3. • According to WHO, reproductive and
sexual ill-health accounts the global
burden of ill-health
For women 20%
For men 14%
• It is closely related to other aspects of
health. Love, affection and sexual
intimacy, all pay a role in healthy
relationship.
4. • Sexual health is not just limited to
absence of disease or dysfunction
during the reproductive years
• It impacts on sexual practice and
action and must be practice free from
sexual abuse, or discrimination and
requires integration into the whole life
cycle.
5. • The word sex denotes whether a
person is male or female or sex
difference. But sexuality is related
to sexual behaviour, gender
consciousness, and sexual nature.
8. Sexual health:
• In 1975 WHO defined sexual health
as, “integration of somatic,
emotional, intellectual and social
aspect of sexual being, in ways that
are positively enriching and that
enhances personality,
communication and love.”
13. • The male determining factor is Y
chromosome leads to development
of internal testes from gonad
medulla; without the male factor
there is development of internal
ovary from the gonad cortex.
14. Establishment of
phenotypic sex:
• When additional internal and
external genital organs develops
and result in actual characteristics
of biologic sex.
15. • This is critical time in sexual
differentiation because each fetus
develops both Wolffian and
Mullerian genital duct system, one
of which must develop other regress
to product actual male or female
external genitalia.
• The Wolffian duct system in the
presence of testosterone give rise to
epididymis, the vas difference and
seminal vesicle in male.
16. • The Mullerian duct gives rise to the
female fallopian tubes and the
uterus and upper part of vagina.
18. Childhood sexual
behaviour:
• Curiosity about sex organ of
opposite sex.
• Masturbation.
• Question regarding pregnancy,
childbirth and related to sexual
matters.
23. • Person who have knowledge about
sexuality and sexual health.
• One who has positive attitude towards
body image.
• Ability to express one’s full sexual
potential.
• Capability to express sexuality.
• Right to make free and responsible
reproductive choice.
24. • Ability to access sexual health.
• Maintain balance between life style
and sexual behaviour.
• Capacity to develop effective
interpersonal relation with both
sexes
28. Psychological factors:
• Disturbance and obstacle in family
relationship.
• Incomplete sexual knowledge.
• Initial sexual experience being bitter.
• Disinterest and disliking for partner.
• Unnecessary hopes and expectation from
partner.
• Tension and pressure.
• Death of beloved one.
29. Hormones and genetic
factors:
• Can affect sperm quality.
• Production of ovulation (failure to
ovulate, irregular menstrual cycle)
30. Sexual health history:
• Multiple partners
• Infectious disease such as mumps
after puberty causes sterility.
34. 1. GENDER IDENTITY
DISORDER:
These disorders are characterized
by disturbance in gender identity, i.e.
the sense of one’s own masculinity
and femininity is disturbed.
• Transexualism
• Dual role transvestism
• Intersexuality
35. 2. PSYCHOLOGICAL AND
BEHAVIOURAL DISORDERS:
• Disorder of sexual development and
maturation includes disorder where
sexual orientation causes significant
distress to the individual or
disturbance in relationships.
36. • The preference as well as physical
and emotional attraction one
develops for a partner of particular
gender is call sexual orientation.
E.g.
Heterosexuality
Homosexuality
Bisexuality
37. 3. PARAPHILIAS:
• Paraphilias (also known as sexual
perversion and sexual deviation).
• It is used to identify repetitive or
preferred sexual fantasies or
behaviours that involve any of following,
• The preference for use of nonhuman
object.
38. • Repetitive sexual activity with
human that involves real or
stimulated suffering or humiliation.
• Repetitive sexual activity with non-
consenting partner.
39. Types of Paraphilia:
• Fetishism: the use of non-sexual or
nonliving objects or part of a
person's body to gain sexual
excitement.
• Masochism: the recurrent urge or
behaviour of wanting to be
humiliated, beaten, bound, or
otherwise made to suffer.
40. • Voyeurism: the recurrent urge or
behaviour to observe an
unsuspecting person who is naked,
disrobing or engaging in sexual
activities, or may not be sexual in
nature at all.
• Pedophilia: sexual activity with a child
that is prepubescent (usually 13
years old or younger)
41. • Gerontophilia: becoming sexually
abused by elderly individuals.
• Incest: sexual attraction to one’s own
children or blood relation.
• Necrophilia: sexual activity with dead
person.
• Zoophilia: aroused by sexual contact
with animal.
42. Treatment of Paraphilias:
• Psychotherapy:
Long term individual or group
psychotherapy is usually necessary.
• Pharamacotherapy
Anti-androgens:
IM Medroxy progesterone acetate
2.5- 10mg/day
43. 4. SEXUAL
DYSFUNCTION:
• It refers to problem during any
phase of sexual response cycle
that prevent individual or couple
from experiencing satisfaction from
sexual activity.
44. Causes of dysfunction:
• Physical causes:
• Diabetes
• Heart and vascular conditions
• Chronic kidney and liver disease
• Alcoholism
• Drug abuse
45. Psychological causes:
• Work: related stress and anxiety
• Marital problems
• Feeling of guilt
• Effect of past sexual trauma
46. Categories of sexual
dysfunction:
Primary sexual dysfunction:
• Person included who have never
experienced satisfying sexual
response.
Secondary sexual dysfunction:
• Person included who has satisfying
sexual response earlier but is suffering
from sexual dysfunction now.
50. • Libido known as sex drive is a
person's overall sexual drive or desire
for sexual activity.
• Sex drive is influenced by
Biological,
Psychological
Social factors.
51. • Sigmund Freud defined libido as
"the energy, regarded as a
quantitative magnitude of those
instincts which have to do with all
that may be comprised under the
word 'love'."
52. FACTORS THAT AFFECT
LIBIDO:
• Sex hormone levels and the
menstrual cycle
• Psychological and social factors
• Physical factors
• Medications
55. • Over the past decades nurses have
advanced their role within sexual and
reproductive health care services
• Reproductive and sexual health care
(including reproductive, abortion and
genetic technologies) is an integral
part of individual, family and
community services provided by
professionals and other in health
care system.
56. • Nurses have a professional
responsibility to provide high quality,
non-judgemental reproductive and
sexual health care for their clients.
• There is now high incidence of teenage
pregnancy and STDs. Nurses are in
ideal position to give sexual health
advice to this age group, because they
often have contact with teenager for
other reason such as chronic disease
management and routine vaccination,
HPV vaccination campaign.
58. • Sexual and contraceptive history
taking
• Safer/protected sex, contraception
advices/methods
• Understand and be able to discuss
different sexuality and sexual
health.
• Ability to challenge stigma and
discrimination.
59. • Supply emergency hormonal
contraception.
• Pre conception advices.
• Pregnancy testing
• Abortion care
• Breast awareness
• Menopausal advices
60. • Testicular and prostate awareness
• STI screening
• HIV testing
• HIV pre and post exposure prophylaxis
• Management of rape/ assault cases
• Examination of skin and treatment of
common genito-dermatologic problems
61. • Examination of oral cavity and
rectum.
• Cryotherapy microscopy
• Recognise sign and symptoms of
STIs.
63. Monthly breast self
examination:
• The method involves the woman
herself looking at and feeling each
breast for possible lumps,
distortions or swelling.
• It should be perform 1st week
following menstruation.
65. • Nurses can asset client to
understand their anatomies and
how their body function.
• The importance of open
communication between partners
should also encourage.
• Details about physiological
changes.
66. COUNSELING FOR
ALTERED SEXUAL
FUNCTION:
• One technique nurse can use to help
client with altered sexual function is
PLISSIT Model, developed by Annon
1974,
P: Permission giving
LI: Limited information
SS: Specific suggestion
IT: Intensive therapy
69. • Nurses with expertise in field of
reproductive health have necessary
knowledge and holistic approach to
contribute to well-informed decision
about: which technologies are
available, who should use
reproductive and genetic
technologies and how these
technologies will be monitored and
evaluated.
70. • Health promotion and disease
prevention strategies that address
the known cause of infertility must
be given priority as effective and
efficient means of increasing
fertility.
72. • Sexual health such as non
reproductive sex, adultery and
incest could have been disruptive
so that code of sexual conduct
were developed and thus become
written laws.
• The penalties of sexual offences
vary greatly from state to state so
that an offense may be
misdemeanour in one state and a
felony in other.
73. LAWS CONCERNING
SEXUAL ACTIVITIES OF
CONSENTING ADULTS:
• Fornification and cohabitation
• Adultery or extramarital sex
• Marital sexual activities: oral-genital
contact, anal intercourse, mutual
masturbation most of these activities
are regarded as felony in most of
states and are ground for divorce.
76. • Article 377 of IPC call for maximum
punishment of life imprisonment for
all sexual acts against human nature
(primarily interpreted to be
homosexuality and including
consenting adults.)
77. Laws governing rape:
• Section 375
• A new Section 376 A
• Protection of women from domestic
violence Act 2005
• Latest guidelines March 10, 2014
