no research has conclusively proven any specific theory.

Some potential reasons that erogenous zones might be pleasurable include the fact that:

 They are highly sensitive, either because they have more nerve endings or
because people do not often touch them.

 They tend to remain covered, making them less accessible or more exciting to
touch.

 They are pleasurable for the partner to touch or sexually attractive to the partner.

Some people enjoy the stimulation of erogenous zones as part of sex or foreplay, while
others can independently orgasm from erogenous zone stimulation.

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INSTRUCTOR: JAYSON B. BENEDICTO
THE SEXUAL RESPONSE CYCLE

Masters and Johnson studied many different sexual behaviors during their
investigations, one of the most important products that came from their research was
the development of the sexual response cycle. The sexual response cycle is a series of
four physiological phases that both men and women go through during intercourse. In
order to accurately observe these physiological changes, the researches carefully
measured blood pressure, respiration rate, and indicators of sexual arousal such as level
of vaginal lubrication in women and the level of swelling and blood flow to the penis in
men. In conclusion, Masters and Johnson determined that the human body undergoes
four distinct phases during sex:

1. Excitement Phase

General characteristics of the excitement phase, which can last from a few minutes to
several hours, include the following:

 Muscle tension increases.

 Heart rate quickens and breathing is accelerated. Skin may become flushed
(blotches of redness appear on the chest and back).

 Nipples become hardened or erect

 Blood flow to the genitals increases, resulting in swelling of the woman's clitoris
and labia minora (inner lips), and

 erection of the man's penis.

 Vaginal lubrication begins.

 The woman's breasts become fuller and the vaginal walls begin to swell.

 The man's testicles swell, his scrotum tightens, and he begins secreting a
lubricating liquid.

2. Plateau Phase

General characteristics of the plateau phase, which extends to the brink of orgasm,
include the following:

 The changes begun in phase 1 are intensified.

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INSTRUCTOR: JAYSON B. BENEDICTO
  The vagina continues to swell from increased blood flow, and the vaginal walls
turn a dark purple.

 The woman's clitoris becomes highly sensitive (may even be painful to touch) and
retracts under the clitoral hood to avoid direct stimulation from the penis.

 The man's testicles are withdrawn up into the scrotum.

 Breathing, heart rate. and blood pressure continue to increase.

 Muscle spasms may begin in the feet, face, and hands.

 Muscle tension increases.

3. Orgasm Phase

The orgasm is the climax of the sexual response cycle. It is the shortest of the phases
and generally lasts only a few seconds. General characteristics of this phase include the
following:

 Involuntary muscle contractions begin.

 Blood pressure. heart rate, and breathing are at their highest rates, with a rapid
intake of oxygen. Muscles in the feet spasm.

 There is a sudden, forceful release of sexual tension.

 In women, the muscles of the vagina contract. The uterus also undergoes
rhythmic contractions.

 In men, rhythmic contractions of the muscles at the base of the penis result in the
ejaculation of semen.

 A rash, or "sex flush” may appear over the entire body.

4. Resolution Phase

During resolution, the body slowly returns to its normal level of functioning, and
swelled and erect body parts return to their previous size and color. This phase is
marked by a general sense of wellbeing, enhanced intimacy and, often, fatigue. Some
women are capable of a rapid return to the orgasm phase with further sexual stimulation
and may experience multiple orgasms. Men need recovery time after orgasm, called a

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INSTRUCTOR: JAYSON B. BENEDICTO
refractory period, during which they cannot reach orgasm again. The duration of the
refractory period varies among men and usually lengthens with advancing age.

THE CHEMISTRY OF ATTRACTION, LOVE AND ATTACHMENT

Love and mating are the most basic, biologically programmed behaviors humans
engage in. Evolution created life, including human life, as a reproductive machine
designed to pass on genes to the next generation.

Think of the last time you ran into someone you find attractive. You may have
stammered; your palms may have sweated; you may have said something incredibly silly
and become dreamy. And chances are, your heart was thudding in your chest. It's no
surprise that, for centuries, people thought love (and most other emotions, for that
matter) arose from the heart. As it turns out, love is all about the brain — which, in turn,
makes the rest of your body go haywire.

According to a team of scientists led by Dr. Helen Fisher at Rutgers, romantic

love can be broken down into three categories: lust, attraction, and attachment. Each
category is characterized by its own set of hormones stemming from the brain.

1. Lust is driven by the desire for sexual gratification. The evolutionary basis for this
stems from our need to reproduce, a need shared among all living things. Through
reproduction, organisms pass on their genes, and thus contribute to the perpetuation of
their species.

The hypothalamus of the brain plays a big role in this, stimulating the production
of the sex hormones testosterone and estrogen from the testes and ovaries. While
these chemicals are often stereotyped as being “male” and “female,” respectively, both
play a role in men and women. As it turns out, testosterone increases libido in just about
everyone. The effects are less pronounced with estrogen, but some women report being
more sexually motivated around the time they ovulate, when estrogen levels are highest.

2. Attraction seems to be a distinct, though closely related, phenomenon. While we

can certainly lust for someone we are attracted to, and vice versa, one can happen
without the other. Attraction involves the brain pathways that control “reward” behavior
which partly explains why the first few weeks or months of a relationship can be so
exhilarating and even all-consuming.

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INSTRUCTOR: JAYSON B. BENEDICTO
 Increased dopamine is associated with motivation, reward, and goal-directed
behavior—hence the drive to pursue your loved one or create them in fantasy if you can’t
be with them. Dopamine also creates a sense of novelty. Your loved one seems exciting,
special and unique to you; you want to tell the world about his special qualities.

Norepinephrine is responsible for the extra surge of energy and "racing heart"
that you feel, as well as the loss of, in some cases, both your appetite and your desire for
sleep. It puts your body into a more alert state in which you are ready for action.

Scientists think serotonin probably decreases at this stage, but more studies need
to be done. Low levels of serotonin are found in obsessive-compulsive disorder (OCD)
and are thought to cause obsessive thinking. In one Italian study of 60 students, those
who were recently in love and those with OCD both had less serotonin transporter
protein in their blood than regular (not recently in love) students.

3. Attachment involves wanting to make a more lasting commitment to your loved

one. This is the point at which you may move in together, get married, and/or have
children. After about four years

in a relationship, dopamine decreases and attraction goes down. If things are going well,
it gets replaced by the hormone’s oxytocin (cuddle hormone) and vasopressin, which
create the desire to bond, affiliate with, and nurture your partner. You want to cuddle
and be close and share your deepest secrets with him or her. You pian and dream
together.

DIVERSITY OF HUMAN SEXUALITY

Diversity is all the ways we're different from each other. It includes things like
race, religion, culture, physical ability, mental ability, family make-up, socio-economic
status and sexual and gender diversity.

Sexuality refers to the sexual feelings and attractions we have towards other
people. There are many different types of sexuality and it can take a while for people to
figure out what is right for them. All are perfectly normal and part of the broad range of
human relationships and experiences. A person's sexuality is a central part of who they
are, and can influence their thoughts, feelings and actions.

Rigid beliefs on sex and gender put people in boxes (or closets), but these beliefs
do not reflect realities on human sexuality, especially how gender roles and expressions,
sexual attraction, and sexual behavior influence how a person views or lives his or her
own sexuality. These notions favor male-female distinctions and are biased against
those who do not fit existing stereotypes on sex and gender.

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INSTRUCTOR: JAYSON B. BENEDICTO
 When we talk about sexual and gender diversity, it's important to understand
these terms:

 Sex: Categories (male, female) to which people are typically assigned at birth
based on physical characteristics (e.g. genitals). Some people may be assigned
intersex, when their reproductive, sexual or genetic biology doesn't fit the
traditional definitions of male or female.

 Sexual Orientation: A person’s emotional and sexual attraction to others. It

can change and may or may not be the same as a person’s sexual behavior.

 Gender/Gender Identity: A person's internal sense of identity as female,

male, both or neither, regardless of their sex.

 Gender Expression: How a person expresses their gender. This can include
how they look, the name they choose, the pronoun they use (e.g., he, she) and
their social behavior.

Each person's sexual orientation, gender identity and gender expression are a part of
who they are.

When talking about these topics, it is common to see the acronym SOGIE, which
stands for Sexual Orientation, Gender Identity and (Gender) Expression.

The acronyms LGBTQ2S+, LGBTQ’, LGBTQ +, GLBT, LGBTTQ and LGBTQz2

refer to the spectrum of sexual and gender identities that are not cisgender and
heterosexual. They include lesbian, gay, bisexual, transgender, two-spirit, queer,
questioning, intersex and asexual. The asterisk (*) or plus sign (+) shows there are other
identities included that aren't in the acronym. These acronyms mean the same as ‘sexual
and gender minorities.

Terms relating to LGBTQIA*

Ally | A person who is not LGBTQ but shows support for LGBTQ people and promotes
equality in a variety of ways. Androgynous | Identifying and/or presenting as neither
distinguishably masculine nor feminine.

Asexual | The lack of a sexual attraction or desire for other people.

Biphobia | Prejudice, fear or hatred directed toward bisexual people.

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INSTRUCTOR: JAYSON B. BENEDICTO
Bisexual | A person emotionally, romantically or sexually attracted to same or opposite
sex

Closeted | Describes an LGBTQ person who has not disclosed their sexual orientation
or gender identity.

Coming out | The process in which a person first acknowledges, accepts and
appreciates their sexual orientation or gender identity and begins to share that with
others.

Gay | A man who is emotionally, romantically or sexually attracted to men

Gender dysphoria | Clinically significant distress caused when a person's assigned

birth gender is not the same as the one with which they identify. According to the
American Psychiatric Association's Diagnostic and Statistical Manual of Mental
Disorders (DSM), the term - which replaces Gender Identity Disorder - "is intended to
better characterize the experiences of affected children, adolescents, and adults."

Gender-fluid | According to the Oxford English Dictionary, a person who does not
identify with a single fixed gender; of or relating to a person having or expressing a fluid
or unfixed gender identity. Gender non-conforming | A broad term referring to people
who do not behave in a way that conforms to the traditional expectations of their
gender, or whose gender expression does not fit neatly into a category.

Intersex | An umbrella term used to describe a wide range of natural bodily variations.
In some cases, these traits are visible at birth, and in others, they are not apparent until
puberty. Some chromosomal variations of this type may not be physically apparent at
all.

Lesbian | A woman who is emotionally, romantically or sexually attracted to other

women.

Living openly | A state in which LGBTQ people are comfortably out about their sexual
orientation or gender identity - where and when it feels appropriate to them.

Non-binary | An adjective describing a person who does not identify exclusively as a

man or a woman. Non-binary people may identify as being both a man and a woman,
somewhere in between, or as falling completely outside these categories. While many
also identify as transgender, not all non-binary people do.

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INSTRUCTOR: JAYSON B. BENEDICTO
 Pansexual | Describes someone who has the potential for emotional, romantic or
sexual attraction to people of any gender though not necessarily simultaneously, in the
same way or to the same degree.

Questioning | A term used to describe people who are in the process of exploring their
sexual orientation or gender identity.

Sex assigned at birth | The sex (male or female) given to a child at birth, most often
based on the child's external anatomy. This is also referred to as "assigned sex at birth."

Transphobia | The fear and hatred of, or discomfort with, transgender people.

Getting to Know your Sexual Identity

Everybody has a sense of their sexuality: this is called your sexual identity. Your sexual
identity is about how you see this part of yourself and how you express it to others.
Sexual identity is different from sexual orientation. Sexual orientation is about your
sexual preferences and who you are attracted to.

Your sexual identity may not match your sexual orientation, for example, you may be a
guy who is attracted to other guys but still identify as ‘straight’. Working out sexual
orientation may be an ongoing process throughout a person’s life. For instance, a young
person might identify one way at one time then differently in a few years’ time.

SEXUAL HEALTH AND SEXUALLY TRANSMITTED DISEASES/

INFECTIONS

Sexually transmitted disease (STI’s) and other sexual-related disease

What are sexually transmitted diseases (STDs)?

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are
infections that are passed from one person to another through sexual contact. The
contact is usually vaginal, oral, or anal sex. But sometimes they can spread through
other intimate physical contact. This is because some STDs, like herpes and HPV, are
spread by skin-to-skin contact.

There are more than 20 types of STDs, including:

 Chlamydia

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INSTRUCTOR: JAYSON B. BENEDICTO
 Genital herpes
 Gonorrhea
 HIV/AIDS
 HPV
 Pubic lice
 Syphilis
 Trichomoniasis
What causes sexually transmitted diseases (STDs)?
STDs can be caused by bacteria, viruses, and parasites.
Who is affected by sexually transmitted diseases (STDs)?
Most STDs affect both men and women, but in many cases the health problems they
cause can be more severe for women. If a pregnant woman has an STD, it can cause
serious health problems for the baby.
What are the symptoms of sexually transmitted diseases (STDs)?
STDs don't always cause symptoms or may only cause mild symptoms. So it is possible
to have an infection and not know it. But you can still pass it on to others.

If there are symptoms, they could include:

 Unusual discharge from the penis or vagina

 Sores or warts on the genital area
 Painful or frequent urination
 Itching and redness in the genital area
 Blisters or sores in or around the mouth
 Abnormal vaginal odor
 Anal itching, soreness, or bleeding
 Abdominal pain
 Fever
How are sexually transmitted diseases (STDs) diagnosed?
If you are sexually active, you should talk to your health care provider about your risk
for STDs and whether you need to be tested. This is especially important since many
STDs do not usually cause symptoms.

Some STDs may be diagnosed during a physical exam or through microscopic

examination of a sore or fluid swabbed from the vagina, penis, or anus. Blood tests can
diagnose other types of STDs.

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INSTRUCTOR: JAYSON B. BENEDICTO
What are the treatments for sexually transmitted diseases (STDs)?
Antibiotics can treat STDs caused by bacteria or parasites. There is no cure for STDs
caused by viruses, but medicines can often help with the symptoms and lower your risk
of spreading the infection.

Correct usage of latex condoms greatly reduces, but does not completely eliminate, the
risk of catching or spreading STDs. The most reliable way to avoid infection is to not
have anal, vaginal, or oral sex.

There are vaccines to prevent HPV and hepatitis B.

Can sexually transmitted diseases (STDs) be prevented?
Correct usage of latex condoms greatly reduces, but does not completely
eliminate, the risk of catching or spreading STDs. If your or your partner is allergic to
latex, you can use polyurethane condoms. The most reliable way to avoid infection is to
not have anal, vaginal, or oral sex.

Methods of Contraception (natural and artificial)

Assessment

Contraceptives are products used to prevent pregnancy by women and men. Each
individual has their own choice in what contraceptive they want to use, so you must
assess their preference first before providing the best contraceptive for them.

 A pregnancy test must be performed first to make sure that the woman seeking
for birth control is not presently pregnant.
 Assess for the OB history of the client, any past sexually transmitted diseases, the
status of the past pregnancies, and if they have used a family planning method
that did not turn out effective.
 Assess subjectively the needs, preferences, desires, and feelings of the client
regarding family planning.
 Assess the sexual practices of the client, the frequency, the number of their sexual
partners, and if they have any allergies to latex.
Natural Family Planning

The natural family planning methods do not include any chemical or foreign body
introduction into the human body. Most people who are very conscious of their religious
beliefs are more inclined to use the natural way of birth control. Some want to use
natural methods because it is more cost effective.

Abstinence

 This natural method involves abstaining from sexual intercourse and is the most
effective natural birth control method with ideally 0% fail rate.

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INSTRUCTOR: JAYSON B. BENEDICTO
  It is also the most effective way to avoid STIs.
 However, most people find it difficult to comply with abstinence, so only a few of
them use this method.
Calendar Method

The Calendar or Rhythm Method

 Also called as the rhythm method, this natural method of family planning
involves refraining from coitus during the days that the woman is fertile.
 According to the menstrual cycle, 3 or 4 days before and 3 or 4 days after
ovulation, the woman is likely to conceive.
 The process in calculating for the woman’s safe days is achieved when the woman
records her menstrual cycle for six months.
 She subtracts 18 from the shortest cycle and the difference is the first fertile day.
 She also subtracts 11 from the longest cycle, and this becomes the last fertile day.
 Starting from the first fertile day until the last day, the woman should avoid
coitus to avoid conception.
 It has an ideal fail rate of 5%, but when used it has a typical fail rate of 25%.

Basal Body Temperature

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  The basal body temperature is the woman’s temperature at rest.
 BBT falls at 0.5⁰F before the day of ovulation and during ovulation, it rises to a
full degree because of progesterone and maintains its level throughout the
menstrual cycle, and this is the basis for the method.
 The woman must take her temperature early every morning before any activity,
and if she notices that there is a slight decrease and then an increase in her
temperature, this is a sign that she has ovulated.
 The woman must abstain from coitus for the next 3 days.
 The BBT method has an ideal fail rate of 9% and has a typical use fail rate of 25%.

Cervical Mucus Method

 The basis of this method is the changes in the cervical mucus during ovulation.
 To check if the woman is ovulating, the cervical mucus must be copious, thin, and
watery.
 The cervical mucus must exhibit the property of spinnbarkeit, wherein it can be
stretched up until at least 1 inch and feels slippery.
 The fertile days of a woman according to this method is as long as the cervical
mucus is copious and watery and a day after it. Therefore, she must avoid coitus
during these days.
 When used typically, it has a fail rate of 25%.

Symptothermal Method

 The symptothermal method is simply a combination of the BBT method and the
cervical mucus method.
 The woman takes her temperature every morning before getting up and also
takes note of any changes in her cervical mucus every day.

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INSTRUCTOR: JAYSON B. BENEDICTO
  She abstains from coitus 3 days after a rise in her temperature or on the fourth
day after the peak of a mucus change.
 Symptothermal method has an ideal failure rate of 2%. 

Ovulation Detection

 The ovulation detection method is an over-the-counter kit that can predict

ovulation through the surge of luteinizing hormone that happens 12 to 24 hours
before ovulation.
 The kit requires the urine specimen of the woman to detect the LH.
 The kit is 98% to 99% accurate and is fast becoming the method of choice by
women.
Lactation Amenorrhea Method

 Through exclusive breastfeeding of the infant, the woman is able to suppress

ovulation through the method of lactation amenorrhea method.
 However, if the infant is not exclusively breastfed, this method would not be an
effective birth control method.
 It is also best to advise the woman that after 3 months of exclusive breastfeeding,
she must make plans of choosing another method of contraception.

Coitus Interruptus(Withdrawal method)

This is one of the oldest methods of contraception.

The couple still proceeds with the coitus, but the man withdraws the moment he
ejaculates to emit the spermatozoa outside of the vagina.
 The disadvantage of this method is the pre-ejaculation fluid that contains a few
spermatozoa that may cause fertilization.
 Coitus interruptus is only 75% effective because of this.
Hormonal Contraception

These hormonal contraceptives are effective through manipulation of the hormones that
directly affect the normal menstrual cycle so that ovulation would not occur.

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INSTRUCTOR: JAYSON B. BENEDICTO
Oral Contraceptives

 Also known as the pill, oral contraceptives contain synthetic estrogen and

progesterone.
 Estrogen suppresses the FSH and LH to suppress ovulation, while progesterone
decreases the permeability of the cervical mucus to limit the sperm’s access to the
ova.
 To use the pill, it is recommended that the woman takes the first pill on the first
Sunday after the beginning of a menstrual flow, or the woman may choose to
start the pill as soon as it is prescribed.
 Advise the woman that the first 7 days of taking the pill would still not have an
effect, so the couple must use another contraceptive method on the initial 7 days.
 If the woman has skipped one day of taking the pill, she must take it the moment
she remembers it, than still follow the regular use of the contraceptive.
 If the woman has missed taking the pill for more than one day, she and her
partner must consider an alternative contraception to avoid ovulation.
 Side effects for OCs are nausea, weight gain, headache, breast tenderness,
breakthrough bleeding, vaginal infections, mild hypertension, and depression.
 Contraindications to OCs are breastfeeding, age of 35 years and above,
cardiovascular diseases, hypertension, smoking, diabetes, and cirrhosis.

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INSTRUCTOR: JAYSON B. BENEDICTO
Transdermal Patch

 The transdermal patch has a combination of both estrogen and progesterone in a

form of a patch.
 For three weeks, the woman should apply one patch every week 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, free from any
applications. And without any redness or irritation.
 Patches can be worn while bathing or swimming, but when the woman notices
that the patch is loose, she should immediately replace the patch.
 If the patch has been loose for less than 24 hours, the woman need not use an
alternative form of contraceptive, but if she is not sure of how long the patch has
been loose, she should replace it and start with a new week cycle and also use an
additional contraceptive method.

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO
Vaginal Ring

 The vaginal ring releases a combination of estrogen and progesterone and

surrounds the cervix.
 This silicon ring is inserted vaginally and remains there for 3 weeks, then
removed on the fourth week as menstrual flow would occur.
 The woman becomes fertile as soon as the ring is removed.
 The vaginal ring has the same effectivity rate as the oral contraceptives.

Subdermal Implants

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO
 The subdermal implants are two rod-like implants embedded under the skin of
the woman during her menses or on the 7th day of her menstruation to make sure
that she is not pregnant.
 It contains etonogestrel, desogestrel, and progestin.
 It is effective for 3 to 5 years.
 Subdermal implants have a fail rate of 1%.
Hormonal Injections

Depo Provera

 A hormonal injection consists of medroxyprogesterone, a progesterone, and given

once every 12 weeks intramuscularly.
 The injection inhibits ovulation and causes changes in the endometrium and the
cervical mucus.
 After administration the site should not be massaged so it could absorb slowly.
 It has an effectiveness of almost 100%, making it one of the most popular choices
for birth control.
 Advise the woman to ingest an adequate amount of calcium in her diet as there is
a risk for decreased of bone mineral density and to engage in weight-bearing
exercises.

Intrauterine Device

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO
  An IUD is a small, T-shaped object that is inserted into the uterus via the vagina.
 It prevents fertilization by creating a local sterile inflammatory condition to
prevent implantation.
 The IUD is fitted only by the physician and inserted after the woman’s menstrual
flow to be sure that she is not pregnant.
 The device contains progesterone and is effective for 5 to 7 years.
 A woman with IUD is advised to check the flow of her menstruation every month
and the IUD string, and also to have a pelvic examination yearly.

Chemical Barriers

 Chemical barriers such as spermicides, vaginal gels and creams, and glycerin
films are also used to cause the death of sperms before they can enter the cervix
and also lower the pH level of the vagina so it will not become conducive for the
sperm.
 These chemical barriers cannot prevent sexually transmitted infections; however,
they can be bought without any prescription.
 The ideal fail rate of chemical barriers is 80%.

Diaphragm

 A diaphragm works by inhibiting the entrance of the sperm into the vagina.

 It is a circular, rubber disk that fits the cervix and should be placed before coitus.
 If a spermicide is combined with the use of a diaphragm, there is a failure rate of
6% ideally and 16% typically.
 The diaphragm should be fitted only by the physician, and should remain in place
for 6 hours after coitus.
 It can be left in place for not more than 24 hours to avoid inflammation or
irritation.
Cervical Cap

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO
  The cervical cap is another barrier method that 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. 
Male Condoms

 The male condom is a latex or synthetic rubber sheath that is placed on the erect
penis before vaginal penetration to trap the sperm during ejaculation.
 It can prevent STIs and can be bought over-the-counter without any fitting
needed.
 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.
 After sexual intercourse, the condom is removed to be disposed.

Female Condoms

 These are also latex rubber sheaths that are specially designed for females and
prelubricated with spermicide.
 It has an inner ring that covers the cervix and an outer, open ring that is placed
against the vaginal opening.
 These are disposable and require no prescription.
 The fail rate of female condoms is 12% to 22%.

Surgical Methods

One of the most effective birth control methods is the surgical method. The two kinds of
surgical methods are used by either the male or the female, and would ensure that
conception is inhibited after the surgery for as long as the client lives.

Vasectomy

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO
  Males undergo vasectomy, which is executed through a small incision made on
each side of the scrotum.
 The vas deferens is then tied, cauterized, cut, or plugged to block the passage of
the sperm.
 This procedure is done with local anesthesia, so advise the patient that mild
local pain can be felt after the procedure.
 Advise the patient to use a back-up contraceptive method until two
negative sperm count results are performed because the sperm could remain
viable in the vas deferens for 6 months.
 There is a 99.5% accuracy rate for vasectomy and has a few complications.
Tubal Ligation

 In women, tubal ligation is performed by occluding the fallopian tubes through

cutting, cauterizing, or blocking to inhibit the passage of the both the sperm and
the ova.
 After menstruation and before ovulation, the procedure is done through a small
incision under the woman’s umbilicus.
 A laparoscope is used to visualize the surgery, and the patient is under local
anesthesia.
 The woman may return to her sexual activities after 2 to 3 days of the operation.
 Educate that menstrual cycle would still occur, and make sure that coitus before
ligation is protected to avoid ectopic pregnancy.
 The effectiveness of this method is at 99.5%.
The reproductive system is our tool as humans to multiply or procreate. However, the
earth would become unlivable if the growth of the population continues to boom. You
have a choice among all these birth control methods, and these are only a call to be a
responsible parent and citizen.

GE2 – Understanding the Self

INSTRUCTOR: JAYSON B. BENEDICTO