PED 206 - Personal Health and Wellness

Chapter 6 and 7 Notes (with terminology)

Gravid- another term for pregnant.

Fornication- sexual intercourse between 2 unmarried people.

Couvade- the practice among some cultures where the male suffers the same symptoms during pregnancy as those the female is experiencing.

Libido- sexual drive or urge.

Fecundity- the ability to produce offspring in a rapid manner and in large numbers (rabbits).

Gestation- period from conception to birth.

Hydrocele- an accumulation of fluid in the scrotum-possibly making one testicle larger.

Masochism- sexual pleasure from being hurt physically or mentally by the partner.

Pedophilia- erotic pleasure from relationships of one form or another with children.

Partruition- process of giving birth (the labor).

Phimosis- the penile skin is abnormally long and cannot be pulled back over the glans (can cause smegma, is surgically corrected).

Pap smear- taking a sample of cervical fluid and examining it for the presence of cancer cells.

Mastectomy- surgical removal of all or part of the breasts.

Vasectomy- sterilizing the male by removing the vas deferens or a portion of it.

Gynecology- a physician specializing in the treatment of the problems of the female reproductive and sexual organs.

Dyspareunia- painful intercourse due to vaginismus in females.

Nymphomania- excessive sexual desire for a woman.

Narcissism- excessive self love, sexual excitement through admiration of one's own body.

Penis captivus- the myth that humans can get caught up in intercourse (only animals).

Contraceptives- methods, substances, or devices used to prevent conception and prevent sexually transmitted diseases.

In her lifetime, the ovaries of an average woman release over 400 eggs, one a month for about 35 years.

Long ago-potions, elixirs, douches made of plant, animal material. Women were told to jump up and down and/or sneeze after intercourse to dispel the sperm. (other methods included lemon juice, olive oil, seaweed)

Today's methods are based on scientific knowledge of human reproductive biology. Some methods are preconceptual (they prevent the union of ova and sperm) or postconceptual (they inhibit the development of the fertilized ovum or embryo).

The most effective method is abstinence: no other single method is 100% effective, free of side effects or 100% safe, as well as cost efficient.

A birth control method is measured in terms of it's failure rate (the percentage of women who become pregnant even though they used that particular method).

Most popular methods listed in order:

  1. pill
  2. female sterilization
  3. condoms
  4. male sterilization

The pill-approved in 1960 by the Food and Drug Administration. It has 150 million users. Reasons for use:

  1. low cost
  2. convenient
  3. reversible
  4. tolerable side effects
  5. 98-99% effectiveness

The pill can come in 21 or 28 day packets. They contain 2 synthetic hormones (progesterone and estrogen). The 21 day packets contain all the hormones, the 28 day packets contain 21 days worth(the other pills contain iron or nothing, they are a different color).

Notes:

  1. 2 days after the last active pill is taken, a menstral period should occur.
  2. Taking it at the same time each day increases the effectiveness.
  3. If you forget-take it immediately and then take regularly scheduled pill.
  4. You may become pregnant if you have sex 7 days after you forget to take a pill.
  5. If you forget 2 days in a row, throw them out and start a new pack.
  6. Don't take with antibiotics and pain relievers, it lessens the effectiveness.
  7. After the pill is stopped, a woman can become pregnant immeadiately.
  8. There is no association between pill use and later birth defects.
  9. Side effects listed on page 154.

Progestin only contraceptives (pills, injections, and implants) They inhibit ovulation and thicken cervical mucus-making it difficult for sperm to reach the egg.

  1. Depo Provera- injected intramuscularly and lasts 12 weeks. It prevents the egg cells from ripening and causes changes in the uterine lining, making pregnancy difficult.
  2. Norplant- they are 6 hormone capsules made of flex material placed under the skin on the inside surface of the upper arm-the hormone is released continuous and lasts 5 years.

There is some discoloration over the sight the professional implants it, and there can be scar tissue, weight gain, and bleeding. These contraceptives do not prevent against STD's.

Barrier methods- physically block the path of sperm in the female reproductive tract and bring sperm in contact with a sperm killing chemical.

1. Diaphragm- a dome shaped latex cup that is placed in the vagina to cover the cervix, which blocks sperm. The rim and cup have a sperm killing cream or jelly. It should be left in place 6 hours after intercourse and not longer than 24 (toxic shock syndrome could occur. The failure rate is 13 out of 100. It is available by prescription and fitted by a doctor (refitting occurs with body changes-pregnancy, weight gain, etc.).

 

Disadvantages: can be dislodged during intercourse, and it must be washed after each use. Also, many women suffer from bladder infections.

 

2. Cervical cap- cup shaped rubber device that covers the cervix (thimble on a finger). It remains in place for 24 hours. Failure rate is 17 out of 100.

 

Disadvantages: it is difficult to insert, remove, and may cause discomfort. It may irritate the cervix and dislodge during intercourse.

3. Vaginal spermicides- foams, gels, creams, suppositories that kill sperm. Failure rate is 18 out of 100. Should be inserted right before intercourse.

Advantages: no doctor prescription needed, can buy in pharmacy, it does protect against some STD's and is almost 100% effective when a condom is also used.

4. condom- made from latex or lamb intestines. These can last up to 5 years if stored properly in a cool dry place (not wallet or glove compartment). Prevents against STD's.

myth: a condom takes away sexual pleasure.

The primary reason condoms may not work is because of human error.

The female condom is one that a woman inserts into her vagina. (page 143). A disadvantage is that the penis must be inserted directly into the outside pouch.

5. IUD- a plastic device placed inside the uterus that weakens sperm, alters the timing of ovum through the fallopean tube, and inhibits the implant of the embryo in the uterine lining. There are 2 used in the U.S., progestasert, which requires replacement each year, and Copper T-380A which can protect for 10 years.

They are highly reliable and simple to use, and are reversible. But some women have severe menstrual flow and bleeding between periods, and pelvic infections.

Fertility awareness methods-used to determine the woman's most fertile days. It is an estimate of when ovulation is most likely to occur or indicate when ovulation has already taken place.

Failure rate 20 out of 100.

  1. calendar- estimating the most likely fertile days based on: 1-ovulation takes place 14 days prior to the onset of the next menstral cycle. 2- ovum capable of being fertilized for 24 hours. 3- sperm deposited in vagina capable of fertilization for 3 days.
  2. Temp- In 90 percent of women the basal body temp rises 1 degree after ovulation due to changes in hormone levels. Keep track of this temp each day and eventually the woman knows when ovulation has occurred.
  3. Mucus- hormone sensitive glands in the cervix produce mucus that changes in amount, color, and consistency during different phases of the menstrual cycle. The mucus is examined during the cycle.

Withdrawal method- the penis is ejected right before ejaculation. The problem with this method is that pre-ejaculatory fluid contains millions of sperm, so pregnancy may still occur.

Sterilization- (sterility is permanently unable to have children). It has become a choice method for married couples, and is nearly 100% effective.

  1. vasectomy- cutting and tying the vas deferens in the male. A 15-30 minute procedure that is reversible. (page 152)
  2. Tubal ligation- blocking the fallopean tubes by cutting, tying, or sealing. (page 153)
  3. Hysterectomy- removal of the uterus.

Abortion- intentional premature termination of pregnancy. The oldest, widest practiced method of birth control. It is the expulsion of an embryo or fetus from the uterus before it is sufficiently developed to survive.
Miscarriage-a spontaneous abortion: one that occurs naturally.

90% of them are performed in the first trimester.

1.5 million performed each year in the U.S.

  1. Vacuum or suction curettage is the safest and most common abortion method-usually performed during the first 12 weeks. A sedative is given, a speculum is inserted into the vagina, and the cervix is cleansed with a surgical solution. The cervix is dilated and a hollow tube attached to the rubber tubing of an electric pump is inserted into the uterus. In 20-30 seconds the uterus is emptied, and the surgeon then scrapes the uterine lining with a spoon like instrument. The entire procedure takes 5-10 minutes.
  2. Dilation and curettage is an alternative vacuum procedure in which the cervix is dilated and the uterus is emptied by cleaning the lining of the uterus with a spoon shaped instrument. (manual vacuum aspiration). The cervix is dilated, and a plastic tube attached to a handheld syringe is inserted. The uterus is emptied with gentile suction provided by the syringe.
  3. Dilation and extraction is performed between the 13th and 20th week by combining vacuum and surgical curettage. The cervix is expanded overnight and the surgeons empty the uterus using instruments and aspirating machine.
  4. chemical methods block the naturally occuring hormone progesterone, which is essential for successful implantation and pregnancy. 95% effective and relatively safe. This medical abortion is used in very early pregnancy, by combining drugs that causes the embryo to be passed out through the vagina, as in a natural miscarriage. It is much safer but it takes up to several weeks to complete, and bleeding may last much longer. Also, more clinic visits are required.

The costs of these abortion are around 1000 dollars.

Legality and morality of abortion-the great debate-------

  • For two centuries, abortion policy in the U.S. followed English common law, which made the practice a crime only when performed after quickening (fetal movement that begins at about 20 weeks)
  • First statutes regulating abortion in the 1820's in New York and Conn to protect mothers from dangerous techniques.
  • In the mid 1800's newspaper advertisements for abortion preparations became common and concern grew that women were using abortion as a means of birth control.
  • At the end of civil war our government wanted more babies to be born, more legislation
  • By 1900 it was illegal in every state, and these anti abortion laws stayed in effect until the mid 1960's.
  • Many women were still having them, but non medical people were performing them, and many people died. (coat hangers, spoons, disinfectant, lye were some things used)
  • Others went to foreign lands to get illegal abortions.
  • 1973 Roe vs. Wade- states could not make laws prohibiting abortion on the grounds that they violated a woman's right to privacy. This decision allowed a woman 12 weeks to decide and after 12 it could be determined by the health of the woman. During the second trimester a state may regulate the factors that protect the health of the woman. During the third trimester it is banned except in the case of preserving the mother's life or health.
  • In order to reduce a woman's access to abortion, states have passed a variety of laws that include bans on public funding, employees, facility cuts for abortion services, mandatory counseling and waiting periods, insurance prohibitions, and requirements for parental counseling for minors.
  • Opponents of abortion have recently focused on specific methods of abortion. Many states and the U.S. Congress have passed legislation outlawing a particular method of late term abortion referred to by abortion opponents as partial birth abortion.
  • Legal efforts have also targeted medications that can be used to induce abortions (RU-486)

    • Do a comparison paper between pro choice and pro life: read 176-77.

  • People have mixed feelings (if this is ok, what's next), (clinic bombings)
  • A huge political topic- when does life begin? When the zygote forms at the conception, or birth?

Emergency contraception are those used after unprotected sexual intercourse.

  1. a two dose regimen of oral contraceptives.
  2. Preven Emergency Contraception kit: 4 pills: 2 taken up to 72 hours after intercourse, and the other 2 12 hours after.

New methods:

  • The sponge
  • Biodegradable implants (remember Norplant)
  • Vaginal rings
  • Chemical contraceptives for men (they are messing with testosterone)
  • Reversible sterilization
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