HLTH471 exam 1

Healthy People initiative

- added to the NIH to help people live longer - They have researchers who aim to find conditions that affect women the most as to have better knowledge and set goals on how to direct them to live a healthier life - Healthy People 2020 has 600 public health objectives specifically for women

Office of Research on Women's Health

- in the NIH is considered the focal point for women's health in federal agencies - They advise the NIH director and staff on women's health - Focal support system and advocate for research that specifically assess the risk women face from disease and conditions; and ensure that the NIH includes biomedical and behavioral research on women's health issues - They develop opportunities and push for the advancement of women who want to pursue a career in biomedical research - They also heavily support gender-based biology to understand the differences in the anatomy and physiology of women compared to other sexes

- On the battlefield

- over 350,000 women went to war acting as nurses, truck drivers, airplane mechanics, some fought and were taken as POWs - War nursing model was created during the civil war where Clara Barton and Dorothea Dix lead a national effort to organize a nursing corp to help those wounded on the battlefield

Four primary mechanisms for achieving birth contraception

1. Sperm is blocked from entering Reproductive Tract 2. Sperm in reproductive tract are prevented from Fertilizing the Ovum 3. The method Prevents Ovulation 4. The Fertilized Egg is prevented from Implanting in the Uterus

Helen O'Connell

1998 was the full physiology of the clitoris documented reviewed everything anyone's ever said about the clit and dissected a bunch of cadavers, but also turned an MRI on the problem and photographed a live clit, which they shared with the broader medical community issue ? Crus clitoris and vestibular bulbs

What Is Pleasure-Based Sex Education?

A holistic approach to sex education that frames sexual activity (and our various relationships to it) as healthy and normal. It foregrounds pleasure, desire, and arousal as integral to a healthy sex life.

Private: Managed Care Plans

An effort to cut healthcare costs by insurance companies. In a managed care plan, companies place limits on what kind of health care they will pay for. Types of Managed Care Plans Health maintenance organization (HMOs) Point-of-service (POS) Preferred provider organizations (PPOs)

SOCIO-ECOLOGICAL MODEL AND GENDER- community

Gender Norms and Expectations (as demonstrated and upheld by community)

Promoting Health & Protective Factors During Pregnancy

Individual Behavior Folic Acid Nutritional Diet Exercise (but not excessive) Not smoking Not drinking Not eating foods that could damage fetal development (unpasteurized cheese, raw fish) Regular antenatal care

Third party payer system- Private

Individual/employer pays premiums to private health insurance 🡪 insurer pays providers (minus copay; deductible)

Patient Protection and Affordable Care Act (PPACA)

More Americans (but not all) receive health insurance. Requires insurance companies to expand coverage Increases government coverage of the poor and near-poor (Medicaid) States offer "exchanges" where employers and individuals can buy insurance. Reduction in some Medicare payments (from the government to hospitals) help prevention care for women

pre-ovulation phase

Ovary & Brain: Follicular phase Uterus Step 1: Menstruation Uterus Step 2: Proliferative phase

Post-ovulation

Ovary: Luteal Phase Uterus: Secretory Phase

Dysmenorrhea

Painful cramping before or during period

interpersonal Young women's Condom use for HIV Prevention in Uganda

Power dynamics (including age/educ gaps); violence in relationship; peers' influence; meaning of condom in relationship; communication with adults/parents; household wealth

SOCIO-ECOLOGICAL MODEL AND GENDER- relational

Power dynamics in relationship; gender socialization in the family

Choosing an Insurance Plan Factors to consider

Preexisting medical conditions Need for services that may not be covered (e.g., psychotherapy, alternative therapies) Copayments Deductibles Prescription plans/formularies Existing providers not in provider network

communityYoung women's Condom use for HIV Prevention in Uganda

Presence of youth-friendly services, norms about premarital sex (ethnicity), gender norms and expectations, community economic level

SOCIO-ECOLOGICAL MODEL AND GENDER- individual

Selves, identities, individual beliefs and attitudes about gender

Follicular phase

What is happening: Signals from the pituitary gland in the brain prompt an ovary to prepare an egg that will be released.

Uterus Step 1: Menstruation

What is happening: The endometrium thins and old blood is being shed and passes through the cervix and vagina.

Uterus: Secretory Phase

What is happening: The lining of the uterus releases or secretes chemicals that will either help an early pregnancy attach if an egg was fertilized, or help the lining break down and shed if no egg was fertilized

Ovary: Luteal Phase

What is happening: The sac that contained the egg (corpus luteum) produces estrogen and progesterone - these changes in hormone levels can cause things like shifts in mood, acne, bloating, and breast pain. If fertilization happens: the sac supports the early pregnancy If it does not happen: estrogen and progesterone levels decrease

Gender Disparities in Health Management

Women in general delay treatment seeking due to: Childcare; transportation; time from work; time in general (KFF, 2015) Women seek care more and see doctor's more often (KFF, 2015) Women get referrals more often, less counseled on diet, exercise, substance use (KFF, 2015) Cost of medication prevents more women from not filling a Rx drug (21%w vs. 13%m) Majority of Medicare beneficiaries are women (55%w, 45%m) Majority of Medicaid=low income women (58%w, 41%m) & children Women are mostly responsible for family planning via BC and birthing

.Sperm in reproductive tract blocked from Fertilizing Ovum

•diaphragm, cervical cap, contraceptive sponge, spermicide (foam, gel, suppository) •hormonal methods (via cervical mucus plug) - pills, injectables, ring, patch, implant, some IUDs

Principles & Practices

●Connecting the dots ●Focusing on balancing the positive and negative outcomes of sex ●Incorporating pleasure in our descriptions of sex, puberty & body changes ●Emphasizing genital variation ●Including & identifying sexual arousal and response ●Incorporating pleasure into contraception & safer sex practices ●Incorporating pleasure into healthy relationships

It's More Inclusive

●Helps break down heteronormativity and normalize queer sexualities ●Representation of trans & intersex bodies ●Disability justice ●Race & Class conscious

goals of pleasure based

●Helps to redefine sex ●Gives us a more complete understanding of consent ●Helps students get in touch with their desire

Public Health Outcomes

●Reduced rates of unintended pregnancy, STI & HIV infections

RJ Takes a Holistic Approach

"A reproductive justice framework takes into account whether a person can afford an abortion; whether a gender non-conforming person can feel safe from the threat of discrimination or violence while accessing such gendered care; whether a person has a clinic nearby or whether they have to travel a significant distance; whether there's an immigration checkpoint along the way; what access to transportation looks like; the economic impact for a person who does not have paid sick leave of taking several days off due to long-distance travel and waiting periods; whether the clinic is wheelchair accessible, and on and on." Tannia Esparza, executive director of Young Women United, says that this frame includes people other than the woman seeking an abortion: "While the reproductive rights movement has advocated for much-needed abortion and contraception rights, the reproductive justice movement acknowledges the realities of whole people, whole families, and whole communities and asks us to challenge the systems that impact us the most."

CHALLENGES TO DISEASE PREVENTION

"Fully one-half of the deaths in the U.S. are due to people's behavioral choices." (page 38, textbook) Why is it so hard to influence or change people's behavior? How much individual behavior change do individuals have the power to change? Individual 'choices' must be considered in broader context

What Is Pleasure?

"The combination of satisfying stimulation of the body with the psychological feeling of enjoyment."

Contraception

"specific term for any procedure used to prevent fertilization of an ovum"

Family Planning

"term generally used to [refer to] the timing and spacing of children

Third party payer system- Public

(Medicaid/Medicare/Veterans Affairs) Government at state/federal level serves as the insurer May include copay, deductibles and other cost-sharing

The progressive era

- 1917: National woman's party was formed - Proposed Equal Rights amendment (after 1920) and is still not ratified to this day - 1920:19th amendment (giving women the right to vote) was ratified

Women in WW2

- Changed the way woman participated in the workforce - Took on jobs in defense plants and companies around the country - Stereotypically would work as a seamstress or a scribe - Increased wages and work hours - Rarely employed in power positions such as manager

Investing in biomedical research specific to women

- Ever since the inclusion of women and minorities in biomedical research there has been extensive research on health outcomes that affect women more than men - Research has found that women are more likely to relapse after quitting smoking compared to men and have higher risk for lung cancer and earlier onset of breast cancer - Women are more likely to awake from general anesthesia faster than men but experience more side effects afterwards - In 2011 the National Research Council report showed the US had been steadily decreasing in life expectancy compared to other countries and the decrease was more significant for the lives of women than men (Mazure, 2015).

- Sheppard-Towner Act 1921

- Increased availability of prenatal and child health care, especially in rural areas - Federally funded clinics for women and children - Educated women on childbirth and pregnancy - Only lasted until 1929 when conservative congress refused to continue funding

- NIH Revitalization Act was amended to the Public Health Service Act to ensure that :

- Outreach programs coordinated by the Director of the NIH and ORWH/ORMH recruit women and minorities to be included as subjects in clinical research and that clinical research includes data that shows whether they are disproportionately affected by any health outcome more than other groups (Mastroianni)

- Margaret Sanger

- Pushed to legalize birth control - 1916: she opened the nation's first birth control clinic in Brooklyn - Was arrested for violating federal ban - Sentenced to 30 days labor - Appealed; legalized contraception for married couples with a prescription

The Grassroots movement

- The 1960s and 1970s - Challenged the health care system in delivering health care to women - FDA approved the birth control pill in 1960. - Civil rights act (protects women against job discrimination) and title nine (athletics) - Up unit, this movement feminists were mostly composed of white middle-class women, but during this time African Americans, Asians, and Latinas joined

- Department of of Health and Human Services Office on Women Health

- This agency cooperates with other federal agencies on any topic considering women's health and focus on finding and addressing inequities in research, healthcare services, and education in women's health

Our Bodies, Ourselves

- This was a guide to the female body and has been expanded on... it is currently in its 13th edition The most recent version was published in 2011 - It has sold millions of copies and received many awards - Originally published called "women and their bodies" and it discussed sexuality and abortion. This was illegal at that time - Title changed in 1971 to our bodies, ourselves - The book talked about women's health - The book became a volunteer-led 501 and focused on advocating for women's health and social justice The book discusses topics such as - Abortion - Birth control - Anatomy and menstruation - Politics of women's health - Sexual orientation

individual Young women's Condom use for HIV Prevention in Uganda

Age, education level, gender beliefs, self-efficacy, knowledge of HIV, access to condoms, no. sexual partners, desires/preferences

STIs Disproportionately Affect Women

A woman's anatomy can place her at a unique risk for STD infection, compared to a man. • The lining of the vagina is thinner and more delicate than the skin on a penis, so it's easier for bacteria and viruses to penetrate • The vagina is a good environment (moist) for bacteria to grow Women are less likely to have symptoms of common STDs — such as chlamydia and gonorrhea — compared to men.• If symptoms do occur, they can go away even though the infection may remain Women are more likely to confuse symptoms of an STD for something else. • Women often have normal discharge or think that burning/itching is related to a yeast infection • Men usually notice symptoms like discharge because it is 4unusual usual Women may not see symptoms as easily as men.• Genital ulcers (like from herpes or syphilis) can occur in the vagina and may not be easily visible, while men may be more likely to notice sores on their penis 5 STDs can lead to serious health complications and affect a woman's future reproductive plans. • Untreated STDs can lead to pelvic inflammatory disease, which can result in infertility and ectopic pregnancy • Chlamydia (one of the most common STDs) results in fe

Gestational Diabetes

Affects about 9% of pregnancies and rising (https://www.cdc.gov/pcd/issues/2014/13_0415.htm) Affects how effective your body's insulin is at breaking down blood sugar (glucose) and converting it to energy Hormone produced by placenta interferes with normal action of insulin Resolves after childbirth Causes : ?? Risk factors: obesity, older maternal age, family history of diabetes, race (racial/ethnic minorities at greater risk) Treatment : lower sugar intake, exercise, medication

Pre-eclampsia

Affects 4-5% of pregnancies in U.S. (CDC, 2018), becoming more common High blood pressure, reduced blood flow, blood vessels 'leak' fluid into tissues - can cause kidney, liver, brain damage Usually not until 20+ weeks in pregnancy Can Cause: Poor function/development of blood vessels in developing placenta, limiting blood flow Symptoms: Severe headaches, changes in vision, upper abdominal pain, nausea, decreased urine output Higher risk if: obese, history of smoking, history of high blood pressure Treatment depends on severity and timing of symptoms during pregnancy

Disparities in maternal morbidity and mortality

Minorities less likely to seek*, start and achieve adequate care Determinants: Perceived racism, minority stress Minorities report higher % of stressful life events Minorities more likely to report perceived discrimination based on race, insurance, comorbidities Insurance status, adequate housing, transportation to care, childcare, neighborhood factors, immigration status

Case Study: Cervical Cancer in Alabama socio-ecological factors

Being in the gap between having too much income to quality for Medicaid, but not being able to afford health insurance or only plans with high premiums/deductibles. Having to wait to turn 65 to get access to Medicare. Lack of doctors in the community. Transportation - if you don't have access to a car, you can't see a provider even if you have insurance. Prejudice of healthcare providers and lack of awareness of the historical trauma of events like the Tuskegee Syphilis experiment - which has occured in another part of Alabama, affected the perception of both the US government and health care providers among black residents of Alabama. These betrayals and systematic failures have had tremendous effects across generations.

Preventing Ovulation

Combination Hormonal methods (pills, ring, patch)

.Sperm blocked from Reproductive Tract

Condom (male and female), withdrawal, abstinence

Fertilized Egg blocked from Implantation

Copper IUD, some pills, emergency contraception (Plan B)

SOCIO-ECOLOGICAL MODEL AND GENDER- societal

Cultural belief system (extent of patriarchal belief system), Distribution of resources (economic, political and social power)

Sex Education: State of the union

Currently, only 24 states require sex ed Restrictions Apply: ●Must be medically accurate (13 states) ●Be "culturally appropriate" and unbiased (8 states) ●Emphasize the importance of sex only within marriage (19 states) ●Include sexual orientation (13 states) but specify a negative focus (4 states) Require that abstinence be included if sex ed is provided (40 states)

Determinants of Adequate Prenatal Care: U.S.

Determinants of Starting Prenatal Care in First Trimester Source of payment (insured vs not) Age of mother Lowest for younger mothers Racism and Access Lowest for Native Americans and Pacific Islanders (51%) Whites: 82%; Blacks 66.5% Education Least likely for those with less than high school education

HEALTH PROMOTION

Efforts to actively bring people to good health (or keep them there) and prevent disease. WHO - Health promotion enables people to increase control over their own health. It covers a wide range of social and environmental interventions that are designed to benefit and protect individual people's health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure.

hormones made by Corpus Luteum and then the placenta

Estrogen - fetal development, milk production Progesterone - suppresses ovulation and supports endometrium, milk production

ideas about gender in healthcare

Many times, women are categorized as being more or less susceptible to certain diseases. This takes away from the fact that predispositions for a disease can vary greatly among women. I could see how gender could be used as a tool in healthcare to try and address disparities faced by women. It is important to distinguish in medicine that there is a difference between gender and biological sex.

The changes in stages are prompted by shifts in hormones - there are four key players here:

FSH Estrogen Lutenizing Hormone Progesterone

Congenital Syphilis high in some states

Factors for Arizona: Laws targeting undocumented immigrants making people afraid to screen or get prenatal care; not expanding Medicaid Factors for California: A spike in drug use in certain counties; lack of medical care for pregnant women with substance use disorder; fear of being arrested if testing positive for drugs while pregnant Factors for Florida: STI surveillance system delaying case reports and communicating with ob/gyns to get mothers and their partners treatment Factors for Louisiana: Medical providers not following screening guidelines and testing mothers at third trimester; rural residents lack access to care Factors for Texas: Rural residents lack access to care; defunding of Title X clinics that provide critical care for women with limited income or without health insurance

Pelvic Inflammatory Disease

Formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage; ●Ectopic pregnancy (pregnancy outside the womb); ●Infertility (inability to get pregnant); ●Long-term pelvic/abdominal pain. As the infection continues, inflammation in the reproductive tract increases and more noticable symptoms occur. It can progress to a point where scar tissue forms or the fallopian tubes rupture

Human chorionic gonadotropin

From the embryo! This is the hormone pregnancy tests detect

Responses that improve prenatal care outcomes:

Medicaid expansion Home visits Group-based care Assess/address social determinants of health at first visit

The Clitoris

Glans - 8,000 nerve endings Size in total ~ 4 inches Another 15,000 nerve endings in remainder of body of clitoris; Estimated twice as many nerve endings as the penis Purpose ? PLEASURE Erectile tissue? Crus, bulbs.

society Young women's Condom use for HIV Prevention in Uganda

Healthcare spending/budget; economic status, levels of poverty; policies/laws on young women's access to sexual health information and services; women's status in society/politics

Perfect Use Effectiveness:

How the method works during clinical trials, in a controlled environment This is an example of efficacy Perfect Use means how well the method works when it's used in a clinical trial - a much more controlled environment in which scientists are guiding the dose, timing of when the method, etc.

Typical Use Effectiveness:

How the method works in the real population. Takes into consideration human error associated with using the method Typical use means how well the method works when real people in real life use it - this number will likely be a bit lower than "perfect use" due to the introduction of human error This is an example of effectiveness

Ectopic Pregnancy

Implantation of embryo outside of uterus, usually in fallopian tube Can cause tube rupture potential life-threatening Symptoms: pelvic pain, vaginal bleeding, shock Causes: Infection/inflammation (from PID due to Gonorrhea, Chlamydia), Smoking, tubal ligation, older maternal age

HPV screening

Men cannot be screened for HPV, so women are advised to complete both a pap smear and HPV test every 3-5 years to screen for cervical cancer.

Medicaid

Majority of recipients are low-income women and children Provides health insurance for low-income Americans Administered by federal and state governments, but largely run at the state level

Long Term Effects of Hormonal Birth Control Usage

No established association or increased risks have been found with long-term usage of hormonal options. Should be able to get pregnant within three months of discontinuing hormonal birth control. Common misattribution of natural declines in fertility due to aging to hormonal birth control use. Fertility naturally declines after 30 and continues to decline until menopause.

Amenorrhea

No longer having a period or having several month gaps without a period

Post-ovulation

Once ovulation occurs, the follicle that contained the egg transforms into something called a corpus luteum and begins to produce progesterone as well as estrogen (10,13). Progesterone levels peak about halfway through this phase (14). The hormonal changes of the luteal phase are associated with common During this phase, the endometrium prepares to either support a pregnancy or to break down for menstruation. Rising levels of progesterone cause the endometrium to stop thickening and to start preparing for the potential attachment of a fertilized egg. The secretory phase gets its name because the endometrium is secreting (producing and releasing) many types of chemical messengers. The most notable of these messengers are the prostaglandins, which are secreted by endometrial cells and cause changes to other cells nearby. Two prostaglandins in particular called, "PGF2α" and "PGE2", cause the uterine muscle to contract (cramp). The amounts of these prostaglandins rise after ovulation and reach their peak during menstruation (16,17). The cramping caused by this prostaglandin helps trigger the period. If a pregnancy occurs, prostaglandin production is inhibited (18) so that these contractions won't impact an early pregnancy. If pregnancy does not occur, the corpus luteum stops producing estrogen and progesterone. The drop in hormones, along with the effects of the prostaglandins, cause the blood vessels to constrict (tighten) and tissue of the endometrium to break down (10).

The importance of prenatal care

Once pregnancy is detected or approximately 8 weeks after last menstrual period, prenatal care is started. The initial visit is used to assess health of mother and risks to mother/baby: Ectopic pregnancy Pre-eclampsia/eclampsia Gestational Diabetes Infections STIs CMV RH factor Assesses fetal growth, development, health

RH factor

Protein on surface of blood cells, reason you are + or - of any blood type Problem RH Incompatibility: If mother is negative (doesn't have protein) and fetus is positive (has protein) If fetal blood comes in contact with maternal blood - antibodies against RH + are produced Next RH+ fetus = "invasion," starves fetus of red blood cells, lack of oxygen Rh disease Prevalence 276/100,000 live births globally https://www.ncbi.nlm.nih.gov/books/NBK459353/ Solution: "vaccine" Rh immunoglobulin prevents production of Rh antibodies

A Focus on the Right to Parent

RJ emphasizes the right to parent. This is another place where race-and the experience of racism-shapes women's experience. Women of color have faced major barriers to parenting through policies like coercive sterilization in public hospitals and prisons and racist stigma about who is fit to parent. "Reproductive justice works to ensure that we can express our sexuality without judgment, plan and prevent pregnancy and also have healthy pregnancies," says Cristina Aguilar, executive director of Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR). This emphasis on parenting, and the challenges facing women of color who want to parent, has been a cornerstone of the RJ movement.

Race Matters

Race is a major dividing line between the two movements, both in terms of leadership as well as approach. RJ architects such as Loretta Ross developed a frame that focuses on the experiences of those marginalized by racism and discrimination because they felt that communities of color and the issues most important to them were not being represented in the traditional reproductive rights movement. Monica Raye Simpson, executive director of the Sistersong Women of Color Reproductive Justice Collective lays this out: "Women of color are concerned about feeding their children, they are concerned about making sure their child gets the medication they need, they are worried about their job security, they are worried about whether or not their child or partner will become the next Mike Brown or Eric Garner. All of these issues are RJ issues."

Uninsured Americans

Significant financial risk if require emergency care Avoidance of preventive care and proper follow-up care Ineligible for discounted pricing structures Significantly less access to care Result: Poorer health, higher hospitalization rates, more advanced disease states, and earlier deaths

Medicare

Single largest insurer in the United States, covering almost 55 million people* Medicare spending grew 4.5% to $646.2 billion in 2015, or 20% of total NHE. Part A Provided to all enrollees and covers inpatient care Part B Optional and covers outpatient services Part D Optional and covers a portion of prescription drug costs

Premenstrual Syndrome (PMS) and Premenstrual dysphoric disorder (PMDD)

Symptoms for PMDD are more severe and is distinguished by its effect on depression and anxiety

Long Term Use of BC Can Increase Risks For:

Synthetic Estrogen: Breast and ovarian cancers - highest risk are women with BRCA mutation Synthetic Progesterone: Blood clots & heart attack - highest risk are 35+ or older and smokers

Long Term Use of BC Can Decrease Risks For:

Synthetic Estrogen: Endometrial and ovarian cancers, osteoporosis, cardiovascular disease

"The Pill"

Take pill every day Contains hormones that prevent ovulation 91%, 99% Soreness, nausea, spotting, decrease sex drive Control over period, clear up acne, protection against other health problems, reduce cramps, no procedure or injections Remember to take it every day, bad side effects, messes with hormones

Proliferative stage

The body begins to create a new layer of blood in preparation for ovulation and potentially a fertilized egg. While the ovaries are working on developing the egg-containing follicles, the uterus is responding to the estrogen produced by the follicles, rebuilding the lining that was just shed during the last period. This is called the proliferative phase because the endometrium (the lining of the uterus) becomes thicker. The endometrium is thinnest during the period, and thickens throughout this phase until ovulation occurs (9). The uterus does this to create a place where a potential fertilized egg can implant and grow (10).

Ovulation

The dominant follicle in the ovary produces more and more estrogen as it grows larger. The dominant follicle reaches about 2 cm (0.8 in)—but can be up to 3 cm—at its largest right before ovulation (6,7). When estrogen levels are high enough, they signal to the brain causing a dramatic increase in luteinizing hormone (LH) (11). This spike is what causes ovulation (release of the egg from the ovary) to occur. Ovulation usually happens about 13-15 days before the start of the next period **note that sperm can live 5-6 days inside the uterus, sex the week before ovulation could result in a pregnancy. 3+ after ovulation the likelihood of pregnancy is significantly reduced

Fertility Awareness Methods

Two Day Method - requires tracking of cervical mucus which has a clear color and sticky texture to determine if one is ovulating. If secretions are present either that day or the day before - ovulation is likely happening and pregnancy is possible.

In the above worksheet, which methods have the largest gaps between "perfect use" and "typical use"? What do you think are the reasons for these gaps for each of these methods?

The largest gaps occur when human error occurs. Any method that involves correctly inserting a device has decreased effectiveness. The fertility awareness plans also vary greatly due to the dedication it takes to correctly monitor menstrual cycles.

Human Papillomavirus (HPV)

The most common STI in the world 14 million cases in the US annually About 25% of all people in the United States currently are infected with HPV - 80 million people in total Mode of transmission: skin to skin contact is why it is so prevalent

How does HPV cause cancer?

damage cells lining the cervix and that cellular damage prompts the growth of cancerous cells on the cervix.

The ovaries

The ovaries are located at the end of the fallopian tubes. These are almond shaped and sized. They are about 4-5 inches below your waitst. 2 functions: 1.Produce eggs 2.Produce sex hormones The ovaries are endocrine glands that produce two classes of sex hormones: estrogens and progesterones.

Menstrual Misinformation

The reproductive tract is self cleaning and requires no additional help! Helpful bacteria, natural secretions, a carefully maintained pH, and your hormone cycle all help to keep the female reproductive tract health

Perimenopause

~10 years before menopause in which menstruation, and fertility drastically decreases alongside levels of estrogen and progesterone. Since those hormones are essential for ovulation, their decline syncs with decline in fertility.

Birth Control

a broad term that refers to procedures that prevent the birth of a baby, so it would include all available contraceptive measures as well as ... abortion procedures.

Tertiary

alleviating pain, halting progression of an illness, limiting disability

The uterus

also known as the womb, is a thick, pear-shaped organ. The uterus is suspended within the pelvic cavity by a series of six ligaments. Non pregnant it is the size of a plum. Inclusive of some of the most powerful muscles in the body. The inner walls are pulled together unless there is a pregnancy. The top of the uterus is the FUNDUS The uterine wall consists of three layers: the endometrium, the myometrium, and the perimetrium. The endometrium is the lining of the uterus, which, in preparation for fertilization, thickens in response to hormone changes during the monthly menstrual cycle. In addition, the endometrium is a source of hormone production. The myometrium, the middle layer, consists of the longitudinal and circular muscle fibers of the uterus. The muscle fibers are interwoven and enable the uterus to expand during pregnancy and contract during labor and childbirth. The myometrium is covered by a thin membrane known as the perimetrium. The perimetrium functions as the external surface of the uterus.

Reproductive rights

are centered around the legal right to access reproductive health care services like abortion and birth control. The Supreme Court's decision in Roe v. Wade represented a watershed moment that cemented a woman's right to choose whether to have an abortion or not. But we are now facing a time when women's reproductive rights are under coordinated, unrelenting and mainstream attacks, and we need to consider new and more nuanced ways of tackling these threats.

cervical cancer minority impact

black women suffer the highest mortality rate due to cervical cancer and Latinas suffer from the highest incidence rate.

Reproductive justice recognizes that legal rights

do not always translate to meaningful access. It centers the experiences of the marginalized-immigrants, people of color, queer and trans folks, youth, and low-income communities," explains Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health. This ideology is a marked departure from reproductive rights-where focusing solely on legal access effectively puts those whose other needs are already being met at its center.

shift to LH

causes the egg to be released from the ovary, a process called ovulation

Policy change using the RJ approach

combining efforts with other movements. "We think about our policy change work from a perspective that is multi-issue," says Miriam Yeung, executive director of the National Asian Pacific American Women's Forum. "We actively try to link organizations and leaders across silos." This type of cross-sector alliance-building has been a strategy of reproductive justice groups. "If we want to see these anti-choice policies disappear," says Sistersong's Simpson, "We have to be willing to show up for our other movements so that we can build our collective power."

Secondary

early detection and prompt treatment of disease

Modern methods

female and male sterilization, the intra-uterine device (IUD), the implant, injectables, oral contraceptive pills, male and female condoms, vaginal barrier methods (including the diaphragm, cervical cap and spermicidal foam, jelly, cream and sponge), emergency contraception and others (e.g., the contraceptive patch or vaginal ring).

progesterones

help regulate the menstrual cycle and stimulate development of the uterine lining in preparation for pregnancy.

What is reproductive justice?

his is almost always the first question we are asked when describing the Black Women's Health Imperative's work in reproductive justice and sexual health. Oftentimes, people think the term reproductive justice is synonymous with reproductive rights. However, the two are distinctly and philosophically different.

Poverty and racial justice

how class-particularly poverty-shapes people's ability to choose when they parent. On the policy level, the movement has tackled the Hyde Amendment, a law passed in 1976 that severely restricts the use of federal funds for abortion services by people on Medicaid and Medicare and federal employees. Some states have stepped in and funded these services, but most don't. That means that unless you have private insurance you must pay for abortion procedures out of pocket. This is just one example of how legal access to abortion means little to those who can't jump other hurdles such as cost. Procedures can cost anywhere from $300-$3000. Maria Elena Perez, director of policy and strategic partnerships at the National Institute for Reproductive Health, explains this further: "The right to reproductive health care is insufficient if low-income women can't afford those services or don't have transportation to the clinic or lack workplace policies that allow them to take time off for appointments." In response to financial hardship, grassroots groups have raised money to help people pay for their procedures through local abortion funds. Many of these groups utilize a reproductive justice analysis in their work.

Traditional methods of contraception

include rhythm (e.g., fertility awareness-based methods, periodic abstinence), withdrawal and others.

Socio-ecological model

individual, interpersonal, organizational, community, public policy

estrogens

influence the development of female physical sex characteristics and help regulate the menstrual cycle.

cervix

located at the back of the vagina, is the mouth of the uterus. Discuss cervical mucous changes. Changes "lcation as well" The opening in the middle of the cervix, called the os, connects the vagina with the uterine cavity. During childbirth, the cervical canal is 50 or more times its normal width.

Where do non-elderly American women get their health coverage?

mostly job dependant

Gaps in Sex Ed

no national standard for sexual education. emphasize external symptoms of STIs - you may have been shown pictures of bumps, redness, discharge, and sores as how to identify STIs and as the most important symptom to notice. or women, the most common symptom of an STI is NO SYMPTOMS AT ALL. Symptoms that are apparent like spotting, discharge, or painful urination for STIs are similar to other common infections such as a urinary tract infection, yeast infection, PMS, or menstruation. The only way to know for certain is to get tested.

Menopause

occurs around age 50 and is when menstruation has not occurred for 12 months Menopause can also be medically induced earlier - surgeries removing the ovaries, cervix, or uterus would also result in the end of menstruation and decline in levels of estrogen and testosterone.

vagina

opens between the labia minora and extends upward into the body, angling toward the lower back. The vagina is approximately 3 to 5 inches in length when not aroused. The vagina consists of three layers of tissue—mucous, muscle, and fibrous tissue—all of which are richly endowed with blood vessels.

At ovultion

ovarian surface opens and the follicle opens up while the egg floats out (some women feel this-mittelschmertz). After ovulation: the fimbrae sweep the egg into the tubes. If a sperm makes its way, you have fertilization=conception. Can have menstruation even without ovulation (happens) called ANOVULATORY cycle (more common as closer to menopause).

Sexual health

physical, psychological, social, cultural, and emotional facets of sexual human interactions. involves many factors such as sexual orientation, gender identity, biological basis of sexual health, sexual arousal, and sexualy trasnmitted infections.

What might determine whether a woman receives adequate prenatal care in the U.S.?

race, insurance, mistrust of healthcare providers, not knowing one is pregnant, knowledge, socio-economic status, cultural norms, family norms, transportation, stigma, geographic location, age, partner support

Standard Days Method

record your periods and determine when you can't get pregnant. 95-99%,76-88% No side effects, prescription, or hormones involved Could make mistakes Daily tracking Time Planning and effort required

Primary

reducing exposure to a risk factor that may lead to injury or disease

A rise in estrogen during the menstrual cycle

tells your pituitary gland to stop producing FSH and to start making more LH

FOLLICLES

the cells have immature eggs in them. During childhood, the ovaries absorb about half of them. Puberty: we have about 400,000 follicles, 300-500 will develop into mature eggs. During the monthly cycle (post first menstruation), only 1 follicle develops fully. Sometimes 2 or more and that can result in a twin or other multiples.

The fallopian tubes

thin, pale, pink filaments. These are also called OVIDUCTS which literally means egg tubes. They are approx. 4 inches long. The outside end of each tube is like a funnel, with fingerlike projections called fimbriae that draw the egg from the ovary into the tube but the fimbrae do not actually touch the ovaries.

FSH

this hormone stimulates the growth of ovarian follicles in the ovary before the release of an egg from one follicle at ovulation. pituitary gland stimulates the ovarian follicle, causing an egg to grow. It also triggers the production of estrogen in the follicle.

Internal female sexual anatomy consists

vagina, cervix, uterus, fallopian tubes, and ovaries