MODULE NO.

7
CHAPTER II: UNPACKING THE SELF
A. THE SEXUAL SELF
Talking about sex should not be considered as a taboo, but instead be deemed normal for there is a need for
people to learn more about their sexuality. Too many young people receive confusing and conflicting
information about relationships and sex, as they make the transition from childhood to adulthood. This has led
to an increasing demand from young people for reliable information, which prepares them for a safe,
productive and fulfilling life. Sexuality education responds to this demand, empowering young people to make
informed decisions about relationships and sexuality and navigate a world where gender-based violence,
gender inequality, early and unintended pregnancies, HIV and other sexually transmitted infections (STIs) still
pose serious risks to their health and well-being. Equally, a lack of high-quality, age- and developmentally-
appropriate sexuality and relationship education may leave children and young people vulnerable to harmful
sexual behaviors and sexual exploitation.

Sexuality is an essential component of healthy development for young people. U.S. Surgeon General David
Satcher echoed these sentiments, stating that, ‘‘sexuality is an integral part of human life,’’ and ‘‘sexual health
is inextricably bound to both physical and mental health.’’

THE DEVELOPMENT OF SEX CHARACTERISTICS

Primary Sexual Characteristics
Primary sexual characteristics refer to the reproductive organs themselves; e.g., the ovaries and testes.
Secondary sexual characteristics refer to other characteristic indicators of adult male and female bodies (e.g.,
body hair). The development of primary sexual characteristics indicates youth have become capable of adult
reproductive functioning (i.e., the ability to make babies). The development of both primary and secondary
sexual characteristics begins during late childhood and continues throughout early adolescence. However, it is
important to remember youth experience these changes at different rates and times. For more information
about the biological and hormonal changes that trigger these changes, and for suggestions about guiding
young teens through this process, please refer to the article on Puberty in the Middle Childhood series.
For females, the most significant primary sexual characteristic is the first menarche, or first menstrual period.
The first menarche indicates girls have begun to ovulate; i.e., to release mature eggs that can become
fertilized by male sperm through sexual intercourse. The average age for the first menstrual period is 12 years,
but girls can reach menarche at any age from 10 to 15 years old and still be considered "normal."
For males, the primary sexual characteristics include an enlargement of the penis and testes, and the first
spermarche; i.e., the first ejaculation of mature sperm capable of fertilizing female eggs through sexual
intercourse. The average age of first spermarche is 13 years, but it can occur anytime between the ages of 12
and 16 years. On average, the testes will begin to enlarge at about 11 years of age, but this growth can occur
anytime between 9 and 13 years. On average, the penis begins to enlarge around age 12, but this growth can
begin at any age between 10 and 14 years. The penis reaches its adult size at about age 14, but this can occur
anytime between the ages 12 and 16.

Secondary Sexual Characteristics

Secondary characteristics are the result of hormonal changes in the body during puberty. These changes
are faster in girls than in boys. Some changes are common in both boys and girls while others are specific to
each gender. This is due to the different hormones released by them. Growth of pubic hair, facial hair and
under the armpit, increase in height, sweating, etc. are some of the secondary sexual characteristics.
 Change in height: Most prominent change that occurs in adolescents is the change in their heights.
Growth hormone secretion and bone growth are much higher during this time.
 Sweat and Sebaceous glands: The pimples and acne in adolescents are mostly due to the increased
activities of sweat and sebaceous glands
 Hair growth: Another observable change is rapid hair growth under the armpit and pubic area.

Females
In females, breasts are a manifestation of higher levels of estrogen; estrogen also widens the pelvis and
increases the amount of body fat in hips, thighs, buttocks, and breasts. Estrogen also induces growth of
the uterus, proliferation of the endometrium, and menstruation.[4] Female secondary sex characteristics
include:
 Enlargement of breasts and erection of nipples.
 Growth of body hair, most prominently underarm and pubic hair
 Widening of hips; lower waist to hip ratio than adult males.
 Elbows that hyperextend 5–8° more than male adults.
 Upper arms approximately 2 cm longer, on average, for a given height.
 Labia minora, the inner lips of the vulva, may grow more prominent and undergo changes in color with
the increased stimulation related to higher levels of estrogen.
Males
The increased secretion of testosterone from the testes during puberty causes the male secondary sexual
characteristics to be manifested. In males, testosterone directly increases size and mass of muscles, vocal
cords, and bones, deepening the voice, and changing the shape of the face and skeleton. Converted
into dihydrotestosterone in the skin, it accelerates growth of androgen-responsive facial and body hair but
may slow and eventually stop the growth of head hair. Taller stature is largely a result of later puberty. Male
secondary sex characteristics include:
 Growth of body hair, including underarm, abdominal, chest hair and pubic hair.
 Growth of facial hair.
 Enlargement of larynx (Adam's apple) and deepening of voice.
 Increased stature; adult males are taller than adult females, on average.
 Heavier skull and bone structure.
 Increased muscle mass and strength.
 Broadening of shoulders and chest; shoulders wider than hips.
 Increased secretions of oil and sweat glands.

THE HUMAN REPRODUCTIVE SYSTEM

The Male Reproductive System
The purpose of the organs of the male reproductive system is to perform the following functions:
 To produce, maintain, and transport sperm (the male reproductive cells) and protective fluid (semen)
 To discharge sperm within the female reproductive tract during sex
 To produce and secrete male sex hormones responsible for maintaining the male reproductive system

Parts :
 Scrotum– A small muscular sac-like organ which
is located below and behind the penis. It consists
of the testes and is mainly involved in maintaining
the temperature required for the of sperm
production.

 Testes – It is also called as testicles. They are a

pair of oval-shaped organs which are mainly
responsible for the sperm production and
synthesis of testosterone- male hormones.

 Penis– It is the primary sexual organ which serves

as both reproductive organ as well as excretory
organ and used for the purpose of sexual
intercourse. It is a cylindrical tube-like organ with a
small opening at the top and is extremely sensitive
as it becomes vertical when a person is sexually
aroused. Semen, containing sperm, is ejaculated
from the opening at the top when the person
reaches sexual climax.

 Urethra– A narrow tube-like structure that

conducts urine and semen from the urinary
bladder to the penis.

 Vas Deferens– It is a muscular tube that carries

mature sperm produced in the testes to the
urethra.

The Female Reproductive System

The female reproductive organs are located near the lateral walls of the pelvic cavity. It is designed to carry
out several functions.
 It produces the female egg cells necessary for reproduction, called the ova or oocytes.
 The system is designed to transport the ova to the site of fertilization.
 Conception
 Menstruation
 Production of female hormones
Parts:
 Ovaries– They is a pair of organs which are
mainly responsible for the production and storage
of ovum, or egg, which are the sex gametes in a
female.
 Uterus– It is commonly known as the womb. It is a
pear-shaped muscular bag-like organ with a
strong muscular lining that holds the baby after
fertilization. The uterus is referred as the site for
the embryo development as it protects the
fertilized ovum and holds it till the baby is mature
enough for birth.
 Cervix– A cylinder ring-shaped tissue which is
composed mainly of fibromuscular tissue. It is
located at the lowermost portion of the uterus and
is involved in connecting the uterus and the
vagina.
 Vagina– – The primary sexual organ which serves
as both excretory organ as well as reproductive
organ.  It is a muscular and tubular part of the
female genital tract that opens outside the body
and the opening of the vagina is called the vulva,
which also includes the clitoris, labia, and urethra.
The vagina connects cervix to the external female
body parts and it is the path for penis during coitus
as well as a fetus during delivery.

Human Reproduction
The average menstrual cycle lasts 28 days, with the cycle’s first day considered to be the first day of
menstruation. During the first 14 days of the cycle, an egg matures in a woman’s ovaries. This maturation process is
stimulated by a hormone called follicle stimulating hormone (FSH). The ‘coat’ around the maturing egg produces
another hormone, estrogen, which makes the lining of the uterus prepare for pregnancy. The uterus grows a
nutrient-rich and secure bedding for the egg to settle into after fertilization. Around day 14 of the cycle, the egg is
ready for release and emerges from the ovary. This release is triggered by an increase in another hormone called
luteinizing hormone (LH). After release, the egg has about a 12-24 hour window where it can be fertilized by a
sperm. Sperm may survive in a woman’s genital tract and be capable of fertilizing an egg for up to three days after
intercourse. Fertilization happens high up in the fallopian tube. If a sperm penetrates the egg, an embryo will begin
to form. This happens through cell division: one cell becomes two, which become four, which become eight, and so
forth. After about seven days, the embryo reaches the uterus and embeds itself in the lining of the uterus. Cells
surrounding the embryo make the hormone human chorionic gonadotropin (HCG), which signals the woman’s body
that pregnancy has occurred and the menstrual cycle stops until after delivery. If conception does not occur the
uterine lining will be shed and the cycle will begin again.

THE SEXUAL RESPONSE CYCLE

Masters and Johnson studied many different sexual behaviors during
their investigations, one of the most important products that came from
their research was the development of the sexual response cycle.
The sexual response cycle is a series of four physiological phases that
both men and women go through during intercourse. In order to
accurately observe these physiological changes, the researches carefully
measured blood pressure, respiration rate, and indicators of sexual
arousal such as level of vaginal lubrication in women and the level of
swelling and blood flow to the penis in men. In conclusion, Masters and
Johnson determined that the human body undergoes four distinct phases
during sex:

1. Excitement Phase
General characteristics of the excitement phase, which can last from a few minutes to several hours,
include the following:
 Muscle tension increases.
 Heart rate quickens and breathing is accelerated.
 Skin may become flushed (blotches of redness appear on the chest and back).
 Nipples become hardened or erect.
 Blood flow to the genitals increases, resulting in swelling of the woman's clitoris and labia minora (inner
lips), and erection of the man's penis.
 Vaginal lubrication begins.
  The woman's breasts become fuller and the vaginal walls begin to swell.
 The man's testicles swell, his scrotum tightens, and he begins secreting a lubricating liquid.

2. Plateau Phase
General characteristics of the plateau phase, which extends to the brink of orgasm, include the following:
 The changes begun in phase 1 are intensified.
 The vagina continues to swell from increased blood flow, and the vaginal walls turn a dark purple.
 The woman's clitoris becomes highly sensitive (may even be painful to touch) and retracts under the
clitoral hood to avoid direct stimulation from the penis.
 The man's testicles are withdrawn up into the scrotum.
 Breathing, heart rate, and blood pressure continue to increase.
 Muscle spasms may begin in the feet, face, and hands.
 Muscle tension increases.

3. Orgasm Phase
The orgasm is the climax of the sexual response cycle. It is the shortest of the phases and generally lasts
only a few seconds. General characteristics of this phase include the following:
 Involuntary muscle contractions begin.
 Blood pressure, heart rate, and breathing are at their highest rates, with a rapid intake of oxygen.
 Muscles in the feet spasm.
 There is a sudden, forceful release of sexual tension.
 In women, the muscles of the vagina contract. The uterus also undergoes rhythmic contractions.
 In men, rhythmic contractions of the muscles at the base of the penis result in the ejaculation of semen.
 A rash, or "sex flush" may appear over the entire body.

4. Resolution Phase
During resolution, the body slowly returns to its normal level of functioning, and swelled and erect body
parts return to their previous size and color. This phase is marked by a general sense of well-being,
enhanced intimacy and, often, fatigue. Some women are capable of a rapid return to the orgasm phase
with further sexual stimulation and may experience multiple orgasms. Men need recovery time after
orgasm, called a refractory period, during which they cannot reach orgasm again. The duration of the
refractory period varies among men and usually lengthens with advancing age.

DIVERSITY OF HUMAN SEXUALITY

Diversity is all the ways we’re different from each other. It includes things like race, religion, culture,
physical ability, mental ability, family make-up, socio-economic status and sexual and gender diversity.
Sexuality refers to the sexual feelings and attractions we have towards other people. There are many different
types of sexuality and it can take a while for people to figure out what is right for them. All are perfectly normal
and part of the broad range of human relationships and experiences. A person’s sexuality is a central part of
who they are, and can influence their thoughts, feelings and actions.
Rigid beliefs on sex and gender put people in boxes (or closets), but these beliefs do not reflect realities
on human sexuality, especially how gender roles and expressions, sexual attraction, and sexual behavior
influence how a person views or lives his or her own sexuality. These notions favor male-female distinctions
and are biased against those who do not fit existing stereotypes on sex and gender.

When we talk about sexual and gender diversity, it’s important to understand these terms:
 Sex: Categories (male, female) to which people are typically assigned at birth based on physical
characteristics (e.g. genitals). Some people may be assigned intersex, when their reproductive,
sexual or genetic biology doesn’t fit the traditional definitions of male or female.
 Sexual Orientation: A person’s emotional and sexual attraction to others. It can change and may or
may not be the same as a person’s sexual behavior.
 Gender/Gender Identity: A person’s internal sense of identity as female, male, both or neither,
regardless of their sex.
 Gender Expression: How a person expresses their gender. This can include how they look, the
name they choose, the pronoun they use (e.g., he, she) and their social behavior.

Each person’s sexual orientation, gender identity and gender expression are
a part of who they are. When talking about these topics, it is common to see the
acronym SOGIE, which stands for Sexual Orientation, Gender Identity and (Gender)
Expression.
The acronyms LGBTQ2S+, LGBTQ*, LGBTQ +, GLBT, LGBTTQ and
LGBTQ2 refer to the spectrum of sexual and gender identities that are not cisgender
and heterosexual. They include lesbian, gay, bisexual, transgender, two-spirit,
queer, questioning, intersex and asexual. The asterisk (*) or plus sign (+) shows
there are other identities included that aren’t in the acronym. These acronyms mean the same as ‘sexual and
gender minorities.

Terms relating to LGBTQIA*

 Ally - A person who is not LGBTQ but shows support for LGBTQ people and promotes equality in a
variety of ways.
 Androgynous - Identifying and/or presenting as neither distinguishably masculine nor feminine.
 Asexual - The lack of a sexual attraction or desire for other people.
 Biphobia - Prejudice, fear or hatred directed toward bisexual people.
 Bisexual - A person emotionally, romantically or sexually attracted to more than one sex, gender or
gender identity though not necessarily simultaneously, in the same way or to the same degree.
 Cisgender - A term used to describe a person whose gender identity aligns with those typically
associated with the sex assigned to them at birth.
 Closeted - Describes an LGBTQ person who has not disclosed their sexual orientation or gender
identity.
 Coming out - The process in which a person first acknowledges, accepts and appreciates their sexual
orientation or gender identity and begins to share that with others.

 Gay - A person who is emotionally, romantically or sexually attracted to members of the same gender.
 Gender dysphoria - Clinically significant distress caused when a person's assigned birth gender is not
the same as the one with which they identify. According to the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders (DSM), the term - which replaces Gender Identity
Disorder - "is intended to better characterize the experiences of affected children, adolescents, and
adults."
 Gender-fluid | According to the Oxford English Dictionary, a person who does not identify with a single
fixed gender; of or relating to a person having or expressing a fluid or unfixed gender identity.
 Gender non-conforming | A broad term referring to people who do not behave in a way that conforms
to the traditional expectations of their gender, or whose gender expression does not fit neatly into a
category.
 Genderqueer | Genderqueer people typically reject notions of static categories of gender and embrace
a fluidity of gender identity and often, though not always, sexual orientation. People who identify as
"genderqueer" may see themselves as being both male and female, neither male nor female or as
falling completely outside these categories.
 Gender transition | The process by which some people strive to more closely align their internal
knowledge of gender with its outward appearance. Some people socially transition, whereby they might
begin dressing, using names and pronouns and/or be socially recognized as another gender. Others
undergo physical transitions in which they modify their bodies through medical interventions.
 Homophobia | The fear and hatred of or discomfort with people who are attracted to members of the
same sex.
 Intersex | An umbrella term used to describe a wide range of natural bodily variations. In some cases,
these traits are visible at birth, and in others, they are not apparent until puberty. Some chromosomal
variations of this type may not be physically apparent at all.
 Lesbian | A woman who is emotionally, romantically or sexually attracted to other women.
 Living openly | A state in which LGBTQ people are comfortably out about their sexual orientation or
gender identity – where and when it feels appropriate to them.
 Non-binary | An adjective describing a person who does not identify exclusively as a man or a woman.
Non-binary people may identify as being both a man and a woman, somewhere in between, or as
falling completely outside these categories. While many also identify as transgender, not all non-binary
people do.
 Outing | Exposing someone’s lesbian, gay, bisexual or transgender identity to others without their
permission. Outing someone can have serious repercussions on employment, economic stability,
personal safety or religious or family situations.
 Pansexual | Describes someone who has the potential for emotional, romantic or sexual attraction to
people of any gender though not necessarily simultaneously, in the same way or to the same degree.
 Queer | A term people often use to express fluid identities and orientations. Often used interchangeably
with "LGBTQ."
 Questioning | A term used to describe people who are in the process of exploring their sexual
 orientation or gender identity.
 Sex assigned at birth | The sex (male or female) given to a child at birth, most often based on the
child's external anatomy. This is also referred to as "assigned sex at birth."
 Transgender | An umbrella term for people whose gender identity and/or expression is different from
cultural expectations based on the sex they were assigned at birth. Being transgender does not imply
any specific sexual orientation. Therefore, transgender people may identify as straight, gay, lesbian,
bisexual, etc.
 Transphobia | The fear and hatred of, or discomfort with, transgender people.

Getting to Know your Sexual Identity

Everybody has a sense of their sexuality: this is called your sexual identity. Your sexual identity is about
how you see this part of yourself and how you express it to others. Sexual identity is different from sexual
orientation. Sexual orientation is about your sexual preferences and who you are attracted to.
Your sexual identity may not match your sexual orientation, for example, you may be a guy who is
attracted to other guys but still identify as 'straight'. Working out sexual orientation may be an ongoing process
throughout a person’s life. For instance, a young person might identify one way at one time then differently in a
few years' time.

SEXUAL HEALTH AND SEXUALLY TRANSMITTED DISEASES/ INFECTIONS

Fast Facts:
 Approximately 12 million girls aged 15–19 years and at least 777,000 girls under 15 years give birth
each year in developing regions.
 At least 10 million unintended pregnancies occur each year among adolescent girls aged 15–19 years
in the developing world.
 Complications during pregnancy and childbirth are the leading cause of death for 15–19-year-old girls
globally.
 Of the estimated 5.6 million abortions that occur each year among adolescent girls aged 15–19 years,
3.9 million are unsafe, contributing to maternal mortality, morbidity and lasting health problems.
 Adolescent mothers (ages 10–19 years) face higher risks of eclampsia, puerperal endometritis, and
systemic infections than women aged 20 to 24 years, and babies of adolescent mothers face higher
risks of low birth weight, preterm delivery and severe neonatal conditions.

More than a quarter of the world’s population is between the ages of 10 and 24, with 86% living in less
developed countries. These young people are tomorrow’s parents. The reproductive and sexual health
decisions they make today will affect the health and wellbeing of their communities and of their countries for
decades to come. In particular, two issues have a profound impact on young people’s sexual health and
reproductive lives: family planning and HIV/AIDS. Teenage girls are more likely to die from pregnancy-related
health complications than older women in their 20s. Statistics indicate that one-half of all new HIV infections
worldwide occur among young people aged 15 to 24.

Sexually Transmitted Disease

The term sexually transmitted disease (STD) is used to refer to a condition passed from one person to
another through sexual contact. You can contract an STD by having unprotected vaginal, anal, or oral sex with
someone who has the STD.
An STD may also be called a sexually transmitted infection (STI) or venereal disease (VD).

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) can have a range of
signs and symptoms, including no symptoms. That's why they may go unnoticed until complications occur or a
partner is diagnosed. Signs and symptoms may appear a few days after exposure, or it may take years before
you have any noticeable problems, depending on the organism.
Signs and symptoms that might indicate an STI include:
 Sores or bumps on the genitals or in the oral or rectal area
 Painful or burning urination
 Discharge from the penis
 Unusual or odd-smelling vaginal discharge
 Unusual vaginal bleeding
 Pain during sex
 Sore, swollen lymph nodes, particularly in the groin but sometimes more widespread
 Lower abdominal pain
 Fever
  Rash over the trunk, hands or feet

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) can be caused by:
 Bacteria (gonorrhea, syphilis, chlamydia)
 Parasites (trichomoniasis)
 Viruses (human papillomavirus, genital herpes, HIV)

Who is most at risk with STI?

 you don’t use condoms during sex or dental dams (a thin latex square held over the vaginal or anal
area during oral sex)
 you have changed sex partners or had more than one sex partner in the last 12 months
 you or your partner share injecting equipment such as a syringes and needles
 you or your sex partner has another STI.

Most Common STDs

 Chlamydia ● Pelvic Inflammatory Disease (PID)
 Genital Herpes  ● Pubic Lice (Crabs)
 Genital Warts  ● Syphilis
 Gonorrhea ● Trichomoniasis
 Hepatitis B (HBV)
 HIV and AIDS
Teenage Pregnancy
Teenage pregnancies and teenage motherhood are a cause for concern worldwide. Every year, an
estimated 21 million girls aged 15–19 years in developing regions become pregnant and approximately 12
million of them give birth. Nowadays, the vast majority of teenage pregnancies occur in low- and middle-
income countries characterized by poor health-care services; therefore, complications during pregnancy, birth,
and postpartum phase are the second cause of death among girls aging between 15 and 19 years worldwide.
Additionally, it is estimated that some three million teenage girls undergo unsafe abortions, which may result in
consecutive reproductive problems or even death.

Adolescents who may want to avoid pregnancies may not

be able to do so due to knowledge gaps and misconceptions on
where to obtain contraceptive methods and how to use them.
Adolescents face barriers to accessing contraception including
restrictive laws and policies regarding provision of contraceptive
based on age or marital status, health worker bias and/or lack of
willingness to acknowledge adolescents’ sexual health needs, and
adolescents’ own inability to access contraceptives because of
knowledge, transportation, and financial constraints. Additionally,
adolescents may lack the agency or autonomy to ensure the
correct and consistent use of a contraceptive method.  At least 10
million unintended pregnancies occur each year among adolescent
girls aged 15-19 years in developing regions
The teenage pregnancy rate in the Philippines was 10% in
2008, down to 9% in 2017. Live births by teenage mothers (aged
10-19) in 2016 totaled 203,085, which slightly decreased to
196,478 in 2017 and 183,000 in 2018. Still, the Philippines has one
of the highest adolescent birth rates among the ASEAN Member
States. Recent World Bank data shows that the Philippines has 47
births annually per 1,000 women aged 15-19, higher than the
average adolescent birth rates of 44 globally and 33.5 in the
ASEAN region.

Sexuality Education in the Philippines

The 2012 Responsible Parenthood and Reproductive Health Act includes a provision that mandates the
Department of Education to implement age and development-appropriate Comprehensive Sexuality Education
(CSE) in formal and non-formal education settings. The long delay in the adoption and integration of CSE in
the K-12 Curriculum is a significant missed opportunity to provide young people with non-judgmental and
scientifically accurate and age-appropriate Sexuality and Reproductive Health information that would curb the
knowledge gap and provide life skills needed to make informed decisions related to risk behaviors with
consequences to their health.
UNFPA, the United Nations sexual and reproductive health agency, recommends the following
measures to reduce teenage pregnancy:
1. Increasing adolescent and youth resilience and protection.
2. Managing fertility rates, improving education and employment opportunities of young people to reap
the demographic dividend
3. Enhancing social protection mechanisms
4. Improving access to adolescent and youth-friendly services, including contraceptives.
5. Strengthening parental skills for adolescents and youth
6. Strengthening inter-agency coordination and collaboration, both horizontally and vertically
7. Robust data and statistics, and more updated evidence to inform policies and programs for
adolescents.
8. Maximizing use of media and communications for health promotion

FAMILY PLANNING AND RESPONSIBLE PARENTHOOD

Family Planning (FP) is having the desired number of children and when you want to have them by
using safe and effective modern methods. Proper birth spacing is having children 3 to 5 years apart, which is
best for the health of the mother, her child, and the family.

Benefits of Family Planning

Mother
 Enables her to regain her health after delivery.
 Gives enough time and opportunity to love and provide attention to her husband and children.
 Gives more time for her family and own personal advancement.
 When suffering from an illness, gives enough time for treatment and recovery.
Children
 Healthy mothers produce healthy children.
 Will get all the attention, security, love, and care they deserve.

Father
 Lightens the burden and responsibility in supporting his family.
 Enables him to give his children their basic needs (food, shelter, education, and better future).
 Gives him time for his family and own personal advancement.
 When suffering from an illness, gives enough time for treatment and recovery.

FAMILY PLANNING METHODS

1. Natural Family Planning (NFP) refers to a variety of methods used to prevent or plan pregnancy, based on
identifying a woman’s fertile days. For all natural methods, abstinence or avoiding unprotected intercourse
during the fertile days is what prevents pregnancy. The effectiveness and advantages of NFP address the
needs of diverse populations with varied religious and ethical beliefs. They also provide an alternative to
women who wish to use natural methods for medical or personal reasons.

NATURAL CONTRACEPTIVE OPTIONS

 Abstinence
Refraining from penetrative sex provides 100% protection from pregnancy, and offers effective
prevention of transmission of sexually transmitted infections as well
 Withdrawal or Coitus interruptus
The withdrawal method of family planning is unlike other natural methods in that it is male-controlled.
Withdrawal has been used for centuries, following the discovery that ejaculation into the vagina leads to
pregnancy; this method prevents pregnancy by preventing contact between the sperm and the egg
 Calendar methods - based on calculations of cycle length
In calendar rhythm method, a woman makes an estimate of the days she is fertile based on past
menstrual cycle length. She does this with the expectation that the length of her current cycle, and thus
the time of her fertile phase, will not vary greatly from previous menstrual cycles.

Methods based on symptoms and signs

Ovulation Method, Billings Method, Cervical Mucus Method
This method is based on the changes in cervical secretions due to the effects of circulating levels of
estrogen and progesterone, as described above. Introduced in the 1960s, this method relies on daily self-
examination for the detection of the quantity and evaluation of the quality of cervical secretions. Women are
taught to feel for secretions throughout their cycles. Couples either abstain from sex or use a barrier method
during menstruation and on alternating days prior to the appearance of cervical mucus. They abstain from
unprotected intercourse from the time that the first sticky mucus appears until four days after the last clear,
stretchy, slippery mucus is observed.

Basal Body Temperature (BBT) Method

 Due to the actions of progesterone on the hypothalamus, a woman’s body temperature rises slightly
after she ovulates (0.2 to 0.5 degrees C) and remains elevated until the end of the cycle, until menstruation.
Women who use this method must chart their temperature every day, immediately after waking up and before
getting out of bed or drinking any liquids. Couples relying on this method must abstain from unprotected
intercourse between the first day of menstruation until after the third consecutive day of elevated body
temperature, so unprotected sex is limited to the postovulatory infertile time.

Sympto-Thermal Method
This method combines several techniques to predict ovulation. It typically includes monitoring and
charting cervical mucus and position and temperature changes on a daily basis and may include other signs of
ovulation, such as breast tenderness, back pain, abdominal pain or "heaviness," or light intermenstrual
bleeding. To use this method correctly, couples must abstain from unprotected sex from the first sign or
sensation of wet cervical mucus until the woman’s body temperature has remained elevated for three days
after peak day is observed.

Lactational Amenorrhea Method (LAM)

Research has confirmed that a form of breastfeeding to achieve contraception, called the lactational
amenorrhea method, or LAM, is more than 98% effective during the first 6 months following delivery. During
breastfeeding, ovulation is inhibited by a series of physiological responses to nipple stimulation. More frequent
or intense suckling sends nerve impulses to the mother’s hypothalamus that disrupt normal signals to the
pituitary controlling hormone secretion; the resulting abnormal pattern of LH secretion is inhibitory to ovarian
activity. When breastfeeding diminishes with less frequent breastfeeding and/or more frequent supplemental
feeding, the chance of ovulation and subsequent pregnancy rises.
2. Artificial Birth Control employs artificial control methods to help prevent unintended pregnancy
through the use of contemporary measures such as contraceptive or birth control pills. Diaphragm,
male and female condoms, spermicide, cervical cap, birth control patch, birth control shot, implants,
IUD, tubal ligation, vasectomy and emergency contraception pill.

Oral Contraceptives
This is a series of pills that a woman takes once each day for a month. At the
end of the month, she starts a new package of pills. The pills have hormones much
like those a woman's body makes to control her menstrual cycle. They work by
keeping the ovaries from releasing eggs or by changing the lining of the uterus or the
mucus of the cervix.

Depo-Provera:
A method of birth control given in the form of a shot. The shot gives protection
for up to 12 weeks. It does not contain estrogen so there are no side effects from that
hormone. It works by keeping the ovaries from releasing eggs or by changing the
lining of the uterus or the mucus of the cervix.

Contraceptive Patch:
A method of birth control that is a small, thin and smooth patch and is put on
a woman's skin. The woman can choose where she wears the patch: the buttocks,
the shoulder, the upper arm, front or back, but not on the breasts. It releases
hormones every day for three weeks so the woman's ovaries don't produce eggs. It
can stay on the body for one week. You change it once a week and on the fourth
week, you don't wear a patch but you will still be protected. You can swim, bathe,
shower and wear it in warm humid weather.

Contraceptive Ring
A method of birth control in the form of a soft ring that fits deep inside the
vagina. It releases low-dose hormones everyday for three weeks so the woman's
ovaries don't produce eggs. It can stay in the vagina for up to three weeks and
provides protection for one month

Intrauterine Device (IUD)

A small device made of plastic. Some contain copper, or a hormone. A clinician chooses the right type
for a woman, and inserts it into her uterus. Some can stay there for 4 years; copper IUDs may be left in place
up to 8 years. IUDs prevent a woman's egg from being fertilized by the man's sperm, and change the lining of
her uterus.

Implanon
Implanon is a small, thin, implantable hormonal contraceptive that provides
effective protection for up to three years.  Implanon must be removed by the end of
the third year and can be replaced by a new Implanon if contraceptive protection is
still needed.  This contraceptive method must be inserted and removed by a trained
healthcare provider.

Diaphragm/Cervical Cap
A soft rubber barrier in a woman's vagina, used with a contraceptive cream or jelly.
The diaphragm or cervical cap is put into a woman's vagina before intercourse. It
covers the entrance to her uterus, and the cream or jelly stops the man's sperm from
moving. The diaphragm can be put in the vagina 6 hours ahead of intercourse, and
left in or 24 hours. The cervical cap can be left in her vagina for up to 48 hours.

Male Condom
It is a sheath of latex that a man can wear over his penis during intercourse.
The condom catches the semen that comes out of a man's penis before,
during and after he ejaculates. This keeps his sperm from getting into the
woman's vagina. Latex condoms also help protect against some infections,
including HIV, the virus that causes AIDS.

Female Condom
It is a loose-fitting sheath that fits inside the woman's vagina. It catches the semen
that comes out of a man's penis when he ejaculates. It covers the cervix, the opening
to the uterus, so sperm can't get through. It also protects against some infections
including HIV, the virus that causes AIDS.