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Relationships and Sex Education

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1 Relationships and Sex Education

2 When we talk about these things IT IS NORMAL to feel
Curious Disgust Comfortable Shy Embarrassed Excited

3 What’s Happening?

4 What is Puberty? It is the time when our bodies change toward an adult body. Start to develop new feelings and interests Start to make sperm cells Or start to make egg cells

5 When do changes happen? anywhere between 8 and 17
most people begin between the ages of 10 and 14 when you start makes no difference to how you develop no age is better any other one

6 What changes happen to boys?
Nose and jaw get bigger and face gets longer Growth of pubic hair Get more muscles Hair and skin can become oily and you may get pimples Body sweats more Growth on body hair (face, under the armpits, legs, chest, etc. Voice deepens Sexual thoughts Penis and testicles grow

7 What causes these changes?
 Both boys and girls make the same sex hormones. The main ones are testosterone and estrogen Boys make lots of testosterone, not so much estrogen Girls make lots of estrogen, not so much testosterone Hormones – chemical messengers that travel in the blood stream from the place where they are made (called glands) to the place where they do their work Each hormone has a specific job The pituitary gland, deep inside your brain, gets things started. It sends out hormones to our sex organs to get them to start making sex hormones 

8 What are the sex organs? Urethra Penis Testicles or testes Scrotum
the tube through which urine and semen leaves the boy’s body Penis tube-like organ that hangs outside the body come in all sizes and shapes, determined by our genes Testicles or testes usually two, one hangs lower Sometimes called balls or nuts Where sperm are made Scrotum bag of skin that holds testicles keeps them at right temperature to make sperm, slightly cooler than body’s temperature gets bigger and baggier and turns a darker colour

9 What happens on the inside?
Hormones from the pituitary make the testicles grow and they start making more testosterone and producing sperm  After puberty you make 200, ,000 sperm cells a day for the rest of your life Sperm build up in tubes around the testicles They travel along some tubes and mix with fluids from glands

10 What happens on the inside?
Sperm + fluids = semen

11 How does the semen come out?
If semen is going to come out, the penis is likely to be erect A penis gets erect when blood rushes into it Muscles push the semen into the urethra and out the penis This is called an ejaculation.

12 What can cause an erection?
Boys get erections for all kinds of reasons – they might happen if you : Are thinking about something sexy When you wake in the morning and have to pee When you are relaxed When you are anxious or frightened For no reason at all

13 When does ejaculation happen?
If a boy wakes up and finds a wet, sticky spot on his bedclothes semen came out when he was sleeping. This is called a “wet dream” If a boy touches or rubs his penis and it gets erect and semen comes out. This is called masturbation. Some boys have wet dreams, some don’t Some boys masturbate, some don’t However it happens is okay

14 So what are normal feelings?
Some guys think about girls and kissing and touching Some guys think about other guys and kissing and touching Some guys don’t think about any of this stuff Some have crushes and fall in love Some don’t Some get angry at parents

15 What’s Happening?

16 What changes happen to girls?
Hair grows under the armpits, around the genitals (pubic hair) Hair on arms and legs grows darker Breasts and nipples get larger Body sweats more Internal and external sex organs grow May have mood swings, sexual thoughts and feelings Start of menstrual cycle

17 What causes these changes?
It is the sex hormones that make the changes that cause children’s bodies grow into adult bodies. Both boys and girls make the same sex hormones. The main ones are testosterone and estrogen. Boys make lots of testosterone, not so much estrogen. Girls make lots of estrogen, not so much testosterone.

18 The parts on the inside are:
Fallopian Tubes Ovaries Cervix Uterus Vagina

19 Female Reproductive System Terminology
Fallopian Tubes: Pair of tubes with finger-like projections where the egg travels to once it has been released. Ovaries: Glands where a woman’s eggs (ova) are found. Uterus: Small, muscular, pear-shaped organ where the baby develops, and where the egg travels when fertilized. Where the period comes from. Vagina: Warm, muscular passageway joining outside and the uterus Ova: Female reproductive cell (egg) Cervix: The “neck” of the uterus where the baby comes through. Makes mucus to help keep sperm alive. Ovulation: The process of a woman releasing an egg once a month.

20 So what are periods and why do they happen?
Girls are born with hundreds of thousands of tiny eggs, called ova – one is called an ovum. These egg cells are only half formed. At puberty, hormones tell the ovaries it is time to start releasing ova. Usually one egg at a time matures (develops) and is released from an ovary.

21 So what are periods and why do they happen?
At the same time, the uterus starts to grow a thick lining on the inside wall. The lining has lots of tiny blood vessels. The lining is there to protect and feed an egg that has combined with a sperm to form a fertilized egg.

22 So what are periods and why do they happen?
If an egg does not meet a sperm, the lining is not needed. It breaks up. Mixed with some blood it comes out the uterus into the vagina and then out the vaginal opening. This is called menstruation but lots of females just call it their period. If a woman is not pregnant then her ovary will release another egg, the lining build up and, if the egg is not fertilized, she has another period. This is called the menstrual cycle.

23 How do girls feel about having periods?
Nervous Scared Excited Curious Weird Mature All feelings are normal

24 When will I get my period?
No one can tell exactly when it will start. Many girls get some white or yellow stuff on their underwear. It is mucus and tells the girl that her period is coming sometime within the next year. How long will the bleeding last? Each female is different. It can vary from 3 – 8 days. During a period we only lose a few tablespoons to about half a cup of blood in that time – not a lot.

25 How often will I get a period?
At first there may not be any pattern to when you will get your next period. Some women never have a regular pattern. Most women eventually have a regular cycle – they know approximately when their next period will happen. The length of a cycle is from the first day of bleeding one month to the first day of bleeding the next time it happens. Each person is different so some women may have a period every 23 days, some every 28 days and some every 35 days. Lots of girls keep a calendar to help them keep track of when they have their period and how long it lasts.

26 What do I do when I get my period?
Females use pads or tampons to catch the blood that comes from the vagina. Sanitary pads are made of material that absorbs the blood. Most have a sticky strip on one side to hold the pad to the underwear. Pads come in a variety of sizes and shapes. A tampon is a small plug of material that fits inside the female’s vagina to absorb the blood. Some girls like to use tampons, especially if they are doing physical activities. Some girls only use pads.

27 So what about Breasts? Your genes determine the size and shape of breasts. The size does not affect how much milk a mother can make to feed a baby. The first thing you may notice is a bump behind the nipple. Then there will be swelling underneath The nipple are gets darker. Breasts grow slowly and one side may be bigger for awhile. They may feel sore at times while they are developing.

28 Healthy care of the reproductive system
Male/Female: *Yearly physicals *Self examinations (Testicles/Breasts) *Clean genital area *Wear athletic supporters (Cups/Sport Bras)

29 Self Breast -Exams When should you start breast self-exams?
-The American Cancer society recommends women begin self breast exams at age 20 but it is a good idea to become familiar with the feel of your breasts and how to perform a self exam at an early age. What's the best time for breast self-exams? -The best time to perform a breast self-exam is about a week after the start of your period.

30 How to perform a self breast exam

31 Breast Cancer Warning Signs
The signs and symptoms of breast cancer include: A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle. A mass or lump, which may feel as small as a pea. A change in the size, shape, or contour of the breast. A blood-stained or clear fluid discharge from the nipple. A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed). Redness of the skin on the breast or nipple. An area that is distinctly different from any other area on either breast. A marble-like hardened area under the skin.

32 Cervical Cancer Cervical cancer is cancer that starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina.  Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of routine use of Pap smears. Cervical cancers start in the cells on the surface of the cervix.

33 Cervical Cancer Causes/Risk Factors
Contracted HPV Having sex at an early age Multiple sexual partners Sexual partners who have multiple partners or who participate in high-risk sexual activities Long-term use of birth control pills (more than 5 years) Weakened immune system Infections with genital herpes or chronic chlamydia infections Poor economic status (may not be able to afford regular Pap smears)

34 Cervical Cancer Symptoms
Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling Abnormal vaginal bleeding Periods become heavier and last longer than usual Symptoms of advanced cervical cancer may include: Loss of appetite Weight loss Fatigue Pelvic, back or leg pain Leaking of urine or feces from the vagina Bone fractures

35 Cervical Cancer Exams/Tests
Pre-cancerous changes of the cervix and cervical cancer can not be seen with the naked eye. Special tests and tools are needed to spot such conditions. Pap smears screen for pre-cancers and cancer, but do not offer the final diagnosis. If abnormal changes are found, the cervix is usually examined under magnification. This is called colposcopy. Pieces of tissue are surgically removed (biopsied) during this procedure and sent to a laboratory for examination.  

36 Pap Smear

37 Testicular Self-Exams
The best time to do an exam is just after a shower. Doctors recommend that all men do monthly testicular self-exams after they start puberty. How do I perform a self-examination? Hold the penis out of the way and examine each testicle separately.  Hold the testicle between the thumbs and fingers with both hands and roll it gently between the fingers.  Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of the testes.

38 Testicular Cancer Warning Signs
Pain or swelling in the testicles, Lumps or nodules in the testicles, whether painful or not, Enlargement of the testicles or change in the way a testicle feels, Pain in the lower abdomen, back, or groin areas, and Swelling of the scrotum or collection of fluid within the scrotum.

39 Sexual feelings You may think about or have dreams about things such as: Kissing someone Naked bodies Being touched Flirting Falling in love It could be someone your age, someone older, someone you know or someone you don’t know like a celebrity. It might be someone of your sex or someone of the opposite sex or both.

40 Sexual feelings When females get sexual feelings they can have a tingly feeling around their sex organs. The vagina gets wet. Some females touch their sex parts to get the intense feeling called orgasm. This is called masturbation. Some girls do it, some don’t.

41 General Facts The healthy sexual experience can contribute to wellness in many ways. Decisions concerning sexual behavior have lifelong consequences. + Pleasure, childbearing, enriched, happy family life. - Unwanted pregnancy, stress, disease strained social relationships, etc. The healthy sexual experience can contribute to wellness in many ways. Because human sexual experience is interpersonal, it is a social one. It affects many more people than a sexual partner. Personal beliefs have much to do with the feelings that participants have toward the sexual experience; thus, spiritual wellness is influenced. Because the sexual experience is often emotionally charged, emotional wellness is also affected. Clearly, intellectual decisions are made concerning the experience, so intellectual well-being is a factor to consider as well. The sexual act is a physical experience that can be pleasurable but that has many long-lasting physical consequences. All five wellness dimensions are involved in decisions concerning participation in, the meaningfulness of, and the long-term consequences of the sexual experience. The healthy sexual experience requires sensitive and thoughtful consideration of the consequences. Decisions concerning sexual behavior have lifelong consequences. Positive consequences of a sexual experience include pleasure, childbearing, and an enriched, happy family life. Negative lifelong consequences can include unwanted pregnancy, emotional and physical stress, and strained social relationships, among others. Unsafe sex also takes a toll in disease and death for large numbers of people worldwide.

42 Types of Sexual Orientation
Heterosexual – Sexually attracted to the opposite sex. Homosexual – Sexually attracted to the same sex. Bisexual – Sexually attracted to both sexes. Asexual – No sexual attraction to either sex.

43 Sexual Legalities Age of consent- The age where you can legally have sex. It varies by state but in CT it is 16 years old. Statutory rape- sexual intercourse with a person (girl or boy) who has not reached the age of consent (even if both parties participate willingly)

44 Some practical guidelines…
You are ready for sex when: -You know all of the possible consequences of sexual activity and you are prepared to deal with them. -You know how to prevent those that you don’t want to have happen. -You are deciding on your own. -You have discussed the above with your partner. -You are ready in each and every one of the ways listed above.

45 You’re not ready to have sex if…
You feel pressured. You want to prove that you are “grown up” You have not discussed all possible consequences with your partner. Your just curious. You feel like you won’t get any dates if you don’t. You feel that you need to do it to save your relationship. You want to lose your virginity-get it over with. You want to sound ‘in the know’ like everyone else. You are not prepared for being pregnant or getting an STD. Your drunk or high. You think that it will make you more popular. You think sex equals love. It goes against your beliefs. Your instincts tell you not to. Its OK to wait.

46 So what’s wrong with saying no?
Nothing! Lots of people are not having sex because they choose not to. Even if you have had intercourse a few times you can still decide it’s not for you-not yet, not now. If you decide you’re going to say no to sex for now, make it work. Stay out of situations where it would be hard to say no. Be smart! Be proud of yourself! Save some of the good things in life for later on, when chances for pleasure without consequences is greater.

47 Some interesting statistics:
Teen pregnancy rates are much higher in the United States than in many other developed countries- twice as high as in England and Canada. Teen pregnancy costs the United States at least $7 billion annually 1 in 4 teenage mothers have a second child within 2 years of their first. The average American adolescent will view nearly 14,000 sexual references per year. Teen mothers are less likely to complete high school (only one-third receive a high school diploma) and only 1.5% have a college degree by age 30. The children of teenage mothers have lower birth weights, are more likely to perform poorly in school, and are at greater risk of abuse and neglect. 3 of 4 girls who have sex do so because their boyfriends want them to. 1 in 5 women aged who are sexual active will become pregnant. (almost 1 million each year) A sexually active teenager who does not use contraceptives has a 90% chance of becoming pregnant within one year. 4 out of 10 girls in the U.S. get pregnant at least once by age 20.

48 Abstinence Abstinence: Deciding to live a lifestyle (at the moment) that does NOT include sexual intercourse, drugs, and alcohol. Form of birth control that is 100% effective against pregnancy.

49 Masturbation Definition- Sexual self stimulation
Why could it be considered healthy? -Releases sexual tension -Develop self control -Continue to practice abstinence -Can’t get pregnant or an STD

50 HIV & AIDS The Human Immunodeficiency Virus (HIV) is a lentivirus that attacks the immune system and causes Acquired Immunodeficiency Syndrome or AIDS. Since its discovery in 1981 AIDS has killed more then 25 million people.

51 HIV/AIDS Greatest health threat to the world
Worldwide HIV/AIDS epidemic 11,000 people infected each day 40 million people currently living with HIV Incidence increasing disproportionately among women and minorities Of all the STIs, HIV/AIDS poses the greatest health threat to the world. Health experts indicate that we are in the midst of a worldwide HIV/AIDS epidemic. Many experts say that the AIDS epidemic has become larger than the plague was. Each year, about 40,000 people in the United States are infected with HIV, and over 1 million are already infected. Worldwide, the problem is even more profound, with about 11,000 people infected each day and a total of 40 million people currently living with HIV. The problem of HIV/AIDS is particularly bad in Sub-Saharan Africa. The rate of HIV infection among adults in Botswana, for example, is over 33 percent. International health agencies and foundations have been working to address the gap in awareness and the limited access to treatments in these parts of the world. See Web01 for more information. Women and minorities are populations in which the incidence of HIV/AIDS is increasing disproportionately.

52 HIV transmission Two mechanisms of transmission Sexual activity
Contact with infected blood (needle sharing or transfusion) There are two mechanisms for most HIV transmission. The two primary mechanisms responsible for the transmission of HIV are sexual activity and contact with infected blood (needle sharing or transfusion). Among men, the greatest number of new cases result from men having sex with men, though a significant number of cases result from heterosexual sex. Among women, risk of transmission is most frequent in heterosexual sex. HIV can only be transmitted via body fluids. Concentrations are too low in sweat and saliva for transmission. The HIV virus is much weaker than the common cold and cannot live outside the human body. 6

53 How is HIV spread? Spread by contact with the following body fluids: (blood, semen, vaginal fluid, breast milk, pre-ejaculate fluid) Concentrations are too low in sweat, saliva, mucus, tears, urine, and feces. Therefore these fluids Do Not transmit the HIV virus.

54 Types of curable STDs Chlamydia Syphilis Gonorrhea I HBV Scabies
Trichomoniasis Pubic Lice Chancroid

55 Types of incurable STDs
HPV-Genital Warts HSV-Herpes HIV/Aids

56 General STD symptoms Painful urination Lower abdominal pain
Vaginal discharge in women Strong Vaginal odor Discharge from the penis in men Pain during sexual intercourse Testicular pain in men Thick, cloudy or bloody discharge from the penis or vagina Frequent urination Rashes or sores in the genital area Flulike symptoms

57 Factors Associated with High Risk of contracting STDs
Being sexual activity Having multiple partners Contact with blood, semen, vaginal fluids Not using a condom (latex) every time you have sex Having risky sexual activity: oral or anal sex Having sex with high risk people: prostitutes, etc. Injecting drugs Sharing a needle or drug paraphernalia Review the factors associated with a reduced risk of HIV/AIDS 8

58 Why are STDs considered a silent epidemic?
People are embarrased to talk about it. People may not know they have one. You can’t tell by looking at someone and symptoms may not always be present.

59 Reasons for Risk Among Young People
Perceived immortality Risky sexual activity Experimenting life-styles Instant gratification Inability to talk about sexual issues These are the factors that account for increased risk among young people. Be smart! If you are having sex, use protection! 14

60 Reasons for Risk Among Young People continued
Perceptions of being in a committed relationship, and therefore, believe they are at low risk for infection Less likely to use condoms Serial Monogamy – multiple committed relationships during the college years Most students do not get regularly tested College students are at risk for HIV and other STIs due to the practice of serial monogamy. Many college students are sexually active, yet most do not use condoms on a consistent basis. This is, in part, due to perceptions that they are in committed relationships and, therefore, are at low risk for infection. Such perceptions are problematic for several reasons. First, college students typically define a regular partner as someone they have been with for as little as 1 month, with most defining a regular partner as someone they have been with for less than 6 months. Second, most college students do not get tested on a regular basis, if at all. Third, when students perceive that they are in a committed relationship, the likelihood of condom use decreases dramatically. This is particularly true when an alternative form of birth control, primarily birth control pills, is being used. The common result is unprotected sexual intercourse between two people who have known one another for a relatively short period of time and who are unaware of their own and each other’s STI status. Many students go through multiple committed relationships during the college years. This type of serial monogamy places college students at increased risk for HIV and other STIs, even though they may not believe that they are engaging in high-risk behavior.

61 What are the responsibilities of someone infected with an STD?
Tell current sexual partner Tell previous sexual partners Get treatment Use protection

62 More STD facts 1 out of 4 sexually active teens will get an STD before graduating high school. You can have an STD without having any symptoms You can contract the same STD more than You can contract an STD the first time you have sexual intercourse. You can have more than one kind of STD at a time. You can get an STD the first time you have sex.

63 How can having a baby or contracting an STI effect your future?
Drop out of school Financial Problems Increased stress Negatively effects your goals Less free time Loss of social time Loss of friends Increased family problems

64 Types of Hormonal Birth Control
Birth Control Pill Transdermal Patch Injectible Contraceptive Vaginal Ring IUD (Intrauterine Device) Sponge

65 Types of Barrier Birth Control
Male Condom Female Condom Diaphragm Cervical Cap Dental Dam

66 Other Birth Control Methods
Tubal Occlusion Vasectomy Rhythm method Withdrawal The morning after pill or emergency contraceptive. (Plan B) But the only form of birth control that is 100% effective is Abstinence!!

67 Summary Topics Puberty Reproductive System HIV/STDs Self Exams
Practical Sex Guidelines Summary slide

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