STUDY GUIDE FOR MODULE NO.

CHAPTER II: UNPACKING THE SELF

A. THE SEXUAL SELF

MODULE 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.

MODULE LEARNING OBJECTIVES

1. Discuss the sexual development involving the human reproductive system, sexual behavior
and human sexual response.
2. Distinguish between attraction, love and attachment
3. Examine the diversity of human sexuality
4. Identify the causes and consequences of sexually transmitted infections and teenage
pregnancy
5. Reflect on the importance of contraception and Reproductive Health law

LEARNING CONTENTS (title of the subsection)

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 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, 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.

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.[4] 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 hip ratio than adult males.
 Elbows that 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.
THE HUMAN REPRODUCTIVE SYSTEM

The Male Reproductive System

The purpose of the organs of the male reproductive system is to perform the following functions:

 To produce, maintain, and transport sperm (the male reproductive cells) and protective
fluid (semen)
 To discharge sperm within the female reproductive tract during sex
 To produce and secrete male sex hormones responsible for maintaining the male
reproductive system
Parts:
 Scrotum– A small muscular sac-like organ which is located below and behind the penis.
It consists of the testes and is mainly involved in maintaining the temperature required
for the of sperm production.
 Testes – It is also called as testicles. They are a pair of oval-shaped organs which are
mainly responsible for the sperm production and synthesis of testosterone-
male hormones.
 Penis– It is the primary sexual organ which serves as both reproductive organ as well as
excretory organ and used for the purpose of sexual intercourse. It is a cylindrical tube-
like organ with a small opening at the top and is extremely sensitive as it becomes
vertical when a person is sexually aroused. Semen, containing sperm, is ejaculated from
the opening at the top when the person reaches sexual climax.

 Urethra– A narrow tube-like structure that conducts urine and semen from the urinary
bladder to the penis.
 Vas Deferens– It is a muscular tube that carries mature sperm produced in the testes to
the urethra.
The Female Reproductive System

The female reproductive organs are located near the lateral walls of the pelvic cavity. It is
designed to carry out several functions.

 It produces the female egg cells necessary for reproduction, called the ova or oocytes.
 The system is designed to transport the ova to the site of fertilization.
 Conception
 Menstruation
 Production of female hormones
Parts:

 Ovaries– They is a pair of organs which are mainly responsible for the production and
storage of ovum, or egg, which are the sex gametes in a female.

 Uterus– It is commonly known as the womb. It is a pear-shaped muscular bag-like

organ with a strong muscular lining that holds the baby after fertilization. The uterus is
referred as the site for the embryo development as it protects the fertilized ovum and
holds it till the baby is mature enough for birth.

 Cervix– A cylinder ring-shaped tissue which is composed mainly of fibromuscular tissue.

It is located at the lowermost portion of the uterus and is involved in connecting the
uterus and the vagina.
 Vagina– – The primary sexual organ which serves as both excretory organ as well as
reproductive organ. It is a muscular and tubular part of the female genital tract that
opens outside the body and the opening of the vagina is called the vulva, which also
includes the clitoris, labia, and urethra. The vagina connects cervix to the external
female body parts and it is the path for penis during coitus as well as a fetus during
delivery.
Human Reproduction

The average menstrual cycle lasts 28 days, with the cycle’s first day considered to be the first day of
menstruation. During the first 14 days of the cycle, an egg matures in a woman’s ovaries. This
maturation process is stimulated by a hormone called follicle stimulating hormone (FSH). The ‘coat’
around the maturing egg produces another hormone, estrogen, which makes the lining of the uterus
prepare for pregnancy. The uterus grows a nutrient-rich and secure bedding for the egg to settle into
after fertilization.

Around day 14 of the cycle, the egg is ready for release and emerges from the ovary. This release is
triggered by an increase in another hormone called luteinizing hormone (LH). After release, the egg
has about a 12-24 hour window where it can be fertilized by a sperm. Sperm may survive in a
woman’s genital tract and be capable of fertilizing an egg for up to three days after intercourse.
Fertilization happens high up in the fallopian tube.

If a sperm penetrates the egg, an embryo will begin to form. This happens through cell division: one
cell becomes two, which become four, which become eight, and so forth. After about seven days,
the

embryo reaches the uterus and embeds itself in the lining of the uterus. Cells surrounding the
embryo make the hormone human chorionic gonadotropin (HCG), which signals the woman’s body
that pregnancy has occurred and the menstrual cycle stops until after delivery. If conception does
not occur the uterine lining will be shed and the cycle will begin again.

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.
 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 well-being, 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 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.
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 hormones 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 plan 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.

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 LGBTQ2 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.
Bisexual | A person emotionally, romantically or sexually attracted to more than one sex,
gender or gender identity though not necessarily simultaneously, in the same way or to the
same degree.
Cisgender | A term used to describe a person whose gender identity aligns with those typically
associated with the sex assigned to them at birth.
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 person who is emotionally, romantically or sexually attracted to members of the same
gender.
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.
Genderqueer | Genderqueer people typically reject notions of static categories of gender and
embrace a fluidity of gender identity and often, though not always, sexual orientation. People
who identify as "genderqueer" may see themselves as being both male and female, neither
male nor female or as falling completely outside these categories.
Gender transition | The process by which some people strive to more closely align their
internal knowledge of gender with its outward appearance. Some people socially transition,
whereby they might begin dressing, using names and pronouns and/or be socially recognized
as another gender. Others undergo physical transitions in which they modify their bodies
through medical interventions.
Homophobia | The fear and hatred of or discomfort with people who are attracted to members
of the same sex.
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.
Outing | Exposing someone’s lesbian, gay, bisexual or transgender identity to others without
their permission. Outing someone can have serious repercussions on employment, economic
stability, personal safety or religious or family situations.
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.
Queer | A term people often use to express fluid identities and orientations. Often used
interchangeably with "LGBTQ."
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."
Transgender | An umbrella term for people whose gender identity and/or expression is different
from cultural expectations based on the sex they were assigned at birth. Being transgender
does not imply any specific sexual orientation. Therefore, transgender people may identify as
straight, gay, lesbian, bisexual, etc.
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

Fast Facts:

😱Approximately 12 million girls aged 15–19 years and at least 777,000 girls under 15 years give
birth each year in developing regions.
😱At least 10 million unintended pregnancies occur each year among adolescent girls aged 15–
19 years in the developing world.
😱Complications during pregnancy and childbirth are the leading cause of death for 15–19-year-
old girls globally.
😱Of the estimated 5.6 million abortions that occur each year among adolescent girls aged 15–
19 years, 3.9 million are unsafe, contributing to maternal mortality, morbidity and lasting health
problems.
😱Adolescent mothers (ages 10–19 years) face higher risks of eclampsia, puerperal
endometritis, and systemic infections than women aged 20 to 24 years, and babies of
adolescent mothers face higher risks of low birth weight, preterm delivery and severe neonatal
conditions.

More than a quarter of the world’s population is between the ages of 10 and 24, with 86% living
in less developed countries. These young people are tomorrow’s parents. The reproductive and
sexual health decisions they make today will affect the health and wellbeing of their
communities and of their countries for decades to come. In particular, two issues have a
profound impact on young people’s sexual health and reproductive lives: family planning and
HIV/AIDS. Teenage girls are more likely to die from pregnancy-related health complications
than older women in their 20s. Statistics indicate that one-half of all new HIV infections
worldwide occur among young people aged 15 to 24.

Sexually Transmitted Disease

The term sexually transmitted disease (STD) is used to refer to a condition passed from one
person to another through sexual contact. You can contract an STD by having unprotected
vaginal, anal, or oral sex with someone who has the STD.

An STD may also be called a sexually transmitted infection (STI) or venereal disease (VD).

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) can have a range
of signs and symptoms, including no symptoms. That's why they may go unnoticed until
complications occur or a partner is diagnosed. Signs and symptoms may appear a few days
after exposure, or it may take years before you have any noticeable problems, depending on the
organism. Signs and symptoms that might indicate an STI include:

 Sores or bumps on the genitals or in the oral or rectal area

 Painful or burning urination
 Discharge from the penis
 Unusual or odd-smelling vaginal discharge
 Unusual vaginal bleeding
 Pain during sex
 Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread
  Lower abdominal pain
 Fever
 Rash over the trunk, hands or feet
Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) can be caused
by:

 Bacteria (gonorrhea, syphilis, chlamydia)

 Parasites (trichomoniasis)
 Viruses (human papillomavirus, genital herpes, HIV)
Who is most at risk with STI?
you don’t use condoms during sex or dental dams (a thin latex square held over the
vaginal or anal area during oral sex)
 you have changed sex partners or had more than one sex partner in the last 12
months
 you or your partner share injecting equipment such as a syringes and needles
 you or your sex partner has another STI.
Most Common STDs
 Chlamydia
 Genital Herpes
 Genital Warts
 Gonorrhea
 Hepatitis B (HBV)
 HIV and AIDS
 Pelvic Inflammatory Disease (PID)
 Pubic Lice (Crabs)
 Syphilis
 Trichomoniasis

Teenage Pregnancy

Teenage pregnancies and teenage motherhood are a cause for concern worldwide. Every year,
an estimated 21 million girls aged 15–19 years in developing regions become pregnant and
approximately 12 million of them give birth. Nowadays, the vast majority of teenage pregnancies
occur in low- and middle-income countries characterized by poor health-care services;
therefore, complications during pregnancy, birth, and postpartum phase are the second cause of
death among girls aging between 15 and 19 years worldwide. Additionally, it is estimated that
some three million teenage girls undergo unsafe abortions, which may result in consecutive
reproductive problems or even death.
 Adolescents who may want to avoid
pregnancies may not be able to do so due to
knowledge gaps and misconceptions on
where to obtain contraceptive methods and
how to use them. Adolescents face barriers to
accessing contraception including restrictive
laws and policies regarding provision of
contraceptive based on age or marital status,
health worker bias and/or lack of willingness
to acknowledge adolescents’ sexual health
needs, and adolescents’ own inability to
access contraceptives because of knowledge,
transportation, and financial constraints.
Additionally, adolescents may lack the agency
or autonomy to ensure the correct and
consistent use of a contraceptive method. At
least 10 million unintended pregnancies occur
each year among adolescent girls aged 15-19
years in developing regions

The teenage pregnancy rate in the Philippines was 10% in 2008, down to 9% in 2017. Live
births by teenage mothers (aged 10-19) in 2016 totaled 203,085, which slightly decreased to
196,478 in 2017 and 183,000 in 2018. Still, the Philippines has one of the highest adolescent
birth rates among the ASEAN Member States. Recent World Bank data shows that the
Philippines has 47 births annually per 1,000 women aged 15-19, higher than the average
adolescent birth rates of 44 globally and 33.5 in the ASEAN region.

Sexuality Education in the Philippines

The 2012 Responsible Parenthood and Reproductive Health Act includes a provision that
mandates the Department of Education to implement age and development-appropriate
Comprehensive Sexuality Education (CSE) in formal and non-formal education settings. The
long delay in the adoption and integration of CSE in the K-12 Curriculum is a significant missed
opportunity to provide young people with non-judgmental and scientifically accurate and age-
appropriate Sexuality and Reproductive Health information that would curb the knowledge gap
and provide life skills needed to make informed decisions related to risk behaviors with
consequences to their health.

UNFPA, the United Nations sexual and reproductive health agency, recommends the following
measures to reduce teenage pregnancy:
1. Increasing adolescent and youth resilience and protection.
2. Managing fertility rates, improving education and employment opportunities of
young people to reap the demographic dividend
3. Enhancing social protection mechanisms
 4. Improving access to adolescent and youth-friendly services, including
contraceptives.
5. Strengthening parental skills for adolescents and youth
6. Strengthening inter-agency coordination and collaboration, both horizontally and
vertically
7. Robust data and statistics, and more updated evidence to inform policies and
programs for adolescents.
8. Maximizing use of media and communications for health promotion

FAMILY PLANNING AND RESPONSIBLE PARENTHOOD

Family Planning (FP) is having the desired number of children and when you want to have
them by using safe and effective modern methods. Proper birth spacing is having children 3 to 5
years apart, which is best for the health of the mother, her child, and the family.

Benefits of Family Planning

Mother
 Enables her to regain her health after delivery.
 Gives enough time and opportunity to love and provide attention to her husband and
children.
 Gives more time for her family and own personal advancement.
 When suffering from an illness, gives enough time for treatment and recovery.

Children
 Healthy mothers produce healthy children.
 Will get all the attention, security, love, and care they deserve.

Father
 Lightens the burden and responsibility in supporting his family.
 Enables him to give his children their basic needs (food, shelter, education, and better
future).
 Gives him time for his family and own personal advancement.
 When suffering from an illness, gives enough time for treatment and recovery.

FAMILY PLANNING METHODS

1. Natural Family Planning (NFP) refers to a variety of methods used to prevent or

plan pregnancy, based on identifying a woman’s fertile days. For all natural
methods, abstinence or avoiding unprotected intercourse during the fertile days
is what prevents pregnancy. The effectiveness and advantages of NFP address
the needs of diverse populations with varied religious and ethical beliefs. They
also provide an alternative to women who wish to use natural methods for
medical or personal reasons.
NATURAL CONTRACEPTIVE OPTIONS
Abstinence
Refraining from penetrative sex provides 100% protection from pregnancy, and offers effective
prevention of transmission of sexually transmitted infections as well
Withdrawal or Coitus interruptus
The withdrawal method of family planning is unlike other natural methods in that it is male-
controlled. Withdrawal has been used for centuries, following the discovery that ejaculation into
the vagina leads to pregnancy; this method prevents pregnancy by preventing contact between
the sperm and the egg
Calendar methods - based on calculations of cycle length
In calendar rhythm method, a woman makes an estimate of the days she is fertile based on past
menstrual cycle length. She does this with the expectation that the length of her current cycle,
and thus the time of her fertile phase, will not vary greatly from previous menstrual cycles.
Methods based on symptoms and signs
Ovulation Method, Billings Method, Cervical Mucus Method
This method is based on the changes in cervical secretions due to the effects of circulating
levels of estrogen and progesterone, as described above. Introduced in the 1960s, this method
relies on daily self-examination for the detection of the quantity and evaluation of the quality of
cervical secretions. Women are taught to feel for secretions throughout their cycles. Couples
either abstain from sex or use a barrier method during menstruation and on alternating days
prior to the appearance of cervical mucus. They abstain from unprotected intercourse from the
time that the first sticky mucus appears until four days after the last clear, stretchy, slippery
mucus is observed.
Basal Body Temperature (BBT) Method
Due to the actions of progesterone on the hypothalamus, a woman’s body temperature rises
slightly after she ovulates (0.2 to 0.5 degrees C) and remains elevated until the end of the cycle,
until menstruation. Women who use this method must chart their temperature every day,
immediately after waking up and before getting out of bed or drinking any liquids. Couples
relying on this method must abstain from unprotected intercourse between the first day of
menstruation until after the third consecutive day of elevated body temperature, so unprotected
sex is limited to the postovulatory infertile time.
Sympto-Thermal Method
This method combines several techniques to predict ovulation. It typically includes monitoring
and charting cervical mucus and position and temperature changes on a daily basis and may
include other signs of ovulation, such as breast tenderness, back pain, abdominal pain or
"heaviness," or light intermenstrual bleeding. To use this method correctly, couples must abstain
from unprotected sex from the first sign or sensation of wet cervical mucus until the woman’s
body temperature has remained elevated for three days after peak day is observed.

Lactational Amenorrhea Method (LAM)

Research has confirmed that a form of breastfeeding to achieve contraception, called the
lactational amenorrhea method, or LAM, is more than 98% effective during the first 6 months
following delivery. During breastfeeding, ovulation is inhibited by a series of physiological
responses to nipple stimulation. More frequent or intense suckling sends nerve impulses to the
mother’s hypothalamus that disrupt normal signals to the pituitary controlling hormone secretion;
the resulting abnormal pattern of LH secretion is inhibitory to ovarian activity. When
breastfeeding diminishes with less frequent breastfeeding and/or more frequent supplemental
feeding, the chance of ovulation and subsequent pregnancy rises.
2. Artificial Birth Control employs artificial control methods to help prevent
unintended pregnancy through the use of contemporary measures such as
contraceptive or birth control pills. Diaphragm, male and female condoms,
spermicide, cervical cap, birth control patch, birth control shot, implants, IUD,
tubal ligation, vasectomy and emergency contraception pill.

Oral Contraceptives
This is a series of pills that a woman takes once each day for a
month. At the end of the month, she starts a new package of pills.
The pills have hormones much like those a woman's body makes to
control her menstrual cycle. They work by keeping the ovaries from
releasing eggs or by changing the lining of the uterus or the mucus of
the cervix.
Depo-Provera:
A method of birth control given in the form of a shot. The
shot gives protection for up to 12 weeks. It does not contain
estrogen so there are no side effects from that hormone. It
works by keeping the ovaries from releasing eggs or by
changing the lining of the uterus or the mucus of the cervix.

Contraceptive Patch:
A method of birth control that is a small, thin and smooth patch and is put on a woman's skin.
The woman can choose where she wears the patch: the buttocks, the
shoulder, the upper arm, front or back, but not on the breasts. It
releases hormones every day for three weeks so the woman's
ovaries don't produce eggs. It can stay on the body for one week. You
change it once a week and on the fourth week, you don't wear a
patch but you will still be protected. You can swim, bathe, shower and
wear it in warm humid weather.
Contraceptive Ring

A method of birth control in the form of a soft ring that fits deep
inside the vagina. It releases low-dose hormones everyday for
three weeks so the woman's ovaries don't produce eggs. It can stay
in the vagina for up to three weeks and provides protection for one
month

Intrauterine Device (IUD)

A small device made of plastic. Some contain copper, or a
hormone. A clinician chooses the right type for a woman,
and inserts it into her uterus. Some can stay there for 4
years; copper IUDs may be left in place up to 8 years.
IUDs prevent a woman's egg from being fertilized by the
man's sperm, and change the lining of her uterus.

Implanon

Implanon is a small, thin, implantable hormonal contraceptive that

provides effective protection for up to three years. Implanon must be
removed by the end of the third year and can be replaced by a new
Implanon if contraceptive protection is still needed. This contraceptive
method must be inserted and removed by a trained healthcare provider.
Diaphragm/Cervical Cap
A soft rubber barrier in a woman's vagina, used with a contraceptive
cream or jelly. The diaphragm or cervical cap is put into a woman's
vagina before intercourse. It covers the entrance to her uterus, and
the cream or jelly stops the man's sperm from moving. The
diaphragm can be put in the vagina 6 hours ahead of intercourse,
and left in or 24 hours. The cervical cap can be left in her vagina for
up to 48 hours.

Male Condom
It is a sheath of latex that a man can wear over his penis during
intercourse. The condom catches the semen that comes out of a
man's penis before, during and after he ejaculates. This keeps his
sperm from getting into the woman's vagina. Latex condoms also
help protect against some infections, including HIV, the virus that
causes AIDS.

Female Condom
It is a loose-fitting sheath that fits inside the woman's vagina. It catches
the semen that comes out of a man's penis when he ejaculates. It
covers the cervix, the opening to the uterus, so sperm can't get
through. It also protects against some infections including HIV, the virus
that causes AIDS.
 LEARNING ACTIVITY 1

FACT OR BLUFF
The following are statements concerning sex, STI and pregnancy. If the statement presented is
true, encircle FACT, otherwise, encircle BLUFF.

Is it a Statements
Fact Bluff 1. You can have sexually transmitted infection and be unaware
you have it.
Fact Bluff 2. Once you have been treated from an STI, you get immunity
from it and cannot acquire the same infection.
Fact Bluff 3. Proper use of condom, prevents any form of STI
Fact Bluff 4. Abstinence is 100% effective from preventing pregnancy.
Fact Bluff 5. Syphilis when left untreated can cause deafness and even
death in later stages.
Fact Bluff 6. Kissing is the safest sexual activity.
Fact Bluff 7. A girl cannot get pregnant the first time she has sexual
intercourse.
Fact Bluff 8. Girls don’t masturbate
Fact Bluff 9. Peeing after sex reduces the risk of STI and Pregnancy
Fact Bluff 10.You can get HIV from tattoo or body piercing.