HLTH 312 (Ch 8-15)

fish oils

-Omega-3 polyunsaturated fatty acids •Have reduced levels of cholesterol and blood pressure in some studies •Most beneficial in people at high risk of CVD and who have already experienced a heart attack or heart failure with reduced left ventricular function

female sexual anatomy

-Ovaries •Produce ova and sex hormones -Fallopian tubes •Transport ova and sperm -Uterus •Receptacle for sperm and organ in which fetus develops -Vagina •Hollow tube that leads from the cervix outside the body -The ovaries release about one ova every month. -Fallopian tubes transport the ova to the uterus. -Cervix •Lower part of the uterus •Secretes mucus -Ovulation •Time of ovum release -Vagina •Approximately 3 to 5 inches long when nonaroused •Normally narrow, but can widen: -During intercourse -When inserting a tampon -During childbirth -During a pelvic examination •Secretions help regulate the growth of microorganisms •Self-cleansing -Vulvovaginitis or vaginitis •Vaginal inflammation characterized by: -Irritation or itching -Redness or swelling of the vagina and vulva -Unusual discharge -Discomfort or burning sensation when urination -Disagreeable odor (sometimes) •Commonly referred to as a yeast infection -Factors that increase susceptibility to vaginitis: •Use of antibiotics •Emotional stress •Diet high in carbohydrates •Hormonal changes •Chemical irritants •Intercourse without adequate lubrication •Excessive heat and moisture retained -Vulva •All external female genital structures -Clitoris •Erotically sensitive organ located above vaginal opening -Labia minora •Smaller, inner pair of folds of skin -Labia majora Larger, outer pair of folds -Urethra •Relatively short exit tube for urine -Urinary tract infection (UTI) •Infection of the urethra/bladder, usually by bacteria •Causes burning urination and frequent urge to urinate -Breasts •Network of milk glands and ducts embedded in fatty tissue Secondary sexual characteristic

sexual abstinence

-People may abstain from sexual activity due to: •Religious reasons •Preference to wait until marriage •Desire to avoid unintended pregnancy •Concern about acquiring a sexual infection •Feeling emotionally unprepared •Negative feelings about sex for various reasons •Desire to avoid negative consequences of hooking up

talking about fertility control

•A couple shares the responsibility for fertility control. •The best time to discuss fertility control is before sexual intercourse. •Communication about birth control and other sexual matters is vital to a healthy sexual relationship.

emergency contraception

•Designed to prevent pregnancy after unprotected vaginal intercourse •Two forms -Chemical drugs •Involves taking levonorgestrel (Plan B One-Step or Next Choice) or ulipristal acetate (Ella) -IUD insertion •Inserting an IUD up to 5 days after intercourse •More effective than hormonal methods

atherosclerosis

•Disease in which fibrous, fatty deposits (plaque) form in the walls of one or more arteries -Most critical when it occurs in one or more of the four coronary arteries and any artery that distributes blood in any part of the brain •Type of arteriosclerosis -Thickening and stiffening of an artery's wall, resulting in a retardation of blood flow •Processes that lead to the development of atherosclerotic plaques: -Prior damage to an artery's wall from nicks and tears due to the force of blood flowing through it or from prior disease -Deposition of excess cholesterol into the arterial wall, usually at the site of prior damage Inflammation •Cholesterol -Waxy substance that is a: •Necessary structural component of every body cell's membranes •Building block of several different hormones •Precursor of bile salts -Comes from food •20% from meals •80% manufactured in the liver from dietary carbohydrates and fats -The liver determines the manufacture of much of the body's cholesterol and its distribution through the blood to tissues and organs when they need it. -Cholesterol is packaged with triglyceride into lipoproteins. •Transports them in the blood •Include high-density lipoproteins (HDL) and low-density lipoproteins (LDL) •LDL Particles -Comprises the majority of cholesterol that gets deposited in plaques that block arteries -Circulate in the blood to deliver cholesterol to tissues to build new cells or as building blocks for other biological chemicals -Excess cholesterol is processed by the liver to maintain normal cholesterol levels in the blood. -If the liver is overwhelmed with LDL particles, it may not be able to process all of them. •Excess LDL particles circulate in the blood and may be deposited in the walls of arteries. -Some can get trapped in an arterial wall and can be oxidized, contributing to the formation of plaque -Plaque can grow and block blood flow or may break apart and cause a blood clot. •This is why LDL is called "bad cholesterol." •HDL Particles -Produced in the liver and intestines and released into the bloodstream -Pick up cholesterol as they circulate through the body and return it to the liver for removal -Helps reduce the buildup of plaques -This is the reason HDL is called "good cholesterol." •Familial hyperlipidemia (FH) -Inherited disease that results in markedly elevated levels of cholesterol in the blood -Normal form of defective genes are responsible for synthesizing LDL receptor proteins on liver cells that bind LDL particles and remove cholesterol from the blood •Without this ability, cholesterol accumulated to exceptionally high levels in the blood. -Usually causes heart attack at an early age •Measuring Cholesterol Levels -Blood tests •Commonly used to measure LDL, HDL, and triglyceride (TG) -For patients with undesirable results, physicians often: •Recommend adopting lifestyle habits to lessen the risk of heart disease •Suggest medication, such as statins -Total cholesterol readings •Below 200 mg/dl -Relatively low risk of coronary heart disease (CHD) •200-239 mg/dl -Moderate and increasing risk of CHD •Total cholesterol level may not be a reliable indicator of CVD risk because the level of HDL in the blood can modify the risk inherent in high cholesterol readings •Measuring Cholesterol Levels -Extensive research has shown a strong association between blood cholesterol levels and coronary heart disease. •The higher the blood cholesterol level, the greater the risk of all forms of cardiovascular disease. •The amount of cholesterol in the diet is not always a good predictor of heart disease. -Populations vary greatly in the level of cholesterol that constitutes a risk for CHD. •Cholesterol, Statins, and Inflammation -Statins •Types of drugs that dramatically reduce the level of blood cholesterol •Inhibit the HMG-CoA reductase enzyme in liver cells that manufactures cholesterol •Force the liver to increase production of the receptors on liver cells that bind LDL cholesterol -Aids the removal of excess cholesterol from the circulation •Generally taken for the rest of the person's life •Potential side effects of statins -Severe and permanent liver or muscle damage -Memory loss and reduced cognitive functioning •Important to weigh the benefits and risks -Inflammation •Immune response to tissue injury and damage •Can be caused by plaques in arteries •Causes an increase in C-reactive protein (CRP) -High level of CRP is not a perfect indicator for the risk of heart disease or a heart attack because many other factors can also affect the level of CRP in the circulation •Risk factors -Several lifestyle habits and biological conditions constitute risk factors for developing atherosclerosis. -Many can be modified by adopting healthy behaviors. -Others can be modified by adhering to competent medical preventive treatment.

responsibility for fertility control

•Two components -A fertility control method must be chosen. -The chosen method must be used consistently and correctly. •Responsibility -One partner having to take total responsibility can create resentment. -The responsibility for fertility control can be shared in a number of ways. •To share responsibility, couples can: -Go to fertility clinics together -Read and discuss different methods -Try various methods to see which are best suited for them -Share the time and financial costs of their chosen method, or divide responsibilities -Share in using the chosen method -Remind each other to use their chosen method

preventing hereditary diseases

•Genetic Counseling -Medical specialty that helps people •Learn about genetic conditions •Find out their chances of being affected by or having a child or other family member with a genetic condition •Make informed decisions about testing and treatment -Reasons for seeking genetic counseling: •Having a family history of a genetic condition •To learn about genetic screening for diseases more common in certain ethnic groups •Other genetics-related concerns -Genetic counseling professionals include: •Clinical geneticists -Doctors with expertise in genetics •Genetic counselors -Nonmedical professionals trained to provide counseling and support for people and families with genetic conditions -Begins with objective calculations of genetic risks to a fetus -Process is subtle and counselors may inadvertently interject personal opinions -Clients should arrive at their own informed decisions after careful consideration of all of the medical facts and risks that have been explained to them. •Genetic Testing -Medically-supervised procedures that identify changes in chromosomes, genes, or proteins to: •Confirm or rule out a suspected genetic condition •Help determine a person's chance of developing or passing on a genetic disorder -Can include: •Identifying single genes or short lengths of DNA to identify variations or mutations that lead to a genetic disorder •Analyzing entire chromosomes or long lengths of DNA to identify changes in chromosome number or shape •Determining the amount or activity level of proteins -Can indicate changes to the DNA that result in a genetic disorder -Available to screen for disorders such as: •Cystic fibrosis •Sickle cell anemia •Hemophilia A •Duchenne muscular dystrophy •Huntington's disease Fragile X syndrome •Prenatal Testing -Amniocentesis •Procedure in which amniotic fluid is removed from the uterus and tested to determine whether genetic or anatomical defects exist in the fetus •Performed around the 15th week of pregnancy •Small risk of harming the fetus or inducing miscarriage •Performed so that prospective parents can decide whether to continue the pregnancy •Identifies the sex of the fetus -Chorionic villus sampling (CVS) •Can be performed as early as 8 weeks into the pregnancy •Provides information on the health of the fetus •Allows the parents to make an earlier decision with respect to terminating the pregnancy -Ultrasound scanning •Use of sound waves to visualize the fetus in the womb •Image of the fetus is displayed on a screen •Used to: -Detect multiple fetuses -Determine the location of the placenta -Gauge the fetus's head size -Aid diagnosis of abnormal brain development and neural tube defects •Genetic Discrimination -Possibility of discrimination against a person because he or she carries a particular gene that predisposes a person toward a disease -Danger of discrimination from employers and insurance companies concerned about the costs of wasted training and lost work, or costs from claims related to a genetic condition -Genetic Information Nondiscrimination Act (GINA) was signed into law in 2008 and forbids: •An employer from firing or not hiring a person based on information obtained from genetic testing •Insurance companies from denying health or life insurance to persons based on information obtained from genetic tests •Companies from charging higher premiums for persons with disease susceptibility genes •Treating Hereditary Diseases -Very few can be treated effectively. -PKU (phenylketonuria) can be managed if an affected newborn is diagnosed at birth. •Can cause mental retardation if an affected child eats phenylalanine •Must maintain a phenylalanine-free diet at least until, and often beyond, puberty -Mandatory testing for inherited metabolic disorders in newborns varies from state to state. •Gene Therapy -Technique for replacing defective genes with normal ones in certain tissues of a person affected with a hereditary disease -Hope is that the: •Normal gene will function once in the cells, •Protein will be produced in sufficient quantity to cure the disease permanently •Gene Therapy -Researchers are testing several approaches: •Replacing a mutated/defective gene that causes disease with a healthy copy of the gene, •Inactivating, silencing, or "knocking out," a gene that is functioning improperly •Introducing a new, different gene into the body to help fight a disease •Gene Therapy -Gene therapies are being developed for: •Inherited immune diseases •Blindness •Lung disease -Technique remains risky and is still under study to make sure it will be safe and effective -Currently being tested only for diseases that have no other cures •Embryonic Stem Cells -Cells derived from human fertilized eggs and grown in laboratory dishes -Have the capacity to differentiate into many different tissues and organs -Hold great promise for treating presently incurable diseases •Embryonic Stem Cells -When a human embryo develops to the point where it contains several hundred cells, it is called a blastocyte. -Internal cells in the blastocyte are embryonic stem cells. •These cells can be removed from early-stage embryos and grown into stem cell lines that retain the potential for developing into specific tissues almost indefinitely. •Embryonic Stem Cells -A major goal is to develop lines of stem cells that contain an individual's own genetic information. •This would involve removing several nuclei from the patient's cells and injecting them into enucleated eggs that would develop into blastocytes from which cells could be removed and grown into embryonic stem cell lines. •If successful, the individualized stem cells can be used to treat the patient's disease without concern about rejection. •Embryonic Stem Cells -Very controversial in the United States •Supporters argue that it has the potential for relieving human suffering and treating incurable diseases. Opponents believe every human embryo, regardless of how it was created, it a potential "person" and that the "soul" enters when fertilization takes place of when an embryo exists •Genome Editing -Also known as gene editing or gene splicing -CRISPR/Cas-9 •Method of gene editing that allows segments of DNA to be changed, added, removed, or distributed to different locations within cells •Being explored as a treatment for single-gene disorders •May be instrumental in treating and preventing complex conditions •Genome Editing -Ethical concerns •Arise when genome editing is used to alter the genomes in eggs and sperm or the DNA of embryos •Changes would be passed from one generation to the next •Could be used to enhance normal human traits •Sperm/egg and embryo gene editing are currently illegal in many countries.

immunizations

•Vaccinations used to prevent a variety of serious diseases caused by both bacteria and viruses •Involves injecting inactivated viruses or bacteria into the body •Generally safe and effective •Crucial for young children and adolescents •New Vaccines -Bacterial meningitis (2005) -HPV (2006) -Herpes zoster (shingles; 2007) -Rotovirus (new 2017 vaccine does not require refrigeration) •Vaccination Risks -Not 100% risk-free -Often mild reactions that disappear in a few days -About one per million vaccinations results in serious neurological damage or death. -In recent years, a vocal minority has attacked vaccination, in general, as being unsafe and unnecessary despite firm scientific evidence to the contrary. -Controversy over vaccinations has arisen from the claim that a mercury-based preservative (thimerosal) is the cause of the marked increase in autism among young children. -Studies have identified no causal association between thimerosol-containing vaccines and childhood autism.

cancer: understanding risks and means of prevention

•1 in 2 men and 1 in 3 women will develop some form of cancer in their lifetimes. •Each year nearly 600,000 Americans die from cancer. •Half of all cancer cases can be cured if detected early. •Most cancers are preventable with a healthy lifestyle. -Avoid cigarette smoke and tobacco in any form. -Maintain a healthy weight and be physically active. Maintain good nutrition.

common STDs

•Categorized according to the type of organism causing them -Viruses -Bacteria -Protozoa -Insects •Trichomoniasis -Vaginal infection caused by the protozoan Trichomonas vaginalis -Symptoms •Occur primarily in women •Include vaginal itching and a cheesy, odorous discharge from the vagina -Men also can carry the organisms in the urethra of the penis and under the penile foreskin. -Can be treated with medication •Bacterial Vaginosis -Overgrowth of certain types of bacteria -Can be sexually transmissible -Symptoms •Vaginal discharge with "fishy" smell •May show no symptoms •Chlamydia -Caused by bacterium Chlamydia trachomatis, which infects certain cells that line the: •Mucous membranes of the genitals, mouth, anus, and rectum •Conjunctiva of the eyes •Lungs (occasionally) -Chlamydial microorganisms bind to surfaces and induce host cells to engulf them •Eventually "steal" nutrients to reproduce and multiply -Often occurs simultaneously with gonorrhea -Can be passed to newborn during childbirth •Commonly causes conjunctivitis and pneumonia -May be no symptoms or very mild symptoms •When symptoms occur, they include painful urination (dysuria) and a whitish penile or vaginal discharge. -Treatable with antibiotics •Can cause inflammation and damage the reproductive organs if left untreated -Chlamydial infections induce an immune response in the host, but infected individuals do not gain immunity to future chlamydial infections. •Treated individuals can be reinfected. •Gonorrhea -Also known as "the clap" -Caused by the bacterium Neisseria gonorrhoeae -Infects the genitals, reproductive organs, mouth, throat, anus, and eyes -Can be passed to newborns as they move through the vagina -Symptoms are similar to chlamydia. •Can be asymptomatic -Can lead to epididymitis in men and infections of the uterus, fallopian tubes, and pelvic region in women if infection progresses •When symptoms do appear, they may include: -Painful urination in both men and women -A yellowish discharge from the penis or vagina -Pain in the groin, testes, or lower abdomen First symptoms appear 7 to 10 days after exposure -Can be treated with antibiotics •New antibiotic-resistant strains constantly emerge. -Chlamydia is also present in nearly half of all cases. •Individuals being treated for gonorrhea should also be tested for chlamydia. •Syphilis -Caused by a spiral-shaped bacterium called Treponema pallidum -Transmitted through genital, oral, and anal contact and through blood •Can also be transmitted to an unborn child during pregnancy -First sign is a painless ulcer (chancre) •Occurs between the 1st week and the 3rd month after infection •Heals if left untreated, but disease enters a second stage -Secondary stage •Characterized by skin rash, hair loss, and the appearance of round, flat-topped growths on most areas of the body •Heals if left untreated, and the infection enters a symptomless (latency) period -Latency period •Syphilis organisms multiply in many other regions of the body. -Tertiary stage •The disease eventually damages vital organs and can cause severe symptoms or death. -Treatment •Can be treated at any stage with antibiotics •Genital Herpes -Herpes is caused by either of two strains of herpes simplex virus (HSV): •HSV-1 -Associated with cold sores on the mouth (fever blisters) •HSV-2 -Associated with lesions on the penis, vagina, or rectum Often asymptomatic -Major symptoms •Presence of one or more blisters, which eventually break to become wet, painful sores •Fever •Pain in the lower abdomen (occasionally) -Virus remains dormant after symptoms disappear •Stress, anxiety, poor nutrition, sunlight, and skin irritation can bring on recurrences. -Recurrences •Usually mild and last only about a week •May be telegraphed by: -A tingling feeling or itching in the genital area -Pain in the buttocks or down the leg •Severity of symptoms varies •Extremely contagious when a sore is present -Transmission is also possible when no sore is present. -Both strains of HSV can cause genital and oral infections with identical symptoms. •People with oral herpes can transmit the infection to partners via oral sex, and to themselves through masturbation. -HSV can also: •Infect the eyes, leading to impaired vision and blindness •Infect newborn babies via the birth canal -No cure -Individuals remain infected for life. -Drugs such as acyclovir can minimize the duration and severity of symptoms. •Human Papillomavirus and Anogenital Warts -Human paillomaviruses (HPV) •Group of more than 100 types of viruses -About 40 can be passed through sexual contact •Approximately 20 million Americans are currently infected. •Nearly all sexually active men and women will be infected at some point in their lives. -Majority of cases are symptomless and go away on their own -Persistent infections can cause cervical cancer in women -Men are also susceptible to HPV infection. •Can infect the genital area, mouth, and throat •Rarely leads to symptoms •Can lead to HPV-caused cancers of the penis, anal region, or back of the throat -Some types of HPV cause anogenital warts. •Visible warts are usually: -Raised or flat -Single or multiple -Small or large -Sometimes cauliflower-shaped -Soft and moist -Pink or flesh-colored -Visible anogenital warts can appear: •On the vulva •In or around the vagina or anus •On the cervix •On the penis, scrotum, groin, or thigh -The warts are contagious. -Treatment •Anogenital warts can be removed by self-applied medications or by a healthcare provider. •Treatments remove the warts, but not HPV in cells, so warts can reappear after treatment. Without treatment, warts may disappear, grow more numerous, or grow larger -Many genital HPV infections do not cause visible warts. •Invisible infections can be detected by: -Applying vinegar to suspected infected regions and looking for infected cells to whiten -Culposcopy -Biopsy -Pap smear -High risk HPV infections •Invisible •Associated with cancer of the cervix, vulva, vagina, anus, penis, or larynx -Low risk HPV infections •Cause visible warts •May cause minor Pap test abnormalities -Vaccination •There is a vaccine against two types of HPV that cause about 70% of cervical cancers, and two types of HPV that cause about 90% of genital warts. •It is highly effective in preventing HPV infection in young women who have not yet been exposed to HPV. -Other methods of preventing HPV infection: •Avoid skin-to-skin contact with an infected person •Avoid sexual contact if warts are visible •Male use of latex condoms •Hepatitis B -Disease of the liver -Caused by hepatitis B virus (HBV) •One of several types of hepatitis viruses •Transmitted sexually and by blood •Sexually transmitted 100 times more effectively than HIV -Symptoms include: •Low-grade fever •Tiredness •Headaches •Loss of appetite •Nausea •Dark urine Jaundice -Treatment •No specific therapy •Rest, proper nutrition, and avoidance of substances harmful to the liver are required. •Recovery can take many months. -Vaccination •A vaccine exists and everyone is advised to be vaccinated. •Molluscum Contagiosum -Caused by molluscum contagiosum virus -Characterized by the appearance of freckle-sized, smooth, rounded, shiny, whitish growths on the skin of the trunk and anogenital region -No associated symptoms Lesions should be removed by a healthcare provider to avoid transmission to others •Pubic Lice -Also known as "crabs" -Barely visible insects that live on hair shafts primarily in the genital-rectal region -Feed on blood taken from tiny blood vessels in the skin, which they pierce with their mouth •May cause itching -Look like small freckles -Eggs are enclosed in nits attached to hair shafts -Transmission •Physical (usually sexual) contact •Contact with objects on which eggs have been laid -Treatment •Wash pubic hair with liquids or shampoos containing agents that specifically kill lice •Infected person's clothes, towels, and bed linens should be washed with cleaning agents made specifically for killing lice •Scabies -Infestation of tiny mites, Sarcoptes scabiei, in certain regions of the skin •Burrow into the skin and lay eggs -May cause intense itching and small round nodules -Transmitted sexually and non-sexually through close personal contact -Can be treated with topical agents that kill mites and their eggs •Acquired Immune Deficiency Syndrome (AIDS) -Caused by human immunodeficiency virus (HIV) infection -HIV infection causes disease by destroying immune system cells, leaving patient vulnerable to bacterial, viral, and fungal infections. -HIV is transmitted via blood, semen, and vaginal fluids of infected individuals. -HIV tests may: •Detect antibodies to HIV •Measure the RNA or DNA of HIV -Symptoms may not manifest for as long as 15 to 20 years after the initial infection. •Still contagious during latency period •First symptoms are similar to those of mononucleosis -As the disease progresses, individuals most often suffer: •Weight loss •Infections on the skin (shingles) or in the throat (thrush) •One or more opportunistic infections •Cancer -Treatment •Relies on: -Medically managing opportunistic infections -Attempting to suppress HIV infection •Uses combination therapies -Not a cure -Not all HIV-infected individuals respond -Must be taken for life -Very expensive -Prevention •No vaccine •Only effective way to control the spread of AIDS is to prevent the transfer of HIV by: -Using condoms -Reducing exposure to infected individuals -Avoiding casual sex -Reducing the Risk of HIV/AIDS •Anyone can get AIDS. •Many homosexual males acquired AIDS early on because: -There was little knowledge of HIV. -Sexual mores in the late 1970s and early 1980s permitted multiple partners, affording HIV rapid access to a large population. -Anal intercourse provides a highly efficient route of infection. •Majority of new cases are among injection drug users who share their drug paraphernalia with others, and those who engage in sexual intercourse with them. •Adult males who undergo circumcision are much less likely to contract HIV/AIDS than uncircumcised males. -Testing for HIV Infection •Recommended for males who have had unprotected sex with other males, and anyone who has: -Had unprotected sex with someone who is known or suspected to be infected with HIV -Had a sexually transmitted disease -Had unprotected sex with someone while drunk -Had sex with someone with unknown AIDS-risky behaviors -Had several sexual partners -Shared needles or syringes to inject drugs of any kind •Testing begins with a counseling session to determine whether testing is appropriate and discuss the meaning of possible test results. •Most common tests use a blood sample. •Results take a week or 2. •Regardless of the results, you will be asked to return to the counseling and testing center to receive the information. •Consumers should be wary of at-home HIV test kits. •Tests can be obtained from physicians and a variety of health agencies. •There are two kinds of HIV testing: -Anonymous Confidential

choosing whether to be a parent

•Parenting is not for everyone. •Parenting usually requires major adjustments in lifestyle to meet the needs of children. •Before committing, potential parents must be as certain as they can that their decision is appropriate for their life goals and that they have the means to care for their children.

choosing fertility control

•Total abstinence is the only 100% effective way of fertility control. •Avoiding an unintended pregnancy requires: -Weighing the benefits and drawbacks of the various methods -Choosing the one that both partners are comfortable with •Most users of fertility control are principally concerned with two questions: -How well does the method work? -Is it safe? •Effectiveness is measured by failure rate -Likelihood of becoming pregnant if using a birth control method for one year -Lowest observed failure rate •Likelihood of becoming pregnant if using a birth control method consistently and as intended -Typical use failure rate •Likelihood of becoming pregnant considering all the potential problems associated with a birth control method •Safety considerations must take into account: -Health risks of a particular method -Physical and psychological consequences of an unintended pregnancy -Woman's age, physical health, whether she has had previous children, and her capacity to care for another child -Risk of death •Reasons for practicing fertility control -Enhancing sexual pleasure -Family planning -Increasing women's life choices -Health considerations World overpopulation

healthy sexuality also includes

-Accepting sex and sexuality as natural aspects of being human throughout the lifespan -Knowing and understanding biological sexual functions and responses -Possessing skills for maintaining and enhancing sexual relationships -Assessing one's own sexuality education and becoming the sex educator of one's own children -Having confidence in one's own values and capacity for making wise sexual decisions -Knowing and accepting sexual values and practices different from one's own -Increasing one's capacity for intimate relationships and communication

high blood pressure (hypertension)

-Affects approximately 32% of Americans 18 years of age or older -Risk increases with age -Not inevitable -Rare in people who are strict vegetarians and who have low-salt diets -About a third of people with hypertension are unaware that their blood pressure is high. -Essential (primary) hypertension •Not caused by any observable disease •Accounts for more than 90% of cases -Secondary hypertension •Caused by a recognizable disease •Blood pressure generally returns to normal when the cause is identified and corrected. -Causes •May be caused by psychosocial factors •People with low income and poor education are at higher risk. •The stress of being a member of a minority group may also increase the risk of high blood pressure and heart disease. -Blood pressure •Measurement of the force with which the heart pushes blood through the circulatory system. •Important indicator of the health of the cardiovascular system •Measured and recorded in terms of millimeters of mercury (mm Hg) -Refers to how high in millimeters blood pressure can lift a column of liquid mercury -Measuring blood pressure •Systolic pressure -Pressure in the arteries when the heart contracts -Higher number in a blood pressure reading •Diastolic pressure -Pressure in the arteries when the heart relaxes -Lower number in a blood pressure reading •Healthy blood pressure is 120/80 mm Hg •Systolic pressure of 120-139 or diastolic pressure of 80-89 is slightly elevated and is considered prehypertensive •High Blood Pressure -Blood pressure can be lowered by: •Maintaining a healthy body weight •Increasing physical exercise •Limiting sodium intake and following the DASH diet •Limiting alcohol intake •Obtaining adequate potassium Managing and coping with stress •High Blood Pressure -Blood pressure medications •Work in different ways, including: -Flushing excess sodium from the body -Helping the heart beat slower and with less force -Relaxing the walls of blood vessels •Some people take two or more medications. •Talk with your physician if you experience side effects. •High Blood Pressure -Dietary Approaches to Stop Hypertension (DASH) •Study that showed that high blood pressure could be significantly lowered by dietary changes •The DASH diet emphasizes: -Several daily servings of fruits and vegetables -Greater intake of potassium, magnesium, and calcium -Less consumption of meat, fat, and sweets •Adopting the DASH diet is the best way to lower blood pressure without drugs and to help maintain a healthy heart.

colorectal cancer

-Affects men and women equally -Causes 50,000 deaths annually in the United States -Rarely diagnosed in persons under age 40 •Appears more often in persons over 50 -Primary screening tests: •Occult blood tests •Flexible sigmoidoscopy •Colonoscopy

secondary sex characteristics (physical)

-Anatomical features appearing at puberty that distinguish males from females -Include: •Extent and distribution of facial and body hair •Body build and stature •Appearance of breasts •Behavioral tendencies

defibrillators

-Electrical device that can restore normal heart rhythm by delivering electrical shocks through the chest to the heart -Should be initiated within a few minutes after the beginning of a heart attack -Automated external defibrillators (AEDs) •Have been placed in many public areas •Can also be purchased by individuals and kept at home -Implantable cardioverter defibrillator (ICD) •Small unit implanted in the chest •Has wires attached to the heart •Delivers a pulse of electricity to the heart to restore normal heartbeats if the heart begins to beat irregularly

the heart and blood vessels

-Arteries •Carry oxygenated blood from the heart to the body -Veins •Return deoxygenated blood to the heart from the body -Capillaries •Tiny blood vessels that branch out from arteries and veins and circulate blood to all the cells in the body -Heart •Highly specialized muscle about the size of an adult fist •Keeps the blood circulating throughout the body •Myocardium -Muscular wall of the heart •Chambers: -Left and right atria (upper chambers) Left and right ventricles (lower chambers) -Blood flow •Deoxygenated blood enters the right atrium and flows to the right ventricle. •Blood flows from the right ventricle to the heart, where it is reoxygenated. •Reoxygenated blood flows through the coronary veins to the left atrium. •Blood flows from the left atrium to the left ventricle, where it is pumped to the body through the aorta. •The Heart Beat -Beats approximately 60-100 times per minute -Characterized by its rhythm -Heart rate •Number of times per minute the lower chambers of the heart contract to move blood out of the heart •Controlled by the sinoatrial node -Sends electrical signals across the surface of the heart, causing the heart muscle fiber to contract •Also influenced by electrical signals from the brain -Arrhythmia (irregular heartbeat) •Symptoms -Fast or slow heart beat -Skipping beats -Shortness of breath -Chest pain -Lightheadedness -Dizziness -Sweating -Atrial fibrillation •Occurs when nerve impulses in the heart interfere with the normal heart beat, causing different areas of the heart beat independently of one another •Causes blood to pool in the atria instead of being pumped into the ventricles •Usually brief and without ill effects •Can cause a stroke if blood flow slows sufficiently to cause a clot that can travel to the brain •Usually develops as people age •Can be managed with various drugs •Pacemaker can be installed if the condition cannot be controlled with drugs -Small electrical device that supplies a steadying electrical signal to the heart -Ventricular fibrillation •Type of cardiac arrhythmia in which the ventricles quiver very rapidly and irregularly instead of contracting forcefully •Results in the heart pumping little or no blood to the body •Can be fatal if the heart beat is not restored within a few minutes •Diseases and conditions that can cause problems with ventricular heart rhythm: -Coronary heart disease -Physical stress -Certain inherited disorders -Structural changes in the heart from high blood pressure

soy

-Boosts the activity of LDL receptors in the liver -Rich source of isoflavones •Block oxidation of LDL particles -Studies indicate that soy is especially effective among people with cholesterol levels above 240 mg/dl.

breast cancer

-Both men and women can develop breast cancer, but it occurs very rarely among men. -Factors that have been proposed as contributing to the increased rate of breast cancer include: •Increased weight •Less exercise Alcohol consumption -Other factors that increase risk: •Having a mother who had breast cancer before age 60 •First menstruation before age 14 •Having your first child after age 30 •Having no biological children •Experiencing menopause after age 55 •Having benign breast disease -Other factors that increase risk: •Having estrogen replacement therapy after age 55 •Consuming more than 3 ounces of alcohol per day •Having inherited BRCA1 or BRCA2 genes •Exposure to xenoestrogens -The Controversy over Mammograms •Mammogram -X-ray image of the breasts that is used to detect the presence of any abnormal breast tissue •For many years, mammograms were recommended for all women over age 40. •In 2008, the U.S. Preventive Services Task Force recommended against routine mammograms for women between ages 40 and 50. -The American Cancer Society opposed the recommendation. •The controversy mainly revolved around the word "routine." -The task force recommended that women under age 50 should decide, in consultation with their physicians, whether a mammogram was helpful. •The evidence indicates that the preventive benefits of routine mammograms are modest. -They often turn up many false positives. -Lifestyle Changes Help Prevent Breast Cancer •Living healthfully •Maintaining a low-fat diet •Consuming adequate amounts of fresh fruits and vegetables •Engaging in physical activity •Limiting alcohol consumption -Treating Breast Cancer •Radical mastectomy -Surgical removal of one or both breasts -Was the recommended treatment for women with a diagnosis of breast cancer for many years •Lumpectomy -Removal of only the tumor -Shown to be just as effective as radical mastectomy •Cancer cells in lymph nodes -Cause for lymph node removal for many years -Chemotherapy or radiation therapy are now recognized as sufficient to prevent recurrence of the cancer. •New DNA tests can also help determine the optimal treatments for each woman's breast cancer.

tobacco smoking

-Can damage blood cells, blood vessels, and the heart through oxidation and inflammation -Increases the risk of atherosclerosis -Major risk factor for peripheral artery disease -Stopping smoking at any time can reverse many of the harmful physiological effects of tobacco on the cardiovascular system.

trans fats

-Chemicals manufactured from natural vegetable oils to be used to make commercial bakery products and for frying in restaurants -Raise the LDL level in the blood -Will be restricted nationally from the U.S. food supply in 2018

avian flu epidemic

-Circulating among birds in Southeast Asia, Europe, and Africa in both domestic and wild birds -Strain called H5N1 -Mostly contracted by handling or eating a bird that is infected •Some cases of human-to-human transmission

lung cancer

-Deadliest of all cancers worldwide -Primary cause is cigarette smoking -Dismal survival rate -Risk varies significantly among ethnic and racial groups •African-Americans and native Hawaiians face the highest risk. Rate is rising rapidly in other nations

diet

-Diets that lessen the risk of CVD emphasize: •Daily consumption of four-to-five cups of fruits and vegetables •Three-to-six servings of whole grain foods •Low-saturated and no trans fats •Low-cholesterol •Low sugar •Low salt

coffee, tea, and cocoa

-Drinking moderate amounts of coffee poses little or no risk for CVD. •May be slightly helpful in certain people. -Green and black tea contain antioxidant chemicals that help block oxidation of LDL particles. •Herb teas do not contain antioxidants. •Chemicals called polyphenols are credited with tea's cardiovascular protective effects. -Cocoa contains chemicals called flavonoids, which seem to increase blood flow and reduce the development of high blood pressure. -Most cocoa sold in the United States is highly processed and sweetened to make it palatable.

psychosocial factors

-Factors that increase the risk for CVD •Smoking and/or overeating to deal with stress •Unpleasant emotional states •Personality factors such as hostility •Stressful social factors -Biological relationships include: •Chronic changes in the stress-hormone system •Inflammation -Both immediate and long-term stressors are related to the risk of CVD. •Examples of immediate stressors -Mental stress -Intense sporting events •Examples of long-term stressors -Work-related stress -Marital dissatisfaction Stressful major life events

cardiopulmonary resuscitation (CPR)

-Hands-on emergency procedure administered to a person who has: •Stopped breathing •Experienced sudden cardiac arrest (SCA) -Caused by heart chambers not breathing in rhythm •Had a heart attack and whose heart stops beating -Caused by death of heart muscle -Signs of cardiac arrest •Absence of heart beats, blood flow, and pulse -CPR involves: •Mouth-to-mouth breathing •Repeated, rapid, and vigorous chest compressions -Forces blood to circulate -Steps •Check for responsiveness. •Carefully place the person on their back. •Tilt the head back and lift the chin until the teeth almost touch, and look for signs of breathing. •If the person is not breathing, pinch the nose and give the person two full breaths about two seconds long to produce a visible chest rise. •Kneel at the person's side, near the chest, place your hands in the center of the chest, between the nipples, and place one hand on top of the other. •With elbows locked, press the heel of your hand into the chest. •Give 30 hard, rapid compressions for every 2 breaths. •Repeat until medical help arrives or until the person starts breathing.

heart failure

-Heart too weakened by arrhythmia or other heart disease to pump sufficient blood throughout the body, even after surgical and medical interventions -Symptoms •Fatigue •Diminished movement capacity •Shortness of breath •Edema -Requires heart transplant •Involves being put on a waiting list for a suitable donor •Person must live and wait near a hospital where heart transplant surgeries are performed •Complex, costly procedure •Not always successful •Requires immune-suppressive drugs for life

2009 influenza pandemic

-In April 2009, hundreds of cases of influenza were reported in Mexico. •Caused by a strain of virus that normally infects swine, so initially it was called "swine flu" •Later, it was determined to be H1N1. -Fortunately, it lacked the virulence gene that made previous pandemic flu so deadly.

emerging infectious diseases

-Infections that newly appear, or re-emerge, within a vulnerable population of people or known infections that are suddenly spreading rapidly -Can be caused by previously known, undetected, or newly evolved infectious agents -Factors that contribute to the emergence of new infectious diseases •Increasing growth and mobility of the world's population •Overcrowding in cities with poor sanitation •Mass-produced food with international distribution •Unsanitary food preparation •New or increased exposure of humans to disease vectors •People living in close contact with animals that can host infectious organisms •Overuse of antibiotics •Poverty •Wars •Destructive ecological changes due to economic development, land use, and climate change -Zika Virus (ZIKV) •Transmitted by mosquitoes •Migrated to South and Central America from Africa and Asia by 2015, causing a very dangerous infection in pregnant women -Children were born with microcephaly •Severity of birth defects varies widely •Congenital Zika Syndrome is a condition in which babies and fetuses show one or more of the following: -Severe microcephaly -Brain damage or diminished brain tissue -Defects at back of eyes -Limited range of motion in joints -Excess muscle tone restricting body movements

mononucleosis

-Infectious disease common in young adults -Caused by Epstein-Barr virus (EBV) infection -About half of all children have become infected with EBV by age 5. -Once infected with EBV, the virus remains in the body for life. -Symptoms that develop when teenagers or young adults become infected include: •Swollen glands •Sore throat •Fever •Chills •Complete exhaustion and loss of energy •Enlarged spleen (about half of cases) Jaundice (only in a small percentage of cases) -Treatment •No specific treatment •Primary focus is rest and fluid intake •Important to avoid strenuous activities to protect the spleen •Also important not to drink alcohol or take other drugs that may further injure the liver -Incubation period •Children may show symptoms in 1 to 2 weeks. •Adults may not develop symptoms for 1 to 2 months. -If infected, you should try not to: •Kiss anyone •Share food or drinks Sneeze or cough near others

aspirin

-Lessens the risk of blood clots -Combats inflammation -Generally prescribed in low-dose form (81 mg) to people who have had a heart attack or stroke -Anti-blood-clotting action can be dangerous •People with low risk of heart disease should not expose themselves to that risk.

alcohol

-Light to moderate alcohol consumption is associated with: •Lower risk of cardiovascular disease. •Reduction in LDL cholesterol •Increase in HDL cholesterol •Reduction in inflammation -Excess alcohol consumption is associated with high blood pressure and weakened heart muscle.

salt (sodium)

-Major reason for recommended reduction in salt intake to 3 grams per day is the possible increased risk of high blood pressure •Reducing salt intake has no effect on blood pressure for people with normal blood pressure. -Eliminating most processed foods from your diet will automatically reduce your daily salt intake.

physical activity

-Makes people feel better -Gives them more energy -Reduces anxiety and depression -Lessens cravings for alcohol, cigarettes, and junk food -Can significantly reduce the risk of cardiovascular disease and death -Strengthens the heart's ability to pump blood to the lungs and throughout the body -Also helps to: •Maintain healthy blood pressure, normal blood sugar and fat levels •Increase blood levels of HDL •Reduce inflammation •Reduce overweight and smoking tobacco

male and female sexual biology is determined at conception

-Males produce sperm. -Females produce ova and bear children. -Gender is determined by sex chromosomes. -XY pair of sex chromosomes determines maleness. -XX pair of sex chromosomes determines femaleness.

sexual difficulties

-May be the result of: •Lack of interest •Erection problems •Rapid ejaculation •Painful intercourse Orgasm difficulties -Lack of interest may be caused by: •Underlying sexual difficulty •Failure to communicate likes and dislikes •Boredom •Stress, fatigue, and depression •Alcohol and other drugs •Pregnancy and children •Hostility and anger •Change in physical appearance •Physical illness

menopause

-Menarche •First menstruation of a young woman •Experienced typically between 12 and 13 years of age -Menopause •Normal and gradual cessation of ovulation and menstruation •Usually occurs between the ages of 50 and 52 years •Not necessarily the end of sexual interest and abilities •Should not be viewed as a disease

prostate cancer

-Occurs primarily in men over 65 -Generally very slow-growing -May never become life-threatening -Tests important to early diagnosis •Finger rectal exam •Prostate-specific antigen (PSA) test -False positives are common. -Primary risk factor is being elderly

the postpartum transition

-Puerperium or postpartum period •The 6 weeks after childbirth -Physiological changes of pregnancy slowly reverse -Mother and partner begin to adjust to the new life situation -"Baby blues" are common, but 13% of women experience significant postpartum depression and require professional help. -Preparation of breasts for nursing begins in the early weeks of pregnancy •Increase in number of milk ducts and deposit of fat in breast tissue -Colostrum •Precursor to mother's milk •Production begins midway through pregnancy •Major substance emitted from breasts in the first few days after birth •Breastfeeding -Prolactin •Hormone that controls the synthesis of milk -Oxytocin •Hormone that causes milk ducts to contract and eject milk from the nipple •Also stimulates uterine contractions, which helps return the uterus to its prepregnant size -Advantages •Economical and readily available •Transfers immunity •Promotes development of the digestive system •Associated with fewer allergies and digestive problems •Provides more balanced nutrition •Helps the uterus return to its normal size •May increase the psychological attachment between mother and child -Some women are unable to or choose not to breastfeed •Many healthy, well-adjusted people were bottlefed infants -Weaning •Discontinuing breastfeeding and using other means to provide nutrients -Physical contact and loving is more important than whether milk comes from a bottle or breast.

testicular cancer

-Rate among young men has been increasing •Causes are unknown •Exposure to xenoestrogens may play a role. -Still quite rare -Can usually be cured if detected early Monthly self-exams are recommended

cardiovascular disease

-Refers to any number of conditions that damage the heart and blood vessels -May stem from: •Biological malformations present at birth -Congenital heart disease •Bacterial infections of the heart and surrounding tissues -Rheumatic heart disease and pericarditis •Injury -May also occur in association with other diseases

coronary heart disease

-Result of fatty deposits (plaque) in the heart's coronary arteries •Impede or completely block the transport of oxygen and nutrients to the heart muscle cells, causing a heart attack

stroke (brain attack)

-Second most frequent cardiovascular disease -Occurs when sufficient blood does not reach brain cells and they die

masturbation

-Self-stimulation to produce erotic arousal -Widely practiced even though it is seen as improper in many circles -People masturbate to: •Experience erotic pleasure •Relieve physical tensions •Produce a sense of relaxation and/or induce sleep •Create feelings of intimacy and bonding with a partner

hepatitis

-Serious liver disease caused by: •Environmental agents such as excess alcohol consumption, exposure to pesticides, and drugs •Infection by hepatitis virus A, B, C, D, or E -Hepatitis A (HAV), B (HBV), and C (HCV) are the most common viral causes. -Hepatitis A •Spread primarily by fecal-oral transmission route -Can also become infected from contaminated water or from eating food handled by an infected person •Symptoms -May include jaundice, fatigue, loss of appetite, abdominal pain, and intermittent diarrhea -Usually clear up within a few weeks •Very effective vaccination is available -Hepatitis B •Causes serious, persistent liver infection and may lead to fatal liver cancer •Does not always produce symptoms -If present, symptoms include jaundice, fatigue, abdominal pain, loss of appetite, nausea, and vomiting •Transmitted via blood •Vaccine is available and is recommended for all children and all persons at high risk of exposure -Hepatitis C •Little is known about this disease. •Most common reason for liver transplant •Consists of many related viruses •Transmitted exclusively via blood and blood products •Treated with Sovaldi (sofosbuvir) and Olysio (simeprevir), which are effective, but expensive •Low risk of infection except for intravenous drug users and healthcare workers exposed to needle punctures -Hepatitis D •Virus is defective •Cannot grow by itself •Only detected in the presence of HBV infection -Hepatitis E •Transmitted via oral-fecal route in contaminated food and water •Causes same symptoms as HAV and does not result in chronic infection •Occurs primarily in developing countries where sanitation is poor No vaccine available

lyme disease

-Serious, difficult-to-diagnose infectious disease caused by Borrelia burgdorferi bacteria deposited by ticks when they bite -Most commonly contracted in woods during warm months when ticks are feeding on deer and small mammals -If unrecognized and untreated, it progresses through three stages. -Stage 1 •Red rash around the tick bite that gradually spreads •May cause fatigue, headaches, and some joint pain -Stage 2 •After a month or 2, 15% of those bitten experience neurological symptoms. -Stage 3 •Weeks to 2 years after the bite, about 60% of people develop arthritis, especially in the knees. -Diagnosis •Can be difficult because symptoms are similar to many other diseases •Blood tests are helpful, but not always reliable. -Treatment •Treated with antibiotics at all stages -Prevention •Currently no vaccine available •New genetic engineering techniques offer hope of eliminating Lyme disease where mice are a reservoir •Being completely covered with clothing in tick-infested areas can help you avoid contracting Lyme disease.

skin cancer

-Skin •Upper layer consists of flat squamous cells. •Bottom layer contains basal cells. •Melanocytes are found between the two layers. -Give skin its color -People with more melanocytes are less susceptible to skin cancer than are light-skinned people. -Exposure to sunlight •Primary cause of all forms of skin cancer •Degree of exposure in childhood largely determines the risk of skin cancer later in life •Two factors contribute to the risk of skin cancer -Sunbathing and booth tanning -Increased UV radiation due to ozone depletion •Reducing sun exposure reduces the risk of skin cancer. -Sunlight contains ultraviolet radiation (UVR) •Energetic form of radiation that can: -Penetrate skin cells -Damage DNA -Initiate genetic changes that may eventually develop into a skin cancer Most dangerous forms are UVA and UVB -Three kinds •Basal cell carcinoma -Can usually be removed surgically •Squamous cell carcinoma -Cancer of the top layer of skin -Usually curable if removed early •Melanoma -Particularly dangerous form of skin cancer -Melanoma •Very dangerous •Difficult to cure once it has spread •Medical treatment -Surgical removal in early stages -Chemotherapeutic drugs to stop the growth of cancer cells -Radiation therapy to kill cancer cells or keep them from growing Immunotherapy

ulcers

-Sores or holes in the lining of the stomach -Was long thought that gastric ulcers were caused by stress, anxiety, smoking, and alcohol consumption •Discovered in 1983 that the Helicobacter pylori (H. pylori) bacterium was the actual cause •About 50% of the U.S. population is infected with H. pylori. -Symptoms •Gnawing or burning abdominal pain •Nausea, vomiting, and loss of appetite (less common) •Anemia (if the ulcer bleeds for a long time) -Tests to detect H. pylori •Blood •Breath Endoscopy -Treatment •Antibiotics cure ulcers. •Therapy is one to two weeks of an antibiotic and a medicine that will reduce the acid in the stomach.

male sexual anatomy

-Testes •Produce sperm and sex hormones -Sperm ducts •Transport sperm from testes to penis -Scrotum •Location of testes •Keep testes cool for sperm production -Semen •Formed as sperm move out of the body and mix with secretions from the seminal vesicles, prostate gland, and Cowper's glands -Penis •Normally soft, but becomes erect when sexually aroused •Foreskin covers the end of the penis •Circumcision (removal of the foreskin) eliminates the buildup of smegma.

regulating blood flow

-The cardiovascular system is equipped with one-way valves in the chambers of the heart and blood vessels. -With every heartbeat, the valves open and close to allow blood to flow in one direction. -Defective valves can be replaced or repaired to allow normal function. -Rheumatic Heart Disease •Serious inflammation of the heart valves •Caused by damage to heart valves from repeated childhood streptococcal infections •Mitral and aortic valves are particularly susceptible •A cardiologist can detect abnormalities in the heart's valves by listening to the heart beat. -Varicose veins •Appear as bluish bulges in veins, usually in the legs •Occurs when the valves of the veins get weakened from fighting the pull of gravity when returning blood to the heart. -Blood tends to accumulate, distending the veins and producing visible varicose veins. •Not life-threatening •Can often be corrected with surgery

stroke

-Third leading cause of death in the United States, after coronary heart disease and cancer. -High blood pressure is related to at least 70% of all strokes. -It is a form of cardiovascular disease that affects arteries supplying blood to the brain. -Brain cells die within minutes without oxygen. -A person who has had a stroke can: •Lose the ability to speak •Become paralyzed in an arm or leg •Lose the use of one whole side of the body -Stroke can occur: •From aneurysms that balloon and rupture •When a weak heart cannot pump enough blood to the brain -Ischemic stroke •Results when one or more blood vessels in the brain become blocked due to a clot in an artery in the brain or in one leading to the brain -Hemorrhagic stroke Results when a blood vessel in the brain ruptures -Warning signs •Sudden weakness or numbness of the face, arm, or leg on one side of the body •Sudden dimness or loss of vision, especially in one eye •Loss of speech, difficulty understanding speech, or trouble talking •Sudden, severe headaches with no known cause •Unexplained unsteadiness, dizziness, or fall -Carotid endarterectomy •Surgical procedure that removes fatty deposits by inserting a stent in a clogged artery in the neck •Might be beneficial for some patients at risk for strokes May precipitate a stroke -Risk factors that can be reduced with lifestyle changes: •High blood pressure •Heart disease •Cigarette smoking •Transient ischemic attacks •High red blood cell count -Risk factors that cannot be changed: •Increasing age •Being male •Race •Diabetes mellitus •Prior stroke •Heredity

the fertility or menstrual cycle

-Women usually produce one ovum every month or so that could be fertilized. -When the ovum is being produced, many changes occur in the body to prepare the body for pregnancy if the ovum is fertilized. -During this time, the endometrium, or lining of the uterus, begins to thicken to support the first stages of pregnancy, and blood vessels increase in size. -If the ovum is not fertilized, the endometrium and blood vessels are shed, causing a discharge called menstruation. -The length of time from one menstruation to another is the menstrual cycle. •Cycles generally vary between 24 and 35 days, with 28 days being the most common. -Hormones from the hypothalamus influence the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). •Induce the secretion of estrogen and progesterone from the ovaries Helps prepare the body for pregnancy -Dysmenorrhea •Abdominal pain and cramping that usually occurs during the first day of menstruation •Prostaglandins induce strong contractions of uterine muscle tissue. -Premenstrual dysphoric disorder •Combination of mood swings, depression, irritability, and anxiety •Severe enough to impair personal functioning -Relief from premenstrual symptoms can be achieved by: •Reducing caffeine, sugar, and salt intake around the time of menstruation •Increasing exercise •Increasing the intake of vitamin B6 •Having an adequate intake of calcium •Taking certain medications -Amenorrhea •Interruption or cessation of regular menstrual periods •May be caused by psychological stress, depression, fatigue, or severe calorie restriction •Examples of factors that can interfere with regular menstruation include psychological stress, depression, marital or sexual problems, fatigue, ingestion of opiate drugs, medications for depression, anxiety, hormonal imbalances, and nutritional abnormalities.

sexuality

according to World Health Organization-"(A) state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled."

why people do not use fertility control

•15% of sexually active, fertile American women don't use birth control despite being at risk for an unwanted pregnancy. •Why? -Low motivation -Lack of knowledge -Negative attitudes about fertility control -Relationship issues

AIDs and HIV

•AIDS (Acquired Immune Deficiency Syndrome) -Fatal infection caused by HIV -Gradually weakens the body's immune system -Course is unpredictable •Long-term HIV-infected survivors have three genes that keep the HIV level low enough to maintain immune function and prevent development of AIDS. •Most HIV-infected patients must take powerful drugs to keep HIV in check and prevent progression to AIDS. -First recognized as a distinct disease in the early 1980s in the United States •More than half of victims live in Africa. -Called a syndrome because it is defined by the appearance of any one of several different infectious diseases -Characterized by a very low level of a particular immune system cell called the CD4 T cell •HIV -Very small virus with little genetic information -Takes control of an infected cell's normal biochemical activities and utilizes them during infection -Dependency factors •Elements HIV takes over in cells •Targets for drugs that can prevent growth of HIV •Anti-HIV drugs -Prevent transmission of HIV from HIV-infected women to their babies during birth •Circumcised men are much less likely to: -Be infected by HIV during intercourse with an infected woman -Transmit HIV to women partners •The HIV Antibody Test -Detects antibodies in blood that are produced in response to infection by HIV -Does not measure the amount of HIV in the body -Positive only after antibodies have reached a detectable level -False-positive results possible -Western blot Measures the presence of HIV proteins •Preventing HIV Infection -HIV is not very infectious compared to other viral infections. •Never transmitted by casual contact •Not transmitted in saliva, sweat, air, water, or by objects that have been used by an HIV-infected person

understanding allergies

•Allergies -Immune system's response to allergens that the body perceives as being harmful, but usually are not -Common allergens •Pollen and mold •Animal hair and house dust •Foods Drugs and chemicals -Body responds to allergens by manufacturing immunoglobulin E (IgE) antibodies, which trigger the allergic reaction -Usually accompanied by: •Secretion of mucus •Release of histamine, an inflammatory chemical abundant in cells of the skin, respiratory passages, and digestive tract •Contact Dermatitis -Skin inflammation caused by touching something -Arises by two mechanisms •Allergic contact dermatitis -Allergic response to specific proteins that contact the skin -Examples: poison ivy and latex •Irritant contact dermatitis -Non-allergic response caused by cell damage and inflammation as a direct result of substances that contact the skin -Example: diaper rash and scented soaps -Anaphylactic shock •Severe allergic reaction involving the whole body •Can cause death •Asthma -Chronic disease involving inflammation and narrowing of the airways, making breathing difficult and occasionally nearly impossible -Caused by: •Tightening of muscles surrounding the airways •Swelling of cells that line the airways •Production of mucus -Often a reaction to inhaling a respiratory irritant -Sufferers are counseled to: •Avoid substances and situations that trigger attacks •Use inhalers containing drugs that help alleviate or prevent asthma attacks -Very severe attacks may require emergency medical intervention -Can arise or be made worse by emotional upset and stress -Risk factors •Family history of allergy •Low socioeconomic status •Non-Caucasian ethnicity •Male gender •Age greater than 5 years •Exposure to tobacco smoke, dust, or cockroaches -Deaths are rare •Food Allergies -Allergic responses to a particular food -Not to be confused with food intolerance -Can be local or can involve the whole body -Most common in children, but can occur in anyone at any age -Six substances account for 90% of the allergic reactions: eggs, peanuts, milk, fish, soy, and wheat -About 20% of people report food intolerance of one sort or another at some time in their lives. •Studies shows that 6% to 8% of children test positive for food allergies and 3% of adults do.

orgasm

•Orgasm -Climax of sexual responses and the release of physiological and sexual tensions -Associated with: •Rhythmic contractions of pelvic muscles •Tightening of the muscles of the face, hands, and feet •Feelings of pleasure -Orgasmic experiences vary greatly from person to person and from encounter to encounter. •May be "big" or "small" •May be no orgasm at all if the person is not sufficiently aroused, or is too tired, tense, or ill -Spectatoring •Observing one's own sexual experience rather than fully taking part in it •Form of psychological detachment

fertility awareness methods

•Also called: -Natural family planning -Rhythm method -Periodic abstinence •Involves attempting to determine when an ovum has been released and is capable of being fertilized -Typically most fertile 14 days before the next menstrual period •Requires estimating either: -When ovulation is most likely to occur -When ovulation has already taken place •Safe days -Days in which the woman is not likely to be fertile •Unsafe days -Days in which the woman is likely to be fertile Fertilization is still possible on safe days •Advantages -No health risks -Only acceptable method in some religions •Disadvantages -Least effective method because people: •Do not keep effective records •Find it too difficult to abstain during unsafe days •Find having to plan sex only for safe days a hindrance to spontaneous lovemaking •Calendar Rhythm -Estimates the most likely fertile days in a woman's cycle by assuming that: •Ovulation usually takes place 14 days (± 2 days) before the onset of the next menstrual flow. •An ovum is capable of being fertilized after 24 hours. •Sperm deposited in the vagina remain capable of fertilization for up to 3 days. -Requires knowledge of the female fertility cycle and instruction in proper calculations •The Temperature Method -Based on basal body temperature (BBT) •Lowest body temperature during waking hours •Rises approximately 1˚F after ovulation in most women -Can determine when ovulation has occurred by keeping a daily record of the BBT •Can use this information to identify safe days and unsafe days •Must still estimate when ovulation will occur using another fertility awareness method -Temperature measurements should: •Take at least 5 minutes •Be taken at the same time each day •Be recorded on a graph -Once the BBT has risen for three consecutive days, a woman can assume that ovulation has taken place. •The Mucus Method -Certain hormone-sensitive glands in the cervix produce mucus that changes in amount, color, and consistency during different phases of the menstrual cycle. Those who use this method learn to recognize the changes in mucus and determine when ovulation occurs -Requires that cervical mucus be examined frequently during the cycle •Collection with a finger is best. -Many factors can interfere with the recognition of mucus patterns. •Important to get instruction from a reliable source -Sympto-thermal method •Using the temperature and mucus methods simultaneously •Chemical Methods -Estimate ovulation with considerable accuracy -Usually marketed to couples trying to become pregnant -Methods •Measuring luteinizing hormone in the woman's urine •Using a fertility monitor to test for changes in the composition of the woman's saliva around the time of ovulation

how birth defects are detected

•Amniocentesis -Aspiration of amniotic fluid to detect certain abnormalities -Performed in: •First trimester for genetic studies •Second trimester for Rh isoimmunization studies •Third trimester for assessing fetal lung maturity •Chorionic Villus Sampling (CVS) -Used to detect biochemical disorders and chromosomal abnormalities in the fetus -Involves removing a small sample of chorionic villi—threadlike protrusions composed of fetal cells found on a membrane surrounding the fetus -Can be performed as early as the 8th week after the last menstrual period

ebola

•Among the smallest viruses -Each virus particle contains only seven genes. •Belongs to a class of viruses called hemorrhagic viruses -Produce extensive bleeding •Death rate averages more than 50% of people infected •Symptoms similar to most viral infections •No specific medicines Patients receive supportive therapy •Death occurs from failure of the kidneys or liver, or from loss of blood. •All body fluids of ebola patients carry infectious viruses. •An ebola virus that provides almost complete protection against the virus has been produced.

what is an STD?

•An infection transmitted by sexual behavior •STD-causing agents can enter the body by: -Breaks in the skin -Mucous membranes of the body's orifices -The blood, either by injection or microscopic abrasions on the penis, vagina, anus, or mouth •A certain number of STD-causing agents must be transferred to cause an infection.

risks to fetal development

•Birth defects -Can be caused by a variety of factors -Affect about 3% of babies born in the United States each year -Can mildly or severely affect the structure and/or function of almost any part of the fetal body -Can significantly hamper life functions -Most occur in the first three months of pregnancy •Principal causes of birth defects include: -Heredity -Mother being older than 34 -Mother's health -Mother's lifestyle -Exposure during pregnancy to environmental pollutants and industrial chemicals •Drugs -Any drug or medicine ingested by a pregnant woman can potentially harm her fetus. A woman should avoid all drugs during pregnancy except those deemed necessary by a healthcare provider •Alcohol -When alcohol crosses the placenta, it: •Reaches a level in the fetus equal to that in the body of the mother •Remains in the fetal blood long after it has disappeared in the mother's blood because the fetus is small and its detoxification system is immature -The fetus is at risk of developing fetal alcohol syndrome (FAS) if the mother drinks 6 or more drinks per day during pregnancy. -Symptoms of FAS •Growth retardation •Facial malformations •Central nervous system dysfunctions •Cigarette Smoking -Increases the chances of: •Spontaneous abortion •Complications that can result in fetal or infant death -Reduces the amount of oxygen in the bloodstream -May be teratogenic, causing cardiac abnormalities and anencephaly -Significant factor in the development of cleft lip and palate

environmental factors that cause cancer

•Certain environmental factors are strongly correlated with the occurrence of particular cancers. •Epidemiology -Branch of science that studies the causes and frequencies of diseases in human populations -Many epidemiological studies show that as many as 80-90% of all cancers are caused by exposure to environmental agents. •Three classes of environmental agents have been shown to increase the risk of cancer -Ionizing radiation -Infectious microorganisms (viruses and bacteria) -Cancer-causing chemicals (carcinogens) Each of these agents increases the risk of cancer by producing genetic mutations •Ionizing Radiation -Can damage cells and chromosomes -Sources •X-rays •UV light -Most common source -Includes UVA and UVB solar wavelengths •Radioactivity -Nuclear incidents and certain types of medical imaging •Infectious Microorganisms -Tumor viruses •Viruses that infect cells, change their growth properties, and cause cancer •Include: -Hepatitis B and C (liver cancer) -Papillomavirus (genital and cervical cancers) -Human T cell leukemia-lymphoma virus (leukemia and lymphoma) -Epstein-Barr virus (cancer of the nose or pharynx) -Tumor viruses (continued) •HIV -Associated with the development of a particular cancer called Kaposi's sarcoma •Helicobacter pylori bacterium -Found in the stomach and causes ulcers -Associated with an increased risk of gastric cancer, one form of lymphoma, and possibly pancreatic cancer •Chemical Carcinogens -Environmental chemicals that can interact with cells to initiate cancer -Examples •Cigarette smoke •Pesticides •Asbestos •Heavy metals (lead, mercury, cadmium) •Benzene •Nitrosamines -In some industries, workers have cancers that almost never arise in the general population. The total number of cancers attributable to industrial chemicals is small compared with those caused by tobacco and diet •Do Xenoestrogens Cause Cancer? -Xenoestrogens •Chemicals found in the environment that mimic estrogen and aid in the development of cancer, specifically breast cancer -Substances that contain xenoestrogens: •Pesticides such as DDT, methoxyclor, kepone, chlordane, atrazine, and endosulfan •Polychlorinated biphenyls (PCBs) •Bisphenol-A (BPA) -Eating broccoli, cabbage, and soy products may help counteract the effects of xenoestrogens.

how the body protects itself

•Skin and mucous membranes -Function as physical barriers to microorganisms -Mildly acidic skin provides a poor habitat for most harmful microorganisms. -Mucous membranes produce secretions that: •Flush away harmful organisms and particles •Contain enzymes that can destroy toxic substances •The body also protects itself with: -Tears that serve to wash foreign particles out of the eyes -Wax that protects the ears -Cilia that keep mucus moving out of the bronchial tubes -Cells and enzymes that form clots to seal off breaks in the skin •Leukocytes -Specialized white blood cells that protect the body during infections -Can increase dramatically in number if an acute infection occurs •Macrophages -Specialized cells that destroy and eliminate foreign particles and microorganisms from the body -Associated with specific organs

childbirth

•Childbirth Preparation -6- to 8-week courses help prepare the expectant couple or parent for childbirth. -Studies show that emotional support during childbirth can: •Shorten labor time •Give the woman a greater perception of control •Decrease the need for pain medication •Lead to fewer complications •Giving Birth -Lightening •Positioning of the fetus for birth by descent in the uterus •Occurs a few weeks before childbirth •Relieves pressure on the mother's internal organs -Fetus is in a head-down position in most births •Breech position is any position other than head-down -Braxton-Hicks contractions •Normal uterine contractions that occur periodically throughout pregnancy •Distinguished from true labor by their occurrence at irregular intervals and short duration -First-stage labor •Starts with uterine contractions and lasts until the cervix is fully dilated -Second-stage labor •Starts when the cervix is fully dilated and the infant descends into the birth canal -Third-stage labor •Lasts from the time of birth until the delivery of the placenta, or afterbirth

common infectious diseases

•Colds -Caused by viruses, primarily human rhinovirus (HRV), that infect cells of the respiratory tract -No vaccine because HRV is genetically diverse -Does not result in long-term illness or death -Takes the immune system about a week to produce antibodies to inactivate the viruses and for tissues to heal -No drug to reduce the risk of catching a cold •Influenza -Much more serious than a cold -Causes body aches, high fever, loss of appetite, and other complications -Can lead to pneumonia and death -New vaccines every year, but not always effective -People with respiratory problems, people with immune system deficiencies, and the elderly are most susceptible. -Easily transmitted: •In droplets from people who are coughing or sneezing •By bodily contact with someone with a cold who has recently wiped his or her nose or mouth -Wash your hands frequently during cold and flu season. -Structure of Influenza Viruses •Hundreds of strains can be constructed by reassortment of its eight segments of genetic information •Two proteins on its surface determine which cells it can attach to and its lethality to specific species -Hemagglutinin (H) protein Neuraminidase (N) protein -Defining an Influenza Pandemic •The World Health Organization defines an influenza pandemic in six phases. •In the final phase, the virus has spread to many countries in at least two distinct regions of the world. •Major pandemics in the last century: -H1N1 strain in 1918 -H2N2 strain in 1957 H3N2 strain in 1968

hormonal contraceptives

•Combined Hormonal Contraceptives -Contain estrogen and progesterone -Chemically similar to a woman's natural ovarian hormones -Available as pills, skin patches, vaginal inserts, and by injection •Combined Hormonal Contraceptives -Combined contraceptive pills •Come in packets of 21, 24, or 28 pills, or as a 90-day extended-use pill •Should be taken at the same time each day •Effectiveness may be lessened when taken with herbal supplements or medications •Combined Hormonal Contraceptives -Side effects of oral contraceptives •Occur in about half of women taking them •May include nausea, weight gain, breast tenderness, mild headaches, spotty bleeding between periods, decreased menstrual flow, increased depression, and decreased sex drive •Combined Hormonal Contraceptives -Beneficial side effects of oral contraceptives •Lessening of acne •Diminution or absence of menstrual cramps •Decreased number of menstrual bleeding days •Absolute regulation of the menstrual cycle •May help prevent certain diseases •Does not impact future fertility •Combined Hormonal Contraceptives -Risks of oral contraceptives •Birth defects (if pills are taken during pregnancy) •Fatal blood clots and heart attacks -Greatest risk in women over age 35 and smokers •Slightly increased risk for liver disease, gallbladder disease, high blood pressure, and stroke •No increased risk of developing breast cancer -Skin patch •Applied to lower abdomen, buttocks, or upper body •Releases hormones slowly •Worn for 1 week, 3 weeks in a row, with no patch on the 4th week •Side effects and effectiveness similar to the pill •May cause skin irritation or fall off vaginal contraceptive ring •Inserted by the woman and replaced every 7 days for 3 weeks •Continuous release of hormones •Hormones, side effects, and risks similar to pills •Can be expelled before the 3 weeks are over •May cause vaginal discharge, vulvovaginitis, and irritation •Progestin-Only Contraceptives -Available as pills, injections, and implants -Inhibits ovulation and thickens the cervical mucus, making it difficult for the sperm to reach the egg -May cause changes in the lining of the uterus that damage sperm and make implantation less likely -Completely reversible •Progestin-Only Contraceptives -Side effects may include: •Menstrual irregularities •Weight gain •Depression •Fatigue •Decreased sex drive •Acne or oily skin •Headaches •Progestin-Only Contraceptives -Mini-pill •Contains 0.35 mg of progestogen or less •Taken daily for 3 weeks -Progestin-only implantation methods •Involve inserting a 1.5-inch rod containing hormones under the skin •Continuously releases hormone into bloodstream •Remains in place for 4 years •Effective, but often discontinued due to side effects •Progestin-Only Contraceptives -Progestin-only injectable methods (Depo-Provera) •Involves injecting a 12-week supply of a hormone intramuscularly •Releases hormone at a steady rate •New injection or other birth control method necessary at the end of 10 weeks •Can be used while breastfeeding, starting 6 weeks after delivery •Increased risk of bone loss with prolonged use

communicating in intimate relationships

•Communication -Symbolic process of creating and sharing meaning -Involves imparting a message to another person to: •Share information or feelings •Coordinate behavior with another •Persuade someone to do something •Most common symbols in communication -Words -Visual images -Posture or body language -Objects -Behaviors •Metamessage -How the message is interpreted •Sending Clear Messages -Clear messages are best delivered with I-statements (sentences that begin with "I"). -You-statements (begin with the pronoun "you") are often put-downs or character assassinations. •Effective Listening -Effective listening is important because the receiver takes in the sender's message and can establish the physical and emotional context for the communication. -The listener needs to communicate to the sender that the sender's message was received. This is called feedback. -Techniques •Give the speaker your full attention. •Make eye contact. •Just listen and be empathic. •Be an open channel for receiving a message. •Give verbal feedback. •Acknowledge the speaker's emotions. •Praise the speaker's effort. •Be unconditional. •Expressing Anger Constructively -Disagreements and conflicts are inevitable in close relationships. -By expressing anger constructively, intimates fight for the success of their relationship as well as for their individual needs. -There should be no "winner" or "loser" in constructive fighting. -Express feelings when you become aware of them. -Agree on a time, a place, and the content for fights. -Be specific as to what you are angry about and stick to the issue. -Attack the problem, not each other. -Try to resolve the issue with an air of compromise and respect. -Know when it is time to stop. -Engaging in sex or any other affectionate behavior before an issue is resolved should not be taken as a sign that everything is forgotten. -Don't hold grudges.

the psychological dimension of sexuality

•Emotions related to sexuality: -Joy, excitement, pleasure, love, and affection •Beliefs that affect sexuality: -Assessment of one's social and sexual attractiveness and self-worth -Appropriate attitudes and behaviors •Socialization -Process by which groups confer attitudes and expectations upon individuals •Gender -Tendency for individuals to classify themselves and be classified by their social group—socially, psychologically, behaviorally, and morally—according to their biological sex -Encompasses gender stereotypes, gender role, and gender identity -Gender stereotypes •Beliefs about the "natural" or "typical" characteristics of males and females -Gender role •Social expectations based on biological sex -Gender identity •Sense of oneself as being a male, female, or non-gendered -Gender identity •Cisgender -Consistent with one's sexual biology •Transgender -Incongruent wholly or in part with sexual biology •Q (Questioning or Genderqueer) -Not accepting the traditional binary definition of gender identity in favor of a more flexible, non-binary definition

chromosomal abnormalities

•Errors can occur when chromosomes are distributed to sperm or egg. •Chromosomal abnormalities result in hereditary diseases. •About 20% of all human conceptions have a chromosomal abnormality of some kind. -Most of these abort spontaneously, resulting in miscarriage. •Down syndrome -Caused by an extra chromosome 21 -Causes heart defects, altered facial features, and mental retardation -Life expectancy is about 40-50 years. -Occurs in about 1 in every 700 babies -Risk increases when maternal age is greater than 35, and even more when greater than 40 •Hereditary Diseases -Result when an abnormal gene is passed on to a child from one or both parents. -A protein is produced that is abnormal or completely missing. -Examples include muscular dystrophy, dwarfism, hemophilia, and phenylketonuria (PKU). -Tests are available to screen newborns for more than 50 inherited disorders. -Fragile X syndrome •Results from a defect on FMR1 •Most common form of mental retardation -Sickle cell disease •Caused by a defect in hemoglobin proteins, •Changes the shape of red blood cells, leading to clogs in small blood vessels -Familial Diseases •Children who suffer from certain diseases are at higher risk of developing these diseases compared with the average risk in the general population. •Only a physician or scientist trained in medical genetics can determine whether a disease or defect is the result of inherited genes, environmental factors, or both.

abortion

•Expulsion or extraction of the products of conception from the uterus before the embryo or fetus is capable of independent life •About 45% of unintended pregnancies end in abortion. •Almost all developed countries permit abortions without restriction completely or with a few grounds. •Two principal methods -Surgical abortion •Removing the post-fertilization contents of the uterus with a vacuum instrument -Medication abortion •Taking medications that stop pregnancy and force expulsion of the uterine contents •Less common than surgical abortion •Dilation and suction curettage (D&C) or vacuum aspiration -Used between the 6th and 14th weeks -Cervix is dilated and uterus is emptied with gentle, machine-operated suction •Dilation and evacuation (D&E) -Performed after the 15th week of pregnancy -Cervix is dilated and uterus is emptied with medical instruments, suction, and curettage •Medication abortion -Carried out prior to the 7th or 8th week after fertilization -Methotrexate or mifepristone (RU 486) •Blocks the action of progesterone, which is responsible for successful implantation and pregnancy -Misaprostol (a prostaglandin) •Induces contractions to expel the uterine contents -Small risk of toxic shock •Complications associated with medical abortion -Failed procedure (ongoing pregnancy) -Incomplete abortion Bleeding •Aftereffects of Abortion -The decision to terminate a pregnancy voluntarily is rarely an easy one. -Unintentionally pregnant women (and often their male partners) experience sadness, grief, and feelings of loss following elective abortion. -A woman's post-abortion mental health reflects her mental health status prior to the abortion. -Factors that increase the risk of negative psychosocial responses: •Need for secrecy •Low anticipated social support for the abortion decision •Low self-esteem •Using avoidance and denial as coping strategies •Characteristics of the particular pregnancy •The Legal and Moral Aspects of Abortion -In the United States, abortion was illegal from 1900 until 1973. -The U.S. Supreme Court decided that abortion laws violated a woman's right to privacy. •The decision of the pregnancy is determined by the woman up to 12 weeks. •Beyond 12 weeks, states can regulate the abortion procedure for only one purpose—to protect the woman's health. -Most people have mixed feelings about abortion. -Some people: •View it as murder •Believe it encourages irresponsible sexual behavior •Consider it a threat to family life -Others argue women must have the right to control their bodies.

west nile virus

•First reported in the United States in 1999 •Can be transmitted to humans via mosquitoes that bite infected birds, blood transfusions, and organ transplants •May cross the blood-brain barrier after two weeks and infect the nervous system •Causes symptoms such as tremors, convulsions, paralysis, coma, and death •Most people do not develop serious symptoms.

intrauterine device

•Flexible plastic T-shaped device -Contains copper or progesterone -Inserted into the uterus by a healthcare professional •Functions -Kills or weakens sperm -Alters the timing of the ovum's or embryo's movement through the fallopian tube •Side effects -May cause heavier menstrual flow or menstrual cramps •Increases risk of: -Pelvic inflammatory disease -Uterine perforations Ectopic pregnancy

coronary heart disease and heart attack

•Heart -Utilizes about 20% of the body's oxygenated blood -Requires considerable energy to run constantly -Supplied by the four small coronary arteries that branch off the aorta •Blockage of any of these arteries can result in the death of heart muscle cells •Significant cell death can cause a heart attack •If a heart attack has occurred, the levels of certain proteins in the blood begin to change. •Heart attack can be diagnosed by measuring: -Creatine kinase -Troponin -Myoglobin -Myosin •Angina pectoris -Chest pain caused by a lack of oxygen due to partial arterial blockage -Treated with nitroglycerin •If a plaque ruptures and a coronary artery becomes completely blocked, the person may have a fatal heart attack. •About 50% of people admitted to the hospital for possible heart attacks in the United States are found not to have had a heart attack. -Chest pains mimicking that of a heart attack can be brought on by: •Severe indigestion (heartburn) •Panic •Stress •Repairing Blocked Coronary Arteries -Cardiac catheterization •Used to determine whether, or to what extent, coronary arteries are blocked •Involves threading a thin tube from an artery in a leg or arm up to the coronary arteries to visualize the blockage -Coronary artery bypass graft surgery (CABG) •Open heart surgery in which blood is diverted around the heart and through a mechanical pump •Part of a healthy artery vein is removed from its normal site and is grafted to the blocked coronary artery •Allows blood to bypass the blocked portion •Risk of brain damage and cognitive loss -Percutaneous Transluminal Coronary Angioplasty (PTCA) •A thin wire is threaded from the femoral artery in the thigh up to the point of blockage. •Another thin tube containing a deflated balloon is threaded up to the area of arterial plaque. •Inflating the balloon pushes the plaque back into the arterial wall. -Stenting •If a blockage is found during an angioplasty, an object called a stent is inserted to prop it open. •Simpler, cheaper, and safer than bypass surgery. •Modern stents slowly release a drug that helps prevent the artery from becoming blocked again. -The particular procedure recommended for individual patients depends factors such as: •Number of arteries blocked •Patient's age •Other complicating diseases •Economic circumstances •Repairing Blocked Coronary Arteries -Clinical studies have shown that blockages can be improved through lifestyle changes. -Patients who are motivated and who change their lifestyle can improve the health of their arteries. •Most patients still opt for the quick fix of surgery, even though it is only a temporary solution for many.

pregnancy

•Human Chorionic Gonadotropin (HCG) -Hormone unique to pregnancy -Released into the maternal bloodstream soon after the embryo implants in the uterus -Stimulates the ovaries to increase production of estrogen and progesterone •Forestalls the next menstrual period •Permits the pregnancy to continue •Increased estrogen and progesterone levels bring about the first noticeable signs of pregnancy: -Absence of the next menstrual period -Occasional nausea and vomiting -Enlarged and tender breasts -Increased frequency of urination -Fatigue Enlargement of the uterus •Ectopic pregnancy -Pregnancy occurring outside the uterus -Usually occurs in a fallopian tube •Known as a tubal pregnancy -Embryo becomes too large for the fallopian tube between the eighth and twelfth weeks •Tube bursts, creating internal bleeding •Critical situation requiring medical intervention •Fetal Development -Pregnancy is divided into three 3-month trimesters. -Nearly all of the fetal body forms by the 10th week after fertilization. -Fetal development and growth take place in a fluid-filled sac called the amnion. -Amniotic fluid protects the fetus during development. -Placenta •Flat, circular vascular structure within the pregnant uterus that provides nourishment to and eliminates wastes from the developing embryo and fetus •Manufactures many hormones needed to sustain pregnancy •Passed as afterbirth after the baby is born -Changes in the mother during pregnancy •50% increase in blood plasma volume •10% increase in heart rate •20% to 30% increase in heart output •Increase in red blood cells •Breathing becomes deeper and slightly faster •Uterus grows from 7-8 centimeters long and 60-100 grams to 30 centimeters long and 1,000 grams •Sexual Interaction During Pregnancy -A woman's sexual interest and responsiveness may change throughout the course of her pregnancy due to psychological, emotional, and physical changes. -Sexual activity and orgasm may be continued, as desired, until the onset of labor. -Unless her healthcare provider counsels otherwise, there is no physical reason to forego sex during pregnancy.

the immune system battles infections

•Immune system -System of organs and cells that protect the body from infectious organisms and harmful substances -Takes time to develop -Antibodies •Proteins that recognize and inactivate viruses, bacteria, other organisms, and toxic substances that enter the body •Passed to newborns through blood and breast milk •Factors that can adversely affect the development and functioning of the immune system -Poor nutrition -Hereditary disorders -Viral infections -Stress Many drugs and chemicals •Severe Combined Immune Deficiency (SCID) -Rare genetic disease that renders the immune system inoperable -Must protect babies with this condition from any exposure to germs to avoid a fatal infection -Only cure is a complete bone marrow transplant -In 2015, an infant with this condition was given an injection of DNA containing a normal copy of the defective gene, which overcame his disease. •The Lymphatic System -System of vessels in the body that trap foreign organisms and particles •The immune system is part of the lymphatic system. -Lymph nodes •Nodules spaced along the lymphatic vessels that trap infectious organisms or foreign particles •"Swollen glands" are enlarged lymph nodes, and indicate that the body is fighting an infection. -Components that produce cells that allow the body to mount an immune response include: •Bone marrow •Tonsils •Adenoids •Spleen Thymus -White blood cells destroy infectious organisms in diverse ways. -T cells (T lymphocytes) attack infectious organisms. •The response is called cell-mediated immunity. -B cells (B lymphocytes) produce antibodies. •Their response is called humoral immunity. -Antigens •Foreign proteins on viruses, bacteria, and other infectious organisms that stimulate an antibody response -Cytokines •Small molecules that coordinate the activities of B cells and T cells -Classifications of T cells •Helper T cells -Increase proliferation of B cells •Killer T cells -Destroy cancer cells and other pathogenic organisms •Suppressor T cells -Retard the growth of other immune system cells •CD4 cells -Important indicators in the diagnosis and development of AIDS

infertility

•Inability to become pregnant or impregnate •Affects approximately one in five American couples -In about 40% of infertile couples, the problem lies with the male partner. -In 40% to 50% of infertile couples, the problem lies with the female partner. -For 10%, no cause can be determined. •Sterility is permanent infertility. •Reproductive capabilities can be impacted by: -Ill health -Cigarette smoking -Chronic use of alcohol, marijuana, or other drugs -Exposure to radiation or toxic chemicals -Malnutrition -Anxiety and stress -Fatigue •Conditions associated with infertility -Inadequate production of hormones such as GnRF, FSH, LH, testosterone, estrogen, and progesterone -Anatomical abnormalities or damage to the reproductive tract -Erectile and ejaculation difficulties -Excessively thick or voluminous cervical mucus production -Failure to have intercourse near ovulation •Enhancing Fertility Options -Artificial insemination •Introduction of semen into the uterus or oviduct by other than natural means -In vitro fertilization (IVF) •Egg is removed from a ripe follicle and fertilized by a sperm cell outside the human body •Fertilized egg divides in a protected environment for about 2 days, and is then inserted into the uterus Success rate ranges from 20-40%. •Enhancing Fertility Options -Gamete intrafallopian transfer (GIFT) •Similar to IVF •Ova are placed in equal numbers in each of the fallopian tubes and semen is introduced directly into the tubes. -Zygote intrafallopian transfer (ZIFT) •Eggs are fertilized in vitro and an embryo is placed in the fallopian tube. GIFT and ZIFT succeed 10-20% of the time

understanding cancer

•Incidence of Various Cancers -Since 2000: •Some have decreased •Others have increased -Overall cancer rates have not changed much since the 1980s. •Suggests that medical science and society at large must turn more attention to prevention if cancer rates are to decline significantly. •What Is Cancer? -Term comes from the Latin word meaning "crab" -Generally defined as the unregulated multiplication of specific cells in the body -Tumor •Mass of abnormal cells •May be benign or malignant -Cells of malignant tumors undergo metastasis and spread throughout the body. -Cancers are medically classified according to the organ or kind of tissue in which the tumor originates. -Major categories •Carcinomas •Sarcomas •Leukemias •Lymphomas -Cancer does not develop all at once. •Cells change their abnormal growth properties one step at a time. •Not all cells acquire the same genetic changes, nor can anyone predict when the changes will occur. -Biopsy •Removal of cells from a tumor for examination under a microscope -Stage I •Cancer cells are still localized. -Stage II •Cancer cells have begun to metastasize. -Stage III •Cancer cells have spread throughout the body. -Stage IV •Tumors are found throughout the body.

fighting infectious diseases

•Infectious diseases are fought in four ways -Sanitation -Treatment -Vaccination -Healthful living •Many medical historians claim that sanitation is the most significant medical advance of all time. •Understanding Antibiotics -Hundreds are available for treating diseases caused by bacteria -Block essential biochemical reactions of microorganisms that infect the body, preventing them from growing -Ineffective against viruses because viruses are not living cells -Antibiotic resistance •Can be transferred among bacteria in nature in a small piece of DNA •Two sources -In agriculture, antibiotics are routinely given to farm animals to prevent infections. -In medical treatment, bacteria can become resistant to frequent exposure to antibiotics in hospitals, and from prescriptions provided unnecessarily for viral illnesses.

the relationship dimension of sexuality

•Intimacy -Feeling of closeness, trust, and openness with another person -Tells us that our innermost self can be shared without fear of attack or emotional hurt and that we are understood in the deepest sense possible Intimate relationships can have an enormous impact on one's sense of vitality and well-being •The Life Cycle of Intimate Relationships -Intimate relationships tend to go through stages •Selecting a partner •Developing intimacy •Establishing commitment -Factors that influence the choice of partners •Proximity •Similarity •Physical appearance •Developing Intimacy -Intimacy develops through a progressive, mutual revealing of innermost thoughts (self-disclosure). -Self-disclosure leads to intimacy when you: •Make positive judgments about the information shared •Communicate trust by engaging in reciprocal self-disclosure •Establishing Commitment -After a period of self-disclosure, the relationship may progress to a state of "us-ness," which has three aspects: •An action, pledge, or promise •A state of being obligated or emotionally compelled •An unwillingness to consider any partner other than the current one •Endings -Occur for a variety of reasons •Feelings of attachment may be absent or weak •Life goals, values, or interests may no longer be shared •Unwillingness or inability to invest personal resources •Assessment of other options •Inability to move the relationship to the next stage •Lack of support from partners' social network -A breakup may cause a person to: •Feel tired and lethargic, sad or depressed, angry or resentful, or guilty •Be unable to sleep or eat •Miss class or be unable to work •Withdraw from friends •Have difficulty concentrating •Feel helpless and hopeless, or skeptical and cynical •Feel relaxed, hopeful, and relieved

the behavioral dimension of sexuality

•Involves: -Genital stimulation and responses and orgasm -Feelings of affection, love, joy, and intimacy -Sexual interest and desire -Being able to discover and create sexual pleasure in oneself and a partner -Evaluating and interpreting the effect of sexual experience on oneself, one's partner, and one's relationship with the partner •Sexual activity requires that a person be interested in creating a sexual experience. •The desire for sexual activity: -Varies among individuals and couples -Changes over time -Is influenced by interpersonal, physical, and psychological factors •Sexual activity -Not reflexive—being aroused or having a sexual opportunity does not automatically lead to sex -Result of a decision based on: •Social situation •Physical and emotional feelings •Personal criteria for being sexual •Expectation of how having sex at that time will affect oneself and the relationship •Sexual Arousal and Response -Everyone has preferences. -Erogenous zones •Genitals •Breasts •Anus •Lips •Inner thighs •Sexual Arousal and Response -Arousal sparks the brain and nervous system to prepare the body for sexual activity •Tightening of many skeletal muscles (myotonia) •Changes in the pattern of blood flow (vasocongestion) •Increased heart rate, blood pressure, and respiratory rate •Increased excitement and erotic feelings •Sexual Arousal and Response -Phase 1: Excitement •Sexual arousal causes specific physiological changes. -Phase 2: Plateau •Physiological changes of the excitement phase level off. -Phase 3: Orgasm •Built-up tensions are released. -Phase 4: Resolution The body returns to the nonstimulated state

preventing cardiovascular disease

•Maintain normal weight. •Avoid consumption of foods containing large amounts of saturated fats, trans fats, and cholesterol. •Eat a diet rich in fresh fruits and vegetables. •Do not smoke. •Consuming green tea and a glass of wine with dinner may be helpful. •Nothing is better for the heart than a healthy diet and plenty of exercise.

diet and cancer risk

•Many studies show that diet is associated with cancer. •Certain dietary choices may help prevent cancer, such as increased consumption of B vitamins, vitamin C, and folic acid. •The diet we consume today may be incompatible with the body chemistry we inherited from our ancestors.

preventing infections

•Methods include: -Maintaining health by proper nutrition, exercise, and sleep -Staying up-to-date on vaccinations -Remembering that stressful situations and emotional upsets make the body vulnerable to infectious microorganisms -Staying away from people and situations known to carry a high risk of infection

agents of infectious disease

•Microorganisms that can cause disease -Bacteria -Viruses -Protozoa -Yeast -Small worms •Viruses -Can only grow and reproduce by infecting a cell and usurping its cellular machinery -Cause diseases such as colds, flu, polio, hepatitis, chicken pox, mumps, measles, herpes, and HIV/AIDS •Bacteria -Cause diseases such as pneumonia, tuberculosis, cholera, plague, typhoid fever, and gonorrhea •Etiology -Specific cause of disease •Communicable disease -Infectious disease that is usually transmitted from person to person •Vector -Carrier of infectious organisms from animals to people or from person to person •Whether a person gets an infectious disease depends on a wide range of factors, including: -Competence of the immune system -Nutritional status -Stress -Presence of other diseases Environmental conditions •In many regions of the world, millions of people still die from infectious diseases. •Many countries lack resources to ensure: -Safe water supplies -Public sanitation -Safe waste disposal -Adequate health care

causes of cancer

•Most Cancers Are Not Inherited -Scientific studies indicate that 90-95% of all cancers are not inherited from parents. -The terms genetic and inherited are not synonymous. •Cancer is a genetic disease in that genes are changed in a person's body cells. •It is not an inherited disease because defective genes were not usually passed on from parents. •Cancer Susceptibility Genes -Make a person carrying such a gene more vulnerable to environmental factors that contribute to the risk of developing cancer •They do not specifically cause cancer. -Believed that most have little effect in the vast majority of people •Only a few play significant roles in the development of specific cancers. -Many genes that increase the risk of colorectal cancer have been identified. •If a person inherits an abnormal form of the APC, MSH2, or MLH1 genes, the risk of colorectal cancer is increased. •During a person's lifetime, mutations continue to arise and accumulate in cells lining the colon. Rapid sequencing of DNA can identify abnormal genes in a cancer patient's tumors

infectious microorganisms

•Most microorganisms are not harmful when they are present in or on the body. -Bacteria perform many essential functions in many parts of the body. -Some areas of the body must remain sterile. •Pathogen -Any microorganism that infects the body and causes disease •Bacteria in Health and Disease -Bacteria play a role in keeping us healthy. -Widespread use of antibiotics has created strains of pathogenic bacteria that are not killed by antibiotic drugs. -Our exposure to bacteria provides a valuable trigger for the immune system to respond and develop.

becoming pregnant

•Most pregnancies last for a 40-week period while the fetus grows inside the uterus. •Fertilization -Fusion of sperm cell with egg, creating a zygote -Usually occurs in the fallopian tubes The zygote moves to the uterus, implants in its inner lining, and develops as an embryo •Ovum -Released from the ovary during the menstrual cycle -Can survive for about 24 hours after being freed from the ovary at ovulation •Sperm -Produced in the seminiferous tubules of the testes -Can survive up to seven days in the vagina •Cervix -Gateway for passage from the vagina to the uterus -Cervical mucus becomes more fluid near the time of ovulation and organizes into channels that orient sperm movement toward the uterus. •Some sperm move through the cervix and uterus after ejaculation in the vagina. -Majority become trapped in coagulated semen in the upper portion of the vagina. -Healthy, motile sperm tend to be released into the uterus continuously throughout the ensuing 48 hours. -Only one sperm succeeds in penetrating the ovum's membrane. •During the first 3 days after fertilization, the cells of the embryo replicate at daily intervals and the embryo moves along the fallopian tube toward the uterus. -By the 4th day, the embryo consists of 50-100 cells. -By the 6th day, the embryo attaches to the lining of the uterus and soon implants.

STD risk factors

•Multiple Sexual Partners -16% of unmarried sexually active people reported having more than one sexual partner in a year. -Many people in sexually exclusive relationships have sex outside the relationship without the "exclusive" partner's knowledge. •False Sense of Security -Using hormonal contraceptives tends to decrease the use of condoms that help prevent STD transmission. •Absence of Signs and Symptoms -Some STDs have very mild or no symptoms, which makes it possible to unintentionally transmit these STDs to others. •Untreated Conditions -Some people lack sufficient knowledge of the signs and symptoms of STDs to know they are infected. -Many people with STDs do not comply with treatment regimens and may remain infectious. •Impaired Judgment -With use of drugs and alcohol, people are more likely to have sex without condoms and more likely to have sex with people they don't know. •Lack of Immunity -Organisms can escape the body's immune defenses, causing individuals to remain infected and transmit the infection. •Body Piercing -A wound gives organisms direct access to the bloodstream. -Pierced genitals may impede proper use of condoms. -Nipple, tongue, and lip jewelry may increase risk of infection via oral sex. •Value Judgments -STDs have been associated with sinfulness, dirtiness, condemnation, shame, guilt, and disgust. -Negative attitudes discourage people from getting checkups and talking with partners. •Denial -Typical thoughts are: •"It won't happen to me." •"He (or she) is too nice to have an STD." •"She (or he) isn't the type of person to have an STD."

health habits during pregnancy

•Nutrition -Fetal nutrients are delivered through the placenta. -The mother's diet must contain adequate nutrients for herself and for her baby's growth and development. -For some women, it is advisable to supplement a well-balanced diet with extra iron and folic acid. -A weight gain of 28 to 30 pounds by the end of pregnancy is considered healthy. •Physical Activity and Exercise -Help overcome feelings of lethargy and discomfort with changes in baby proportions -Help prepare the mother's body for childbirth -Can improve circulation and reduce varicose veins -Maintain the habit of being active -Amount depends on the woman's previous experience with exercise •Emotional Well-Being -Emotional well-being of the mother influences the health of the pregnancy. -Pregnancy can be a time of intense feelings for the woman, her partner, and others close to her. -Intense emotions are natural and normal. -Quiet meditation and relaxation may help. -Massage is also beneficial. •Prenatal Care -Professional prenatal care helps ensure: •Fewer pregnancy-related illnesses •Early discovery of problems with the placenta or uterus •Discussion of proper nutrition •Advice on alcohol, tobacco, and drugs •Screening for maternal infections (e.g., rubella, syphilis, gonorrhea, and herpes) Screening for Rh incompatibility

congenital defects

•Observable physical or biological abnormalities physicians examine newborns for immediately after birth •Not necessarily inherited •Generally result from complex interactions of genes and environmental factors •Cleft lip -Results from developmental abnormalities in the formation of the oral cavity -Has been known to occur in only one of a pair of identical twins -Attributed to both environmental factors and genetics •Spina bifida -Affects 1 in 1,000 newborns -Occurs when one or more spinal vertebrae fail to close and the spinal cord and nerves bulge through the cleft -Leaves the person vulnerable to paralysis-causing damage and life-threatening infections -Can be treated to some degree with surgery •Anencephaly -Very abnormal brain development -Most serious congenital defect to the nervous system -Results in stillbirth or death soon after birth -No treatment •Folic acid -Most effective supplement for preventing birth defects -Should be taken before and during pregnancy -Found in fortified flours and cereals -Females who may become pregnant should take a folate supplement. •Vitamin B12 also helps reduce birth defects. •Teratogen -Any environmental agent that causes abnormal development of a fetus -Can avoid many with a little care -Pregnant women should not: •Drink alcohol •Smoke cigarettes •Take illegal drugs •Thalidomide -Marketed in 1957 in Europe for pregnant women experiencing "morning sickness" -Was thought to be safe, but caused severe deformities of the arms and legs and stillbirths -Was not approved for sale in the United States until 1998 when it was approved for use in treating skin lesions associated with leprosy •Not approved for women who might become pregnant •Fetal Alcohol Syndrome (FAS) -Birth defects and mental disabilities caused by ingestion of even moderate amounts of alcohol by the mother during pregnancy -Raises ethical issues •Does a mother have a right to do with her body as she sees fit even if it means harming the baby? •Does society have the right to regulate the consumption of alcohol and other harmful substances by a pregnant woman?

heredity and disease

•One inherits about 20,000 genes from each parent. •Genes are arranged in a linear array along threadlike structures called chromosomes. -Each person carries 23 pairs of chromosomes in virtually every cell of the body. •Different genes are expressed in different tissues. •DNA (deoxyribonucleic acid) -Chemical substance that carries all of a person's genetic information in chromosomes in cells •Each chromosome contains thousands of different genes. -Together, these genes determine the uniqueness of each human being. •Congenital (birth) defect -Any abnormality observed in a newborn that occurred during development -Affects 3-4% of American babies -Causes •Abnormal chromosome or abnormal number of chromosomes •Chemical error in one or more genes •Toxins, drugs, or other environmental factors

medical interventions for pregnancy

•Options for controlling discomfort -Relaxation techniques -Deep breathing -Acupuncture -Hypnosis -Massage and support of the perineum -Medications that block pain awareness (analgesia) -Medications that block pain sensations (anesthesia) •Induction of Labor -Medically stimulating uterine contractions and labor -20% of America's childbirths are induced. -Most common methods •Administering prostaglandins to the cervix •Breaking the amniotic sac •Administering the hormone oxytocin (Pitocin). •Episiotomy -Incision in the perineum to facilitate passage of the baby's head during childbirth -Increase the risk of injury -Do not aid significantly in postbirth healing -Should be performed only when medically necessary •Cesarean Birth -Delivery of the fetus through a surgical opening in the abdomen and uterus -May be recommended in circumstances such as: •Fetal head is too large for the mother's pelvic structure •Maternal illness •Active herpes infection in the vagina •Fetal distress during labor •Birth complications such as breech fetal presentation •Previous C-section -Less safe than uncomplicated vaginal deliveries -Cost more -Comprises nearly 30% of births in the United States -Commonly performed because: •Parents or physician want a convenient labor •Physician and hospital do not want to risk a difficult labor to avoid an expensive lawsuit

the human microbiome

•Overall composition of microorganisms inhabiting a human body -Most inhabit the intestines (gut) -Also found in the nose and vagina, and on the skin •Produces more than 60,000 different proteins Enormous diversity of microbial proteins can affect human metabolism and overall health •These microorganisms might also affect the brain and play a significant role in: -Anxiety -Depression -Other mental afflictions •Fecal Microbiota Transplantation (FMT) -Involves obtaining a fecal preparation from a carefully screened, healthy stool donor and transplanting it into the colon of a patient experiencing repeated Clostridium difficile (C. difficile) infections -Often completely eradicates C. difficile infection in as little as a day -May also be effective in treating Crohn's disease •A Healthy Microbiome -How can one acquire a healthy microbiome? •Consume a healthy diet •Limit exposure to cigarette smoke and other pollutants, antibiotics, and antiseptics •Manage stress •Reinvigorate the microbiome after taking medications

barrier methods

•Physically block the path of sperm movement in the female reproductive tract •Usually bring sperm in contact with a spermicidal chemical -Most often nonoxynol-9 •The Diaphragm -Dome-shaped latex cup placed in the vagina to cover the cervix -Primary purpose is to hold a spermicide in place next to the cervix -No major medical problems associated with use -Can be inserted up to 6 hours before intercourse -Should be left in place for at least 6 hours after intercourse, but not longer than 24 hours •The Diaphragm -Must be fitted by a physician or nurse practitioner and refitted after weight gain or loss -Should be washed after each use -Can dislodge during intercourse -Increases risk for toxic shock syndrome -Should be checked periodically for holes -Lasts 1-2 years with proper care •The Cervical Cap -Cup-shaped rubber device that snugly covers the cervix -Must be used with a spermicide -Must remain in place for 8 hours after last intercourse -Disadvantages •Difficulty with insertion and removal •Occasional discomfort during intercourse •Possible irritation of the cervix •Should not be left in place for more than 48 hours •The Contraceptive Sponge -Spongy dome-shaped device containing spermicide -Inserted in the vagina to cover the cervix -Can be left in place for 24 hours -Discarded after use -Less effective than diaphragm or cervical cap -Increases risk of toxic shock syndrome if left in the vagina longer than 24 hours •Vaginal Spermicides -Available as foams, creams, jellies, and suppositories without a prescription -Placed in vagina immediately before intercourse and before every subsequent intercourse in a sexual episode -Effectiveness depends on a sufficient quantity of sperm-killing chemical bathing the cervix at the time of ejaculation -Tend to be slippery -May cause an allergic reaction -Can cause irritation if they do not dissolve completely before intercourse -Do not cause birth defects •Male Condoms -Membranous sheath that covers the penis and catches the sperm before it enters the vagina -Typically made of latex or polyurethane -Effective for five years when stored properly -Must be used with water-based lubricants -Very effective when used with another barrier method -Help prevent the transmission of sexual diseases •Female Condoms -Loose-fitting polyurethane plastic pouch that lines the vagina. -Has two flexible rings •An inner ring at the closed end, used to insert the device inside the vagina and hold it in place •An outer ring that remains outside the vagina and covers the external genitalia -Advantages •Can be used with any type of lubricant •Warms up instantly to body temperature once inserted •Provides protection from STDs, including HIV •Prevents pregnancy -Disadvantages •Outer ring may be pushed inside the vagina •Difficult insertion and removal •Minor irritation •Discomfort or breakage •More expensive than male condoms

withdrawal

•Removing the penis from the vagina just prior to ejaculation -Small emission can occur before ejaculation and may contain sperm or sexually transmitted bacteria or viruses -Sperm released near the vagina may inadvertently enter later -Can diminish a couple's sexual pleasure

preventing STDs

•Requires widespread public health programs and services for STD education and treatment •Individuals must: -Get immediate treatment for an STD -Take responsibility not to infect others -Practice safer sex to reduce the risk of infection •Stigma associated with STDs -Great hindrance to prevention efforts -Makes people reluctant to think and talk about them -Makes society want to ignore STD epidemics -Prevention would be enhanced if sexually active individuals: •Developed an open attitude about talking about STDs •Acquired the necessary communication skills •Practicing Safer Sex -Abstain from sexual intercourse -Know a partner's sexual history -Use condoms together with spermicides when having sex -Barriers to safer sex •Denying that there is a risk •Believing that the campus community is insulated from STDs •Feeling guilty and uncomfortable about being sexual •Succumbing to social and peer pressure to be sexual •STD Communication Skills -Talk to your partner before having sexual intercourse. -Disclose all of the information that you would like to be told. -Consider what you will do if your partner is offended that you want to know his or her sexual history.

douching

•Rinsing the vagina with fluid after sexual intercourse •Almost totally ineffective -Takes only a few seconds for thousands of sperm to move through the cervix and enter the uterus -Force of the douche spray may propel sperm into the uterus

reducing the STD epidemic in the US

•STDs of greatest concern -HPV -HIV/AIDS -Chlamydia -Gonorrhea •Recommended approach -Providing antibiotics so person undergoing treatment can distribute them to known sexual partners to treat themselves anonymously

the orientation dimension of sexuality

•Sexual orientation -Propensity to be sexually and romantically attracted to members of a particular sex -Homosexuality •Same-sex attraction -Heterosexuality •Other-sex attraction -Bisexuality •Both-sex attraction •American culture has traditionally forbidden same-sex sexual and intimate relationships. •Neither the American Psychological Association nor the American Psychiatric Association considers same-sex orientation to be a mental illness. •Same-sex intimate relationships are largely similar to other-sex ones. •LGBT community -Social-political group organized by lesbian, gay, bisexual, and transgender individuals -Advocates for the same legal rights and social acceptance of all citizens •Transgender -Refers strictly to gender identity and whether this sense of oneself is consistent with one's sexual anatomy •Transvestism -Adopting the appearance of the other sex •Homosexuality -Attraction to and desire of emotional attachment to members of one's same biological sex

sterilization

•Sterility -Being permanently unable to have children -May be the most desirable form of birth control for people certain they do not want children -Has no effect on sexual arousal or activities -Nearly 100% effective Relatively safe and low-cost •Male Sterilization -Vasectomy •Surgical procedure in men in which segments of the vasa deferentia are removed and the ends tied to prevent the passage of sperm •Minimal effect on volume of ejaculate •Requires no other form of contraception •Can sometimes be reversed •Uncomplicated and causes few problems •Female Sterilization -Tubal ligation •Surgical procedure in women in which the fallopian tubes are cut, tied, or cauterized to prevent pregnancy •Low incidence of post-operative complications •Accidental pregnancy possible if blocked tube spontaneously reopens •May be reversible -Hysterectomy •Surgical removal of the uterus •Not recommended solely for sterilization •Greater chance for postoperative complications •More expensive than tubal ligation •Risk of negative psychological effect

cancer treatments

•Surgery -Standard treatment -If even a few cancer cells remain, they may grow into new tumors. •Radiation therapy -Use of high-energy radiation to kill cancer cells •Chemotherapy -Use of toxic chemicals to kill cancer cells •Radiation therapy and chemotherapy -Destroy normal cells as well as cancer cells -Only limited amounts of each treatment can be administered. •Cancer drugs -Hundreds are available, and many are effective for treating a specific cancer. -Many are also very expensive. •Many patients seek out alternative therapies. •Cancer Immunotherapies -Methods to enable the immune system to work better against cancer •Scientists are working on a more targeted immunotherapy in which immune T cells are induced to recognize and attack a patient's specific cancer cells. -Checkpoint inhibition •Removes a cancer's ability to block the immune system, allowing an effective anti-cancer immune response to proceed •Cancer Immunotherapies -CAR-T therapy involves: •Removing T cells from the blood of a person with cancer •Modifying them in a laboratory or clinic so they are better able to find and destroy cancer cells •Replacing them into the body •Curing Childhood Cancers -There are 20,000 new child cancer patients every year. -80% are cured and live to adulthood. -Many have ongoing medical problems and are likely to die prematurely. -A healthy lifestyle is crucial to help reduce the damaging effects of the toxic treatments used to cure their cancer. •Cancer Vaccines -HPV •Cervical cancer -Hepatitis B and C viruses •Liver cancer •Coping with Cancer -Diagnosis can lead to feelings of: •Hostility •Resentment •Deep personal loss •Hopelessness -These feelings may also be important factors in coping with cancer. -Coping strategies •Effectiveness depends on focusing the mind on way to enhance the healing process. •Meditation and relaxation techniques are important. •Learning how to use visual imagery can help. -Coping with cancer requires courage and conviction. •The patient must believe that a cure is possible and work toward that end.

the metabolic syndrome

•The Metabolic Syndrome -Model that puts people who have at least three of the following risk factors at risk for cardiovascular disease, diabetes, and premature death: •Waist circumference greater than 40 inches for men and 35 inches for women •Elevated triglyceride level of 150 mg/dl or greater •Low HDL level •Hyperglycemia •Hypertension

recognition of "self"

•The immune system distinguishes cells of the body as "self" from foreign substances and other cells that are "nonself." All of the antibody-producing cells that could attack the body's own cells are destroyed during fetal development •Autoimmune Diseases -Mistakes in the functioning of the immune system that cause it to attack tissues in the body -Causes include: •Some inherited disorders •Environmental factors such as viral infections, nutritional problems, and other unknown agents -Lupus erythematosus •Antibodies attack DNA, causing rashes, pain, and anemia •Mostly affects women -Arthritis •Variety of chronic diseases involving inflammation, stiffness, and pain in joints of the body -Multiple sclerosis •Affects the central nervous system •Organ Transplants -Tissue or organs from one person are grafted into another person. Because the immune system detects foreign antigens, it might reject the transplanted organ, causing destruction of the cells -Histocompatibility •Degree to which the antigens on cells of different persons are similar •Determined by immunological tests -Human leukocyte antigen (HLA) •Antigens measured to determine the suitability of an organ for transplantation from donor to recipient -Commonly transplanted organs •Kidneys •Hearts •Livers -Immunosuppressive drugs •Suppress the functions of the immune system after organ transplants to prevent the recipient's body from rejecting the donor's organ •Blood Transfusions: ABO and Rh Factors -Most important surface antigens of red blood cells: •ABO •Rh-positive/Rh-negative proteins. -Type O blood •Has neither A nor B antigens; universal donor -Type AB blood •Have both A and B antigens; universal recipient -If the mother is Rh-negative and the fetus is Rh-positive, and some of the fetal blood cells enter the mother's blood supply, production of anti-Rh antibodies can be stimulated. •May not cause issues until the next pregnancy if the Rh-positive antibodies in the mother attack the infant's red blood cells •Mother can be injected with anti-Rh antibodies.

cardiovascular diseases

•The incidence of death from cardiovascular diseases among Americans has been declining steadily in recent decades. -More people have become aware that most CVD is preventable by adopting healthy living habits. Effective surgical, medical, and psychological treatments for several of these diseases are being developed

protecting against sexually transmitted diseases and AIDS

•There are 30 different infectious diseases that can be passed from person to person through sexual contact. -11 are common in North America. •Every year, approximately 370 million people acquire STDs. 20 million of those are in the United States

adoption

•There are three avenues a couple can pursue to adopt a child: -State-licensed private or public adoption agencies •Handle about 70% of all adoptions -Independent or private adoption •Intermediary is often an attorney, physician, or cleric -International adoption •State and federal requirements must be met •Shorter waiting period