School Science Lessons
Sexuality education
2012-01-28 SP
Please send comments to: J.Elfick@uq.edu.au
Table
of contents
WARNING!
Before planning to teach any of the topics or content below, get permission
from the head of your school science department OR the principal of your
school.
10.0.0 Sexuality education
10.4.0 Conception
10.1.0 Female reproduction system
10.6.0 Human relationships
10.2.0 Male reproduction system
10.5.0 Pregnancy
10.3.0 Puberty and adolescence
10.00 Sexuality education
10.00 Sexuality education
10.0.1 Design of a school sexuality education programme
10.0.2 Research on sexual behaviour of students
10.0.1a "Teen girls don't learn how to say no to
sex"
10.1.0 Female reproduction
system
10.1.1 Female reproductive system
10.1.4 First menstruation (period) and sanitary protection
10.1.2 Hormones
10.1.7 Menopause, climacteric
10.1.3 Menstruation (periods) ovulation and the menstrual
cycle
10.1.5 Premenstrual tension, PMT
10.1.6 Vaginal discharges
10.2.0 Male reproduction
system
10.2.1 Male reproductive system
10.2.3 Nocturnal emissions
10.2.2 Seminal fluid, semen
10.2.4 Undescended testicles
10.3.0 Puberty and adolescence
10.3.1 Puberty and adolescence
10.3.4 Puberty and skin care
10.3.2 Puberty in boys
10.3.3 Puberty in girls, the breast
10.4.0 Conception
10.4.1 Conception, the role of the male
10.4.2 Conception, the role of the female
10.4.3 Conception, twins
10.4.4 Conception, sex of the baby
10.5.0 Pregnancy
10.5.5 Childbirth
10.5.6 Childbirth, After the birth, mental adjustment
10.5.4 Pregnancy, care of the mother and foetus
10.5.1 Pregnancy, changes in the woman
10.5.2 Pregnancy, the embryo stage
10.5.3 Pregnancy, the foetus (foetus) stage
10.6.0 Human relationships
10.6.4 Adolescent friendship
10.6.5 Communication with adults
10.6.1 "Falling in love"
10.6.2 Looking for help, coping with emotions, coping
with stress
10.6.8 Masturbation and orgasm
10.6.6 Mood swings, emotional "ups and downs"
10.6.3 Sexual feelings in children
10.6.11 Sexual assault, rape, acquaintance rape,
date rape, rape crisis centres, domestic violence
10.6.10 Sexual feelings of boys
10.6.9 Sexual feelings of girls
10.6.12 Sexuality and the law, laws related to reproductive
health of adolescents
10.6.7 "Touching" and "sex play"
10.6.13 Your sexual identity
10.00 Sexuality education
The "facts of life" usually refers to the facts about sex and birth. However,
learning about love and how to get on with people is just as important as
learning about sex. Young people need to understand their own body, how it
works, and how to look after it. So how they feel about themselves and about
other people is as important as what they know about the machinery of the
human body.
10.0.1 Design of a school
sexuality education programme
A school sexuality education programme may contain the physical and emotional
changes occurring during puberty, social pressures for dating and becoming
sexually active, the desirability and benefits of sexual abstinence, teenage
pregnancy, sexually transmitted diseases and HIV/AIDS, date rape, sexual abuse,
how alcohol and drug use decrease judgement, sexual activity is never a test
of love, class activities to act out ways of resisting pressures to have
sexual activity and use drugs, sexuality can be expressed in a variety of
ways. School curricula always highlight the need for abstinence. When teaching
a sexuality education lesson, keep to the words in the text or the lesson
plan approved by a senior colleague. Do not refer to any particular person.
Show the prepared diagrams. Do not draw your own diagrams in front of the
students. One teaching method that has worked well is to give each student
an assignment to prepare a short lecture on a different part of the reproductive
system so that all students are taking part in this topic.
10.0.1a Teen girls don't
learn how to say no to sex
Sex education in schools is often too little too late an academic says.
Adolescent health specialist Rachel Skinner looked at the sexual experience
of 58 girls aged between 14 and 19.
The showed that girls were aware of the consequences of unprotected sex but
lacked the negotiating skills to resist peer pressure.
Most respondents said that they regretted their first sexual experience.
Dr Skinner said many of the girls were not prepared when they lost their
virginity.
"Many of the teenagers said how sex education was something that was too
little and too late in their schooling years", Dr Skinner said.
"These young people knew about risks of unprotected sex ... rather than how
to negotiate with a partner about having sex at a time when they feel ready
for it."
The Courier-Mail (Brisbane) Wednesday, May 29, 2009
10.0.2 Research on sexual
behaviour of students
Sexual intercourse is a necessary part of adult human behaviour if the species
is to survive but it is not a necessary part of the behaviour of children
or adolescents. Most parents never regard it as acceptable behaviour. Most
children or adolescents are minors subject to the authority and responsibility
parents and schools acting "in loco parentis" (in the place of a parent).
A school sexuality education programme can address the real problems that
confront the students only if it is based on knowledge of the sexual behaviour
of the students. In many countries, research among adolescents reports an
age-related increase in sexual behaviours with most adolescents taking part
in sexual activity of some kind.
10.1.1 Female reproductive
system
See diagram 10.4.1: Female organs | See diagram 10.4.1a: Ovulation | See diagram 10.4.1b: Menstruation
Women have two glands, ovaries, one on each side in the lower abdomen. Two
Fallopian tubes lead from the ovaries to the uterus (womb) then to the vagina
and then to the outside. Each ovary produces egg cells, ova, from fluid-filled
Graafian follicles scattered through the ovary. The ovum is much bigger than
a sperm but it is still very small, about 0.025 mm, you can just see it. Although
the ovary is only the size of an almond, each ovary contains 150 000 to 200
000 ova. Every month, from the time of puberty, a Graafian follicle bursts
to release an ovum. This release, ovulation, occurs about half way through
the menstrual cycle, usually between days 13 and 17. The ovum can be fertilized
for about 24 hours after ovulation. The released ovum passes down the Fallopian
tube towards the uterus. The uterus (womb) is a hollow, muscular, pear-shaped
organ. Before pregnancy it weighs about 60 g, and measures about 9 cm long
and 6 cm wide. However, the uterus can enlarge to contain a baby. The lower
part of the uterus opens through a narrow neck, the cervix, into the vagina.
The vagina is a highly elastic passage, 8 to 10 cm long, leading outside
the body. During birth, the baby can pass from the uterus through the cervix
and vagina to the outside because the cervix and vagina can expand enough
to let the baby pass through. In front of the external opening of the vagina
is the clitoris, the sensitive part associated sexual feelings. The labia
majora (outer labia) are the large fleshy lips that enclose the entrance
to the vagina and the tube leading to the bladder, the urethra. Urine is
stored in the bladder until it is passed through the urethra to outside the
body. The labia minora (inner labia) are delicate folds of skin that protect
the vaginal entrance. They are usually enclosed by the outer labia. During
sexual intercourse the cervix produces mucus. Near the time of ovulation,
the mucus becomes clear, abundant, elastic and slippery. This mucus helps
the sperm to reach the uterus and Fallopian tubes to fertilize the ovum.
After a Graafian follicle has burst to release an ovum, it is replaced by
a tissue, the corpus luteum or yellow body, that can act as a gland and produce
hormones.
10.1.2 Hormones
The male and female sex hormones are all steroids, a group of lipids with
four aromatic rings. Puberty starts in boys and girls when the hypothalamus
in the forebrain starts to release gonadotrophin-releasing hormone, (GnRH),
that stimulates the anterior pituitary gland below it to start releasing gonadotrophin
hormones, the follicle-stimulating hormone (FSH), and the luteinizing hormone,
(LH). FSH stimulates the formation of sperm in the testes and the development
of the Graafian follicles in the ovaries. LH stimulates the testes to produce
the main male sex hormones testosterone and androsterone. Also, LH stimulates
ovulation, the formation of the corpus luteum in the Graafian follicle after
ovulation and the production of progesterone hormone by the ovary. The stimulated
Graafian follicle and the corpus luteum produce oestrogen (estrogen) one
of a group of female sex hormones that start the development of female sex
organs and secondary sex characteristics, e.g. breasts and axillary hair.
Oestrogen also stimulates the lining of the vagina that can be examined in
vaginal smears. Small amounts of oestrogens are also produced in the adrenal
cortex, the placenta and even in the testes. After ovulation, the Graafian
follicle continues to secrete the steroid hormone progesterone to prepare
the lining of the uterus, endometrium, to receive the fertilized ovum. If
a fertilized ovum does not implant in the lining of the uterus, the corpus
luteum degenerates and a new Graafian follicle starts to mature. If the fertilized
ovum does implant in the lining of the uterus, the corpus luteum continues
to produce progesterone that maintains the state of the endometrium, prevents
release of ova, and prevents menstruation until after the completion or termination
of pregnancy. The placenta produces hormones to maintain the state of pregnancy
including progesterone, oestrogens and human chorionic gonadotrophin hormone,
(HCG), detected in pregnancy tests. This hormone maintains the release of
progesterone by the corpus luteum when the anterior pituitary gland stops
releasing gonadotrophin hormones during pregnancy. Progestogens are any group
of steroid hormones that have the effect of progesterone to maintain pregnancy.
Progestins are synthetic hormones that mimic the action of progesterone.
10.1.3 Menstruation (periods)
ovulation and the menstrual cycle
Menstruation, (Latin: "mensis", month), is the monthly flow of blood and
uterus lining, endometrium. Menstruation starts on day 1 of the menstrual
cycle. Ovulation occurs about half way through the menstrual cycle, on days
13 to 17. The most fertile day is day 14 of a consistent 28 day cycle. During
days 15 to 28 the lining of the uterus, endometrium, increases in thickness
in preparation for a possible pregnancy. Its lining thickens into a cushion
of blood vessels, glands and liquid. If the ovum is not fertilized during
days 15 to 28, it does not stick to the wall of the uterus and is washed
through the uterus and out through the vagina. On days 1 to 4, menstruation
starts by bleeding and the loss of the outer part of the endometrium leaving
the base of the endometrium. The loss occurs in spurts or trickles every few
minutes until by day 5, at the end of the menstrual period, all the lining
of the uterus is lost. The menstrual period usually lasts 5 to 7 days. The
volume of blood discharge is 30 to 80 mL but it can be 10 to 210 mL. Probably
no girl is absolutely "regular" so the length of the menstrual cycle may be
28 plus or minus 9 days. Being very irregular for the first two or three years
is common for a girl's periods. Girls start to have periods during puberty,
usually between 10 to 14 years old, about 2 years after the start of breast
development, but it can be earlier or later. They continue having periods
to the end of their fertile life, i.e. until the menopause. Some girls have
regular periods from the first menstruation but other girls are never regular.
A regular pattern may not occur until after two years or more. Once the cycle
is established, they can expect to continue to have menstrual periods regularly
until they are about 50 years. Girls should mark the first day of each period
on a calendar and calculate the time between periods from the first day of
bleeding. When first menstruating, the time between periods may vary but
later a regular pattern develops. Similarly the amount of menstrual discharge
may vary. Some girls experience cramps and pain during their periods, dysmenorrhoea.
The cramps may be caused by an oversupply of the hormone prostaglandin that
causes the uterus to contract to expel the blood and endometrium. To relieve
pain during their period, they can try body stretches, exercise or placing
a hot water bottle over the abdomen. Girls should be as fit during menstruation
as at any other time, so there is no need to behave differently. They can
play sport but most women do not like to swim during the period. If they
do swim, they should use a tampon. They should not be very active if the
period is heavy or if they feel uncomfortable. The best advice to a girl
who feels uncomfortable is to "take it easy", have a shower, wash the hair
as usual, then rest.
If women are not pregnant after one year of trying to become pregnant, they
should get medical advice. However, fertility starts to decline after 35
years and declines much faster after 40 years.
10.1.4 First menstruation
(period) and sanitary protection
The first period usually occurs between 10 and 14 years but it can be earlier
or later. Girls should consult a doctor if they have not begun to menstruate
by 16 years. Before day 1 of the first menstrual cycle, girls may notice a
slight brownish stain in the pants. They should plan for which sanitary protection
they will use by asking their mother or a nurse. They should keep the sanitary
protection ready at home and carry one or two pads in a small cosmetic purse
in the school bag. At school, women teachers understand sanitary protection
and will help girls if they are not prepared. Sanitary napkins may be pads
worn externally or tampons inserted inside the vagina. Adhesive pads worn
inside the usual pants are comfortable and reliable. Tampons are popular
with older girls. Some women use both napkins or tampons during the period.
Sanitary protection must be changed every three to four hours. Menstrual flow
has no odour until it meets the air. A pad or tampon left in place too long
may begin to smell and cause infection. Never wear tampons overnight. A tampon
worn for longer than eight hours can cause toxic shock syndrome, (TSS). This
is an acute illness with a sudden onset of high fever, vomiting, abdominal
pain, diarrhoea, headache, muscle pain and rash. Before using tampons, read
the instructions on the packet. Wash the hands before, and after, inserting
tampons. Store tampons carefully and insert them gently. Use of a hand-held
mirror makes insertion easier. Leave the string hanging out to make removal
easier. Remember to remove the last tampon when the period is finished.
10.1.5 Premenstrual tension,
PMT
Girls may have an uncomfortable "dragged down" feeling low in the stomach
or pelvic area just before a period begins, and for the first 12 hours after
the period has started. Some girls say they feel bloated, and they can weigh
more. These symptoms usually soon disappear after the period. The sweat glands
are more active during menstruation so personal cleanliness is more important
at this time. Some girls experience loose bowel motions just before a period
but constipation is more common. At this time they should drink more water,
eat extra fruit and fresh, vegetables, eat wholemeal bread, and exercise regularly.
They do not need to use laxatives. Some girls experience cramping and pain
during their periods (dysmenorrhoea). This cramping may be caused by an oversupply
of the hormone prostaglandin that causes the uterus to contract during menstruation.
If they have pain during the period, they may find it helpful to do some
stretches, exercise or yoga, or place a hot water bottle over the abdomen.
10.1.6 Vaginal discharges
At puberty, the walls of the vagina thicken and vaginal secretions are produced
as a slight discharge. Girls may notice differences in the secretions at different
times between menstrual periods. At the time of ovulation, the mucus may
be thinner, clearer, and "stringy", slippery like egg white. This is normal
and healthy. The vagina is self-cleaning so do not use perfumed sprays on
the vagina. Do not use plastic-backed panty shields because they do not allow
adequate air to circulate, and may provide a breeding ground for bacteria.
Consistent, heavy vaginal discharges may indicate an infection. A thick,
white discharge with a yeasty smell is a symptom of Candida albicans, (thrush). This is a
common condition that can be easily treated easily by a doctor or nurse. However,
sexually transmitted diseases can also cause vaginal discharge so girls should
see a doctor or nurse if the discharge is unusual.
10.1.7 Menopause, climacteric
The menopause, climacteric, is the time the ovaries stop producing eggs,
menstruation stops and the woman becomes infertile. It usually occurs at about
50 years. This change of life is a normal and natural event. However, the
hormone imbalance that occurs with the slowing down of ovarian function can
produce mood swings, irritability, hot flushes, loss of sex drive and loss
of self-esteem. Long-term effects of lack of oestrogen may cause osteoporosis,
bone thinning in elderly women. Some doctors prescribe hormones to help women
during menopause, but other doctors do not prescribe hormones because of possible
side-effects.
10.2.1 Male reproductive system
See diagram 10.11: Male reproduction organs
The testes (testicles) manufacture and secrete the hormone testosterone.
Testes contain cells that begin to form sperm, spermatozoa, in long tubules,
the seminiferous tubules. The spermatozoa then move along a long coiled tube,
the epididymis, where they become mature and are stored ready for ejaculation.
After ejaculation in the semen, the sperm can fertilize an ovum for about
72 hours. The epididymis connects the testis to the vas deferens that connects
to the urethra that runs through the penis. The spermatozoa need a liquid
to swim in and some nourishment. This is provided by the seminal fluid, the
semen. Two seminal vesicles, male sex glands, open into the vas deferens before
it joins the urethra. They produce most of the liquid in semen. Also, the
nearby prostate glands and Cowper's glands (bulbourethral glands) add fluid
to the semen. The temperature of the testicles should be lower than body
temperature for the sperm to develop normally so they hang outside the body
in a bag, the scrotum. Wearing tight trousers for a long time may damage the
production of sperm. It is quite normal for a boy's two testicles to be different
sizes. The penis contains a rich blood and nerve supply. It can change from
being small and soft to being hard and erect when spongy tissue in the penis,
corpus cavernosum and corpus spongiosum, fills with blood and cause the erection
of the penis. Erection ("hard-on", "stiffie") occurs when a man is excited
sexually. The penis of humans does not contain any bones and is not made
of muscle. The foreskin is a fold of skin that protects the glans penis at
the end of the penis. The skin beneath the foreskin must be kept clean. The
foreskin should be pushed back daily and the glans washed. The foreskin may
be removed surgically in infant boys by circumcision. Circumcision is required
by some religious beliefs. The seminal vesicle secretes an alkaline fluid
that forms the bulk of the semen. The prostate gland also secretes fluid
that is part of semen. The semen passes through tubes called the epididymis,
vas deferens and urethra. During normal activity, urine from the bladder
passes down the urethra and through the penis to the outside. However, when
the male becomes sexually excited, spongy tissue in the penis fills with
blood so that the penis becomes longer and erect. During sexual intercourse,
the sperm swimming in the liquid semen are discharged quickly into the vagina
of the female. The sperms travel through the uterus and up the Fallopian
tube because of their swimming motion, and perhaps contraction in the Fallopian
tubes, to fertilize an ovum or die.
10.2.2 Seminal fluid, semen
At peak sexual excitement, semen is quickly pumped out of the end of the
urethra in an erect penis. This is called ejaculation or "coming". Each ejaculation
from the penis contains 200 to 500 million sperm in a seminal fluid, the semen.
The thick white seminal fluid is secreted by glands, prostate gland, seminal
vesicles and Cowper's gland. It contains sugars to nourish the sperm and
prostaglandins that act like hormones to cause contraction of the smooth muscle
in the vagina. Each sperm, spermatozoon, can only be seen under a microscope.
Each spermatozoon looks like a tadpole with a head, middle piece and tail
to help it swim. Muscular movement of the vagina during sexual intercourse
may help the sperm to travel from the vagina into the fallopian tubes. Both
semen and urine can pass through the urethra but they can never pass along
it simultaneously because a sphincter muscle holds back urine when the penis
is erect.
10.2.3 Nocturnal emissions
During puberty, boys can easily become sexually aroused and ejaculation can
occur while they are asleep. These nocturnal emissions, "wet dreams", are
the natural way of discharging excess semen. After a nocturnal emission the
sheets or pyjamas may feel sticky when the boy wakes after a sexually exciting
dream or a nightmare or sometimes remembering nothing about it. The boy should
not be ashamed of any stain on the bed linen. It can be removed by washing
in cold water or by normal machine washing.
10.2.4 Undescended testicles
Testicles begin to develop in the lower part of the abdomen long before a
boy is born. Shortly before birth, they move down through the two inguinal
canals to the scrotum. Sometimes one or both testes remain either in the
abdomen or in the inguinal canal. This is called an undescended testicle.
Take a baby boy to the doctor if he does not have two testicles in the scrotum.
Testicles that have descended normally will sometimes retract into the body
but they may move back into place.
10.3.1 Puberty and adolescence (puberty, Latin: pubertas, adult)
Adolescence is the process of becoming adult. Puberty is the period when
a growth spurt occurs for 2 to 3 years and the reproductive organs develop.
The sweat glands may produce a thickened sweat during stress, strong emotions
or sexual excitement and cause an unpleasant body odour. Before puberty the
pituitary gland at the base of the brain begins to produce hormones that cause
changes throughout the body. In boys, the testes (testicles, balls) start
to produce the male hormone, testosterone. In girls, the ovaries start to
produce the main female hormone, oestrogen. Some boys and girls are frightened
by the changes that occur during puberty but other are very interested in
the changes during puberty that are producing "a new you".
10.3.2 Puberty in boys
In boys, puberty usually begins between the ages of thirteen or fourteen
years, but the whole process takes three or four years until they are physically
mature. They growing taller and perhaps broader and more muscular. They may
feel awkward, with arms and legs that seem too long. Hair appears on the chin,
upper lip, under the arms, in pubic area and perhaps on the chest and other
parts of the body. The larynx, "Adam's apple", gets bigger. The voice begins
to "break" when the vocal chords become longer and thicker and vibrate more
slowly to produce a deeper sound. They may be embarrassed by a voice that
squeaks unexpectedly before it settles to its new, lower pitch. They may
develop acne (pimples) on the face and neck, caused by inflammation of the
sebaceous glands. However, acne can usually be cured with careful facial
cleanliness and medical treatment. The testicles and other sex organs become
larger. If they have sexual intercourse with a girl any time after puberty
begins, they could make her pregnant. They may compare their body with the
bodies of other boys and be worried if they see another boy of the same age
who has a larger penis or more hair or bigger arm and leg muscles. They may
wonder whether they will ever catch up with these physical attributes. However
most boys realize that different boys pass through the events of puberty things
in a different sequence and at a different rate. So each boy has his own
biological programme of development.
Both boys and girls should eat plenty of fresh fruit and vegetables and reduce
fatty and sugary foods such as pastries and sweet biscuits. They should avoid
crash diets and enjoy regular exercise, sport, and dancing.
10.3.3 Puberty in girls, the
breast
See diagram 10.3.3: Mammary gland, breast, vertical
section
Girls usually begin puberty earlier than boys, usually between 8 to 13 years.
The breasts begin to develop "breast buds" with a dark area around the nipple,
the areola, and the body becomes more rounded as fat is deposited under the
skin at the hips, thighs and buttocks. Hair begins to grow under the arms
and around the pubic area. They start to have menstrual periods, a sign that
the reproductive organs are maturing. Some girls feel strangely top heavy
and wish they did not have to worry about wearing a brassiere. The nipple
area of the breast is sexually sensitive and under the region under the nipples
may feel sore. Breasts vary in size and shape. The smaller breast feeds the
baby just as well as a larger breast. Each breast contains alveolar glands
that secrete milk, lactiferous ducts that take the milk to the nipple and
fatty tissue. The first sign of puberty is usually a surge of growth they
become taller, the breasts develop, hair begins to grow under the arms and
as an inverted triangle in the pubic area. The bones in the face may grow
to change a round face to an oval face. Growth of pelvic bones may result
in wide hips. They will probably experience mood swings, partly because of
all the hormonal activity, and partly because they are becoming a young adult.
It takes time to get used to the idea of being a woman. They must cope with
new sexual feelings, perhaps even the intense feeling of being "in love".
Girls with dark hair may notice extra hair on the upper lip but it may not
last. They develop the adult female shape, the hips widen slightly, the thighs
become more rounded and the breasts develop. Any time after the beginning
of puberty, the body may start to produce ova (eggs). If an ovum (egg) is
fertilized by a male sperm, they could become pregnant or "in the family way".
Both boys and girls should eat plenty of fresh fruit and vegetables and reduce
fatty and sugary foods such as pastries and sweet biscuits. They should avoid
crash diets and enjoy regular exercise, sport, and dancing.
10.3.4 Puberty and skin care
The new sex hormones developing in adolescents' testes or ovaries affect
the sweat glands, that produce sweat, and sebaceous glands, that produce
oily sebum. The best way to stop a sweaty smell is to use plenty of soap
and water. Deodorants may help, but excessive use of antiperspirants is not
good for the body. They should shower at least once per day. Acne, acne vulgaris
is caused by extra activity of the sebaceous glands in the skin that produce
sebum, a natural oil that keeps skin supple. Hormones active during puberty
make the sebaceous glands produce extra sebum that can clog the pores of
the skin by forming plugs. The sebaceous glands keep producing sebum that
cannot get out because of the plug and that region of the skin becomes inflamed
and tender. The plugs of sebum form pustules called "white heads" which may
form "black heads" when contacted by air. There is no single treatment for
acne to suit everybody. However, a doctor can usually find a successful medical
treatment. Frequent gentle washing with water and a mild soap usually helps.
Use an astringent (drying) face lotion, rather than one containing oil. Eat
plenty of fresh fruit and vegetables and less of any foods that seem to make
acne worse, e.g. chocolate. If the white head or black ahead acne pimples
are squeezed, the sebum leaks into the skin causing more inflammation and
may make it easier for other infections to get into the skin.
10.4.1 Conception, the role
of the male
When a man is sexually excited, his penis becomes hard and erect and grows
bigger because of extra blood flow into the penis. In humans the penis contains
no bones and is not made of muscle. If he has a climax, or "comes" when his
penis is inside the woman's vagina, millions of sperm are released at the
time of ejaculation. These sperm move into the uterus and then the Fallopian
tubes. A baby is conceived if the head of a sperm unites with an ovum and
fertilizes it. Normally, an ovum is released about every 28 days, 14 days
before the beginning of the next period. The ovum takes 3 to 6 days to travel
down the Fallopian tube and reach the uterus. If just one sperm enters the
ovum while it is in the Fallopian tube or uterus the ovum is fertilized. The
rest of the sperm die within two or three days. Any time they have sexual
intercourse a baby could be conceived. During sexual intercourse, if the penis
is in the vagina or even close to the female genital area, some semen may
escape into the vagina, even if the male does not reach orgasm.
10.4.2 Conception, the role
of the female
Ovulation is the release of an ovum from an ovary about 14 days before a
period. Conception usually occurs a short time after ovulation. However, ovulation
can be influenced by stress, illness, sexual excitement or changes in routine.
Therefore, usually, predicting the time when a baby is likely to be conceived
is difficult. Conception occurs if a sperm from a male fertilizes an ovum
in a Fallopian tube. During sexual intercourse a man inserts his penis (the
male sex organ) in a woman's vagina and ejaculates ("reaches a climax", "comes")
1 to 2 teaspoons of semen containing millions of sperm. After girls start
menstruating, and sometimes even before, they can become pregnant if any
semen is deposited in or even just outside the vagina. It is not necessary
for either or both sexual partners to reach orgasm for conception to occur.
The bodies of men and women undergo a similar experience during sexual arousal.
Blood flows to the man's penis to cause an erection and to the woman's vaginal
area to make it soft and moist. The heartbeat and breathing quicken leading
to orgasm, climax, when the increasing arousal leads to spontaneous contractions
in the muscles around the penis, ejaculation, and in the vagina, accompanied
by pleasant erotic sensations. These contractions help drive the semen through
the man's penis into the woman's vagina and through the vagina, uterus and
Fallopian tubes.
10.4.3 Conception, twins
About one in ninety pregnancies results in twins. Identical twins are the
result of one ovum dividing into two after it has been fertilized. Each half
develops separately and two babies are born. Because both come from the same
ovum and sperm, they are always the same sex and usually look very alike.
The non-identical twins, "fraternal twins", are the result of two ova being
fertilized at about the same time by two different sperms. These twins can
be the same or different sexes and are no more like each other than ordinary
brothers and sisters. Twins occur by chance although some families seem to
have a history of twins.
10.4.4 Conception, sex of
the baby
The sex of a baby is determined when it is conceived. The two types of chromosomes
are the X chromosome and Y chromosome. A woman's chromosomes are always X.
The cells of her body each contain twenty two pairs of XX chromosomes and
one pair of XX sex chromosomes, which make her a woman. However, her ovum
contains twenty two X chromosomes and only one of the pair of X sex chromosomes.
The cells of the man's body each contain twenty two pairs of XX chromosomes
and one pair of sex chromosomes consisting of one X sex chromosome and one
Y sex chromosome. The sperm from the male carries twenty two X chromosomes
and either one X sex chromosome or one Y sex chromosome. If the sperm carries
a Y sex chromosome, the baby will have one X sex chromosome from the mother
and one Y sex chromosome form the father, so the baby is a boy. If the sperm
carries an X chromosome, the baby will have two X sex chromosomes, one X sex
chromosome from the mother and one X sex chromosome from the father, so the
baby is a girl. It is just a matter of chance, whether a sperm carrying the
X sex chromosome or the Y sex chromosome fertilizes the ovum. However, the
sex ratio at the time of birth, secondary sex ratio, is 105 boys to 100 girls.
Amniocentesis, amniotic fluid test, (AFT), a prenatal diagnostic test, is
performed at about 16 weeks of pregnancy using a syringe to take a sample
of uterine fluid containing foetal cells to be analysed for chromosome abnormalities,
e.g. Down syndrome. However, the test may also be used to determine the sex
of the foetus by examining for presence of the y chromosome. In some countries
where boy or girl the foetus may be illegally aborted if a boy or girl is
preferred resulting in abnormal gender ratios especially where there is strong
preference for boy babies. The methods of gender selection is the subject
of many folk tales and expensive pre-intercourse treatments. Male sperm swim
faster than female sperm perhaps because the Y chromosome is much smaller
than the Y chromosome so the advice for conceiving a boy, using the "Shettles
Method" is sexual intercourse close to ovulation, alkaline vaginal pH, no
sexual intercourse for 5 days before ovulation, deep penetration during sexual
intercourse and female orgasm to coincide with male orgasm.
10.5.1 Pregnancy, changes
in the woman
See diagram 10.23: Fertilization
The start of pregnancy is conception when a sperm fertilizes an ovum usually
in the upper end (ovarian end) of the Fallopian tube (oviduct). The final
stage of meiosis occurs and the fertilized ovum starts dividing to form the
embryo that keeps moving down the Fallopian tube to the uterus. Usually it
sticks to the lining of the uterus, implants, where it absorbs food and oxygen.
The lining of the uterus becomes thicker and stays there so it is not lost
by menstruation. For most women, the first sign of being pregnant is when
the menstrual periods stop. Menstruation does not occur until after the baby
is born. An organ forms to attach the embryo to the inner wall of the uterus,
the placenta, and absorb food and oxygen from the mother and take away the
wastes from the baby. About eight weeks after conception the main organs have
formed and the embryo is then called a fetus (foetus). The fetus is joined
to the placenta by the umbilical cord that contains two arteries to carry
blood to the placenta and a vein to carry blood back to the fetus, a surroundingmedium
called Wharton's jelly and an outer sheath.. So the mother provides food
and oxygen to the fetus and excretes wastes from the fetus through her lungs
and kidneys. However, the mother's circulatory system is quite separate from
the circulatory system of the fetus so her blood does not mix with the blood
of the unborn baby. Oxygen and nourishment are exchanged by diffusion in
the placenta.
10.5.2 Pregnancy, the embryo
stage
See diagram 10.24.1 Pregnancy 1 | See diagram 10.24.2: Pregnancy 2 | See diagram 10.24.3: Pregnancy 3
The fertilized ovum completes meiosis and starts dividing and the cells keep
dividing until a hollow ball of cells, the blastocyst forms. During this process
the embryo is floating freely down the Fallopian tube until it enters the
uterus. Six to eight days after ovulation the blastocyst becomes attached
to the wall of the uterus, implants, and the placenta forms at the place of
attachment. The placenta allows transfer of oxygen and nutrients from the
mother to the foetus and wastes from the foetus to the mother.
10.5.3 Pregnancy, the fetus
stage
See diagram 10.25.1: Pregnancy 4| See diagram 10.25.2: Pregnancy 5 | See diagram 10.26: Just before birth
The baby develops during the 40 weeks of pregnancy At the fourth week, the
embryo is 7-8 mm long and has a distinguishable head and body. Little buds
begin to develop where the limbs will grow. This is the stage when the embryo
is very sensitive to diseases, e.g. rubella, or chemicals, e.g. thalidomide.
The head is about a third of the total size of the embryo. At the sixth week,
the embryo is 1.3 cm long and floats in a "watery sac" of amniotic fluid that
protects it from bumps and shocks. Blood vessels can now be seen in the umbilical
cord through which blood travels to and from the placenta. After the eighth
week the embryo is called a foetus (fetus). It is now about 3 cm long, and
real bones begin to develop to replace cartilage. Most body organs such as
heart and liver have appeared but they are very immature. The eyes of the
fetus are shut and do not open for many months. After the sixteenth week
the fetus is about 18 cm long. It is quite active, and they can feel it kicking
and stretching its arms and legs. After the twenty eighth week the fetus
is nearly 30 cm long and hair and nails have developed. The skin has produced
a creamy coating (vernix) which protects it from the effects of being immersed
for so long in salty water inside its sac. Between week twenty eight and
week forty, the fetus develops and grows bigger.
10.5.4 Pregnancy, care of
the mother and fetus
Choose a healthy diet when planning a pregnancy and avoid smoking. Reduce
the use of medications during pregnancy to a minimum, as prescribed by a doctor.
The rapidly developing tissues of the embryo and fetus are sensitive to the
effects of all drugs, including alcohol and tobacco. The placenta is not
a barrier to the passage of most drugs. The health risks associated with
non-medical drug use during pregnancy include low birth weight, complications
during pregnancy and prenatal mortality. The baby may be born addicted to
a drug taken by the mother. Do special exercises during pregnancy to train
the abdominal muscles.
10.5.5 Childbirth
See diagram 10.27: Birth
1. The baby is born about nine months, 40 weeks, 280 days, after conception.
2. The whole process of labour takes about 12 hours for first mothers and
less for later mothers. At the beginning of labour the muscles in the wall
of the uterus start to contract and the muscles in the cervix relax, so it
can expand. The mother is then "being in labour". These contractions become
more frequent and intense as the birth gets closer. The amnion membrane that
enclosed the baby in the uterus pushes out through the cervix and breaks under
the pressure from the contacting uterus to release amniotic fluid (the breaking
of the waters). The head of the baby moves into the cervix because of the
increased contractions of the uterus helped by contractions of the muscles
in the abdomen and pushing contractions controlled by the mother. The cervix
gradually opens and the vagina stretches to let the baby pass through. The
baby is pushed through the vagina until the head can be seen and the mother
can be given help to expel the baby from her body. A baby is usually born
head first. If it is born buttocks first, this is called a "breech" birth.
3. When the baby is born, the umbilical cord still connects the baby to the
placenta still inside the uterus. After the baby has been born, the doctor
or midwife ties or clamps the umbilical cord with a plastic cord clip or
sterile rubber band and cuts it about five centimetres from the baby.. The
short piece left attached to the baby dries up and usually drops off within
a few days. The place where it was attached heals and leaves a depression
in the abdomen of the baby that looks like a knot, the navel (umbilicus,
omphalus, "belly button").
4. Within two hours after the birth, the umbilical cord, the placenta and
ruptured membranes (afterbirth) that have been surrounding the baby, separate
from the wall of the uterus and come away through the vagina. A doctor or
nurse should check that the afterbirth is entire and none of it is left behind
in the vagina.
5. The baby is almost helpless when it is born so the mother must care for
it. Soon after birth the baby should be put to the mother's breast to suck
milk. Breast milk is the best milk for babies unless the mother has certain
diseases. The mother should feed the baby with her milk for as many months
as possible. Early breast milk, just after the birth, is most important because
it contains colostrum that helps the baby to establish an immune system to
protect against disease. Mothers who are breast feeding should not take aspirin
because it can be passed to the feeding baby and cause Reye’s Syndrome, a
potentially lethal disease of the liver and brain.
6. The baby should be placed to sleep on the back and not allowed to sleep
face down (prone sleeping) to avoid the possibility of Sudden Infant Death
Syndrome (SIDS).
10.5.6 After the birth, mental
adjustment
1. Adjusting it to being responsible for another human being 24 hours a day
is not easy. Postnatal depression, "baby blues", fleeting feelings of misery
and helplessness is common in mothers after the birth of the first baby. It
soon goes away especially if the partner is sympathetic and helpful. However,
extreme depression after giving birth may need medical treatment.
2. A new mother may feel very insecure and unattractive but daily postnatal
exercises can help to restore her self-image. Pelvic floor exercises can repair
any vaginal slackness caused by the stretching of the pelvic floor muscles
during pregnancy and delivery.
3. Breasts will not be as firm, whether breast-feeding or not. Brown skin
colour around the nipples and the brownish vertical "tummy stripe" developed
during pregnancy may take four months to fade. Stretch marks fade gradually
to become silvery lines.
4. Breast-feeding alone is a natural contraceptive for one third of women,
but up to 20% of breast-feeding women ovulate and could conceive within 12
weeks of giving birth.
5. During pregnancy and particularly soon after the birth of a baby, some
women prefer to be held and cuddled rather than have sexual intercourse.
After the birth, the best time to resume sexual intercourse is when both partners
feel they are ready and on medical advice. If lack of oestrogen soon after
the birth in a breast-feeding mother causes dryness in the vagina, she should
use a water-based lubricant. Fatigue caused by broken nights and busy days
may reduce the sexual interest of parents. However, intimacy does not have
to result in intercourse.
10.6.0 Human relationships
10.6.1 "Falling in love"
Falling in love is one of the most wonderful and exciting experiences life
has to offer. However, learning to cope with this intense feeling can be even
more difficult than learning to cope with new sexual feelings. Love can be
so exciting that it seems to take over the whole life. However, most people
"fall in love" more than once before they find a permanent sexual partner.
They should ask themselves: "Is this relationship a sharing and caring one?",
" Do we have common interests and enjoy the same activities?", "Are they
both able to talk and listen to each other?", "Do we both care about the other
and the way he or she feels?". Talk over their feelings with an adult they
can trust.
Being in love may be caused by the amine dopamine that acts as a neurotransmitter
and hormone. Dopamine has many functions in the brain. . It is produced in
women after giving birth and is secreted into the body as a result of taking
narcotic drugs.
10.6.2 Looking for help, coping
with emotions, coping with stress
Feeling depressed can mean that you feel sad, guilty, exhausted, lost, hopeless,
powerless. Feeling depressed and having clinical depression is not the same.
You can feel depressed if you do not get a job or an expected reward or if
a relationship breaks up. Sadness is a normal human emotion felt when you
lose something or someone. It does not take over your whole life like clinical
depression can. The symptoms of clinical depression may be feeling depressed
for most of the day nearly every day, being continually irritable, having
diminished interest or pleasure in all or most activities, more than 5% change
of body weight, feelings of worthlessness or inappropriate guilt, diminished
ability to think or concentrate, recurrent thoughts of death or suicide, an
attempt at suicide. Many people have suffered from clinical depression at
some time in their lives so it is nothing to be ashamed about. So if you
have these symptoms do get medical help.
10.6.3 Sexual feelings in
children
Most societies treat male children differently to female children and have
different expectations of the behaviour of each sex. Parents should treat
a child's genital play or toilet training with calm acceptance of a natural
part of life. Boys and girls will express an interest in the differences in
the sexes. In the early years children may ask "Where do babies come from?".
In late childhood they may be curious about changes that occur in puberty.
By the middle of childhood, boys and girls often segregate themselves in play
and develop a collective opinion about the opposite sex. By the age of five
years a child becomes very aware of the physical sexual differences between
boys and girls. By the age of six years, a child may display some interest
in sex play through games such as "doctors and nurses" or "mummy and daddy".
By the age of seven years, girls to want to play with other girls and boys
with boys. Boys may say that they want to avoid "girl germs". Among friends
they may express their dislike of the opposite sex. At eight years of age
growth hormones are beginning to be released leading to puberty still some
years away. By about nine or ten years of age sex will become a keen interest
and a child will want to discuss it with friends and will look for illustrative
material that describes or displays the human body. In late childhood there
can be growing shyness or self-consciousness of a child's own naked body.
All of these childhood experiences give a child a picture of sex. However,
a child should in addition receive sound information to be prepared for puberty
and adulthood.
10.6.4 Adolescent friendship
Adolescents may find that the friendships with other boys and girls become
more intense at this time. It is important to be able to talk and listen,
care about others and care about other peoples' feelings. They may lack confidence
and feel unsure of themselves. However, most other boys and girls of this
age have the same problems. Life is easier for them if they have a group of
friends, boys and girls, who enjoy the same activities. Around 13 to 14 years,
girls are usually taller than boys of their own age so they feel awkward.
10.6.5 Communication with
adults
Keeping communication lines open with the adults who care for they can help
to avoid many problems. As they grow and change, the relationships with different
members of the family will probably change. They must take a greater role
in making decisions and being responsible for themselves. Making this change
can be difficult for parents and other adults who are used to doing these
things for them. Sometimes adolescents just do not have the understanding
or experience to decide on what is acceptable behaviour. The family's lifestyle,
cultural background and religion will affect their feelings about what adolescents
may do and where they go. Some families have inflexible rules, but others
do not. Adolescents should try talking matters over with the parents. If
this is really too difficult, they should discuss their problems with a school
counsellor or another adult they respect. If they can talk about the problems,
they will be easier to solve.
10.6.6 Mood swings, emotional
"ups and downs"
Young people may feel more emotional during puberty. They may experience
"mood swings", wildly happy then miserable. Mood swings may occur from one
extreme to the other. One minute they may feel aggressive and full of confidence,
then the next minute they may feel uncertain and unsure of themselves. They
may feel cheerful and outgoing, then, for no apparent reason, feel moody and
withdrawn. These changes of feelings are normal. However, mood swings may
make it hard to get along with other members of the family. There may be
arguments over how to divide the time between study and fun, the hours to
keep, the friends to choose, the clothes to wear or even the hairstyle.
10.6.7 "Touching" and "sex
play"
"Touching" and "sex play" are not harmful in themselves, but they can stir
up sexual excitement that is hard to control. A girl can become pregnant
the first time she has intercourse after puberty begins. The best rule for
adolescents is never to get into a situation where they feel they might be
persuaded to do something that they do not want to do, or that goes against
their conscience. In some societies, a girl is never allowed to be alone
in a room with a man unless he is her father or husband.
10.6.8 Masturbation and orgasm
A boy masturbates by stroking or rubbing his penis, usually until ejaculation.
It is a way of relieving sexual tension. Some boys get very worried if they
get into the habit of frequent masturbation. The practice should not cause
any physical or mental harm unless carried to excess. Girls masturbate by
caressing or rubbing the clitoris, often until they reach orgasm. Orgasm is
the climax of sexual excitement. A man usually reaches this climax when he
ejaculates. However, a woman may have an orgasm during intercourse or when
her clitoris is being stimulated. Having an orgasm is not at all related to
conception of a baby. A woman can still become pregnant whether or not she
has had an orgasm.
10.6.9 Sexual feelings of
girls
Sexual excitement may lead to a feeling of moisture at the entrance of the
vagina, "down there". Fluid is produced by two small glands so that, in sexual
intercourse, the penis can enter the vagina without causing discomfort. Adolescent
girls are often physically ready for sexual relationships before they are
mature enough to handle them. They have nothing to fear by saying "NO!". Individuals
in a group do things they would prefer not to because they do not want to
be different from the rest. They must not put themselves at risk of pregnancy
or contracting a sexually transmitted diseases. If they do start sexual activity
they should learn the proper way to use a condom before the first act of
sexual intercourse. The risk of sexually transmissible diseases increases
with the number of sexual partners. When the periods start, and occasionally
just before, women can still become pregnant, so there is no "safe period".
10.6.10 Sexual feelings of
boys
Boys can be sexually aroused and have an erection anytime, and for many reasons.
They could be turned on by the sight of a girl or by thinking about something
sexually exciting or by kissing, touching, stroking, and even tight clothing.
At first, these erections may be embarrassing. They should try to think about
something else or go for a run or any other physical activity. Many men wake
up in the morning with an erection due to hormone activity when asleep. After
urinating the erection goes away. Adolescent boys can have sexual relationships
before they are mature enough to handle them. However, they should not be
in a hurry to start sexual activity. People in a group may do things they
would prefer not to because they do not want to be different from the rest.
However, they do not have to act in the same way as the friends do. Saying
"No" to sexual intercourse is the only guaranteed way not to put themselves
at risk of causing pregnancy of becoming infected with a sexually-transmitted
disease.
If they do start sexual activity they should learn the proper way to use
a condom before the first act of sexual intercourse. Boys should practise
how to put on and take off a condom. In many countries, it is against the
law for anyone to have sexual intercourse with a girl if either of them is
less than 16 years of age.
10.6.11 Sexual assault, rape,
acquaintance rape, date rape, rape crisis centres
Rape can be defined as:
1. Where a person is incapable, because of a mental disorder or developmental
or physical disability, of giving legal consent, and this is known to the
person committing the act. The prosecuting attorney shall prove, as an element
of the crime, that a mental disorder or developmental or physical disability
rendered the alleged victim incapable of giving consent.
2. Where it is accomplished against a person's will by means of force, violence
or fear of immediate and unlawful bodily injury on the person or another.
3. Where a person is prevented from resisting by any intoxicating or anaesthetic
substance, or any controlled substance, administered by or with the privacy
of the accused.
4. Where a person is at the time unconscious of the nature of the act, and
this is known to the accused.
5. Where a person submits under the belief that the person committing the
act is the victim's spouse, and this belief is induced by any artifice, pretence,
or concealment practised by the accused, with intent to induce the belief.
6. Where the act is accomplished against the victim's will by threatening
to retaliate in the future against the victim or any other person, and there
is a reasonable possibility that the perpetrator will execute the threat.
As used in this paragraph "threatening to retaliate" means a threat to kidnap
or falsely imprison, or to inflict extreme pain, serious bodily injury, or
death.
7. Where the act is accomplished against the victim's will by threatening
to use the authority of a public official to incarcerate, arrest, or deport
the victim or another, and the victim has a reasonable belief that the perpetrator
is a public official.
Domestic violence refers to recurring patterns of sexual violence where the
male appears to be unaware that his behaviour was violent and the female may
even accept such behaviour as normal or think she cannot escape it. Domestic
violence is the physical, sexual, emotional or psychological abuse of trust
and power between partners in a spousal relationship. Most domestic violence
is perpetrated by men against women. In Australia, domestic violence is the
leading cause of injury to women of reproductive age, the single most common
trigger of female suicide, implicated in over 60% of the murders of women,
a major cause of maternal mortality (death during pregnancy or in the months
after childbirth).
10.6.12 Sexuality and the
law
In many countries, the age of consent for homosexual and heterosexual sex
is 16 years but it may vary in different states of a country. The only defences
that might be accepted are usually closeness of age, e.g. a 17 year old and
a 15 year old, or the belief that the other person was over the age of consent.
For example in the United Kingdom (UK) it is against the law for anyone for
a boy to have sexual intercourse with a girl if either of them is less than
16 years. It is an offence for a boy or man to have sexual intercourse with
a girl less than 16 years, even if she agrees. Her sexual partner is breaking
the law. Girls, unlike boys, cannot be prosecuted for having sexual intercourse
if they are less than 16 years. A woman who has sex with a boy who is less
than 16 years can be prosecuted for indecent assault. If the girl is less
than 13 years, the maximum penalty is life imprisonment. It is no defence
for the boy to say in court that the girl "wanted it". For men, the age of
consent for male gay relationships is 18 years. A sexual relationship between
men younger than this is illegal. Sexual contact between men is permitted
only if both men consent, are 18 years or over, and it takes place in private
with no one else present.
10.6.13 Your sexual identity
The following information is offered by the Health Queensland (Ministry of
Health, State of Queensland, Australia)
We all get a wide range of messages about sex and relationships from family,
friends, magazines and other people around us like church groups or community
leaders. Sometimes these messages are very different. You may have heard of
the terms heterosexual, homosexual and bisexual.
A heterosexual person is attracted to people of the opposite sex. Most people
are heterosexual.
A homosexual person is attracted to people of the same sex. Sometimes words
like gay (for men) and lesbian (for women) are used. Because these words are
often used in a hurtful way, not everyone who is homosexual wants to be given
these labels. About 10% of the population identifies as either being gay
or a lesbian.
A bisexual person is attracted to people from both sexes. It is not clear
what percentage of the population is bisexual.
Whatever your sexual orientation, whether you see yourself as straight, gay,
a lesbian or bisexual, it is important to understand that no form of sexual
orientation is unlawful. Some people have strong feelings about sexual orientation.
Society encourages, expects and conditions most people to be heterosexual.
People who are different often experience discrimination. In Australia, anti-discrimination
law protects the rights of individuals and unlawful discrimination can be
addressed through the legal system.
It's OK to be you. It's OK for others to be themselves too. Respecting others
and accepting them is an important way of ensuring that your communities
are safe places for everyone.