Transcript Slide 1

Male Reproductive System
bladder
seminal vesicle
prostate gland
vas deferens
urethra
cowper’s glands
rectum (anus)
epididymis
penis
testicle (testes)
scrotum
Female Reproductive System
fallopian tubes
ovum
fimbria
ovary
uterine lining
uterus
cervix
vagina
No Risk
(no potential, no
evidence)
•
•
•
•
•
•
abstinence
masturbation
hugging, kissing, casual contact
sitting on toilet seats
coughing & sneezing
mosquitoes & other animals
Minimal Risk
(some potential, no
evidence)
• giving/receiving oral sex with barrier
• sharing toothbrushes or razors
• using drugs with shared pipe or straw
Note:
• Transmission is unlikely, but possible.
• Hepatitis C and HIV can live on these surfaces.
Low Risk
(potential & some
evidence)
• anal or vaginal sex with a latex condom
• oral sex on a woman
• oral sex on a man, taking semen in one’s
mouth or swallowing it
Note:
• Condoms are not 100% effective (break, misused).
• Oral sex has fluids involved (semen, vaginal).
• Risk increases with if have mouth/throat infections or
cuts (possible entry into blood stream).
High Risk
(potential &
evidence)
• anal or vaginal sex without a condom
• sharing needles & drug injection equipment
• sharing piercing/tattooing needles
Note:
•
•
•
•
Exchange of fluids (semen, vaginal, anal).
Greater risk of infection.
Use new condom on toys when sharing.
Syringes or other equipment can have [infected] blood remain
in barrel and tip.
• HIV only lives for a short time outside body when exposed to
oxygen (30-60 seconds).
• Hepatitis C can live up to 2 weeks on a surface.
• Tattoo shops are regulated by Health Unit. See certificates!
ABSTINENCE
Means not having vaginal, anal or oral sex.
Also includes skin to skin sexual activity without penetration.
•
•
•
•
•
Avoid STI’s
Early sexual activity is linked to cervical cancers
No risk of pregnancy
Sexual activity can change friendships and relationships
Abstaining can have a positive impact on your future
(education, career, ability to have children, quality of life and
a healthy lifestyle, etc.)
• Positive self-esteem
Masturbation - Fact or Fiction
Yes
____
It is common and a personal choice
for males and females.
Is masturbation normal?
No
____
Is masturbation harmful? There is no evidence to say‘yes’.
No
____
Can I get an STI from masturbation?
____
Can I get pregnant from masturbation?
No
Masturbation is the self-stimulation of the genitals to
achieve sexual arousal and pleasure, usually to the point
of orgasm (sexual climax).
Oral Sex - Fact or Fiction
Yes Is oral sex actually sex?
____
____
Yes Is it okay to use a condom during oral sex?
Yes Can I get an STI from having oral sex?
____
No Can I get pregnant from oral sex (swallow sperm)?
____
No Is oral sex only something a guy has done to him?
____
Oral sex is the stimulation of the external genitals (sex organs) by
the mouth (sucking or licking).
Cunnilingus (eating out, licking out) is the oral stimulation of the
clitoris or vagina.
Fellatio (giving head, blowjob) is the oral stimulation of the penis.
Oral Sex - The Facts
How risky is oral sex?
• Oral sex is a low risk sexual activity.
• Sexually transmitted infections (STIs) such as gonorrhea,
chlamydia, herpes, syphilis and HIV can all be transmitted through
oral sex.
• STIs are transmitted when fluids are exchanged:
– Having small cuts in your mouth, even when you do not know it (e.g., dental
work, brushing or flossing, eating sharp foods).
– Skin torn on genitals, even if it you do not know it (e.g., before or during oral
sex).
– If your partner is menstruating (having her period).
– Holding infected fluids such as semen, vaginal fluids or menstrual blood in your
mouth for a long time or swallowing it.
• You cannot get pregnant from having oral sex.
How can Oral Sex be
done in a safer manner?
•





Use a condom for oral sex on men
Use a dental dam for oral sex on women
Do not use saran wrap
Try to avoid getting fluids such as semen, vaginal
fluids or menstrual blood in your mouth
Do not have oral sex right after brushing or flossing
your teeth (wait about 30 minutes)
Use anti-bacterial mouthwash after oral sex
Bacterial
Chlamydia
An often-asymptomatic infection
That can lead to reproductive complications
What is it?
• Most common bacterial sexually transmitted infection.
• Greatest number of infections found in people 15 to 24 years old.
• Can affect the cervix and urethra, and occasionally the rectum,
throat, and eyes.
How is chlamydia transmitted?
• Unprotected oral, vaginal or anal sex with an infected partner.
• Penetration and ejaculation are not required for transmission.
• It can be passed from an infected mother to her infant during
birth, causing lung and/or eye infections.
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Bacterial
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Chlamydia
An often-asymptomatic infection
That can lead to reproductive complications
What are the signs and symptoms?
Chlamydia:
Clear or milky urethral discharge
may be a symptom of chlamydia in
men.
• Many infected individuals have no symptoms.
• Symptoms may occur from 2-6 weeks after initial exposure.
Male
• clear, watery or milky discharge
• itchy urethra
• painful urination
• testicular pain
• eye or rectal infection (rarely)
Female
• vaginal discharge
• painful urination
• lower abdominal pain
• vaginal bleeding after intercourse or between menstrual periods
• pain during intercourse
• eye or rectal infection (rarely)
Although chlamydia is usually
asymptomatic in women, it may
present with inflammation of the
cervix.
Bacterial
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Chlamydia
An often-asymptomatic infection
That can lead to reproductive complications
Considerations and possible complications:
• Chlamydia is often associated with other undetected or untreated infections.
• Increased risk of contracting and transmitting HIV.
Male
• Inflammation of the testicles, prostate and scrotum
• Rashes, sores and joint pain
• Infertility (in rare cases)
Female
• Infection spreading to the uterus and fallopian tubes (pelvic inflammatory disease)
• Rashes, sores and joint pain
• Infertility
• Chronic pelvic pain
Bacterial
Gonorrhea
An often-asymptomatic infection
That can lead to reproductive complications
What is it?
• The second most common bacterial STI.
• Two-thirds of reported cases in Canada are in men.
• Most common in individuals 15 to 29 years.
• Can affect the cervix, urethra, rectum, throat, and occasionally the eyes.
• Often occurs as a co-infection with chlamydia.
How is gonorrhea transmitted?
• Unprotected oral, vaginal or anal sex with an infected partner.
• Penetration and ejaculation are not required for transmission.
• It can be passed from an infected mother to her infant during birth,
causing an eye infection.
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Bacterial
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Gonorrhea
An often-asymptomatic infection
That can lead to reproductive complications
What are the signs and symptoms?
Male
Most men develop symptoms within 2-7 days of infection:
• Thick, yellowish-green discharge from penis
• Painful urination
• Testicular pain or swelling
• Rectal pain, discharge or itching
Female
Women are most often asymptomatic (can’t see symptoms). Those that
do exhibit symptoms may experience:
• Increased vaginal discharge
• Painful urination
• Lower abdominal pain
• Vaginal bleeding after intercourse or between menstrual periods
• Pain during intercourse
• Rectal pain, discharge or itching
Gonorrhea:
Yellowish-greenish discharge from
the penis may develop in men
within two to seven days of
infection.
Infected women who develop
symptoms may notice an increase in
vaginal discharge.
Bacterial
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Gonorrhea
An often-asymptomatic infection
That can lead to reproductive complications
Considerations and possible complications
• Gonorrhea is often associated with other undetected or untreated infections.
• Increased risk of contracting and transmitting HIV.
Male
• Inflammation of the testicles
• Rashes, sores and joint pain
• Infertility (in rare cases)
Female
• Infection spreading to the uterus and fallopian tubes (pelvic inflammatory disease)
• Chronic pelvic pain
• Infertility
• Risk of ectopic pregnancy (fetus grows outside uterus cavity - e.g., fallopian tube)
Bacterial
Syphilis
A staged STI once considered rare in
Canada, but now on the rise
What is it?
• An infection sometimes called the great imitator because symptoms
mirror those of some common medical conditions
• Progresses in stages
• Infectious in the first year after contraction
How is syphilis transmitted?
• Through oral, vaginal or anal sex with an infected partner
• Through direct contact with bacteria contained in syphilitic sores or
rashes
• In rare cases, from sharing unclean needles or receiving a blood
transfusion
• From an infected mother to her fetus, which can result in fetal death or
causing birth defects
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Bacterial
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Syphilis
A staged STI once considered rare in
Canada, but now on the rise
What are the signs and symptoms of infectious syphilis?
Syphilis:
The first sign of syphilis in men is
often a small, painless sore (chancre)
on the penis.
Primary syphilis
• 3 days to 3 months = small painless sore called a chancre.
• The sore appears where the bacteria entered the body (e.g. external
genitalia, on the cervix, in the vagina, under the foreskin, in the anus,
mouth or throat).
• The chancre is painless and can be missed easily; while it heals on its
own without treatment, the infection remains.
The chancre sore appears where the
bacteria entered the body.
Bacterial
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Syphilis
A staged STI once considered rare in
Canada, but now on the rise
Secondary syphilis
A person may develop a range of symptoms from 2 to 24 weeks after
exposure, most commonly:
• A general sick feeling
• A rash anywhere on the body but classically on the palms of the hands
or soles of the feet
• Patchy hair loss
• Flat, smooth warts in the genital area (not the same as those caused
by HPV)
Early latent syphilis
Is generally asymptomatic, but for the first year after infection lesions or
rashes of primary or secondary syphilis can recur and the infection can
be transmitted.
Syphilis:
The first sign of syphilis in men is
often a small, painless sore (chancre)
on the penis.
The chancre sore appears where the
bacteria entered the body.
Bacterial
Syphilis
A staged STI once considered rare in
Canada, but now on the rise
Considerations and possible complications
• Syphilis increases the risk of transmitting or becoming infected with HIV.
Untreated syphilis may lead to tertiary syphilis, which can damage:
• The cardiovascular system (heart and blood vessels)
• The nervous system
• Other major organs of the body
• Death
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Viral
Genital Herpes
A very common viral infection that can cause genital and anal sores
What is it?
• Herpes simplex virus (two types: HSV-1, traditionally associated with
cold sores, and HSV-2, traditionally associated with anogenital herpes)
• May cause a single outbreak or recurrences over time
Recurrences may be triggered by:
• The menstrual cycle in women
• Emotional stress
• Illness (especially fever)
• Sexual intercourse
• Surgery
• Exposure to sun (including tanning beds)
• Use of certain medications
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Viral
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Genital Herpes
A very common viral infection that can cause genital and anal sores
How is genital herpes transmitted?
• Through direct vaginal, oral or anal sexual contact with an infected
partner
• By receiving oral sex from a partner with a history of cold sores
• Transmission of the virus when there are no symptoms or lesions
• From an infected woman to her infant during pregnancy or birth
• Less commonly through contact with contaminated objects such as
towels
Condoms have limited effectiveness at preventing infection as they do
not cover the entire genital area.
Genital herpes:
During a herpes outbreak, blister-like
sores often occur, surrounded by
redness and inflammation.
Herpes sores may develop on the
vulva.
Viral
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Genital Herpes
A very common viral infection that can cause genital and anal sores
What are the signs and symptoms?
• Not all infected people develop symptoms
• Symptoms may emerge 2-21 days after initial infection; usually after six
• Prior to an outbreak, the infected person may feel a tingling or burning sensation where
the virus first entered the skin or in the case of a recurrence, where there were lesions
During an outbreak:
• Painful sores (external or internal)
• Inflammation and redness
• Fever
• Muscular pain
• Tender lymph nodes
An outbreak resolves in 17 days for men and 23 days for women, on average.
Atypical signs and symptoms (without lesions)
• Genital pain, urethritis, aseptic meningitis or cervicitis.
Possible complications
• Increased risk of transmitting or becoming infected with HIV
Viral
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Genital Herpes
A very common viral infection that can cause genital and anal sores
Considerations
• Avoid sexual activity from the start of burning/tingling symptoms until all lesions have
completely healed
• Pay attention to personal hygiene to avoid transmission by contaminated clothing/towels
• Be aware of the potential for recurrences; watch for signs and symptoms
as they may not be obvious
• Condoms and drug therapy can reduce but not eliminate the risk of transmission
• Though chronic in nature, herpes is a manageable infection. Counselling may be useful to
help with relationship issues
• Advise your gynecologist of your history of infection; precautions can be taken during
pregnancy and delivery to minimize risk of transmission to the baby
Viral
Hepatitis B
A vaccine-preventable viral infection that affects the liver
What is it?
• A virus that affects the liver
• A virus found in blood and body fluids including the vaginal secretions,
semen, breast milk and saliva of infected individuals
• Most infected people (90%) naturally produce antibodies to fight the
disease, but some develop chronic hepatitis B; they carry the virus all
their lives and are infectious for life
• Chronic infection can significantly damage the liver
• Most common in developing countries
How is hepatitis B transmitted?
• Through anal, vaginal or oral sex with an infected person
• Through exposure to infected blood or blood products (e.g. injection
drug use with shared equipment, accidental exposure, needlestick)
• Occasionally from contact with shared household items (such as
toothbrushes or razors)
• During childbirth (transmission from mother to infant)
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Viral
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Hepatitis B
A vaccine-preventable viral infection that affects the liver
What are the signs and symptoms?
In up to 50% of people, there are no outward signs of infection.
Up to 8 weeks after exposure to the virus, some people experience flu-like
symptoms including:
• Tiredness
• Nausea and vomiting
• Decreased appetite
• A rash
• Joint pain
• Yellowing of the eyes and skin (in rare cases)
Hepatitis B:
People with chronic hepatitis B
are at risk of suffering
progressive liver disease and
liver cancer.
Viral
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Hepatitis B
A vaccine-preventable viral infection that affects the liver
Considerations and possible complications
• All sexual and household contacts of people with hepatitis B should be advised
to be vaccinated to prevent infection
• Chronic hepatitis B can lead to severe liver damage including cirrhosis (scarring of the liver)
and cancer
• Individuals who develop chronic hepatitis B infection require liver-function monitoring and may
benefit from treatment with interferon or an anti-viral medication
• Babies born to mothers with hepatitis B are at a high risk of becoming chronic carriers. They
should receive an injection of antibodies immediately after birth, followed by the vaccine
Viral
Genital Warts / HPV (Human Papilloma virus)
A very common viral infection that can cause anogenital warts
and cervical cancer
What is it?
• One of the most common sexually transmitted infections
• There are over 100 types of HPV; 40 can cause anogenital infection
• It is estimated that 75% of the adult population will have at least one
HPV infection during their lifetime
• Low-risk HPV types cause anogenital warts and other benign lesions
• High-risk HPV types are associated with cancer (mainly of the cervix)
• Vaccination is available to prevent certain types of HPV
• Most HPV infections clear on their own within one to two years
How is HPV transmitted?
• Through direct sexual contact (primarily vaginal and anal sex, but oral
sex is also a risk)
• Other sexual activity with intimate contact (genital rubbing or activity
causing friction)
• To an infant during delivery (rare)
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Viral
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HPV (Human Papilloma virus)
A very common viral infection that can cause anogenital warts
and cervical cancer
What are the signs and symptoms?
• Many individuals infected with low-risk types have no symptoms (do not
develop visible warts or lesions)
• In some people, anogenital warts develop within one to eight months on
the vulva, cervix, penis, scrotum, anus or in the urethra. These can be
small, soft, flesh-coloured growths, with a cauliflower-like appearance
• The size and number of warts may change over time; eventually most
will clear
• During pregnancy, warts may increase in size and number then
regress/resolve after delivery
Other symptoms may include:
• Itchiness
• Discomfort during intercourse
• Bleeding with intercourse
HPV:
Men with HPV may develop warts on
the penis—small, flesh-coloured
growths cauliflower-like in
appearance.
Genital warts may appear on
the vulva within one to eight
months of infection.
Parasitic/Fungal
Candidiasis (Yeast Infection)
A common fungal infection caused by overgrowth
of the naturally occurring yeast Candida
What is it?
• 75% of women develop vaginal candidiasis at least once in their lifetime
• Candida can also affect the mouth, esophagus, skin or blood.
• Yeast is normally found in a woman’s vagina. When the fungus begins to
grow in excess, it may develop into candidiasis.
Causes of overgrowth include:
• Pregnancy
• Recent or current use of antibiotics and certain other prescription
medications
• Sexual activity
• Poorly controlled diabetes
• A weakened immune system
• Genital moisture retention caused by tight-fitting clothing
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Parasitic/Fungal
Candidiasis (Yeast Infection)
A common fungal infection caused by overgrowth
of the naturally occurring yeast Candida
How is a yeast infection transmitted?
While yeast infection can be transmitted sexually, it is not generally
considered an STI.
Men sometimes develop signs of a yeast infection on the head (glans) of
the penis after having intercourse with a woman with vaginal candidiasis.
(She may have no symptoms.)
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Parasitic/Fungal
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Candidiasis (Yeast Infection)
A common fungal infection caused by overgrowth
of the naturally occurring yeast Candida
What are the signs and symptoms?
Female
Women with vaginal candidiasis may experience:
• Vaginal itching
• Swollen or red vulva and vagina
• Thick white, clumpy discharge resembling cottage cheese
• Burning of the external genitalia on urination
• Pain with intercourse due to vaginal dryness and irritation of the vulva
Male
Men with an infection of the penis may develop balanitis (inflammation of
the head of the penis) and may experience:
• Itching
• Red dots on the tip of the penis
• Dry peeling skin
• Burning on urination (occasionally)
Considerations and possible complications
• Yeast infections can increase the risk of acquiring and transmitting HIV
Candidiasis:
Women with candidiasis may
experience swelling in the vulva or
vagina accompanied by discharge
resembling cottage cheese.
Parasitic/Fungal
Pubic Lice & Scabies
Infections caused by parasitic infestations
What are pubic lice?
• Tiny crab-like insects that nest in pubic hair; also found in chest, armpit
and facial hair, eyebrows and eyelashes
• Adult insects bite and feed on the blood of their host and lay small eggs
(nits) that attach to the shaft of the hair
How are pubic lice transmitted?
• Transmission occurs primarily during intimate sexual and non-sexual
contact
• Pubic lice can live for one to two days in the bedding, towels and clothes
of an infected individual. These items can be a source of transmission
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Parasitic/Fungal
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Pubic Lice & Scabies
Infections caused by parasitic infestations
What are the signs and symptoms?
Pubic lice and nits are small and can be difficult to spot. Infected
individuals may experience:
• Skin irritation and inflammation accompanied by itchiness and redness
• Small blue spots on the skin where lice have bitten
• Louse feces (fine black particles) in the infected person’s
undergarments
Considerations and possible complications
• Persistent scratching of irritated skin can cause a secondary bacterial
infection
• All sexual partners who have had contact with the infected person in the
month before diagnosis should be treated to help prevent reinfestation
• Clothes, bedding and other possible contaminated items should be
washed or dry-cleaned, or bagged for a week. Items that cannot be
washed or bagged should be vacuumed
Pubic lice:
The insects bite their host to feed on
blood.
Parasitic/Fungal
Pubic Lice & Scabies
Infections caused by parasitic infestations
What are scabies?
• Parasitic mites that burrow below the surface of the skin
• Eggs laid under the skin hatch; larvae move to new areas and spread
infection
• Mites prefer warm zones (folds of skin on elbows, wrists, buttocks,
knees, shoulder blades, waist, breasts and penis, between the fingers
and under nails)
How are scabies transmitted?
• Through close contact—sexual or non-sexual
• Scabies can live for three days on clothing, towels and bedding; these
can be a source of transmission
What are the signs and symptoms?
Within 3-4 weeks of infestation:
• Intense itchiness, especially at nighttime
• Reddish rash (on fingers, wrists, armpits, waist, nipples, penis)
• With recurrences, the same symptoms occur but more rapidly (within
hours to days of a re-infestation)
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Parasitic/Fungal
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Pubic Lice & Scabies
Infections caused by parasitic infestations
Considerations and possible complications
• Persistent scratching of irritated skin can cause a secondary bacterial
infection
• All household contacts and recent sexual partners within the past month
should be treated to prevent re-infestation
• Clothes, bedding and other possible contaminated items should be
washed or dry-cleaned, or bagged for three days to one week. Items
that cannot be washed or bagged should be vacuumed
• Severe infections are commonly seen in people with compromised
immune systems: the skin can become scaly or crusty, requiring more
complex and aggressive treatment
Scabies:
Parasitic mites burrow below the
skin’s surface.
Parasitic/Fungal
Trichomoniasis
A sexually transmitted parasitic infection commonly referred to as trich
What is it?
An infection caused by Trichomonas vaginalis, a microscopic, singlecelled organism that can be found in the urethra, bladder, vagina, cervix,
or under the foreskin.
How is trichomoniasis transmitted?
• Through unprotected sexual activity, including mutual masturbation and
sharing of sex toys
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Parasitic/Fungal
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Trichomoniasis
A sexually transmitted parasitic infection commonly referred to as trich
What are the signs and symptoms?
Female
About half of infected women show signs of infection including:
• off-white or yellowish-green frothy vaginal discharge
• sore or itchy vagina
• pain during intercourse or urination
Male
Trichomoniasis infections tend to be asymptomatic in men. When
symptoms occur, they can include:
• irritation or redness at the urethral opening
• burning during urination or ejaculation
Trichomoniasis:
Half of infected women develop
symptoms, including yellowish-green
frothy vaginal discharge.
Parasitic/Fungal
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Trichomoniasis
A sexually transmitted parasitic infection commonly referred to as trich
Considerations and possible complications
• Trichomoniasis infections can increase the risk of acquiring and transmitting HIV
• Trich may occur in conjunction with other STIs, such as gonorrhea, chlamydia, syphilis,
HIV and hepatitis B
• In pregnancy, trichomoniasis infection may increase the risk of pre-term delivery and
low birth weight
Testing/Screening
Importance and Timing
The early detection and treatment of STIs is critical
to prevent further spread of infections
Decreasing the risks
Early identification and treatment of an STI can help decrease the
possibility of complications, both for an infected individual and their
sexual partner(s). This is especially true for women, as undetected and
untreated infections can lead to pelvic inflammatory disease, ectopic
pregnancy, chronic pelvic pain and even infertility.
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Testing/Screening
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Importance and Timing
The early detection and treatment of STIs is critical
to prevent further spread of infections
When to get tested
• Individuals who suspect they may have contracted an STI should ask
their health care provider for guidance about when to get tested.
Recommendations vary by type of infection.
• Regardless of symptoms, at-risk individuals should be screened
regularly.
• Visible symptoms should not be the only reason for testing, as many
Testing men:
A penile exam using a swab to
collect
urethral discharge
infections are asymptomatic. If symptoms are not present or a person is
infectious before symptoms appear, the infection can be unknowingly
passed on to others.
• At the start of any new sexual relationship, it is a good idea for both
partners to get assessed and screened for infections.
• Suspicion or diagnosis of an STI should prompt testing for other STIs if
not already done.
Testing women:
A pelvic exam using a speculum to
take swabs from the cervix and
vagina
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Testing Methods
Diagnosing Sexually Transmitted Infections
Urine sample:
For testing of certain STIs, a urine
sample
may be requested.
The main methods of testing/screening are:
1. Swab from the urethra, cervix, vagina, anus or throat
2. Urine test
3. Blood test
Approaches differ by infection and gender, and vary across the country.
Blood test:
For testing of some STIs, a
blood sample is required.
Smear:
Cervical and urethral samples may
be used to prepare a smear for
testing.
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Testing Methods
Diagnosing Sexually Transmitted Infections
STI
Bacterial
Chlamydia
Gonorrhea
Syphilis
Viral
Genital Herpes
Diagnostic Method
Swab from the infected area.
Urine sample for men; urine sample for women
where available, when a pelvic exam is not done or indicated
Swab from the infected area or a urine sample in
cases where a swab is not an option
Blood sample and/or swab from the sore
Hepatitis B
HIV
Swab from sore(s) and/or a blood test (currently not widely
available)
Physical exam for visible warts
Pap test to detect abnormal cells in the cervix
Blood test
Blood test
Parasitic/Fungal
Trichomoniasis
Lice/Crabs/Scabies
Yeast Infection
Physical examination and vaginal swab
Examination of skin and hair
Physical examination and vaginal swab
HPV*
Individuals infected
with high-risk HPV
types usually have
no noticeable
symptoms even
though the virus
may be causing
changes at a
cellular level.
Currently, cervical
cancer screening
(primarily the Pap
smear) is used to
detect cellular
changes in the
cervix that may
progress to cancer
if not found early
and treated if
necessary. In some
regions, HPV DNA
testing is available
and used in
conjunction with the
Pap test in cervical
cancer screening.
Prevention
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Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
Blocking transmission
Barrier methods are very effective in the prevention of many
sexually transmitted infections (STIs). Male and female
condoms made of latex and polyurethane offer the best
protection.
Note: Latex and polyurethane condoms may not fully protect
against herpes and HPV, as the viruses can be found in
areas not protected by a condom. Dental dams are an
effective option for oral sex.
Proper use of barrier methods is critical.
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
• Male condom
• Female condom
• Dental dam
Prevention
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Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
Male condom
Male condom:
A male condom prevents the
exchange
of fluids during intercourse.
A male condom is a sheath placed on an erect penis to
prevent the exchange of fluids between partners during
intercourse or oral sex.
Polyurethane condoms are also highly effective, but are more
prone to breakage.
Condoms made from sheep membrane are not effective
barriers.
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
Latex condoms offer protection against the transmission of
many (not all) STIs.
Prevention
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Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
Male condom
Male condom:
A male condom prevents the
exchange
of fluids during intercourse.
• Found in many stores.
• Available without doctor prescription.
• Inexpensive.
• Protects against most STIs.
• Allows male partner to assume some responsibility.
DISADVANTAGES
• Must be available at time is sexual activity.
• May slip or break.
• Must be stored and handled properly.
• Does not protect against all STIs (e.g., craps, herpes).
• Expiry date.
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
ADVANTAGES
How To Use A Male Condom
1. Check expiry date. Open package
carefully so don’t rip the condom.
2. Make sure tip of condom points
through the ring.
3. Pinch end to remove air.
4. Place on tip of penis leaving 1/2 inch
space at end for semen collection.
5. Unroll over erect penis right down to
the base. (Uncircumcised men
should put back foreskin.)
6. After ejaculation (and before soft)
hold condom against penis as slide
the condom off.
7. Discard into trash.
Demo
Prevention
www.sexualityandu.ca
Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
Female condom
A female condom is a polyurethane sheath worn inside the
vagina during sexual intercourse.
It should not be used with a male condom.
Female condom:
The female condom is inserted into
the vagina prior to entry by the penis.
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
It has two rings, an inner one at the closed end, used to
insert the condom and hold it in place behind the pubic bone;
and an outer ring that remains outside the vagina.
Prevention
www.sexualityandu.ca
Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
Female condom
ADVANTAGES
DISADVANTAGES
• Must be available at time is sexual activity.
• Requires proper insertion technique.
• May slip and break.
• May be uncomfortable.
• Expiry date.
Female condom:
The female condom is inserted into
the vagina prior to entry by the penis.
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
• Found in many stores.
• Available without doctor prescription.
• Protects against most STIs.
• Woman remains in charge.
How To Use A Female Condom
1. Check expiry date. Open package
carefully so don’t rip the condom.
2. Inner ring should be far in the vagina.
3. Outer ring should be outside the
vagina.
4. Guide penis into condom.
5. NOT to be used with a male condom.
6. After intercourse, remove condom by
pulling it out gently.
7. Discard into trash.
www.sexualityandu.ca
Prevention
Barrier Methods
Prevention approaches are important to decrease the transmission of STIs
A dental dam is a thin square of latex that can be used as
a shield during oral sex. The dam is placed over a
woman’s vulva, acting as a barrier between her genitals
and her partner’s mouth.
Dams are for sale in some pharmacies and sexual-health
clinics, but can also be made using a condom. Simply
unroll the condom, cut off the tip and base and cut down
the length of the tube. Then unroll the condom into a
rectangular sheet.
Cutting a condom to make a dental
dam
1
2
3
llustrations: © 2007 GCT II Solutions and Enterprises Ltd.
I
Dental dam
What does HIV stand for?
H uman
I mmunodeficiency
V irus
What does AIDS stand for?
A cquired
I mmune
D eficiency
S yndrome
Viral
HIV (Human Immunodeficiency Virus)
A virus that attacks the body’s immune system,
leaving infected individuals unable to ward off other illnesses
What is it?
• Virus that destroys cells critical to a person’s immune system, robbing
the body of its ability to fight other infections and illnesses.
• Weakens the immune system over time (months to years) until other
infections occur and Acquired Immunodeficiency Syndrome or AIDS (the
fatal stage of HIV infection) develops.
www.sexualityandu.ca
The Healthy Immune System
Word Bank
virus
bacteria
illness
antibodies
normal
antibiotics
multiplies
immune
T-cells
B-cells
white blood cells
chemically
protozoan
fungi
bacteria
fungi
protozoan
virus
1. A germ (__________,
___________,
___________,
____________,
etc) invades the body and quickly _____________.
multiplies
immune
white
2. The healthy ___________
system fights back by sending _________
blood
cells
__________
__________
to destroy the invaders.
T-cells
3. First, the __________
surrounds and “eat” some of the invaders, then
______________
notify the ___________
which, in turn, produce
chemically
B-cells
antibodies
_____________
which destroy the germs.
illness
4. Germs that survive the attack can cause __________.
Antibodies
5. ______________
help to finally destroy all the germs.
Normal
6. ___________
health is restored.
AIDS-Infected Immune System
Word Bank
Kaposi’s
B-cells
factories
attaches
T-cells
HIV
cannot
antibodies
destroyed
die
pneumonia
opportunistic
dementia
HIV
1. The _______
invades the body and quickly multiplies. The immune system
tries to fight back by sending white blood cells to destroy the invaders.
T-cells
2. __________
surround and attempt to “eat” the HIV but the HIV
attaches
____________
itself to the T-cells causing them to become HIV-producing
_____________.
factories
cannot
B-cells
3. The T-cells _____________
chemically notify the __________,
and
therefore, the __________
cannot produce _____________.
B-cells
antibodies
destroyed
4. The immune system is ______________
and the person is susceptible to
opportunistic
many ________________
diseases, such as:
pneumonia
Kaposi’s sarcoma, and AIDS
pneumocystis carinii ______________,
__________
_____________
complex. These diseases usually cause the person to
dementia
____________.
die
Viral
HIV (Human Immunodeficiency Virus)
A virus that attacks the body’s immune system,
leaving infected individuals unable to ward off other illnesses
How is HIV transmitted?
When the body fluids of an infected person (blood, semen, pre-semen,
vaginal secretions, breast milk) enter the blood stream of another
individual—specifically, from:
• Unprotected vaginal, oral or anal sex
• Shared needles or other drug equipment (i.e. water, cookers, crack
pipes)
• HIV-infected blood or blood products
• Household items such as toothbrushes and razors that have touched
infected blood
• Transmission during pregnancy, childbirth or breastfeeding
(transmission from mother to child)
• HIV cannot be transmitted by mosquitoes or other insects that have
made contact with infected blood, nor can it be transmitted through
saliva, sweat, tears, urine or feces of infected individuals, unless blood is
present.
www.sexualityandu.ca
HIV
Transmission
infected
body
fluid
enters
bloodstream
Fluids that can pass HIV
infection:





Blood
Semen (includes ejaculate / precum*)
Vaginal fluids
Breast milk
Anal mucous/fluids
*Precum is present almost immediately after a man’s penis is erect, so its not ok to just
“pull out” right before ejaculation….condoms should be used during the entire sexual
act when penetration is occurring.
How does HIV get into our
bloodstream?
Through a Mucous Membrane.
• Mucous membranes are found in our
mouth, stomach, rectum, and genital areas.
• Mucous membranes are only a few cells
thick and are therefore are not a good
protective barrier.
• High risk HIV can be transmitted through
mucous membranes in genitals, anus, and
rectum.
• Some risk HIV can be transmitted through
mouth [oral sex] because body fluids can
enter the bloodstream through cuts (cold
sore, blister, canker, bleeding gums from
flossing, etc).
These are MYTHS. AIDS is not transmitted by:
• Insects or animals
• Coughing or sneezing
• Casual body contact (shaking hands, hugging)
• Food
• Dishes or glasses
• Pools or saunas
You might want to write a
few of these down (wink).
• Toilet seats
• Playground equipment
• Drinking fountains
• Telephones
• Artificial insemination (using a sperm bank to become pregnant)
AIDS IS NOT AN EASY DISEASE TO GET!
Viral
www.sexualityandu.ca
HIV (Human Immunodeficiency Virus)
A virus that attacks the body’s immune system,
leaving infected individuals unable to ward off other illnesses
What are the signs and symptoms?
2-4 weeks after exposure, some infected individuals may experience
mild flu-like symptoms that last a few weeks then disappear.
HIV:
An individual who is diagnosed with
HIV requires regular medical
consultation.
For most people, symptoms don’t emerge until years after exposure.
Once the immune system is weakened, the following may develop:
• Frequent fever or sweats
• Joint or muscle pain
• Persistent skin rashes
• Swollen glands
• Sore throat
• Fatigue or lack of energy
• Headaches
• Rapid, unexplained weight loss
• Nausea, vomiting, or diarrhea
A blood test to check for HIV antibodies is the only way to detect HIV
infection. It may take up to three months for an infection to be detectable.
Anyone at high risk who tests negative initially should retest three months
later for certainty.
HIV destroys cells critical to the
immune system, leaving carriers
susceptible to other infections.
Symptoms of HIV infection:
• Flu-like (prolonged); fever, loss of appetite, sore
throat, etc.
• Swollen lymph nodes.
• Can take up to 4 weeks for “seroconversion” to
occur (antibodies are detected in blood).
• After initial symptoms, any others may not occur
for months/years.
• Differs from 1 person to the next person.
Mark has a friend who can do
cheap tattoos and piercing,
should he have it done?
Answer : Maybe...
Only have tattooing and piercing done at a
certified establishment. Equipment that has
not been properly cleaned can transmit HIV,
Hepatitis and bacterial skin infections.
Tattooing and Piercing Get Good Clean Art
What are the risks?
 Blood-borne infections
 Skin infections
 Skin disorders
 Allergic reactions
Be a smart consumer. Take your time. Think about it.
 Go to an Expert Artist in an Inspected Shop
Here's a checklist of what the artist
must provide for your safety:
Clean Hands
New Sterile Needles
Clean and Sterilized Equipment
Clean Skin
No Double Dipping
Quality Jewelry
Gun Control
After Care Instructions
HIV Testing in Waterloo Region
1. Family doctor
2. Anonymous testing available at the Waterloo
Regional Community Health Department
3. Confidential HIV testing available at the Waterloo
Regional Community Health Department STD clinics
in Waterloo and Cambridge
*The fastest growing HIV positive age group, including
teenagers, is the 15-24 year old age group!!!
Aids Information Video
Click the above hyperlink to access the video
http://teachaids.org/flash/english/
AIDS: Answers for Young People Video 11559- 19 mins.
doubling
Among teenagers in the U.S., AIDS is more than ___________
every two years! The progress
5-10
of AIDS is slow. It’s often _________
years before you get sick.
acquired
AIDS stands for
A-__________________
immune
I-___________________
deficiency
D-__________________
syndrome
S-__________________
skin
The first line of defense against AIDS is the ________
and mucous membranes. The second
immune
system
line of defense is the ___________
_________.
This immune system manufactures white
T
B
blood cells which help fight disease. The ___-cells send out an alarm to the ___-cells
which
are the fighters that attack any invading organism. Together the T-cells and B-cells help fight
off sickness and disease.
When the AIDS virus, known as HIV (Human Immunodeficiency Virus), enters the body it
T
attacks the ___-cells.
Once it takes over the T-cells, the virus will multiply and take over the Tcell. This T-cell will weaken and break therefore exposing other T-cells in the body to the virus.
B
Eventually the T-cells will no longer be able to activate the fighter ___-cells
which means the
immune system can no longer do its job. This means that the body can’t fight off disease.
AIDS: Answers for Young People continued
infected
sick
Primary Stage- You become ____________
with the HIV virus but you don’t feel ________.
Virus takes _________
years
to damage the immune system enough to make you feel sick. You
carrier
become a __________
of the AIDS virus during this stage.
protect
Middle Stage- Your immune system doesn’t ___________
you and you will start to notice
sweats
symptoms such as: swollen glands, mouth sores, night ____________,
bad coughs, rashes,
flu
chronic diarrhea, unexplained weight loss, and _______-like
symptoms that don’t go away.
Full
blown
Final Stage-________
- ____________
AIDS. During this stage serious diseases like
lungs
cancer
pneumonia in the _________,
and __________
that causes bleeding under the skin and inside
the body can occur. The _________
and nervous system are also attacked during this stage.
brain
cure
drugs
There is no _________
for AIDS. Modern _________
have helped extend the life expectancy of
AIDS patients. The AIDS virus is transmitted through blood, ___________,
and
semen
_____________
vaginal
fluid. Obviously sex and any activities where blood could be exchanged need
to be avoided. Don’t share needles, razors, and don’t become blood brothers or sisters with
piercing should be done by professionals. The AIDS
anybody. Tattooing and any body __________
virus can also transmitted from mother to baby. Since ________,
they’ve been able to test
1985
blood for the AIDS virus and so there’s very little risk of getting AIDS from blood transfusions.
denial
There’s a __________
amongst teenagers about the possibility of getting AIDS.
Peer
ready
_________pressure
often influences teen to become sexually active before they are ________.
abstinence
The best way to avoid getting AIDS is by ____________.
The bottom line is “Be smart and be
careful
drinking
drugs
_____________!”
Avoid ______________
and taking ___________
as they can impair your
common sense. Get _____________
and live!
educated
Male Reproductive System
An erection is caused
by blood entering the
penis. Semen, when
released near or in the
vagina, enters into the
female reproductive
system.
vas deferens
seminal vesicle
bladder
prostate gland
penis
testicle
Fluid from the
anus
prostate gland,
cowpers gland, and
the seminal vesicle
are added to the sperm
to form semen.
erection
Sperm are produced
in the testes.
The scrotum contracts
when it’s cold and
sags when it’s hot to
keep sperm
production at the
correct temperature.
sperm
scrotum
The Menstrual Cycle
Egg enters the
fallopian tube
Ovum enters the uterus
Lining of the
uterus is called
the endometrium.
A pad is
placed on the
outside of the
vagina to
absorb
menstrual
flow. A
tampon is
placed inside
the vagina to
absorb
menstrual
flow.
The Menstrual Cycle
DURING MENSTRUATION
Days 1-5:
Menstruation occurs and the
lining of the uterus, with a
small amount of blood, leaves
the body. At this time another
egg is maturing in the ovary.

AFTER MENSTRUATION
Days 6-15:

BEFORE MENSTRUATION
Days 16-28:
If the egg is fertilized by the
male sperm cell, it embeds
itself in the wall of the uterus.
If the egg is not fertilized, the
blood vessels in the wall of
the uterus shrink and break
down. Then menstruation
begins again.

The lining of the uterus repairs
itself and once again prepares
for a fertilized egg. Around
days 13 to 15, an egg is
released from an ovary. This is
called OVULATION.
When a doctor asks what
day of your cycle you are
at, you count the first day
of your last menstrual
cycle as Day 1.
The Process of Fertilization
4. The baby
will be
attached to
the lining of
the uterus by
the umbilical
cord. The
baby gets the
food, oxygen,
and nutrients
needed to
survive and
grow, through
the umbilical
cord. If
menstruation
occurred, that
indicates no
pregnancy, as
the egg would
have no place
to implant
(embed)
itself.
1.
2.
4.
Sperm meet
the egg in the
fallopian tube,
many sperm
try to
penetrate the
egg.
3.
3. The egg
continues to
divide (grow)
and embeds
itself in the
lining of the
uterus
1. Sperm
enters the egg
which means
fertilization
has occurred
(conception).
Fertilization
occurs in the
fallopian tube.
2. Egg splits
which means
the baby is
beginning to
grow.
Birth Control Options
Females
• Oral (The Pill)
• Transdermal Patch
Hormonal
• Vaginal Ring
• Injection
• Intrauterine Device (IUD)
• Sterilization
• Condom
• Diaphragm or Cervical Cap
Barrier
• Sponge and Spermicide
Males
• Condom
• Sterilization
Abstinence is the best
method of birth control.
Oral Contraceptives
sexualityandu.ca
What are they?
• Prescription tablets taken once a day
• There are two main types:
1. Combination pill which contains two female hormones similar to
the body’s own estrogen and progesterone
2. Progestin-only pill (or mini-pill) which does not contain estrogen
• Available under a variety of brand names with various strengths and
formulations
How do they work?
• Stop the release of a mature egg
• Thicken the cervical mucus making it difficult for sperm to get to the egg
• Change the lining of the uterus making implantation difficult
Failure rate: 80 per 1000 women per year (8%)
Oral Contraceptives
sexualityandu.ca
What are the advantages?
1. One of the most effective reversible birth control methods
when taken consistently and reliably
2. Simple and easy to use
3. Regulates menstrual cycle and reduces cramps
4. Does not interfere with intercourse
5. Decreases acne
6. Reduces the risks of endometrial and ovarian cancer
7. May reduce perimenopausal symptoms
Oral Contraceptives
sexualityandu.ca
What are the disadvantages?
1. Must be taken every day. The progestin-only pill must be
taken at the same time every day
2. May cause irregular bleeding or spotting
3. Effectiveness may be reduced by other medications
4. Should not be used by women over the age of 35 who smoke
5. May increase the risk of blood clots, particularly in women
who have
certain blood disorders or a family history of blood clots
6. Does not protect against STIs
7. May increase the number of headaches
8. May not be suitable for breastfeeding women
Transdermal Patch
sexualityandu.ca
What is it?
• A patch that releases hormones through the skin
• Can be placed on the buttocks, upper outer arms, lower abdomen, or upper
torso
excluding the breast
• A new patch is applied once a week for three weeks followed by one week
without a
patch
How does it work?
• Prevents the ovary from releasing an egg
• Thickens the cervical mucus making it difficult for sperm to get to the egg
• Changes the lining of the uterus making implantation difficult
Failure rate: 80 per 1000 women per year (8%)
Transdermal Patch
sexualityandu.ca
What are the advantages?
1. A reversible and highly effective birth control method
2. Once-a-week regimen; no daily contraceptive routine required
3. Simple and easy to use
4. Regulates menstrual cycle and reduces cramps
5. Does not interfere with intercourse
6. Expected to provide other benefits similar to oral contraceptives;
research is needed
Transdermal Patch
sexualityandu.ca
What are the disadvantages?
1. May cause irregular bleeding or spotting
2. May cause breast sensitivity or headache
3. Does not protect against STIs
4. Patch may detach from skin (less than 2%)
5. Possible skin irritation at the application site
Vaginal Ring
sexualityandu.ca
What is it?
• A flexible, nearly transparent ring that measures 54 mm (about 2 inches)
across
• The ring releases a continuous dose of hormones for three weeks while
it is in the vagina
How does it work?
• Prevents the ovary from releasing an egg
• Thickens the cervical mucus making it difficult for sperm to reach the egg
• Changes the lining of the uterus making implantation difficult
Failure rate: 80 per 1000 women per year (8%)
Vaginal Ring
sexualityandu.ca
What are the advantages?
1. A reversible and highly effective birth control method
2. Once-a-month regimen; no daily contraceptive routine
required
3. Regulates menstrual cycles
4. Does not interfere with intercourse
5. Does not require daily attention
6. Expected to provide other benefits similar to oral
contraceptives;
research is needed
Vaginal Ring
sexualityandu.ca
What are the disadvantages?
1. Does not protect against STIs
2. May cause irregular bleeding or spotting
3. May cause side effects such as headache, nausea, or breast
tenderness
4. May cause vaginal discomfort
5. The ring may be expelled from the vagina but this is
uncommon
Injectable Contraceptive
sexualityandu.ca
What is it?
• It contains a hormone called progesterone; it does not contain estrogen
• The injection is given in the upper arm or buttocks every 12 to 13 weeks
(four times a year)
How does it work?
• Prevents the ovary from releasing an egg
• Thickens the cervical mucus making it difficult for sperm to get to the egg
• Changes the lining of the uterus making implantation difficult
Failure rate: 30 per 1000 women per year (3%)
Injectable Contraceptive
sexualityandu.ca
What are the advantages?
1. One of the most effective reversible birth control methods available
2. Does not contain estrogen
3. No daily contraceptive routine required; 1 injection lasts for 3 months
4. Effectiveness is not reduced by other common medications
5. May be suitable for breastfeeding women or women who smoke
6. With continued use, menstrual cycles cease in over half of users after
the first year, and two-thirds of users after two years of use
7. Improves symptoms of endometriosis
8. Reduces the risk of endometrial cancer
9. Effective immediately when given during the first 5 days of a normal
menstrual period
Injectable Contraceptive
sexualityandu.ca
What are the disadvantages?
1. Initially, irregular bleeding is the most common side effect
2. Decrease in bone mineral density which may be reversible
when a
woman stops taking the injection. Calcium
supplementation is
advised.
3. May be associated with weight gain in some women
4. Takes an average of nine months after the last injection for
the
ovaries to start releasing eggs again
5. Does not protect against STIs
6. The lack of a monthly period may be bothersome for some
women
sexualityandu.ca
Side-Effects of Hormonal Contraception
Side effects that may occur during the first few months on
hormonal contraception include :






irregular bleeding, spotting
nausea
mood swings
bloating
breast tenderness
headaches
sexualityandu.ca
Side-Effects of Hormonal Contraception
Reason:


-
Your body is getting used to birth control
Fluctuating hormone levels when you start
When will it stop?
 Most symptoms are normal and will decrease or stop in the first
2-3 months.
If they bother you or don’t get better:
 Talk to your healthcare provider
 There might be a method that’s better suited for you.
sexualityandu.ca
Myths and Misconceptions about Hormonal Contraception
Common myths and misconceptions








Causes weight gain
Causes acne
Causes infertility
Causes birth defects
Should take a break from time to
time
Smokers should not be taking it
Women over age 35 should not
take the Pill
No need for condoms if you’re on the Pill
Intrauterine Device(IUD)
sexualityandu.ca
What is it?
• A T-shaped device with a copper wire around it
• It is inserted into the uterus by a physician in the
doctor’s
office
• Two threads may be felt in the vagina, so a woman can
check for herself to ensure that the IUD is still in place
How does it work?
• Causes changes in the lining of the uterus
• Prevents the sperm from fertilizing the egg
• Decreases the ability of the sperm to penetrate the cervical mucus
Failure rate: 8 per 1000 women per year (8%)
Intrauterine Device(IUD)
sexualityandu.ca
What are the advantages?
1. Long-acting contraceptive; can be left in place for up to five
years
2. No daily contraceptive routine required; device provides five
years of contraception
3. Does not contain estrogen
4. Does not interfere with intercourse
5. May reduce the risk of endometrial cancer
6. May be suitable for women who are breastfeeding
Intrauterine Device(IUD)
sexualityandu.ca
What are the disadvantages?
1. Possible side effects include irregular bleeding or spotting in
the first
months after insertion
2. Perforation of the uterus may occur at the time of insertion
but this
is rare
3. May increase menstrual bleeding or menstrual cramping
4. May be expelled from the uterus. This happens in 2–10% of
users
5. Does not protect against STIs
Female Sterilization
sexualityandu.ca
Tubal occlusion “Having your tubes tied”
Sites of
Sterilization
What is it?
• A surgical procedure to close or block the fallopian tubes
Techniques include:
• Laparoscopy – special instruments are inserted through two tiny
incisions (less than 1 cm long) in the abdomen
• Mini-laparotomy – also requires a small cut in the abdomen
• Hysteroscopy – use of a thin telescope inserted into the uterus
Fallopian tubes may be blocked by using one of the following:
• A clip or a ring
• Cautery (an electric current)
• Removing a small piece of each tube
• Hysteroscopy for the insertion of tubal plugs (Essure)
How does it work?
• The fallopian tube is blocked and therefore the
sperm and egg cannot meet
Failure rate: 5 per 1000 women per year (5%)
Essure
Ligation
Clips
Cauterization
Female Sterilization
sexualityandu.ca
What are the advantages?
1. No daily contraceptive routine
required; nothing to remember
2. Private
3. Does not interfere with intercourse
4. No significant long term side effects
Female Sterilization
sexualityandu.ca
What are the disadvantages?
1. Usually permanent and difficult to have reversed
2. Possible post-sterilization regret
3. Possible short-term surgery-related complications:
abdominal discomfort; bruising, bleeding, or infection
at the
incision site; reaction to anesthesia
4. If pregnancy occurs, there is a higher chance that it will be
an
ectopic pregnancy
5. Does not protect against STIs
sexualityandu.ca
Female Condom
What is it?
• Soft, disposable, polyurethane sheath
• Available in drugstores without a prescription
How does it work?
• Placed in the vagina before intercourse
• Lines the vagina completely, preventing direct contact between the penis and the
vagina and preventing the exchange of body fluids
• Sperm is trapped in the condom, which is thrown away
after intercourse
• A new condom should be used for each repeated
act of intercourse
Failure rate: 210 per 1000 women per year (21%)
Female Condom
sexualityandu.ca
What are the advantages?
1. Available widely without a prescription
2. No daily contraceptive routine or continued use required
3. Woman remains in charge of placement and use
4. Protects against some STIs
Female Barrier Methods
Diaphragm and Cervical Cap
Cervical Cap
Diaphragm
What are they?
• Intravaginal barrier methods that are used together
with a spermicide
• The diaphragm is a latex dome with a flexible steel
ring around its edge (a non-latex diaphragm is also
available)
• The cervical cap is thimble-shaped silicone cap
• Positioned into the vagina (diaphragm) or over the
cervix
(cervical cap) before intercourse
• Must be left in the vagina for 6–8 hours after intercourse
How do they work?
• A pelvic examination by a qualified health care
professional is required for fitting diaphragms and
cervical caps
• Inserted into the vagina and fit over the cervix
• When positioned properly, they block the entry to
the uterus so sperm cannot enter and
fertilize the egg
• Spermicide should be reapplied for
each repeated act of intercourse
Failure rate: 160-320 per
1000 women per year (16-32%)
sexualityandu.ca
Female Barrier Methods
sexualityandu.ca
What are the advantages?
1. Does not contain hormones
2. Can be used by women who are breastfeeding
3. Some protection against certain STIs
Female Barrier Methods
sexualityandu.ca
What are the disadvantages?
1. Must be available at time of intercourse
2. Requires proper insertion technique
3. Does not protect against certain STIs
4. Cannot be used by people who are allergic to spermicides
5. Diaphragm may increase the risk of persistent urinary tract
infection
6. Cervical cap should not be used during menstruation
7. May become dislodged during intercourse
8. Cervical cap may cause vaginal odour and discharge
Female Barrier Methods
sexualityandu.ca
Sponge and Spermicides
What are they?
• The sponge is a soft, disposable, polyurethane foam device impregnated with a
spermicide
• Spermicides disable sperm and come in several forms, including creams, jellies,
tablets, suppositories, foams, and film
How do they work?
Sponge
• Fits over the cervix
• Traps and absorbs sperm to augment effect of
spermicide
• Spermicide in the sponge disables the sperm
• Effective for up to 12 hours
Spermicides
• Contain an ingredient that disables sperm
• Should be used together with another form
of contraception
Failure rate: 160-320 per 1000 women per year (16-32%)
Female Barrier Methods
sexualityandu.ca
What are the advantages?
1. Does not contain hormones
2. Can be used by women who are breastfeeding
3. Can be used by women who smoke
4. Spermicide may provide added lubrication
Female Barrier Methods
sexualityandu.ca
What are the disadvantages?
1. Must be available at time of intercourse
2. Does not protect against certain STIs
3. Cannot be used by people who are allergic to spermicides
4. Requires proper insertion technique
5. Sponge users may experience vaginal irritation or infection
6. Spermicide must be inserted into the vagina in advance
(time depends on product)
7. If left in the vagina in excess of the recommended time,
symptoms of toxic shock syndrome may appear
Malereproductivesystem
Seminal vesicles
Vas deferens
Prostate gland
Penis
Epididymis
Testicle
sexualityandu.ca
Male Barrier Methods
sexualityandu.ca
Male Condom
What is it?
• A soft disposable sheath
• Available in various shapes, sizes, thicknesses,
colours and flavours
• Most are latex, but non-latex condoms are also
available in polyurethane, silicone, and lambskin
How does it work?
• Fits over the erect penis
• Acts as a physical barrier preventing direct genital
contact and the exchange of genital fluids, so the
sperm does not enter the uterus and fertilize
the egg
• A new condom is used for each repeated act
of intercourse
Failure rate: 150 per 1000 women per year (15%)
Male Barrier Methods
sexualityandu.ca
What are the advantages?
1. Available widely without a prescription
2. Inexpensive
3. Latex condoms protect against STIs
4. Allows the male partner to assume some responsibility for
birth control
5. Both partners can participate in their use
6. May help the wearer avoid premature ejaculation
Male Barrier Methods
sexualityandu.ca
What are the disadvantages?
1. Must be available at time of intercourse
2. May slip or break during intercourse
3. Must be stored and handled properly
4. People with latex allergies cannot use latex condoms, but
may be
able to use non-latex condoms
5. May reduce sensitivity for either partner
6. May interfere with the maintenance of an erection
7. May reduce spontaneity
8. Lambskin condoms do not protect against STIs
Male Sterilization
sexualityandu.ca
Vasectomy
What is it?
• A surgical procedure to close or block the vas deferens (the tubes that carry sperm
to the penis)
How does it work?
• The vas deferens are closed so that no sperm is released to fertilize the egg
Common techniques include:
• Conventional vasectomy – one or two incision are made in the scrotum
to reach the vas deferens
• No-scalpel vasectomy – a puncture opening
is made in the scrotum
Vas deferens are closed by:
Urethra
• Electric current (cauterization)
• A mechanical method, such as a clip
• Removal of a small segment of each tube
• Another form of contraception is required
until a semen analysis shows no sperm
Failure rate: 1.5 per 1000 women per year (0.15%)
Site of
Vasectomy
Vas
deferens
Male Sterilization
sexualityandu.ca
What are the advantages?
1. No contraceptive routine required; nothing to remember
2. Private
3. Does not interfere with intercourse
4. No significant long-term side effects
5. Simple procedure
6. Less invasive and more cost-effective than tubal ligation for
women
7. Allows the male partner to assume some responsibility for
birth control
Male Sterilization
sexualityandu.ca
What are the disadvantages?
1. Difficult to have reversed
2. Possible post-sterilization regret
3. Possible short-term surgery-related complications: pain and
swelling; vasovagal reaction; infection at the incision site
4. Does not protect against STIs
5. Not effective immediately. Must do a follow-up sperm
analysis that shows no sperm are present in the semen
STI Prevention
sexualityandu.ca
Dental dams and gloves
A dental dam is a small piece of latex similar to the material
used for latex condoms.
• It can be used during oral sex. The dental dam is stretched
across a woman’s vagina to prevent the exchange of bodily
fluids.
• It can also be used in other activities where a barrier is
desired.
• Latex surgical gloves can also be used in activities where a
barrier is desired.
General tips
• When using latex dental dams, gloves, or condoms, apply only
water- based lubricants. They are available at drugstores.
• Use new dental dams, gloves, or condoms for each partner.
• Do not re-use latex barriers or turn them over and use the
other side.
STI Prevention
sexualityandu.ca
Cutting a condom to make a dental dam
• When a dental dam is not available, a latex condom can be cut
to create a latex barrier.
1. Unroll a new condom.
2. Using scissors, cut off both ends of the condom,
removing the closed tip and the round loop at the base.
3. Cut the condom lengthwise so that it opens up into a
rectangle.
• If you are going to use the barrier for oral sex, you may wish
to select a condom without spermicide or lubrication. A
flavoured condom may be a good choice.
1
2
3
sexualityandu.ca
STIprevention
Method
STI protection
Oral contraceptives
no
Transdermal patch
no
Vaginal Ring
no
Injectable contraceptive
no
Intrauterine system (IUS)
no
Intrauterine device (IUD)
no
Female sterilization
no
Female condom
yes*
Diaphragm and cervical cap
limited
Sponge and spermicides
limited
Male condom
Male sterilization
yes with latex condoms*
no
* Remember that no method of protection from STIs is perfect. Some STIs can be
passed through skin-to-skin contact.
Birth Control: Myths and Methods
+ 50 million
1. How many sperm are contained in semen when a man ejaculates? ________________
one
2. How many sperm does it take for a female’s egg to become fertilized? ______________
semen
3. Why is “pulling” or “withdrawal” not considered a method of birth control? Some
___________
is released prior to ejaculation, therefore pregnancy can occur.
________________________________________________________________________
5
4. Sperm can live in the female’s body for up to ______
days.
5. Before using any method of birth control, it is always important to read the
directions/instructions
_______________________________.
No
6. Does ovulation always occur on the 14th day of a woman’s menstrual cycle? ________
7. Douching and feminine deodorants are ________
methods of birth control.
not
8. In a relationship, who is responsible for providing the birth control? Explain.
Both partners are equally responsible to ensure that pregnancy and STI’s are avoided.
_________________________________________________________________________
_________________________________________________________________________
kill
9. Foams, film, gels and suppositories (spermicides) ________
sperm at the entrance to the
cervix
______________.
spermicide
10. The sponge contains ______________________
and is activated with water. It also
traps
blocks
_________
and absorbs the sperm. It also __________
sperm at the cervix.
Birth Control: Myths and Methods continued
prevents
11. The male condom ___________________
sperm from entering the vagina and helps to
prevent STI’s.
prevents
12. The female condom ____________________
sperm from entering the vagina and helps to
prevent STI’s.
egg
13. The pill prevents the _________
from being released from the ovary. It thickens cervical
mucous and decreases the lining of the uterus so an egg can’t implant if it was released.
No egg=no pregnancy.
spermicide
14. The diaphragm is used with __________________
which is placed inside the diaphragm
and on the rim to block sperm from entering the cervix.
spermicide
15. The cervical cap is used with ____________________
which is placed inside the cap and
on the rim to block sperm from entering the cervix. It’s smaller than the diaphragm and
uses suction to adhere to the cervix. Pinching the cap with the fingers causes the suction.
hormones
16. IUD has two types. The IUS releases ___________________
and thickens cervical mucous
making it hard for the sperm to travel and it changes the uterine lining to prevent the egg
copper
from implanting. The IUD is _________________
wire and it thickens the cervical mucous
and changes the uterine lining and prevents the egg from implanting. It is not meant for
those less than 25 years of age or those who have never been pregnant.
17. Norplant is 6 hormone implants put into an _____________
in the upper arm. These
incision
hormones prevent the release of an egg. It is good for 5 years. It is no longer available in
Canada.
Birth Control: Myths and Methods continued
injection every 3 months, which also prevents the
18. Depo-provera is a liquid hormone ___________
release of an egg.
19. The rhythm (calendar) method involves the couple planning to have sex at a time when the
egg
_________
is not in the fallopian tube.
vas deferens
20. A vasectomy is when the _______________________
are cut and sealed so that sperm
are not able to get to the semen and therefore no sperm are in the semen that is released
from the male.
fallopian tubes
21. A tubal ligation is when the _________________________
are cut and sealed so that
sperm can’t make it to the egg.
abstinence
22. _______________________
is the only method of birth control that is guaranteed to be
100% effective.
It’s OK to have sex if you have
been drinking or doing drugs?
Answer : Maybe…
• A person can not consent to sex if that
person is high on drugs or alcohol and this
could constitute sexual abuse
If this happened to you or your friend who
would you go to for help?
Basic Facts About AIDS
1. AIDS is fatal.
2. It is not spread by casual contact.
3. It is spread by sex, contaminated blood and needles.
4. It can pass from mother to the unborn child.
5. Reduce your number of sexual partners and remember
one partner is safer (monogamy).
6. Latex condoms are your best protection if you become
sexually active.
7. Someone can look healthy and still spread infection.
Tips to Reduce RISKS!









Practice abstinence (no sex)
Practice monogamy (one partner) if becoming sexually
active
Get tested (annually)
Comfortable sharing sexual history with partner
Using, storing, disposing of latex condoms properly
Lubricant is a good choice
Use dental dams
Don’t use illegal drugs or share needles
Don’t share objects that get blood on them such as
razors or toothbrushes.