Adolescent means “to grow to maturity” and is an important period in life span. Reproduction means “production of offspring “. Health means “state of complete physical, mental, and social well being. After birth the child grows towards maturity and makes them a contributing member of the society.
ADOLESCENT REPRODUCTIVE HEALTH:
ANATOMY AND PHYSIOLOGY OF FEMALE SEXUAL ORGANS:
The principal organs are ovaries, uterus, uterine tubes, and vagina.
Female reproductive cycle includes both ovarian cycle and menstrual cycle.
Female reproductive function begins with the development of “ova” in the ovaries. The oogonia (primitive germ cell) are dominant from fetal period and are transformed to mature oocyte at puberty.
OVARIAN CYCLE OR MENSTRUAL CYCLE:
A single ovum is expelled from an ovarian follicle in to the abdominal cavity in the middle (14th day) of each month (28 days) menstrual cycle this process of rupture of grafian follicle with release of the ovum is called ovulation. Thus the 12-18 days in a 28days cycle is called fertile period.
This ovum is engulfed by fimbrae and is transported to a uterus by the fallopian tube. When fusion of sperm and ovum which develop in to fetus, thus menstruation stops. This process is called as fertilization.
When the ovum is not fertilized then menstruation starts which is cyclical discharge of blood, mucus, unfertilized ovum, and torn endometrial from the uterus per vagina.
Puberty is the period during which the secondary sex characteristics begin to develop and capability of sexual reproduction is attained where boys attained manhood and girls attained womanhood.
PUBERTY IN FEMALES:
Girls begin there growth spurt between
9-13 yrs of age
Increase in body fat
Development of sexual character like pubic hair, and auxiliary hair appear.
Development of breast tissue
Rapid increase in height and weight
begin to menstruate
ASPECTS OF ADOLESCENT REPRODUCTIVE HEALTH:
Sex education and sexual behavior
Sexually transmitted disease
Menstrual hygiene refers to the hygiene during menstrual period.
It includes use of clean pad changing of soaked pad proper disposal of used pad, perineal and personal hygiene with daily activities like diet, exercise, and rest.
During menstruation Daily twice bathing is essential because to reduce body heat and fatigue.
Washing the genital region daily with soap and water to prevent genital infection.
The diet should consist of vegetables and fruits which gives nourishment and normal diet.
During menstruation iron rich foods helps to maintain the hemoglobin level.
Sanitary napkins can be used to observe the menstrual flow.
Use sanitary napkins or use clean cotton cloth. If cloth is to be reused wash with soap dry in sunlight and preserve in with napthalin balls in plastic bags. Change the napkin three times a day and every 4-6hrs per day.
Used napkins should not be reused because its very unhygienic and lead to reproductive tract infection.
Used napkin should be burned immediately.
When the blood stained napkin rub against the thigh the skin of the thigh gets sore and walking may become uncomfortable. So the thigh region should be kept dry.
From the onset of the first day of menstruation it is better to carry a spare napkin in your bag.
Moderate exercise and adequate rest is also important during menstruation.
Maintain personal hygiene by bath, washing the perineum with soap and water after micturation and defecation
Clean the pubic hair before the menstruation.
Adolescent girls become fertile following the menarche (first menstrual period). After menarche, sexual intercourse (especially without contraception) can lead to pregnancy. The pregnant teenager may then miscarry, have an abortion, or carry the child to full term.
CAUSES OF TEENAGE PREGNANCY:
Poor academic achievement
Lack of awareness
PROBLEMS OF TEENAGE PREGNANCY:
Anemia, hypertension, cervical trauma, premature delivery, obstructed labour
SOCIO ECONOMIC PROBLEM:
Dropout from the school, less education, unemployment, increased divorce, poor socio economic status.
Teenage pregnancy is not socially acceptable, so girls feel guilty, afraid and upset and think they have done some wrong and worry for it.
SEXUAL BEHAVIOUR AND SEX EDUCATION
Adolescent sexuality refers to sexual feelings, behavior and development in adolescents and is a stage of human sexuality. Sexuality is often a vital aspect of teenagers’ lives. The sexual behavior of adolescents is, in most cases, influenced by their culture’s norms and mores, their sexual orientation, and the issues of social control such as age of consent laws.
Sex education, also called “Sexuality Education” or informally “Sex Ed” is a broad term used to describe education about human sexual anatomy, sexual reproduction, sexual intercourse, human sexual behavior, and other aspects of sexuality, such as body image, sexual orientation, dating, and relationships. Common avenues for sex education are parents, caregivers, friends, school programs, religious groups, popular media, and public health campaigns.
Adolescent are physically capable of sexual functioning and even of emotionally falling in love, but they must realize that it is always wiser to wait they become adults and are married before they try to convert their curiosity in to actual practice.
During adolescent young people will find that, their friends are very important to them, what their friends and the parents think about them is very important. This is normal and prepares them to become independent. However this also makes them want to be like their friends and their friends may urge them to do things which they should really not be doing, for eg) homo and hetero sexual relationship.
Homosexual relationship is not healthy practice in girls.
Adolescent must understand that, they have a choice of saying, ‘No’ to pressure from their friends. Sexual curiosity and fantasies may arouse string sexual feeling in adolescents and they may attempt to satisfy these feelings by masturbation. (self stimulation of the genitals to achieve sexual satisfaction). This is common activity among adolescent but it is not a healthy practice. Many religions and cultures donot approve of masturbation.
Physical attraction between sexes through, natural cannot be the sole basis for a lifelong relationship. Premarital sex must be avoided. A girl can get pregnant it she has sex only one.
Sexual relationship belongs with the marriage most religious, cultural and social traditional and family values favor postponing intercourse until marriage. Safe sex means use of condom or other contraceptive devices. Some of the adolescents may find it difficult to divert their mind from sexual matters. It may help to take up some physical activity like sports or some hobby. This will help them to growth and developing balanced manner. Adolescent girls can protect herself from sexual abuse by going for outing with family members. Avoid to outing with girls friends and boy friends. Adolescent girls must be prepared psychologically before menarche. Explanation about sexual behavior and sex education will reduce sexual curiosity in the adolescents. Marriages should be arranged by parents and love marriages are not appropriate in Indian society.
REPRODUCTIVE TRACT INFECTON, SEXUALLY TRANSMITTED DISEASE(STD):
RTI include the variety of bacterial, viral, and protozoa infections of the lower and upper reproductive tract of both sexes. Common STD are gonorrhea, syphilis, human papiloma virus, HIV, herpes AIDS.
COMMON CAUSES OF REPRODUCTIVE TRACTINFECTIONS:
Infections due to inadequate personal, sexual, and menstrual hygienic practices.
Sexually transmitted diseases (STD) that are transmitted through unsafe sexual contact.
Infections which are due to unsterile medical procedures such as, unsafe delivery or unhygienic copper T insertion.
SIGNS AND SYMPTOMS OF RTI/ STD:
Foul smelling vaginal discharge in women
Urethral discharge in men
Genital ulcers in both men and female
Lower abdominal pain in women can be pelvic inflammatory diseases(PID)
Scrotal swelling of inguinal lymph nodes in both men and women.
PREVENTION AND TREATMENT OF RTI / STD:
Avoid premarital sex and multiple partners
Both husband and wife should be faithful
Practice safe sex
Approach the health personnel immediately in case of onset of any signs and symptoms
ACQUIRED IMMUNO DEFICIENCY VIRUS:
It’s a serious illness it impaired the body’s ability to fight infections. Its caused by the germ called HIV. Normally human blood contains the white blood cells, which act like an army and kills all infected germs when the person affected with HIV. The end result of AIDS is death.
HOW TO HUMAN IMMUNO DEFICIENCY VIRUS SPERAD:
multiple sex partners
sexual intercourse with affected person
sharing an infected needles
parental transfusion – mother to fetus
HIV CANNOT ENTER OR SPERAD THROUGH:
sharing clothes and foods
cough, saliva, hugging and kissing
SIGNS AND SYMPTOMS:
loss of body weight
chronic diarrhea more than a month
prolong fever more than one month
persistent cough for more than one month
general itching and skin diseases
HIV IS FOUND IN THE FOLLOWING BODY FLUIDS:
PREVENTION OF AIDS:
Avoid homo and hetero sexual relationship before marriage. Stay faith fully to your partner after marriage.
If blood transfusion is needed. Check to ensure that it has been tested for HIV.
Sterile syringes and needles should be used every time.
Do not demand injections from your doctor.
Adequate knowledge and safe behavior are the two ways to prevent AIDS. Teach your friends and others to be safe.
Refers to the measures taken to prevent pregnancy by avoiding union of sperm and ovum.
To avoid unwanted pregnancy
To use at various stages of reproductive life as after marriage
To delay first pregnancy
To ensure spacing between two pregnancies.
CONDOMS – it is a sheath or covering made of thin latex rubber to fit over the man’s reproductive organ to prevent the entry of sperms in to vagina and gives effective protection against sexually transmitted diseases including AIDS.
ORAL CONTRACEPTIVE PILLS-it is a set of 28 tablets containing estrogen and progesterone hormones and iron arranged in sequence called mala D and mala N. the pill works by suppressing the release of the ovum from the ovaries, by making cervical mucus scanty and thick there by reducing transportation of sperms and by altering the inner lining of uterus thus affecting implantation.
INTRA UTERINE DEVICE / COPPER T:
IUD is a small T- shaped device made of polyethylene having copper T wire wound around its vertical arm with a thread attached at the lower end of the vertical arm.
Action – inhibits migration of sperm in upper genital tract, inhibits ovum transportation
Timing of insertion-at hospital and PHC by medical officer, 1-10 days of beginning of menstruation have to insert copper T
TUBECTOMY FOR FEMALES: It’s a surgical procedure involves blocking the fallopian tubes by cutting it: thus, preventing the passage of egg in the female.
VASECTOMY FOR MALES: It’s a quick surgical procedure where a part of vas deference is cut.
The teacher summarizes the anatomy and physiology of reproductive health and its aspect regarding menstrual hygiene, teenage pregnancy, sex education and sexual behavior, and contraceptive devices.
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