REPRODUCTIVE HEALTH

The term reproductive health refers to healthy reproductive organs with normal functions. According to WHO reproductive health means a total well being in all aspects of reproduction, i.e., physical, emotional, behavioral and social.

Strategies for reproductive health

By using the following ways, we can make awareness about the reproductive health related aspects. Introduction of sex education in schools to provide right information to children. Discourage the children from believing myths and having misconception about sex related aspects. Provide proper information about reproductive organs, adolescence and related changes. Provide proper advice about the importance of safe and hygienic sexual practices. Provide the consequences about the sex related diseases such as STD, AIDS etc.

Educate the marriageable age group about the birth control measures, care of pregnant mothers, prenatal and post natal caring, significance of breast feeding, equal opportunities for the male and female child, etc. Awareness about the uncontrolled population growth, sex abuse, and sex related crimes, etc. Provide medical assistance about the various problems such as abortion, contraception, menstrual problems, infertility, etc. Provide information about the misuse of amniocentesis, consequences of female foeticides etc.

Population explosion

Population explosion
Better living condition and increased health facilities leads to the considerable increase in population. In 1990, world population was 2 billion (200crores) and in 2000 it was 6 billion In India , at the time of independence, population was 350 millions and at 2000 it reached 100 crores (1 billion). This shows that every sixth person in the world is an Indian.

Reasons for population explosion

Decrease in death rate, Maternal mortality rate (MMR), Infant mortality rate (IMR), Better living condition , increased health facilities , Increase in the number of people in reproducible age etc.

Major impacts of population explosion

Some of the major impacts of population explosion are the following: Shortage of food, land, cloth Unemployment Environmental pollution Disease due to poverty and malnutrition Lack of educational facilities etc.

Measures to control population explosion

The government has taken serious measures to control population explosion. Some of them are the following: Motivate small families using various contraceptive methods. Show advertisements such as happy couple with two children with a slogan we two ours two. Statutory rise of marriageable age of the females to 18 years and males to 21 years. Incentives given to couples with small family.

Is sex education necessary in schools? Why?

Sex education is necessary in schools, because, It will help the students to understand the problems such as uncontrolled population growth, social evils such like sex abuse and sex related crimes. This will enable the students to think and take up necessary steps to prevent them and thereby build up a socially responsible and healthy society.

CONTACEPTIVES
Contraceptives are devices used to prevent unwanted pregnancies. Characteristics of contraceptives They should be user friendly, easily available, effective and with no or least side effects. It does not interfere with the sexual drive , desire and sexual act of the user .

Contraceptives can be classified into the following groups

Natural /traditional methods Barrier methods IUDs(Intra Uterine Devices) Oral Contraceptives Injectables Implants Surgical Methods

NATURAL METHODS

These methods prevent the chances of ovum and sperm meeting. This include:1. Periodic abstinence It is a method in which the couples abstain or avoid from coitus from day 10 to 17 of the menstrual cycle. This period is called the fertile period . 2. Withdrawal or Coitus Interruptus In this method, the male partner withdraws his penis just before ejaculation. 3. Lactational amenorrhea It is also called absence of menstruation. Menstrual cycle does not occur during intense lactation following delivery. Therefore as long as the mother breast feed the child fully, the chances of conception are almost nil .however this method is effective only up to six months following delivery.

BARRIER METHODS
Following are the barrier methods for the men and woman to block the meeting of sperm and ovum 1. Condoms These are made of thin rubber or latex. They are used to cover the penis in male or vagina and cervix in the female just before coitus to prevent the entry of semen into the female genital tract. 2. Diaphragms, cervical caps and vaults These are made of rubber that is inserted into the female reproductive tract to cover the cervix during coitus. They block the entry of sperms into the genital tract through the cervix.

Male Condoms

Female Condom

Diaphragms

cervical caps

3. Intra Uterine Devices (IUDs)

These devices are inserted in the uterus through vagina with the help of doctors or expert nurses. Eg:- Copper releasing IUDs (CuT,Cu7,Multiload 375) , hormone releasing IUDs(Progestasert,LNG-20)etc. The copper ions released by the IUDs suppress the sperm motility and the fertilizing capacity of sperms. The hormone releasing IUDs make the uterus unsuitable for implantation.

Copper T

 i-pill emergency contraceptive pill. Just one pill within 72 hours of unprotected sex is all it takes to prevent a possible pregnancy and a traumatic abortion. Because prevention is better than abortion. Isnt it?

4. Pills
These are available in the form of tablets containing either progestogens or progesterone estrogen combinations. These are taken daily for a period of 21 days starting within the first five days of menstrual cycle .after a gap of 7 days repeat the same pattern till the female desires to prevent pregnancy . Eg; Saheli is a non-steroidal once a week pill for the female .It will inhibit ovulation and implantation .It has high contraceptive value with very few side effects.

i-pill emergency contraceptive pill

. Just one pill within 72 hours of unprotected sex is all it takes to prevent a possible pregnancy and a traumatic abortion. Because prevention is better than abortion. Isnt it?

5. Surgical methods
This include, (a) Vasectomy It is a sterilization procedure in the males. In this, a small part of the vas deferens is removed or tied up through a small incision on the scrotum.

(b) Tubectomy
It is a sterilization procedure in the females .In this ,a small part of the fallopian tube is removed or tied up through a small incision in the abdomen or through vagina .

MEDICAL TERMINATION OF PREGNANCY

Voluntary or intentional termination of pregnancy before full term is called MTP or induced abortion. India legalized MTP in 1971 with some strict conditions to avoid its misuse like the indiscriminate and illegal female foeticides. MTPs are relatively safe only in the first trimester of pregnancy.

Amniocentesis
(Amniocentesis is banned in our country. Is this ban necessary? Comment.) It is a prenatal diagnostic used to determine the chromosomal abnormalities of the unborn child. This technique may be misused for sex determination and the MTP of the female child. So statutory ban on amniocentesis is necessary.

SEXUALLY TRANSMITTED DISEASES (STDS)

Diseases or infections which are transmitted through sexual intercourse are collectively called STDs or Venereal Diseases (VD) or Reproductive Tract Infections (RTI). AIDS , Gonorrhoea ,Syphilis, Genital herps ,Chlamydiasis ,Genital warts Trichomoniasis ,hepatitis .B are some common STDs. AIDs and hepatitis .B are also transmitted by sharing the needles , transfusion of blood , surgical instruments etc. Except ,AIDS , hepatitis and genital herpes , all other diseases are curable if detected early and treated properly .

Preventive measures to avoid STDs

Avoid unknown sexual partners. Stick on to only one sexual partner. Use condoms during coitus In case of doubt, consult a qualified doctor for detection and get proper treatment if diagnosed with disease.

INFERTILITY
Inability to conceive or produce children even after 2 years of sexual co-habitation is called infertility . A large number of infertility clinics are available now a days to help such couples by providing special techniques commonly known as Assisted Reproductive Technologies (ART) The ART includes the following 1.In vitro fertilization
It is popularly known as test tube baby programme . In vitro fertilization means fertilization outside the body . In this method , ova from the wife or donor and sperm from the husband or donor male are collected and are induced to form zygote in the laboratory. The zygote thus formed is allowed to develop in vitro until it reaches 8 celled stage. Then it is transferred into the fallopian (ZIFT-zygote intra fallopian transfer). In the 32 celled condition it is transferred into the uterus (IUTintra uterine transfer) for complete development.

 2.Gamete Intra Fallopian Transfer (GIFT) It is the transfer of ovum taken from a donor into the fallopian tube of another female who is unable to produce it, but can give suitable environment for fertilization and further development . 3.Intracytoplasmic Sperm Injection (ICSI) It is a method in which the sperm is directly injected into the ovum to form the zygote in the laboratory. 4.Artificial Insemination (AI) In this method , the semen is collected either from the husband or from the donor and introduced into the vagina or into the uterus

Professor Robert Edwards- Father of invitro fertilization

Nobel Prize winner - 2010

Louise Brown, the world's first "test tube baby" with her mother Lesley. Photo taken 9 October, 1978.

Professor Robert Edwards-1989

Professor Robert Edwards,lessley Brown, Louise Brown & her son

Human embryo developing invitro

Intracytoplasmic Sperm Injection (ICSI)