Study Guide for Exam 1
Popular in Human Sexual Behavior
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Study Guide for Exam # 1 Chapter One: Sexuality in Perspective 1. Definitions of coitus, gender, rape, sex, sexual behavior, and sexuality Gender: refers to a person’s sense of being female or male. Sex :(a) refers to sexual/reproductive anatomy or (b) to the state of being female or male or (c) behavior that produces or is likely to produce an orgasm in at least one person Sexual Behavior: produces or is intended to produce sexual arousal Coitus: a form of sex in which a vagina enfolds a penis; also known as penilevaginal intercourse or PVI Sexuality: patterns of sexual behavior, beliefs, attitudes, emotions, and fantasies. Rape: genital activity without the active consent of one of the people involved o Affirmative consent must be ongoing throughout a sexual activity and can be revoked at any time. 2. Sexual attitudes and practices of Victorians, Puritans, Muslims, and ancient Greeks Ancient Greeks: openly acknowledged both heterosexuality and homosexuality in their society and explained the existence of the two in a myth: original humans were double creatures with twice the normal number of limbs and organs. The gods, fearing their power, split them in half and forever after each one continued to search for its missing half Muslims: sexual intercourse is one of the finest pleasures of life o However, laws of the Koran vary from country to country Victorians: norms about sexuality were extremely rigid, oppressive and conservative; women had sex because it was their civil duty to keep the husband sane Puritans: viewed sex within marriage as a gift of God and an essential enjoyable part of marriage 3. What is true about sexual attitudes and behavior across cultures? All societies have strong sexual norms, but they vary greatly o Incest taboos are almost universal o Adult exposure of genitals is taboo especially for women o Fairly similar ratio of heterosexuals and homosexuals o Samegender sexual behavior is never predominant o Generally similar expressions of jealousy o All societies regulate sexual behavior in some way o Poor complexion is considered unattractive Societies respond differently to: kissing, inflicting pain, masturbation, premarital sex, extramarital sex, sex with samegendered partners, and standards of attractiveness 4. Major differences and similarities in sexual behavior between species including how they compare to humans. What species has sex for emotional bonding more frequently than humans? Most sexual behavior found in humans is found in other mammals o Masturbate, participate in samegender sex, give sexual signals Sexual behavior is more hormonally (instinctively) controlled among lower species and controlled more by the brain (learning, social context, and other environmental factors) in the higher species, like primates Human females are able and willing to engage in sex during any phase of their hormonal (menstrual) cycle while hormonally controlled species only engage in sexual behavior when they are in “heat” (estrus) Humans = less hormonally controlled, less instinctual, and generally use sex for bonding and pleasure Bonobos (this is a species of the ape) have sex every day and are very matriarchal; have sex for emotional bonding more frequently than humans 5. For what are Anthony Comstock and Margret Sanger famous? Anthony Comstock clerk at a post office who was appalled by pornographic mail; passed a bunch of laws (Comstock Laws) prohibiting everyone from talking about sex or contraception, which led to many unwanted pregnancies (laws went away after WWII) Margaret Sanger social worker/nurse who distributed condoms (imported them illegally) and sex information; eventually pushed the idea of birth control and was the founder of Planned Parenthood 6. What is the major contribution to sexuality by Sigmund Freud and by Henry Havelock Ellis? Freud helped to start the first American Sexual Revolution with his psychoanalytic movement; lived and worked among many women who were forced to repress sexual needs Henry Havelock Ellis compiled a vast collection of info on sexuality, which published a series of volumes called Studies in the Psychology of Sex; Considered the forerunner of modern sex research 7. What caused and what ended the two American sexual revolutions? About when did they occur? First American Sexual Revolution (20sGreat Depression) o Caused by the work of Freud, new technologies, and women obtaining the right to vote o Stopped from the Great Depression Second American Sexual Revolution (60s late 70s) o Caused by the invention of birth control pills (invented 1960, common in late 60s), work of Masters & Johnson, Playboy (included writings and the first use of “clitoris”), general disregard of authority o Stopped by disillusionment (marriage > sex), herpes, & AIDS Chapter 4: Sexual Anatomy 1. Recognize from verbal description or from diagrams and know the sexual sensitivity and function of the following: External Female Anatomy: Clitoral crura: two longer spongy bodies that lie deep in the body and run from the tip to either side of the vagina, under the lips o Fill with blood, erecting the clitoris Clitoral glans: the tip o Rich supply of nerve endings, making it extremely sensitive o No reproduction purpose Clitoral prepuce: a knob of tissue in front of the vaginal opening and the urethral opening (this is also known be the clitoral hood) o Covers the shaft of the clitoris for protection Clitoral shaft: consists of 2 corpora cavernosa that extend about an inch into the body o Corpora cavernosa fill with blood, erecting the clitoris Inner labia: 2 hairless folds of skin lying between the outer lips and running right along the edge of the vaginal opening o Important in sexual stimulation and arousal o Enclose and protect the urethra and vagina Outer labia: rounded pads of fatty tissue that lie along both sides of the vaginal opening; they are covered with pubic hair (this is different than the inner labia that doesn’t have public hair on it) o Important in sexual stimulation and arousal Mons pubis: rounded, fatty pad of tissue covered with pubic hair at the front of the body that lies on the pubic bone Vulva: the collective term for the external genitals of the female o The vulva consists of: clitoris, mons pubis, inner & outer lips, vagina opening (can also be referred to as the introitus:), urethral meatus Bartholin glands: lie just inside of the inner lips, located on either side of the vaginal entrance. o Have no significant function but sometimes become infected Perineum: area of skin between the vaginal opening and the anus o Can be sensitive Areola: darker area surrounding the nipple o Supports nipple & has glands to keep nipple moisturized during breastfeeding Breast: consist of about 15 or 20 clusters of mammary glands and of fatty and fibrous tissue that surround the clusters of glands o Produces milk for baby Nipple: tip of the breast into which the milk ducts open o Richly supplied with nerve endings; important in erotic stimulation o Used for breastfeeding Internal Female Anatomy: Cervix: the narrow lower 1/3 of the uterus, called the cervix, opens into the vagina. o Allows the passage of menstrual fluid, directs sperm into uterus during fertilization, protects the uterus/fetus from pathogens Endometrium: the inner layer of the uterus that is richly supplied with glands and blood vessels o Uterus layer in which implantation occurs; if implantation does not occur, the layer is shed (menstruation) Fallopian tube: extremely narrow pathway that extends from the sides of the upperend of the uterus o The fallopian tubes are lined with hair like projections called cilia. o Pathway by which the ova (egg) travels from the ovary toward the uterus and the sperm reach the egg Fertilization of the egg (ova) typically occurs in the infundibulum, the section of the tube closest to he ovary The fertilized egg then travel the rest of the way through the tube to the uterus The infundibulum curves around toward the ovary; at its end are numerous fingerlike projections called fimbriae: that extend toward the ovary. Fimbriae: fingerlike projections that extend toward the ovary o Help to move the released ovum from the ovary to the fallopian tube GSpot: sensitive spot on the front vaginal wall o More sensitive than the rest of the vagina; but not nearly so sensitive as the inner lips, outer lips, or clitoris Ovary: the two organs about the size and shape of unshelled almonds that lie on either side of the uterus o Produce eggs (ova) and manufacture sex hormones (estrogen/progesterone) Pubococcygeus muscle: surrounds the vagina, urethra, and anus o Muscles responsible for contractions (orgasm, childbirth) and controls urine flow o Can be strengthened through exercise (kegel exercises) Skene's gland, or female prostate (also called the paraurethral gland): lie between the wall of the urethra and the wall of the vagina o Responsible for female ejaculation (In combination with the Gspot); secretes fluid (in some women) that is biochemically similar to male prostate fluid o Many find it to have special erotic sensitivity on the wall of the vagina Vagina: tubeshaped organ into which the penis is inserted during coitus: it also receives the ejaculation (sometimes might be referred to as the birth canal) o In the resting state its walls lie against each other like the sides of an uninflated balloon: during arousal it expands like an inflated balloon, allowing space to accommodate the penis. o Used for sexual intercourse (coitus), receives the sperm, and serves as the passageway for childbirth o Nerve supply is mostly to the lower 1/3 (near the introitus: vagina opening), near the opening (sensitive to erotic stimulation); inner 2/3 is relatively insensitive except for feelings of deep pressure Vaginal introitus: the vaginal opening Vestibular bulbs: (or the bulbs of the clitoris) are two organs about the size and the shape of a pea pod. They lie on either side of the vaginal wall, near the entrance (introitus), under the inner lips. They are erectile tissue and lie close to the crura of the clitoris. o Fill with blood when aroused, which then becomes trapped, causing an erection; tightly cuffs the vaginal opening, causing the vulva to expand outward Uterus: the womb, it is about the size and shape of an upsidedown pear. o Holds and nourishes a developing fetus External Male Anatomy: Penis: the male external sexual organ, which functions both in sexual activity and in urination. o Serves important functions in sexual pleasure, reproduction, and elimination of body wastes by urination. o While the entire penis is sensitive to sexual stimulation, the corona and the rest of the glans are the most sexually excitable region of the male anatomy. Penile glans: the tip or head of the penis o The opening at the end of the glans is the meatus (urethral opening), through which urine and semen pass. o Has an opening for urine and semen excretion o Sexually sensitive Corona: raised ridge at the end of the glans o Sexually sensitive Penile prepuce (foreskin): an additional layer of skin that forms a sheathlike covering over the glans (foreskin); absent when circumcised Penile shaft: main part of the penis Frenulum: tissue on the underside of the penis below the corona o Most sensitive part of the penis Scrotum: loose pouch of skin, lightly covered in hair, containing the testes Internal Male Anatomy: Corpus cavernosum: two spongy bodies lying on top of the penis that run parallel to the urethra o Richly supplied with blood vessels and nerves and become engorged with blood during an erection; when flaccid, they contain little blood Corpus spongiosum: single spongy body lying on the bottom of the penis (urethra runs through the middle of it) o Richly supplied with blood vessels and nerves and becomes engorged with blood during an erection; when flaccid, it contains little blood Seminal vesicle: two saclike structures that lie above the prostate, behind the bladder and in front of the rectum o Produce about 2/3 (60%) of the semen for ejaculation Prostate gland: lies below the bladder and is about the size and shape of a chestnut; it is composed of both muscle and glandular tissue o Produces remaining 1/3 (40%) of semen; secretes a milky alkaline fluid (part of ejaculate) to protect sperm from the acidity of the vagina o Sexually sensitive when going through the rectum (gets bigger during arousal) Spermatic cord: tube going from testes into the body that passes through the inguinal canal o Contains the vas deferens, epididymis, arteries, veins Inguinal canal: the canal from which the testes descend Testis: reproductive glands (gonads) o Manufacture sperm (seminiferous tubules) and sex hormones (interstitial cells) Interstitial cells (aka Leydig's cells): found in the connective tissue lying between the seminiferous tubules o Produce testosterone; pour the manufactured hormones directly into the blood vessels Seminiferous tubules: long series of threadlike tubes curled and packed densely in the testes (~1,000) o Manufacture and store sperm Epididymis: long tube about 20 ft in length that is coiled into a small crescent shaped region on the top and side of the testis o Where sperm are stored and ripened, possibly for as long as six weeks Vas deferens: passes up and out of the scrotum and then follows a peculiar circular path as it loops over the pubic bone, crosses beside the bladder, and then turns downward and passes through the prostate and narrows into the ejaculatory duct, which opens into the urethra o Upon ejaculation, sperm pass from the epididymis into the vas deferens (only thing severed in a vasectomy) Cowper's gland: located just below the prostate and empty into the urethra o Secrete a small amount of a clear alkaline fluid during arousal, which appears as droplets at the tip of the penis neutralizes the acidic urethra to protect the sperm 2. Generally, how often should women douche? Never 3. What part of the nervous system maintains the penis in its flaccid state and what part creates and maintains erections? Flaccid state = sympathetic nervous system Erect state = parasympathetic nervous system 4. What chemical involved with erections is controlled by Viagra? Viagra inhibits PDE5, blocking the breakdown of cGMP, increasing the levels of cGMP, and prolonging an erection 5. What causes erections: both in the general sense and specific mechanisms? Erections are caused by nitric oxide, causing release of cGMP. 6. What is smegma? A substance cheesy in texture that is produced by the Tyson’s glands under the foreskin; if the foreskin is not pulled back and the glans washed thoroughly, the smegma may accumulate and smell Chapter 6 (A little of 5): Hormones, Menstruation, & Menopause 1. What are the functions of estrogen, folliclestimulating hormone (FSH), gonadalreleasing hormone (GnRH), luteinizing hormone (LH), oxytocin, progesterone, and testosterone? Estrogen: the group of female sex hormones. o Function: helps changes for puberty as well as the mensuration cycle. Testosterone: a hormone secreted by the testes in males (and also present as lower levels in females) o Function: has important functions in stimulating and maintaining the secondary sex characteristics (such as beard growth), maintaining the genitals and their spermproducing capability, and stimulating the growth of bone and muscle. Progesterone: a sex hormone secreted by the ovaries. o Function: helps with the mensuration cycle and maintain pregnancy. Folliclestimulating hormone (FSH): a hormone secreted by the pituitary: it stimulates follicle development in females and sperm production in males. o Function: helps control sperm production and stimulates maturation of eggs. Luteinizing hormone (LH): a hormone secreted by the pituitary; it regulates estrogen secretion and ovum development in females and testosterone production in males. o Function: helps control testosterone in men and ovulation in women Oxytocin: a pituitary hormone that stimulates milk ejection from the nipples and contractions of the uterus during childbirth. o Function: Referred to as the “cuddling hormone” Helps with bonding between friends (for women) Associated with orgasms Gonadalreleasing hormone (GnRH): a hormone secreted by the hypothalamus that regulates the pituitary’s secretion of gonadstimulating hormones. o Function: Regulates the pituitary and and helps with FSH and LH 2. What gender differences are there in the amount and function of the hormones listed above? There are many similarities in the sex hormones of the two genders Sex hormones Systems in Males: The most important hormone produced by testes is testosterone. o Testosterone levels in males are relatively constant. o The hypothalamus, pituitary, and testes work together in a similar negative feedback loop, ensuring that testosterone is maintained at a fairly constant level. o FSH (folliclestimulating hormone) and LH (luteinizing hormone) are produced by the pituitary glands and these hormones affect the functioning of the testes. o FSH controls sperm production o LH controls testosterone production Sex hormones in Females: the ovaries produce two important hormones, estrogen and progesterone. o Estrogen brings about many of the changes that occur during puberty Estrogen is also responsible for maintain the mucous membranes of the vagina and stopping the growth of bone and muscle, which account for females being generally smaller than males. o In adult women the levels of estrogen an progesterone fluctuate according to the phases of the menstrual cycle and during various stages such as pregnancy and menopause. o FSH and LH regulate the levels of estrogen and progesterone. o Same negative feedback loop that the males goes through with FSH, LH and the GnRH o Women also have oxytocin that helps stimulate milk ejection from the nipples and contractions of the uterus during childbirth. However, oxytocin is produced in both males and females but we aren’t sure if men experience the same bonding experience that women do. The female sex hormone system functions much like the male sex hormone system. The ovaries and testes produce many of the same hormones, but in different amounts. 3. Know the four phases of the menstrual cycle in order. The menstrual cycle has four phases: o Follicular phase: proliferative or prevultaory phase o Ovulation o Luteal phase: secretory or postovulatory phase. o Mensuration 4. During each phase of the menstrual cycle, what's happening with the ovaries & oocytes, the endometrium, the cervix, the follicle & corpus luteum, and the relevant hormones? Follicular phase: the first phase of the menstrual cycle, beginning just after menstruation, during which an egg matures in preparation for ovulation. o At the beginning of the phase, the pituitary secretes relatively high levels of FSH (it functions to stimulate follicles in the ovaries). At the beginning of the follicular phase, it signals one follicle (occasionally more than one) in the ovaries to begin to bring an egg (ova) to the final stage of maturity. At the same time, the follicle secretes estrogen. Ovulation: release of an egg (ova) from the ovaries; the second phase of the menstrual cycle. o Phase in which the follicle ruptures open, releasing the mature egg (ova). By this time, estrogen has risen to a high level, which inhibits FSH production, and so FSH has fallen back to a low level. The high levels of estrogen also stimulate the hypothalamus to produce GnRH, which causes the pituitary to begin production of LH. A surge of LH triggers ovulation. o **LH tells the ovaries to release the ovum Luteal phase: the third phase of the menstrual cycle, following ovulation o After releasing an egg, the follicle, under stimulation of LH, turns into a glandular mass of cells called the corpus luteum. The corpus luteum manufactures progesterone, so progesterone levels rise during the luteal phase. The progesterone is what causes the thickening of the uterine wall. High levels of progesterone also inhibit the pituitary’s secretion of LH, and as LH levels decline, the corpus luteum degenerates. With this degeneration comes a sharp decline in estrogen and progesterone levels at the end of the luteal phase The falling levels of estrogen stimulate the pituitary to begin production of FSH, and the whole cycle begins again. Menstruation: the fourth phase of the menstrual cycle, during which the endometrium of the uterus is sloughed off in the menstrual discharge. o Menstruation is a shedding of the inner lining of the uterus (the endometrium), which then passes out through the cervix and the vagina. o During this phase, estrogen and progesterone levels are low and FSH levels are rising o Menstruation is triggered by the sharp decline and progesterone levels at the end of the luteal phase. 5. What hormone signals the brain that a woman is pregnant? Human chorionic gonadotropin (HCG): a hormone secreted by the placenta: it is the hormone detected in pregnancy tests. 6. If a woman has PMS, in what phase of the menstrual cycle does it occur? Luteal Phase Symptoms of PMS (premenstrual syndrome occurs in the luteal phase of the mensuration cycle) o Mood changes Often less than with mensuration and possibly less than with ovulation Changes with menstrual cycle tends to be less than other general influences such as stress, anxiety, depression, decrease or increase in lust, easily stressed out, depression, inability. o Changes in attention Forget, confusion, difficulty staying on task o Physical changes Breast tenderness, bloatness, bloating in arms and legs, migraine, back pains, low energy, nausea. 7. What is the average age of menopause for women? 51 but varies a lot 8. How does sexual and reproductive functioning change in men with age? Biological changes: o Andropause= decline not cessation o Noncancerous enlargement of prostate gland Psychosocial changes: o Male midlife crisis o Generatively versus stagnation o Family relationships Not the same type of menopause that women go through They do have this general decline in testosterone over time Begins to decline between the ages of 2025. Men are a little less active while this goes down. Men continue to make sperm their entire life Chapter 6: Reproduction 1. How many sperm in a typical single ejaculation? How long does it take a man to make that many sperm? 200300 million sperm occurs during a typical single ejaculation It takes a man at least 24 hours to make that amount of sperm 2. Where in a woman’s body does conception occur? Outer third of the fallopian tube (near the ovary) 3. What are the parts of sperm, what part contains an enzyme to dissolve the zona pellucida? Head: this part is what contains the enzyme that dissolves the zona pllucida. o Contains DNA o Also contains acrosome, a chemical reservoir: secrets enzyme called hyaluronidase which dissolves the zona pellucida surrounding the egg (ova) Midpiece: o Contains mitochondria (energy) Tail: o Flagellation (swimming sperm) 4. What surrounds the ovum that sperm have to get through in order to fertilize the ovum? Zona Pellicula 5. How long do sperm and ova live in a woman’s body? What is the optimum time for coitus with respect to ovulation if a couple desires to conceive a child? Sperm can live in women’s bodies up to 5 days Ovary may be fertilized for 1224 hours after ovulation Optimum time for coitus/conception: 14 days before menstruation 6. How accurate are home pregnancy tests? The accuracy of home pregnancy tests is determined by its sensitivity and following the directions, but regardless, home pregnancy tests, are not 100% accurate Not well enough researched to determine effectiveness 7. What is the placenta? Placenta: the mass of tissue that surrounds the conceptus early in development and nurtures its growth. 8. What psychological changes occur in women during pregnancy? What factors seem to influence these changes? What differences exist by trimester and when comparing firsttime mothers to women who had been pregnant previously? st 1 Trimester: Many factors contribute to emotional state: o Attitude towards pregnancy o Social class: link between low income and depression during pregnancy. More unwanted pregnancies among lowincome women. o Availability of social support: women with supportive partner less likely to be depressed o Depression not uncommon during this timedue to fatigue and lack of energy o Women’s anxiety in this trimester often center on concerns about miscarriage. 2 Trimester: Period of calm and wellbeing Fear of miscarriage has passed due to fetal movement Discomforts of 1 trimester past and tensions with labor and delivery are not yet present nd Depression is less likely in 2 trimester if woman has partner Women who have had previous pregnancy are more distressed during this time, reflecting the demands associated with the care of children while one is pregnant Feelings of nurturance or maternal responsiveness to the infant increase steadily from prepregnant to the postpartum period (not related to hormone levels) 3 Trimester: rd Patterns noted earlier continue into 3 trimester First time mothers report a significant increase in dissatisfaction with their husbands from 2 to 3 trimester Couples who report higher levels of affection exchanged also report lower levels of anxiety and of insomnia in the rd 3 trimester. One view is happy and calm: other view is irrational and depressed, happy, etc., with emotions constantly changing. Factors that influence these changes include attitudes toward pregnancy, social class, and availability of social support. 9. How long can women who have a normal, healthy pregnancy continue to have coitus? What major category of pregnant women is most likely to be advised not to have sex? What, if any, changes in frequency of coitus occur with pregnancy? Given a normal, healthy pregnancy, intercourse (coitus) can continue safely until 4 weeks before the baby is due In cases where a miscarriage or preterm labor is threatened, couples are advised not to have sex st Most pregnant women continue to have sex during pregnancy: the most common pattern is a decline in the 1 trimester, variation in the 2 trimester, and an even greater decline in the 3 trimester. 10. What are BraxtonHicks contractions? BraxtonHicks contractions cccur during the 3 trimester Painless contractions of the uterus, not part of labor; thought to strengthen the uterine muscles, preparing them for labor 11. What sexual position is most frequently the best one during the last stages of pregnancy? Side to side position is the most suitable for the partners to have coitus (intercourse) in during the last stages of pregnancy. 12. Know the stages of labor and the major events that occur in each stage. Beginning of Labor: 1. May be a discharge of a small amount of bloody mucus (plug in cervical opening during pregnancy which prevents germs) or water breaks (10% of women more commonly breads at the end of the 1 stage). st 2. 24 hours after this, labor usually begins 3. Proposed that increased production of antiprogesterone reduces the inhibiting effect of progesterone and labor begins. st 1 stage: 1. Regular contractions start causing the cervix to experience effacement (thinning out) and dilation (opening up). The vagina opening must dilate to 10 cm before baby can be born. 2. Divided into another 3 stages: early, late, and transition a. Early: contractions 1520 minutes apart. Quite comfortable. b. Late: cervix dilated about 58 cm. Generally shorter than 1 stage and contractions are more frequent and more intense c. Transition: cervix dilated 810 cms and is short and difficult. Pain and exhaustion. 3. 1 stage can last anywhere from 224 hours; averages about 1215 hours for 1 pregnancy and about 8 hours for later pregnancies 4. Women told to go to the hospital when contractions are 45 minutes apart 2 Stage: Delivery 1. Starts with baby’s head coming out and moving into the vagina or birth canal. 2. Lasts from a few minutes to a few hours and is generally much shorter than the 1 stagest 3. May perform episiotomy (helps quickly enlarge the vagina opening to allow the baby to pass through) 4. Baby comes completely out of womb and takes first breaths. Still connected to umbilical cord. rd 3 Stage: 1. Placenta detaches from the walls of the uterus and the afterbirth (placenta and fetal membranes) is expelled. Can take from a few minutes to an hour. May be accompanied by several contractions. 2. The episiotomy is sewn up. 13. What is an episiotomy? What does research say about its benefits? Episiotomy is an incision of slit made in the perineum Physicians believe it will prevent impaired sexual functioning in later life, reduce the severity of perineal lacerations, and reduce post delivery pain and medication use However, recent research didn’t find that any of those benefits result. 14. How does the rate of Cesarean deliveries in the USA compare with other Western countries? Do Cesarean deliveries improve mortality? Does having one Cesarean delivery mean a woman will have a Caesarean for all subsequent deliveries? US has considerably higher rates of Cesarean (Csection) as compared to Europeans countries o Caesarian section, Csection, is a surgical procedure in which one or more incisions are made through a mother’s abdomen and uterus to delver one or more babies. A Csection is often performed when a vaginal delivery would put the baby’s or mother’s life or health at risk. Some are also performed upon request without a medical reason to do so. Associated with higher rates of complications requiring hospitalization for mother or baby Women may perform vaginal birth after a Cesarean o There are many reasons why a women might need a Csection and sometimes it might be an emergency Csection but that doesn’t mean pregnancies following can’t be delivered through the vagina. 15. What is the minimal waiting time after giving birth vaginally, without an episiotomy, to have coitus? According to Hyde et al’s (1996) data how long before about 90% of couples have resumed normal sexual activity? Should wait at least 2 weeks in order to avoid infection and hemorrhage In the month following birth, only 17% of couples resumed sex. 9/10 couples resumehaving sex after 4 months of postdelivery. 16. What recommendation is made about whether mothers should breastfeed their newborn infants? What effect does breastfeeding have on coital activity? At both 1 month and 4 months after, women who were breastfeeding reported significantly less sexual activity and lower sexual satisfaction. This is because lactation suppresses estrogen production, which in turn decreases vaginal lubrication Health institutes strongly encourage breastfeeding since breast milk is the ideal food for a baby and provides the baby with the right mixture of nutrients, contains antibodies that protect from diseases, is free from bacteria, and is always the right temperature Breastfeeding is associated with a reduced risk of obesity at ages 5 and 6 “Breastfeeding ensures the best possible healthy as well as the best developmental and psychosocial outcomes for the infant.” 17. What is the most common cause of infertility in men today? In women today? In women, pelvic inflammatory disease caused by sexually transmitted infection especially gonorrhea or Chlamydia, is the most common cause In men, most commonly caused by infections in the reproductive system caused by sexually transmitted diseases. 18. Recognize artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) Artificial insemination: involves artificially placing semen in the vagina to produce a pregnancy; thus it means accomplishing reproduction without sexual intercourse. Can be done by husband when he has a low sperm count or donor when the husband is sterile. In Vitro fertilization: scientist makes sperm and egg meet in a test tube. The fertilized egg is then implanted in the uterus of a woman. Great for infertile couple where the woman’s fallopian tubes are blocked. 42% successful births in the US. Expensive. Gamete Intrafallopian Transfer (GIFT): improvement in some cases over IVF. Sperm and eggs are collected then inserted together into the fallopian tube, where natural fertilization can take place, followed by natural implantation. Success rates not yet reported. Contraception 1. What issues should be considered when choosing a form of contraception? Objective considerations o Effectiveness Perfect user (if someone takes it perfectly) vs. typical user failure rates o Reversibility (you might not want kids now but you still want to) o Known side effects and interactions o Personal and family medical history o Cost Subjective Considerations o Ethical consideration o Personal preferences o Personal desires, limitations (Ex. Like taking birth control at the same time every single day), and lifestyles. o Political factors: not every location has the same resources and access to birth control. Discuss contraception before coitus o If couple does not want to be pregnant, never pressure for coitus without contraception Genuinely consider methods of male responsibility o Bank sperm o Male condoms? If a women is using some type of contraception such as rhythm, pills, IUD, etc. o Emotional support (varies with the importance) with patience and without nagging Instrumental support if asked o Contribute financial support 2. What are erotophobes and erotophiles? Erotophobes: has problems discussing sex which could lead to a problem describing to a man that he has to put on a condom. Erotophiles; you have no problems as thinking of yourself as a sexual person and if it appropriate you have no problem talking about sex. 3. Contraceptive myths (Ineffective “techniques”) Women douching Coitus in a hot tub/Jacuzzi Man drinks (Mountain Dew: or any other beverage) Coitus standing up (or any other position) Woman (or man) being a Virgin Woman jumping up and down 4. How men be helpful with birth control in general and if they have a girlfriend using birth control pills, patch, or ring. Discuss contraception before coitus o If couple does not want to be pregnant, never pressure for coitus without contraception Genuinely consider methods with male responsibility o Male condoms are also a good form of contraception o Bank sperm now because men have the best sperm currently and as they age, their sperm becomes older and less healthy. Bank sperm is a good idea because they can freeze your sperm and have the healthiest sperm at this age, and one day when you want children, it might be a great idea to do this sperm Bank idea. If woman is using rhythm, pills, IUD, etc.: Emotional support (varies with the importance) with patience and without nagging o Instrumental support if asked (if someone needs help putting the patch on or putting the ring in or if they need to remember to take the pill every day). Contribute financial support 5. What are the strengths, limitations, and risks for abstinence, combination pills, depoprovera injections, diaphragms, female condom, implants, IUDs, male condoms, minipills, patch, ring, spermicides, sterilization, rhythm method, and withdrawal? Limiting Coitus: Abstinence: Theoretical failure= 0 o Typical= ? o Possible side effects: possible sexual frustration o Health Risks: none o Advantages: complete freedom from worry about pregnancy or STDs, free o Disadvantages: may limit range of romantic partners May impulsively decide to stop without using alternative contraception o Cost: free! Withdrawal: theoretical failure= 4% o Typical= 26% (can’t have sperm near the lips (vuvla) because one sperm can cause pregnancy) o Possible side effects: frustration o Health risks: none o Advantages: Always available o Disadvantages: partner cooperation required, limits ability to focus on pleasure o Cost: free Rhythm methods: theoretical failure= 29% o Typical= 25% o Possible side effects: slight frustration during abstinence o Health risks: none o Advantages: accepted by the Roman Catholic Church and other religions Easy to switch to attempting to become pregnant Woman becomes more familiar with her body o Disadvantages: partner cannot be sure used Effectiveness very dependent on the regularity of the woman’s menstrual cycle May have only 12 safe days per menstrual cycle o Cost: more or less free: except if ovulation kit ($50500) Breastfeeding: Theoretical failure= <1 % Typical = 2% Possible side effects: none o Can be complicated because we shouldn’t be able to breast feed unless they are pregnant o Once a women is pregnant and has had a baby, they can use breastfeeding as a form of contraception o The process of breastfeeding is only effective for contraception for 6 months. Health risks: none Advantages: acceptable to all religions including Romanic Catholic, free, no hassle during sex, healthy for baby, promotes bonding with baby Disadvantages: only effective for 6 months, must be started immediately after delivery, cannot have had period since delivery, must feed baby at least every 4 hours during the day & every 6 hours at night & cannot give baby any other food. Cost: free! Chemical disruption of hormones: The pill (s): o The combination Pill Theoretical failure= 0.3% (extremely low) Typical= 8% Certain medicines and supplements may make the pill less effective. Vomiting and diarrhea may also keep the pill from working Possible side effects: breast tenderness, bleeding between periods, and nausea are most common and usually go away within 3 months; headaches, depression, weight gain, change in libido, mood swings Health risks (all are rare): heart attack, stroke, developing high blood pressure, liver tumors, gallstones, or jaundice (yellowing of the skin or eyes) These ricks increase if: age 35 or older, very overweight, certain inherited blood clotting disorders, diabetic, high blood pressure, high cholesterol, need prolonged bed rest, smoke Advantages: simple, safe, convenient and allows for spontaneity Reduces risk of ectopic pregnancy, ovarian and endometrial cancer, pelvic inflammatory disease, iron deficiency anemia and ovarian cysts Makes menstrual cycle regular Allows control of when menstruation occurs Reduces menstrual discomfort and PMS Reduces vaginal dryness and painful intercourse related to menopause Many types reduce acne Easily reversible Disadvantages: partner cannot be sure used Best taken at same time Less effective for very overweight women Some other medications reduce their effectiveness Cost: $15 to 50 per month o The “mini” pill (progestin only) Theoretical failure= 0.5% Typical= 410%: especially important to take at the same time every day Possible side effects: irregular menstrual cycle, bleeding between periods Health risks: ovarian cysts Advantages: safer for older women and those with clotting problems Allows for spontaneity Reduces risk of ovarian & endometrial cancer and for pelvic inflammatory disease Reduces menstrual discomfort (some women cease to have periods) Easy to use Reversible Disadvantages: partner cannot be sure used, may forget to take it, best taken same time every day Cost: about $35 per month The patch: o Theoretical failure= 0.3% o Typical= 18 % (less effective if weigh >198 lbs.) o Possible side effects: irritate skin, headaches, depression, weight gain, change in libido, mood swings Nausea, breast tenderness and bleeding between periods are the most common side effects, but all usually clear up in less than 3 months o Health risks: all rare: heart attack, stroke, thromboembolic disorders (women using the patch may have a higher risk of getting blood clots than women taking most kinds of birth control pills), high blood pressure, liver tumors, gallstones, or jaundice. Loss effectiveness in same situation as the combination pill o Advantages: lasts a week, partners know it is being used, simple, and convenient, allows for spontaneity Reduces risk of acne, ovarian and endometrial cancer and for pelvic inflammatory disease Makes menstrual cycle regular, reduces menstrual discomfort and PMS Reversible o Disadvantages: may be seen by others, may have more risks and side effects than the pill, may be less effective with overweight women o Cost: $1550 per month The ring: o Theoretical failure= 0.5% o Typical= 5% o Possible side effects: acne, breast tenderness, headaches, depression, weight gain, nausea, lower libido, mood swings, vaginal irritation/ infection o Health risks: elevated blood pressure &/or blood sugar, changes in cervical cells; rarely: heart disease, blood clotting, liver and gall bladder complication o Advantages: easy to insert, allows for spontaneity, reduces risk of ovarian and endometrial cancer and for pelvic inflammatory diseases, makes menstrual cycle regular, reduces menstrual discomfort, reversible o Disadvantages: no STD protection, some find It difficult to remove, may be felt during coitus, same caveats as combination birth control pills o Cost: $15 80 per month The implant: o Theoretical failure= 0.010.09% o Typical= 0.010.09% o Possible side effects: may cause irregular bleeding, change in periods: fewer and lighter for some and others may have a longer and heavier one (less common) o Health risks: all very rare: heavy irregular menstrual bleeding, local infection at site, ovarian cysts, lump in breast, migraine, headaches, depression o Advantages: allows for spontaneity, implanon 3 years (last for 3 years), no need to remember something, reduces risk of endometrial cancer and pelvic inflammatory infection, reduces menstrual discomfort, reversible Implanon may be used during breast feeding Most effective form of birth control except for abstinence o Disadvantages: no STD protection, my lower libido, weight gain or being over 155 lbs. reduces effectiveness. o Cost: implantation cost $400$800 for inserts: if left for 3 years it averages to $1122 per month DepoProvera injections: o Theoretical failure= 0.3% o Typical= 3% o Possible side effects: headaches (common), depression, weight gain (increases with longer use), dizziness, irregular midcycle bleeding; rarely: migraine with aura, breast tenderness, nausea, nervousness; slight > risk of breast cancer o Health risks: if (very rare) pregnancy, risk of ectopic pregnancy, drug interactions o Advantages: allows for spontaneity, lasts 3 months, no need to remember something, reduces risk of endometrial cancer and pelvic inflammatory infection, reduces menstrual discomfort and fewer, lighter periods (after 1 year, half of people will cease having periods) o Disadvantages: cannot be reversed in the 3 months of use and return to fertility may be delayed, sometimes heavier longer, periods, may lower libido; many first0time users do not repeat o Cost: about $35 to $75 dollars for injection (=$25/month) The Intrauterine Device (IUD): Theoretical failure= 0.6% (copper T), 0.1% (progestin T) Typical failure= 0.8% (copper T), 0.1% (progestin T) Possible side effects: spotting between periods, menstrual cramps/backaches; copper T may greatly increase menstrual flow all likely to clear in a few weeks to months Health risks: vaginitis, cervicitis (rare during first 3 weeks, very rare after that, risk increases if exposed to STDs); very rarely pushed through uterus on insertion (usually physician will notice and correct but if not surgery may be required later), temporary low blood pressure and heart rate Disadvantages: may have cramping or backaches at first; may (extremely rarely) become ejected (check string), PID or STD at time of insertion greatly increases risk of serious infection, higher initial cost, ParaGuard may increase menstrual flow, may (very rarely) push through wall of uterus at insertion. If woman has not given birth, may be dilated which may be painful and physician may want an ultra sound of the uterus which adds to the cost. Advantages: extremely effective, allows for spontaneity, lasts for 5 years (Mirena, progestin T) or 12 years (ParaGard, copper), no need to remember something, does not disrupt menstrual cycle, easy to know if in place, quickly reversible: ParaGard does not affect hormones, Mirena reduces menstrual flow and cramping, ability to become pregnant returns quickly after removal, can be used while breastfeeding, 99% of IUD users are pleased with them. Emergency contraception: ParaGard (the copper type) can reduce risk of pregnancy by 99.9% if inserted <5 days after unprotected coitus If become pregnant with IUD (extraordinarily rare), have removed immediately Cost: $5001000 for insertion Spermicides: Theoretical failure= 618% Typical= 2629% Possible side effects and health risks: vaginal irritation that may increase risk of HIV o Rare: allergies to nonoxynol9 Advantages: provides some lubrication, partner may know it is being used Disadvantages: must plan for use, may disrupt spontaneity, poor taste Cost: about $3 per use Barrier Methods The diaphragm: o Theoretical failure: 6% (with spermicide) o Typical: 16% o Possible side effects and health risks: greater risk for toxic shock syndrome; rare: allergies to nonoxynol9, vaginal soreness, urinary infections o Advantages: readily available (but requires physician visit), can be inserted a few hours before use and used for several coital acts, may encourage couple to talk about contraception, partner may know being used, reversible o Disadvantages: must plan for use, may disrupt spontaneity, requires partner cooperation, may become dislodged, must be resized if weight changes by 15 lbs., difficult for obese women to insert o Cost: about $35 + $125 for initial fit, yearly rechecks are about $75 Male condoms: o Theoretical failure: 2% (with spermicide) o Typical= 15% o Possible side effects and health risks: Rare: allergies (some allergies to latex can be serious) o Advantages: Readily available, provides protection against STDs, partner knows being used, gives man more responsibility; may also be used with anal and/or oral sex. o Disadvantages: must plan for use, may disrupt spontaneity, requires partner cooperation, not 100% protection against STDs, loss of sensitivity (better with polyurethane), poor taste if has spermicide (flavored condoms also available) o Cost: free to $10 per use (usually $1 per condom) Female condoms: o Theoretical failure= 5% (with spermicide) o Typical = 20% o Possible side effects and health risks: Rare: allergies to nonoxynol9 o Advantages: readily available, provides protection against STDs, partner knows being used, reversible; may enhance sex play, for some women enhances clitoral stimulation, stays in place even if man looses erection: may also be used with anal sex. o Disadvantages: must plan for use, may disrupt spontaneity, requires partner cooperation, not 100% protection against STDs, loss of sensitivity (less than with male condom), poor taste, sometimes squeaks o Cost: $4.00 per use. Sterilization: Theoretical/typical failure= 0.10/0.15% vasectomy / 0.5% tubal ligation Possible side effects: temporary soreness after surgery Health risks: usual risks with an surgery (much less for vasectomy) Advantages: permanent, allows for spontaneity, no need to remember something Disadvantages: psychological difficulty with being infertile Cost: $3501000 (vasectomy), $1,5006,000 (tubal ligation); however, these are lifetime costs 6. Know in detail, specifics of correct use of the male condom. 1. Be honest with yourself! If any possibility of otherwise unprotected sex, have condoms available. 2. Choose the right type for you. 3. Check the date (check again immediately before use) 4. Store properly, but have available. 5. Be assertive with yourself and your partner about their use. 6. Tear the package open carefully. 7. Put on while penis is erect and immediately before it touches vulva or any orifice (butt or mouth). 8. Squeezehold by reservoir/tip 9. If foreskin covers glans, roll back: place on top of glans of penis with rollup outside 10. Still holding reservoir/tip, unroll all the way to base of penis (enjoy whatever activity you are engaging in) 11. As soon as the person wearing the co
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