REPRODUCTI

VE &SEXUAL
HEALTH
REPRODUCTIVE DEVELOPMENT

• Reproductive development begins at the moment of

conception and continues through life.
INTRAUTERINE DEVELOPMENT

• Sex assigned at birth is generally determined at the moment

of conception by chromosome formation, which is supplied
by sperm and ovum to create a new life.
• A gonad produces the cells for reproduction. (Ovary for
females and testis for males.)
• Week 5 or 6, mesonephric and paramesonephric ducts, the
tissue that will become ovaries and testes have already
formed.
• Week 7 or 8, in chromosomal males, gonadal tissue begins
formation of testosterone.
• Under the influence of testosterone, the mesonephric duct
develops into male reproductive organs and the
paramesonephric duct regresses.
• If testosterone is not present by week 10, the paramesonephric
duct becomes dominant and develops into female reproductive
organs.
• When ovaries form, all of the oocytes are already present.
• Week 12, the external genitals begin to develop.
• In males, penile tissue elongates and ventral surface of the penis
closes to form urethra.
• In females, with no testosterone present, the uterus, labia minora, labia
majora form. If for some reason testosterone secretion is halted In
utero, a chromosomal male could be born with female-appearing
genitalia (ambiguous genitalia).
• If a pregnant woman should be prescribed a form of testosterone or,
because of a metabolic abnormality, she produces a high level of
testosterone, a chromosomal female could be born with male-
appearing genitalia
PUBERTAL DEVELOMENT

• PUBERTY is the stage of life at which secondary sex changes begin.

• In most girls, these changes are stimulated when the hypothalamus
synthesizes and releases gonadotropin-releasing hormone (GnRH),
which then triggers anterior pituitary to release follicle-stimulating
hormones (FSH) and luteinizing hormone (LH).
• FSH and LH are termed gonadotropin hormones because they continue
to cause the production of eggs and influences menstrual cycle
throughout women’s lives.
• the mechanism that initiates the pubertal change is not well
understood, but the hypothalamus apparently serves as a gonadostat or
regulation mechanism to “turn on” gonad functioning.
THE ROLE OF ANDROGEN

• Andogenic hormones are the hormones responsible for muscular

development, physical growth, and the increase in sebaceous gland
secretions that cause typical acne in both boys and girls during
adolescence.
• In males, androgenic hormones are produced by the adrenal cortex and the
testes and, in females, by the adrenal cortex and ovaries.
• The level of the primary androgenic hormones, testosterone, is low in
males until puberty when it rises to influence pubertal changes in the testes,
scrotum, penis, prostate, and seminal vesicles; the appearance of male
pubic, axillary, and facial hair; laryngeal enlargement with it’s
accompanying voice change; maturation of spermatozoa; and closure of
growth plates in long bones.
• In girls, testosterone influences enlargement of the labia
majora and clitoris and the formation of axillary and pubic
hair.
THE ROLE OF ESTROGEN

• When triggered at puberty by FSH, ovarian follicles in females

begin to excrete a high level of the hormone estrogen.
• This increase influences the development of the uterus,
fallopian tubes, and vagina; typical female fat distribution; hair
patterns; and breast development.
• It also closes the epiphysis of long bone in girls the same way
testosterone closes the growth plate in boys.
• The beginning of breast development is termed thelarche,
which usually starts 1 to 2 years before menstrautiuon.
SECONDARY SEX
CHARACTERISTICS • Growth spurt
IN GIRLS: • Increase in the transverse
diameter of pelvis
• Breast development
• Growth of pubic hair
• Onset of menstruation
• Growth of axillary hair
• Vaginal secretions
SECONDARY SEX
• Increase in weight
CHARACTERISTICS
IN BOYS: • Growth of testes
• Growth of face, axilliary and
pubic hair
• Voice changes
• Penile growth
• Increase in height
• Spermatogenesis (production of
sperm)
FEMALE
FEMALE
ANATOMY
ANATOMY
 FEMALE INTERNAL
STRUCTURES
1. Vagina
A hollow, membranous and
muscular canal about 8 to 12cm
long located in front of the rectum
and behind the bladder. Its upper
portion is separated from the rectum
by the cul-de-sac of Douglas.
It extends from the cervix of the
uterus to the external vulva
 Functions of the vagina
1) Organ of copulation
2) Discharges menstrual flow
3) Birth canal
 Rugae
 These are transverse folds of skin in the
vaginal wall that is absent in childhood,
appear after puberty and disappears at
menopause.
 They are most numerous in nulliparous
women and lessen with each childbirth and
advancing age.
 The important function of rugae is to allow
the vaginal canal to stretch and enlarge
considerably during delivery.
 Vaginal Column
 These are the
longitudinal folds of skin
in the vaginal canal
which also allows the
vaginal canal to enlarge
during delivery in order
to accommodate the
fetus.
 Vaginal pH
 Vaginal pH before puberty is 6.8 to 7.2, which is alkaline. After
puberty vaginal pH becomes acidic, going down to pH of 4-5.
2. Uterus
 A hollow, muscular, pear-shaped
organ located in the lower pelvis
(true pelvis), posterior to the bladder
and anterior to the rectum
 It is approximately 5-7 cm long, 5
cm wide, and weights 60 grams.
 Functions of the uterus:
1) Its cardinal function is as an organ
of reproduction
2) Organ of menstruation
3) Uterine contraction to expel the
fetus during labor and to seal torn
blood vessels after delivery of the
placenta
Parts of the uterus
1. Fundus
 The uppermost convex portion located
between the insertions of the fallopian
tubes.
 This is the most muscular area of the
uterus; as such it is the thickest and
the most contractile portion.
 It is used as an obstetrical landmark:
a) During pregnancy, palpation of its
height is used to assess uterine growth
b) During postpartum period, to assess
for uterine involution.
 The ideal site for implantation of the
zygote.
2. Cornua
 The areas of the uterus at
which the fallopian tubes
are attached.
3. Isthmus
 This is the upper third of
the cervix which is very
thin, becoming
prominent only near the
end of pregnancy and
during labor to form the
lower uterine segment
together with the cervix.
4. Corpus
This is the body
of the uterus
which makes up
two-third of the
said organ.
It houses the
fetus during
pregnancy
5. Cervix (neck of the uterus)
 It measures about 2.5 cm long
and 2.5 cm in diameter.
 It is chiefly composed of elastic
and collagenous tissues and
only 10% muscle fibers.
 It is composed of 3
interwoven layers of
smooth muscle
arranged in
longitudinal, transverse,
and oblique directions
 Thickest at the fundal
area of the uterus and
thinnest in the cervix
Functions of the ovaries:
1. Oogenesis - The ovaries are responsible for
development and maturation of ovum
2. Ovulation - Refers to the release of ovum
from the ovary
3. Hormone production - The ovaries are the
main source of estrogen and progesterone in
nonpregnant women
Ovarian Follicles

1. Primordial Follicles
The primordial follicles
are formed during
intrauterine life. Most of
them regress before birth
They are the immature
follicles inside the ovary
that contain immature
ova.
2. Graafian Follicles
The term Graafian follicle is
derived from the name of
Regner de Graaf, the dutch
anatomist who first
described it in 1672
It is described as a blister
like structure barely visible
to the naked eye. As it
develops, the oocyte within it
mature.
It secretes large amounts of
estrogen under the influence
of FSH
3. Corpus Luteum (yellow body)
 The cells of the empty Graafian follicle
produce a yellowish fluid called lutein.
Lutein fills the space that was once
occupied by the ovum giving it a
yellowish coloration. This is why the
follicle is termed corpus luteum after
ovulation which means yellow body.
 The primary hormone produced by
corpus luteum is progesterone, although
it secretes some estrogen.
4. Corpus Albicans (white body)
 Complete regression of the corpus
luteum occurs before menstruation,
later it will be seen as a white fibrous
tissue, called corpus albicans or corpus
albicantia.
5. Ovum
 The ovum or egg cell is the female sex
cell or gamete.
 Oogenesis refers to the development and
maturation of ovum
 The ovum is regularly released by the
ovary through the process of ovulation.
 It has two layers of protective covering:
1) Corona radiata – the outer layer
2) Zona pellucida – the inner layer
 The egg cell has a lifespan of 24 hours,
thus, it can only be fertilized within this
period. After 24 hours, it regresses and
reabsorbed.
 MAMMARY GLANDS/BREASTS

 The female breasts are accessory organs of reproduction

meant to provide the infant with the most ideal nourishment
after birth
 They are situated over the pectoralis major muscles,
between the second and sixth ribs. The breasts are
supported by the Cowper’s ligaments.
External Structures:
1. Nipple or Mammary Papillae
 Located at the center of the anterior
surface of each breast. It has 15-20
opening connected to lactiferous ducts
and in which milk flows out
2. Areola
 The pigmented skin that surrounds the
nipple. Both nipple and areola have
pigmented and wrinkled skin.
3. Montgomery Tubercles
 Glands in the areola that secrete an oily
substance that keeps the areola and
nipple lubricated.
Internal Structures:
1. Lobes
 15 to 20 lobes are found in each breast that are
divided into several lobules
2. Lobules
 Composed of clusters of acini cells
3. Acini cells
 These are the milk secreting cells of the breasts
that are stimulated by prolactin hormone
4. Lactiferous ducts
 Ducts that serves as passageways of milk
5. Lactiferous sinus
 Dilated portions of the ducts located behind the
nipple that serves as reservoir of milk.
Hormones that Influence the Mammary Glands:
1. Estrogen
 Stimulates development of the ductile structure of the breast
2. Progesterone
 Stimulates the development of the acinar structures of the breast
3. Human Placental Lactogen
 Promotes breast development during pregnancy
4. Oxytocin
 Let-down reflex. This hormone is inhibited by progesterone
5. Prolactin
 Stimulates milk production.
 This hormone is inhibited by estrogen.
MALE
MALE
ANATOMY
ANATOMY
MALE EXTERNAL STRUCTURE
SCROTUM:

 pouch of loose skin that

becomes covered
lightly with hair at puberty
 consists of two
compartments which
hold the testes
TESTES (2):

 produce germ
cells (sperm) and
male sex hormone
testosterone
PENIS:
1. male organ of sexual intercourse
2. contains the opening through which
semen and urine pass
Male Internal Structures
Epididymis
- a tightly coiled tube.
- app. 20 ft. long.
- Responsible for conducting sperm from
the testis to the vas deferens.
- Sperm are immobile and incapable of
fertilization as they pass or are stored
at the epididymis level.
- It takes at least 12 to 20 days for them
to travel the length of the epididymis.
VAS DEFERENS (2):

- it carries sperm from the

epididymis through the
inguinal canal into the
abdominal cavity, where it
ends in the seminal vesicles
and the ejaculatory ducts.
- Vasectomy ( severing of the
vas deferens)
SEMINAL VESICLES (2):

- small glans each about 2 inches long

- lie behind the bladder and open into
the ejaculatory ducts, where the
fluids they secrete combine with
sperm
- the fluid they produce nourishes
sperm and helps them become active
Ejaculatory Ducts.

- the two ejaculatory ducts pass

through the prostrate gland and
join the seminal vesicles to the
urethra.
PROSTATE GLAND:
- lies beneath the bladder
- contains muscle fibers and glandular
tissue that secrete prostatic fluid
which is milky and alkaline
- provides the characteristic texture and
odor of the seminal fluid
- the alkalinity neutralizes some of the
acidity of the vaginal tract,
prolonging the life span of sperm as
it passes through the female
reproductive system
COWPER’S GLANDS
(Bulbourethral gland) (2):

- lie below the prostate

- empty their secretion into the
urethra
- during sexual arousal they
secrete a drop or so of clear,
slippery fluid that appears at the
urethral opening
SEMEN:
- made up of fluids from the
seminal vesicles, prostate gland and
Cowper’s glands
- about 70% of the ejaculate is secreted by
the seminal vesicle
- the other 30% consists of sperm and fluids
from the prostate gland and Cowper’s gland
 sperm only accounts for 1% of semen
 ejaculate = 200 - 400 million sperm
PELVIS
 FUNCTION
• Primary function : allow
movement of the body, especially
walking and running.
• Permits a person to sit and kneel.
• Adapted for childbearing, and
because of its increased width and
rounded brim women are less
speedy.
• The pelvis transmits the weight of the
trunk to the legs, acting as a bridge
between the femurs.
• This makes it necessary for the sacro-
iliac joint to be immensely strong and
virtually immobile,
• It also takes the weight of the sitting
body onto the ischial tuberosities.
• The pelvis affords protection to the
pelvic organs and, to a lesser extent,
to the abdominal contents.
• The sacrum transmits the cauda
equina and distributes the nerves to
the various parts of the pelvis.
 THE GYNAECOID
PELVIS
• The true female pelvis.
• Its characteristics give
rise to no difficulties in
childbirth, providing the
fetus is of normal size
HOW IMPORTANT IS THE PELVIS?

• A knowledge of pelvic anatomy is needed for the

conduct of labour as one of the ways to estimate the
progress made is by assessing the relationship of the
fetus to certain pelvic landmarks.
• A midwife must be competent to recognise a normal
pelvis in order to be able to detect deviations from
normal and refer them to the doctor.
PHYSIOLOGY
PHYSIOLOGY
&
& SEXUAL
SEXUAL
RESPONSE
RESPONSE
MENSTRUAL CYCLE

MENSTRUATION:

 the cyclical bleeding that stems from the shedding of the uterine lining
 humans ~ averages 28 days
 regulated by estrogen & progesterone
 ovulation may not occur each time
 follows ovulation by 14 days (±2)
CHARACTERISTICS OF NORMAL MENSTRUAL CYCLES
CHARACTERISTICS DESCRIPTION

Beginning ( Menarche )

Average age at onset, 11-13 yrs;average range, 9-17 yrs

Interval between cycles

Average, 28 days; cycles of 23-35 days not unusual

Duration of Menstrual flow

Average flow, 2-7 days; ranges of 1-9 days not abnormal

Amount of menstrual flow

Difficult to estimate; average ; 30-80 ml per menstrual period;

Color of menstrual flow saturating pad or tampon in less than an hour is heavy
bleeding
Dark red; a combination of blood, mucus, and endometrial cells
Odor

Similar to that of marigolds

MENSTRUAL CYCLE

MENOPAUSE:

 the cessation of menstruation

 commonly occurs between the ages of 45
& 50 and lasts 2 years
 estrogen levels drop producing many
unpleasant side effects (ex. night sweats,
hot flashes)
MENSTRUAL CYCLE

MAN-OPAUSE (?):

 men cannot undergo menopause because

they have never menstruated
 they can experience a gradual decline in
testosterone levels but it is unlike the sharp
decline of estrogen
MENSTRUAL CYCLE

DYSMENORRHEA:

 mild to severe pain or discomfort during

menstruation
 pelvic cramps, nausea, headaches,
backaches, bloating
MENSTRUAL CYCLE

PREMENSTRUAL SYNDROME (PMS):

 symptoms that regularly afflict many women

during the four to six days prior to menstruation
each month
 combination physical & psychological
 ex. anxiety, depression, irritability, weight gain,
abdominal pain
HOW YOUR HORMONES WORK 

• Your menstrual cycle is under the control of an array of hormones produced in various parts
of the body: 

• Gonadotrophin-releasing hormone (produced in the hypothalamus, which is in the brain) 

• Follicle stimulating hormone (produced in the pituitary gland, which is also in the brain) 

• Luteinising hormone (produced in the pituitary gland) 

• Estrogen (produced in the ovaries)

• Progesterone (also produced in the ovaries) 

MENSTRUAL CYCLE

The whole process starts in the brain.

The hypothalamus produces gonadotrophin-releasing
hormone (GnRh), which travels to the pituitary
gland and signals it to release follicle-stimulating
hormone (FSH).
FSH is carried round the body in the bloodstream and
stimulates the ovaries to start ripening eggs.
Between 15 and 20 egg-containing sacs, called follicles,
then start to mature in the ovaries.
One follicle (or very occasionally, two or more) grows
faster than all the others. 

FSH also stimulates the ovaries to produce estrogen.

This encourages the eggs to mature and starts to
thicken the lining of the uterus so that it's ready to
support a pregnancy, should fertilization occur. 
MENSTRUAL CYCLE

 Ovulation: the egg is released 

 As estrogen levels rise, levels of FSH fall temporarily

and then rise again, accompanied by a huge surge
of luteinizing hormone (LH) from the pituitary gland.
It is this hormone that triggers ovulation, the moment
that the most mature egg bursts out of its sac and away
from the ovary. The egg is immediately caught up by
the ends of the fallopian tube. 

Normally your cervix (the neck of your uterus)

produces a thick, opaque mucus that sperm can't
penetrate. Just before ovulation, though, estrogen
changes the mucus so that it becomes thin, clear and
stretchy(Spinnbarkheit). This allows the sperm to swim
through the cervix into the uterus and up to the fallopian
tubes where fertilization may take place. 
MENSTRUAL CYCLE

• After ovulation 

• In the ovary, the now empty follicle collapses and

becomes a corpus luteum. This small yellow mass of
cells starts to produce the hormone progesterone.

• Progesterone changes the mucus in the cervix so that,

once again, it becomes impenetrable to sperm. It also
acts on the lining of the uterus, which becomes thick and
spongy as a result of an increased blood supply, ready to
receive a fertilized egg.

• As levels of progesterone rise, your breasts may feel

stretched and tingly. The pituitary gland stops producing
FSH so that no more eggs mature in your ovaries. 
MENSTRUAL CYCLE

• If fertilization occurs... 

• If the egg is fertilized in the fallopian tube, it

will continue to travel to the uterus, where it
beds down in the lining. At this implantation
stage the fertilized egg is made up of about
150 cells. The journey from ovary to uterus
takes about five days. Your progesterone
levels will stay high and you may start to feel
the early signs of pregnancy. 
MENSTRUAL CYCLE

• If fertilization doesn't occur ... 

• If the egg isn't fertilized or doesn't

successfully implant, it starts to disintegrate
and the corpus luteum shrinks. Your estrogen
and progesterone levels drop and the lining of
your uterus starts to produce prostaglandins.

• These chemicals cause changes in the blood

supply to your uterus, breaking up the lining,
and stimulating the uterus to contract.

• Your period starts and the lining of your

uterus is shed along with the unfertilized egg,
and your menstrual cycle starts again
 TEACHING ABOUT MENSTRUAL
HEALTH
AREA OF CONCERN TEACHING POINTS
* Exercise  Continue for general well-being.Sustained excessive exercise can
cause amenorrhea.

* Sexual Relations
 Not contraindicated.Heightened or decreased orgasm is noticed.
Orgasm may increase menstrual flow.Conception is improbable but
* Activities of Daily life not impossible.

• Pain Relief
* Rest  Nothing is contraindicated.

* Nutrition  Ibuprofen is recommended.

 Helpful if dysmenorrhea occurs at night

 Iron Supplement.
 Calendar Method

JULY

SUN MON TUE WED THU FRI SAT

1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30
 Cervical Mucus
Method

JULY

SUN MON TUE WED THU FRI SAT

1 2 3 4
5 6 7 8 9 10 11
12 13 14 15 16 17 18
19 20 21 22 23 24 25
26 27 28 29 30
SEXUAL FUNCTIONS

ERECTION:

 the enlargement and stiffening of the penis as a

consequence of filling with blood (a spinal reflex)
 can double in length and become firm in a
matter of 10-15 seconds
 bladder closes off during arousal
SEXUAL FUNCTIONS

EJACULATION:

 expulsion of semen from tip of penis

 a spinal reflex triggered when sexual stimulation
reaches the threshold
 often, but not always, occurs together with
orgasm (subjective sensations)
 occurs in two stages
SEXUAL FUNCTIONS

STAGE 1 ~ EMISSION:

 involves contractions of the

prostate gland, seminal vesicles &
vas deferens
 forces seminal fluid into a small
tube called the urethral bulb which
closes at both ends, trapping the
fluid
SEXUAL FUNCTIONS

STAGE 2 ~ EXPULSION:

 propulsion of seminal fluid through the urethra

and out of the urethral opening at the tip of the
penis
 the muscles at the base of the penis contract
rhythmically, expelling semen
 usually accompanied by orgasm
SEXUAL FUNCTIONS

RETROGRADE EJACULATION:

 ejaculate empties into the bladder rather than

being expelled
 result is a dry orgasm
 usually harmless as the semen is later expelled
during urination but may have an underlying
health risk cause
SEXUAL RESPONSE

APHRODISIAC:

 a substance that arouses or increases

one’s capacity for sexual pleasure
 no foods have been shown to be sexually
stimulating
 Spanish Fly is a toxic irritant
 basic fuel of desire = testosterone
SEXUAL RESPONSE

PHEROMONES:

 chemical substances secreted externally

which are odorless
 detected through a “sixth sense” triggering
sexual behavior in many organisms
 contained in vaginal secretions & urine
SEXUAL RESPONSE

ORGASM:

 the climax of sexual excitement

 similar physiological response to sexual
stimulation for men and women
 described by Kaplan as a three-stage model of
sexual response
KAPLAN’S MODEL

STAGE 1 ~ DESIRE:

 the drive & interest level for sexual activity

which arises in the brain
 testosterone is the key hormone for desire
level in both men & women
 strengthened by fantasy & stimulation
KAPLAN’S MODEL

STAGE 2 ~ EXCITEMENT:

 increased muscle tension, heart rate & blood

pressure
 women – engorged clitoris, labia & vagina,
vaginal lubrication
 men – penile erection, enlargement & elevation of
testes, Cowper’s secretion
KAPLAN’S MODEL

STAGE 3 ~ ORGASM:

 involuntary muscle spasms throughout body,

mostly in vagina & penis
 blood pressure, heart rate & respiration peak
 slightly longer duration for females
 MASTURBATION

 sexual self-stimulation either manual or

with the aid of an artificial device such as a
vibrator
 physically & psychologically harmless
 negative attitudes may be associated
 reasons: relieve sexual tension, for
physical pleasure, to relax, partner
unavailable, to get to sleep…
 LOVE
LOVE
&
& ATTRACTION
ATTRACTION
ATTRACTION
minimal standards for attractiveness?
beauty in the “eye of the beholder”?
do men prefer big breasts?
opposites attract?
should I “put on a happy face”?
what do you look for “long-term”?
the “matching hypothesis”
 ATTRACTION

MINIMAL STANDARDS FOR

ATTRACTIVENESS

o sensitivity, warmth and intelligence ARE NOT more important to us

o research shows that attractiveness is the key factor when choosing a
partner
 ATTRACTION
“EYE OF THE BEHOLDER”

o broad agreement among cultures that we all want physically attractive

partners
o many men prefer women to be less slender than many women think
o many men prefer a bust size smaller than what women think
 ATTRACTION

DO OPPOSITES ATTRACT?

o we are drawn to those with similar attitudes, background & tastes

o match made in the neighborhood, not in heaven
o women place more value on similar attitude, men on physical
attraction
 ATTRACTION

COME ON, SMILE 

o a smile DOES make you more attractive

o both genders rated a smiling photo more attractive than a non-smiling
pose
o more true for photos of women than photos of men
 ATTRACTION

LONG-TERM RELATIONSHIPS

o physical attraction was rated lower for men & women when discussing long-
term relationship appeal
o warmth, honesty, sensitivity & faithfulness ranked higher
o single most important quality - HONESTY
 ATTRACTION

MATCHING HYPOTHESIS

o who is “right” for you?

o people tend to develop romantic relationships with people who are similar to
themselves
o motive for seeking matches seems to be fear of rejection by more appealing
people
ATTRACTION TEMPLATE
WHAT SOCIETY SAYS

NICE IF

SHOULD

MUST
 LOVE
STYLES OF LOVE
♥ romantic love
♥ game-playing love
♥ friendship
♥ logical love
♥ possessive / excited love
♥ selfless love
 LOVE

ROMANTIC LOVE:

♥ lust
♥ similar to our concept of passion
♥ “my lover fits my ideal”
♥ “my lover & I were attracted to one another immediately”
 LOVE

GAME-PLAYING LOVE:

♥ the chase is most important

♥ “I get over affairs pretty easily”
♥ “I keep my lover up in the air about my commitment”
 LOVE

FRIENDSHIP:

♥ respect, intimacy
♥ loving attachment with nonsexual affection
♥ “the best love grows out of an enduring friendship”
 LOVE

LOGICAL LOVE:

♥ practical
♥ “I consider my lover’s potential in life before committing myself”
♥ “I consider whether my lover will be a good parent”
 LOVE

POSSESSIVE / EXCITED LOVE:

♥ passion
♥ “I get so excited about my love that I cannot sleep”
♥ “when my lover ignores me I get sick all over”
 LOVE

SELFLESS LOVE:

♥ similar to generosity & charity

♥ “I would do anything I can to help my lover”
♥ “my lover’s needs & wishes are more important than my own”
♥ unhealthy if only one partner
TRIANGULAR
THEORY OF
LOVE
THREE COMPONENTS OF LOVE
INTIMACY:
♥ the experience of warmth toward another person
that arises from feelings of closeness, bondedness
& connectedness to the other

PASSION:
♥ an intense romantic or sexual desire for another
person, which is accompanied by physical arousal

COMMITMENT / DECISION:
♥ a component of love that involves both short and
long-term issues
 NT
ME

IN
TI
IT

M
M

AC
M

(CONSUMMATE)
CO

Y
PASSION
 NON LOVE

♥ all three components of love are absent

♥ Most of our personal relationships are of this type
♥ Casual acquaintances that do not involve any elements of love
 LIKING=
INTIMACY ONLY

♥ A loving experience with another person or friendship in which

intimacy is present but passion & commitment are not
 INFATUATION= PASSION
ONLY

♥ Passionate, obsessive “love at first sight” without intimacy or

commitment
 EMPTY LOVE=
COMMITMENT ONLY

♥ Decision to love each other without intimacy or passion

♥ Includes stagnant relationships that no longer involve emotional
intimacy or physical attraction
 ROMANTIC LOVE=
INTIMACY & PASSION

♥ Lovers physically & emotionally attracted to each other but

without commitment
♥ Includes a summer romance
 COMPANIONATE LOVE=
INTIMACY & COMMITMENT

♥ Long-term committed friendship such as a marriage in which the

passion has faded
 FATUOUS LOVE=
PASSION & COMMITMENT

♥ Commitment based on passion but without the time for intimacy

to develop
♥ Includes a “whirlwind courtship”
 CONSUMMATE LOVE

♥ The full or complete measure of love

♥ Involving the combination of passion, intimacy & commitment /
decision
♥ Many of us strive to achieve this love
♥ Maintaining this love is even more difficult than achieving it
 INTIMACY
INTIMACY
RELATIONSHIPS
RELATIONSHIPS
&
& COMMUNICATION
COMMUNICATION
 A COUPLE’S
JOURNEY
♥♥♥♥♥♥♥♥♥♥♥♥♥
HOW A
RELATIONSHIP
DEVELOPS
 ♫ THE ROAD IS
LONG…♪
FIVE STAGES
♥ ROMANCE
♥ POWER STRUGGLE
♥ STABILITY
♥ COMMITMENT
♥ CO-CREATION
 COUPLE’S JOURNEY

ROMANCE

♥ we sense our possibilities & create a shared vision

 COUPLE’S JOURNEY

POWER STRUGGLE

♥ we learn to recognize and validate differing needs and

perceptions
♥ we learn to say who we are & what we want
♥ should be symmetrical, parallel, complimentary
 COUPLE’S JOURNEY

STABILITY

♥ learn to take responsibility & expand our senses of identity through dialogue
with each other
♥ our differences are OK
♥ we each have our strengths
 COUPLE’S JOURNEY

COMMITMENT

♥ experience ourselves as interdependent ~ “we”

♥ learn to live with impossibility & unsolvable problems
 MYTHS OF LONG-TERM
RELATIONSHIPS
♥ Relationships will make you feel complete
♥ Your partner should change for you if s/he really loves you
♥ If you truly love each other, romance should continue
♥ Your partner should understand you
♥ Any differences should always be settled
♥ In a good relationship, you have identical dreams & goals
♥ A relationship must be stable in order to be healthy
♥ The more open you are with your partner, the more satisfying the
relationship will be
♥ If you are not fulfilled, your relationship must be at fault
♥ Sexual disinterest is inevitable in a long-term relationship
HOW MARRIED PEOPLE MET
THEIR PARTNER Mutual Friends
(MICHAEL ET AL., 1994)

5 Self Intro ductions

13
35
Family Members
15

Co -w o rkers,
32 Classmates o r
Neighbo rs
O ther
  JEALOUSY 

♥ “the green-ey’d monster” – Shakespeare

♥ evidence of jealousy in all cultures
♥ can impair a relationship by producing feelings of mistrust or possessiveness
♥ fear of losing the loved one, anger
♥ may lead to depression, spousal abuse, suicide or even murder
♥ in mild forms, can reveal how much you care
  JEALOUSY 

♥ may derive from low self-esteem

♥ these people are often overly dependent on their partner
♥ fear that they will not find another partner
♥ for women, feelings of inadequacy lead to feelings of jealousy
♥ for men, jealousy leads to inadequacy
♥ can lead to perceiving anyone as a rival
  JEALOUSY 

♥ unfortunately, many lovers play games

♥ they let their partner know they are attracted to other people
♥ they flirt openly with others
♥ they may make up stories to get more attention from their partner, to inflict
pain, or to take revenge
 LONELINESS

♥ many people experience loneliness, sometimes even in a relationship

♥ loneliness can cause depression, anxiety & withdrawal from social
activities
♥ lonely people tend to have several of the following characteristics:
 LONELY PEOPLE

♥ lack of social skills

♥ lack of interest in other people
♥ lack of empathy
♥ fear of rejection
♥ failure to disclose personal information to potential friends
♥ cynical about human nature
♥ demanding too much too soon
♥ general pessimism
 REDUCE LONELINESS

CHALLENGE FEELINGS OF
PESSIMISM

♥ adopt the attitude that things happen for you when you make them
happen
♥ make a plan for your future & start with small steps, one day at a time
♥ remind yourself of all the things you can be grateful for in your life
 REDUCE LONELINESS

CHALLENGE YOUR CYNICISM

ABOUT HUMAN NATURE

♥ yes, lots of people are selfish & not worth knowing

♥ but, if you assume all people are like that you are doomed to loneliness
♥ find people who have the qualities that you value ~ they are out there!
 REDUCE LONELINESS

FAILURE OF RELATIONSHIPS IS
NO REASON FOR GIVING UP

♥ yes, a break-up can be awful & social rejection can be painful

♥ face it, we are not going to appeal to everyone & must learn to live with rejection
♥ keep looking for those people that have qualities which you value
 REDUCE LONELINESS

IMPROVE YOUR
DATE-SEEKING SKILLS

♥ sit with people in the cafeteria instead of by yourself in a corner

♥ SMILE  and say “hi” to people that interest you
♥ practice opening lines in front of a mirror
 REDUCE LONELINESS

MAKE SOCIAL CONTACTS

♥ join committees
♥ attend recreational activities
♥ go to church
♥ join social action groups such as community betterment or environmental
♥ help out at your local animal shelter
♥ go to drop-in centres
 REDUCE LONELINESS

BECOME A GOOD LISTENER

♥ ask people how they’re doing

♥ ask for their opinion about events & activities
♥ actually listen to what they say before you plan your response
♥ tolerate different opinions – no two people will have identical perspectives
 REDUCE LONELINESS

REMEMBER THAT YOU

ARE WORTHY OF FRIENDS

♥ yup, warts & all, you can be a good friend

♥ none of us is perfect (or even close to it)
♥ we are all unique & you may connect with more people than you imagine
♥ give people a chance!
 INTIMACY

♥ involves feelings of emotional closeness & connectedness with another

person
♥ desire to share each other’s innermost thoughts & feelings
♥ mutual trust, caring & acceptance
♥ does not have to be sexual (ex. friends, family that you are very close to)
 INTIMACY

REQUIRES:

♥ knowing & liking yourself

♥ trusting & caring
♥ being honest
♥ making a commitment
♥ maintaining individuality
♥ communicating
 INTIMACY

KNOWING & LIKING YOURSELF:

♥ coming to know & value yourself is important to build intimacy with

others
♥ know your innermost needs & feelings
♥ develop the security to share those feelings
 INTIMACY

TRUSTING & CARING:

♥ with trust comes feelings of security to disclose information & feelings

♥ trust builds gradually as partners learn whether or not it is safe to share
♥ caring is an emotional bond
♥ involves meeting each other’s needs
 INTIMACY

BEING HONEST:

♥ involves sharing freely & openly

♥ does not mean partners must tell each other everything, but there is a
healthy balance of revealing information
♥ total honesty can be devastating to a relationship, especially when it
comes to past relationships or criticism
 INTIMACY

MAKING A COMMITMENT:

♥ requires commitment to maintain the relationship through good times &

bad
♥ does not mean that the relationship must be lifelong
♥ the couple commits to work together to overcome problems instead of
running at the first sign of trouble
 INTIMACY

MAINTAINING INDIVIDUALITY:

♥ when the I becomes we

♥ neither partner should take on the personality of the other person
♥ each partner should maintain their interests, goals, needs, likes & dislikes
 INTIMACY

COMMUNICATING:

♥ good communication means sending & receiving messages with your

partner
♥ requires good listening & clear speaking
♥ is not always verbal
 COMMUNICATION

PROBLEMS:

♥ speaker may use words differently than the listener, leading to

misunderstanding
♥ speaker’s words may not match his or her tone of voice, facial expression, or
body gestures
♥ speaker may not be able to put into words what he or she truly means or feels
 COMMUNICATION

NONVERBAL:

♥ feelings are also expressed through tone of voice, gestures, body posture
& facial expressions
♥ touching the arm, gazing into the eyes, hugging, holding, speaking softly
or speaking forcefully
 COMMUNICATION

ACTIVE LISTENING:

♥ first, adopt the attitude that you might actually learn something!
♥ when the other person is speaking, show that you understand their ideas &
feelings ask questions to help clarify
♥ try to grasp the meaning the speaker’s words instead of planning your
next line
 COMMUNICATION

PROVIDING INFORMATION:

♥ your partner cannot read your mind!

♥ take the opportunity to tell your partner that s/he has done something right
♥ when giving criticism, focus on the problem without causing guilt or fear
♥ do not give ultimatums unless you’ll follow through with it
 SEXUAL
SEXUAL
ASSAULT
ASSAULT &
&
COERCION
COERCION
 WHAT IS SEXUAL ASSAULT?

• Any form of sexual contact without voluntary consent

• Can range from unwanted sexual touching to sexual violence resulting in serious
physical injury
• Often referred to as rape
• Are assigned levels depending on the seriousness of the assault
 LEVELS OF SEXUAL
ASSAULT
• Level 1 Sexual Assault
• Involves no physical injury or minor physical injury
• Maximum sentence of 10 years
• Level 2 Sexual Assault with a weapon, threats to a third party or causing bodily
harm.
• Maximum sentence of 14 years
• Level 3 Aggravated sexual assault
• Involves wounding, maiming, disfigurement, or endangering the victim’s life
• Maximum sentence of life
 INCIDENCE RATES

• 25 493 sexual assaults reported to the police (1998)

• About 1 every 15 minutes
• 97% of the reported cases were level 1
• A national random telephone sample reported twice as many sexual assaults, many
are simply unreported
 STATISTICS CANADA 1998

• 85% of the victims of sexual assault were female

• 60% of the victims were under the age of 18
• Male victims were even younger, averaging age 11.
 TYPES OF SEXUAL
ASSAULT

• Stranger sexual assault

• Acquaintance sexual assault
• Multiple perpetrators (gang rapes)
• Sexual assault of men
• Spousal sexual assault
• Sexual assault by women
 STRANGER SEXUAL ASSAULT

• Committed by someone previously unknown

• Often select victims who are vulnerable
• Live alone, older or retarded, walking down deserted streets, asleep
or intoxicated.
• Often try to find a safe place and time to commit the assault
• 3% of women over the age of 18 have been assaulted by a
stranger
• Women between the ages of 18 – 44 years were the most
likely to be attacked
• Most assaults took place in public places
• Street, bars or clubs, or in public buildings
ACQUAINTANCE SEXUAL
ASSAULT
• Victims are more likely to be assaulted by someone they know
• Classmates, co-workers, family friends, etc.

• Often do not perceive what happened as sexual assault

• Can happen in a dating situation
• This most often involves intercourse

• More likely to occur when the couple have had too much to drink
 MULTIPLE PERPETRATORS

• Men who participate in group sexual assaults are trying to conform to the stereotype
of the tough, competent, “masculine” he-man
• Exercise of power is a major motive although some may also be expressing anger
against women
• Often each gang member may become more aggressive as he takes his turn.
 SEXUAL ASSAULT OF MEN

• Prevalence is unknown
• Estimates of 1 in 10 victims
• More likely to be committed by strangers, usually heterosexual men
• Motives include domination and control, revenge and retaliation, and gang status
and affiliation
 SPOUSAL SEXUAL ASSAULT

• 8% of women reported being sexually assaulted by their partner

• Most often goes unreported
• Motives vary, but include sex to dominate their partner, degrade their partner, within
the context of marital violence, or the solution to all marital disputes
• Survivors are often fearful of serious injury or death.
 SEXUAL ASSAULT BY
WOMEN
• Rare
• Often involves aiding or abetting men who are attacking another woman
• May occur in gang attacks
• Often aid in luring a woman into a safe place for sexual assault or may hold the
woman down while the assault occurs
• Women can also sexually assault men
• May help in the sexual assault of men as well
 SOCIAL ATTITUDES AND
MYTHS

• “women say no when they mean yes”

• “all women like a man who is pushy and forceful”
• “the way women dress, they are just asking to be raped”
• “rapists are crazed by sexual desire”
• “women want to be forced to have sex”
 SOCIAL ATTITUDES AND
MYTHS
• Create a social climate that legitimizes sexual assault
• Both men and women are suseptible
• Are related to other social attitudes
• gender-role stereotyping,
• the perception of sex as adversarial
• the acceptance of violence in interpersonal relationships
 PSYCHOLOGICAL
CHARACTERISTICS OF
SEX OFFENDERS

• No single type of sex offender

• Majority of sex offenders are in control of their behaviour, and know that it is illegal.
• Median age of sex offenders was 32 (1999)
• Generally have less than a grade 12 education
• Often report feeling socially inadequate
 SEX OFFENDERS

• Are more likely than other men to:

• Condone sexual assault and violence against women
• Hold traditional gender-role attitudes
• Be sexually experienced
• Be hostile toward women
• Engage in sexual activity in order to express social dominance
• Be sexually aroused by depictions of sexual assault
• Be irresponsible and lack a social conscience
• Have peer groups, such as fraternities, that pressure them into
sexual activity
 MOTIVES FOR SEXUAL
ASSAULT

• Three Basic Motives:

1. Anger
2. Power
3. Sadistic
 ANGER MOTIVE

Vicious, unplanned attack

Triggered by anger and resentment toward women
Usually employ more force than is needed to obtain
compliance
Victim is often forced into performing degrading and
humiliating acts
Fellatio or anal intercourse
Perpetrator reports suffering humiliations at the hands of
women and used assault as revenge.
 POWER MOTIVE

• Desire to control and dominate women is primary motive

• Sexual gratification is secondary motive
• Is an attempt to “resolve disturbing doubts about his masculine identity and worth, or
to combat deep-seated feelings of insecurity and vulnerability”
• Only enough force to subdue the woman is used
 SADISTIC MOTIVE

• Ritualized and savage attack

• Carefully plan their assaults and use a pretext to approach their targets, such as
asking directions or offering/requesting assistance
• Some bind, torture, or murder their victims.
• Mutilation of victims is common.
• Often preoccupied with violent pornography
• Motivated by anger, power, or sadistic urges.
 IF YOU ARE SEXUALLY
ASSAULTED…
Don’t change anything about your body
Don’t wash or even comb your hair
Strongly consider reporting the incident to police
You may prevent another woman from being assaulted
Ask a relative or friend to take you to a hospital if you can’t get an
ambulance or police car
Seek help in an assertive way
Injuries you are unaware of my be detected. Insist on a written or photographic
record be made documenting the condition
Question health professionals
Ask about your biological risks
Ask what treatments are available
Ask for whatever help will make you comfortable
 REDUCING THE RISK OF
SEXUAL ASSAULT

• Establish a set of signals with other women in the building or

neighbourhood
• List yourself in the phone directory and mailbox by first
initials only
• Use dead-bolt locks
• Lock windows and install iron grids on first-floor windows
• Keep doorways and entries well lit
• Keep your keys handy when approaching the car or the front
door
 REDUCING THE RISK OF
SEXUAL ASSAULT
Do not walk by yourself after dark
Avoid deserted areas
Do not allow strange men into your house or apartment
without first checking their credentials
Keep your car doors locked and windows up
Check out the back seat of your car before entering
Don’t live in a risky building
Don’t give rides to hitchhikers
Don’t converse with strange men on the street
Shout “FIRE!” not “RAPE!”
 ADJUSTMENT FOR
SURVIVORS OF SEXUAL
ASSAULT
• Many survivors are extremely distraught for days
• Often report eating disorders, headaches, irritability, mood changes, anxiety,
depression, menstrual irregularity.
• May become withdrawn, sullen, and mistrustful
• Some may experience guilt or shame if they feel partially to blame for the assault.
 POSTTRAUMATIC
STRESS DISORDER

• An anxiety disorder brought on by exposure to a traumatic event

• Often includes flashbacks, disturbing dreams, emotional numbing, nervousness
• May persist for years
 RAPE TRAUMA SYNDROME

• For several weeks after the attack, people behave in a disorganized manner
• May cry uncontrollably, experience feelings of anger, shame, fear, and nervousness
• Most people benefit from counseling
• Long-term adjustment involves coming to terms with feelings and being able to
remember the event without re-experiencing it.
 SEXUAL ABUSE OF
CHILDREN

• May range from exhibitionism, kissing, fondling, sexual touching, oral sex and anal
or vaginal intercourse
• Any sexual contact between an adult and child is considered abusive because the
child is below age of consent
• Voluntary sexual activity between children of similar ages is not sexual abuse
 PATTERNS OF ABUSE

• 4 out of 5 children are abuse by relatives or family friends or acquaintances

• Average age of abuse is between 6-12 years old for girls, 7-10 years old for boys
• Genital fondling is the most common type of abuse
• Abused children rarely report the abuse
• Estimated that 90% of cases are not reported.
 EFFECTS OF CHILD
SEXUAL ABUSE

• Short and long-term effects include anger, depression, anxiety, eating disorders,
inappropriate sexual behaviour, self-destructive behaviour, sexual promiscuity, drug
abuse, suicide attempts, PTSD, low self-esteem, sexual dysfunction, mistrust of
others, feelings of detachment
 EFFECTS OF CHILD
SEXUAL ABUSE

• Abused children commonly act out

• Late adolescence and early adulthood seem to pose especially difficult periods
for survivors
• Effects are often long-lasting
 PREVENTING CHILD
SEXUAL ABUSE
• Prevention programs
• Teach children to understand what sexual abuse is and how
they can avoid it
• Teach children to recognize “good” and “bad” touching
• Encourage the child to talk about it
• Teach children messages like “It’s not your fault”, etc.
• Remind the child they and their families will be safe
• Threats are often used to get the child not to tell anyone about the
abuse.
• ADULTS ARE LEGALLY OBLIGATED TO REPORT
SUSPECTED ABUSE TO AUTHORITIES
 SEXUAL HARASSMENT

• Any sexually oriented conduct – physical, verbal, or by innuendo – that is a

condition of employment, interferes with job performance, or creates a hostile or
offensive work environment.
• Can be committed by men or women
 SEXUAL HARASSMENT

• May have more to do with the abuse of power than with sexual desire
• The harasser is often in a dominant position and abuses that position by exploiting
the victim’s vulnerability.
 RESISTING SEXUAL
HARASSMENT

1. Familiarize yourself with your employer’s policy on sexual

harassment
2. Convey a professional attitude
3. Discourage harassing behaviour, and encourage appropriate
behaviour
4. Avoid being alone with the harasser
5. Maintain a record
6. Talk with the harasser
7. Write a letter to the harasser
8. Seek support
9. File a complaint
10. Seek legal remedies
 WHERE CAN YOU GET
HELP?
Planned Parenthood Edmonton
#50 9912-106 St …………..(780) 423-3737
• Pregnancy tests and pregnancy options (pro-choice)
• Referrals to health care services
• Doctors, counseling, contraception, fertility, parenting programs, pregnancy resources for men
and women
• Phone line to answer any questions about sex you have!
 WHERE CAN YOU GET
HELP?
Sexual Assault Centre of Edmonton
#205 14964-121A Ave
24 hour crisis line: (780) 423-4121
Business line: (780) 423-4102
• Free public education
• 24 hour crisis line
• Crisis intervention
• Short-term counseling
• Numerous support groups for adults, youth, and children
 WHERE CAN YOU GET
HELP?

Child Abuse Hot Line ……1-800-387-5437

• To report suspected cases of child abuse

Can also call the police or child welfare to report suspected cases of child abuse (physical, emotional or
sexual)
 WHERE CAN YOU GET
HELP?

If you don’t know or can’t remember where to go…

• Call Capital Health Link (780) 408-LINK(5465)

• For sexual assaults or suspected child abuse call the police: (780) 423-2567

• In here? Talk to your caseworker, psychology, or a guard. Information is always

available, just ask!
THE