4What is Puberty?It is the time when our bodies change toward an adult body.Start to develop new feelings and interestsStart to make sperm cellsOr start to make egg cells
5When do changes happen? anywhere between 8 and 17 most people begin between the ages of 10 and 14when you start makes no difference to how you developno age is better any other one
6What changes happen to boys? Nose and jaw get bigger and face gets longerGrowth of pubic hairGet more musclesHair and skin can become oily and you may get pimplesBody sweats moreGrowth on body hair (face, under the armpits, legs, chest, etc.Voice deepensSexual thoughtsPenis and testicles grow
7What causes these changes? Both boys and girls make the same sex hormones. The main ones are testosterone and estrogenBoys make lots of testosterone, not so much estrogenGirls make lots of estrogen, not so much testosteroneHormones – chemical messengers that travel in the blood stream from the place where they are made (called glands) to the place where they do their workEach hormone has a specific jobThe 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
8What are the sex organs? Urethra Penis Testicles or testes Scrotum the tube through which urine and semen leaves the boy’s bodyPenistube-like organ that hangs outside the bodycome in all sizes and shapes, determined by our genesTesticles or testesusually two, one hangs lowerSometimes called balls or nutsWhere sperm are madeScrotumbag of skin that holds testicleskeeps them at right temperature to make sperm, slightly cooler than body’s temperaturegets bigger and baggier and turns a darker colour
9What 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 lifeSperm build up in tubes around the testiclesThey travel along some tubes and mix with fluids from glands
10What happens on the inside? Sperm + fluids = semen
11How does the semen come out? If semen is going to come out, the penis is likely to be erectA penis gets erect when blood rushes into itMuscles push the semen into the urethra and out the penisThis is called an ejaculation.
12What can cause an erection? Boys get erections for all kinds of reasons – they might happen if you :Are thinking about something sexyWhen you wake in the morning and have to peeWhen you are relaxedWhen you are anxious or frightenedFor no reason at all
13When 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’tSome boys masturbate, some don’tHowever it happens is okay
14So what are normal feelings? Some guys think about girls and kissing and touchingSome guys think about other guys and kissing and touchingSome guys don’t think about any of this stuffSome have crushes and fall in loveSome don’tSome get angry at parents
16What changes happen to girls? Hair grows under the armpits, around the genitals (pubic hair)Hair on arms and legs grows darkerBreasts and nipples get largerBody sweats moreInternal and external sex organs growMay have mood swings, sexual thoughts and feelingsStart of menstrual cycle
17What 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.
18The parts on the inside are: Fallopian TubesOvariesCervixUterusVagina
19Female 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 uterusOva: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.
20So 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.
21So 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.
22So 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.
23How do girls feel about having periods? NervousScaredExcitedCuriousWeirdMatureAll feelings are normal
24When 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.
25How 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.
26What 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.
27So 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 underneathThe 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.
28Healthy care of the reproductive system Male/Female:*Yearly physicals*Self examinations (Testicles/Breasts)*Clean genital area*Wear athletic supporters (Cups/Sport Bras)
29Self 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.
31Breast 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.
32Cervical CancerCervical 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.
33Cervical Cancer Causes/Risk Factors Contracted HPVHaving sex at an early ageMultiple sexual partnersSexual partners who have multiple partners or who participate in high-risk sexual activitiesLong-term use of birth control pills (more than 5 years)Weakened immune systemInfections with genital herpes or chronic chlamydia infectionsPoor economic status (may not be able to afford regular Pap smears)
34Cervical Cancer Symptoms Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smellingAbnormal vaginal bleedingPeriods become heavier and last longer than usualSymptoms of advanced cervical cancer may include:Loss of appetiteWeight lossFatiguePelvic, back or leg painLeaking of urine or feces from the vaginaBone fractures
35Cervical 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.
37Testicular 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.
38Testicular 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, andSwelling of the scrotum or collection of fluid within the scrotum.
39Sexual feelingsYou may think about or have dreams about things such as:Kissing someoneNaked bodiesBeing touchedFlirtingFalling in loveIt 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.
40Sexual feelingsWhen 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.
41General FactsThe 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.
42Types 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.
43Sexual LegalitiesAge 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)
44Some 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.
45You’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.
46So 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.
47Some 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 annually1 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.
48AbstinenceAbstinence: 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.
49Masturbation 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
50HIV & AIDSThe 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.
51HIV/AIDS Greatest health threat to the world Worldwide HIV/AIDS epidemic11,000 people infected each day40 million people currently living with HIVIncidence increasing disproportionately among women and minoritiesOf 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 increasingdisproportionately.
52HIV 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
53How 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.
54Types of curable STDs Chlamydia Syphilis Gonorrhea I HBV Scabies TrichomoniasisPubic LiceChancroid
55Types of incurable STDs HPV-Genital WartsHSV-HerpesHIV/Aids
56General STD symptoms Painful urination Lower abdominal pain Vaginal discharge in womenStrong Vaginal odorDischarge from the penis in menPain during sexual intercourseTesticular pain in menThick, cloudy or bloody discharge from the penis or vaginaFrequent urinationRashes or sores in the genital areaFlulike symptoms
57Factors Associated with High Risk of contracting STDs Being sexual activityHaving multiple partnersContact with blood, semen, vaginal fluidsNot using a condom (latex) every time you have sexHaving risky sexual activity: oral or anal sexHaving sex with high risk people: prostitutes, etc.Injecting drugsSharing a needle or drug paraphernaliaReview the factors associated with a reduced risk of HIV/AIDS8
58Why 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.
59Reasons for Risk Among Young People Perceived immortalityRisky sexual activityExperimenting life-stylesInstant gratificationInability to talk about sexual issuesThese are the factors that account for increased risk among young people.Be smart! If you are having sex, use protection!14
60Reasons for Risk Among Young People continued Perceptions of being in a committed relationship, and therefore, believe they are at low risk for infectionLess likely to use condomsSerial Monogamy – multiple committed relationships during the college yearsMost students do not get regularly testedCollege students are at risk for HIV and other STIs due to the practice of serial monogamy. Many collegestudents 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.
61What are the responsibilities of someone infected with an STD? Tell current sexual partnerTell previous sexual partnersGet treatmentUse protection
62More STD facts1 out of 4 sexually active teens will get an STD before graduating high school.You can have an STD without having any symptomsYou can contract the same STD more thanYou 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.
63How can having a baby or contracting an STI effect your future? Drop out of schoolFinancial ProblemsIncreased stressNegatively effects your goalsLess free timeLoss of social timeLoss of friendsIncreased family problems
64Types of Hormonal Birth Control Birth Control PillTransdermal PatchInjectible ContraceptiveVaginal RingIUD (Intrauterine Device)Sponge
65Types of Barrier Birth Control Male CondomFemale CondomDiaphragmCervical CapDental Dam
66Other Birth Control Methods Tubal OcclusionVasectomyRhythm methodWithdrawalThe morning after pill or emergency contraceptive. (Plan B)But the only form of birth control that is 100% effective is Abstinence!!
67Summary Topics Puberty Reproductive System HIV/STDs Self Exams Practical Sex GuidelinesSummary slide