CHAPTER 1-THE FEMALE REPRODUCTIVE ORGANS

1.Internal reproductive organs – include ovaries, fallopian tubes, uterus, and vagina

A. Ovaries

o two almond-shaped organs approximately 3 cm long, 2 cm wide, and 1 cm thick

located in the lower abdomen and attached to the margins of the uterus and to the pelvic
wall by ligaments;
o reproductive glands that produce eggs and female sex hormones;
o contain 300,000 to 500,000 primary oocytes (immature eggs in different stages of
development contained within primordial follicles (immature follicles). These oocytes are
protected by the varies until such time that they are ready for release. One egg,
sometimes more, is released during ovulation
o produce hormones estrogen and progesterone which regulate reproductive functions
secondary sex characteristics, play a role in bone metabolism and cancer management

The Ovarian Cycle

 Series of events that occur in the ovaries during and after the maturation of the
oocytes for fertilization.
 Likewise in this cycle, the uterus is prepared for a possible pregnancy.
 During a woman’s reproductive period from menarche or the onset of menstruation
(approximately 9-14 years old) to menopause or the caesation of menstruation
(approximately 48-52 years old), she regularly undergoes the ovarian cycle.
 vvvvvControlled by the hypothalamus through gonadotropin releasing hormones to the
pituitary gland, which in turn sends gonadotropin-releasing hormones to the pituitary
gland which in turn sends gonadotropic hormones (FSH and LH) to the ovaries.
 FSH – follicle-stimulating hormone- stimulates the primary oocyte to resume its
meiotic division and mature; it also stimulates the primordial follicle to increase its lining
cells and form an outer covering that produces estrogen;
 These changes transform the immature egg within the immature follicle into a mature
egg within a Graafian follicle.
 LH- luteinizing hormone—causes a Graafian follicle to burst (ovulation), releasing
the mature egg (secondary oocyte); it also transforms the remnants of Graafian follicle
into a yellow body called corpus luteum
 Corpus luteum- secretes progesterone which prepares the lining of the uterus, primed
with estrogen , for the implantation of fertilized egg. If no implantation occurs within 7 to
10 days, the corpus luteum regresses, degenerates, and its hormonal secretion diminishes.
The cycle repeats with another ovulation. However, if the egg is fertilized, the corpus
luteum persists becoming the corpus luteum of pregnancy. With its own hormones, the
corpus luteum maintains the early pregnancy until the placenta can take over.
  During ovulation, some women may feel a slight pain in one side of the lower abdomen
(mittelschmerz) or a rise in basal body temperature. These symptoms may be monitored
by couples trying to conceive or wanting to prevent pregnancy.

B. Fallopian tubes

 Otherwise known as oviducts;

 Pair of tubes about 10-12 cm long that connects the ovaries to the uterus;
 have fringe-like projections with motile cilia that help direct the egg into its lumen;
 propels the ovum from the ovary towards the uterus;
 receives the sperm coming from the uterus;
 provides the site for fertilization (in which sperm meets and penetrates the egg;
 propels the fertilized egg by ciliary current and contractions to the uterus


C. Uterus

o Otherwise known as the womb

o Hollow, pear-shaped muscular organ about 7-8 cm long;
o Consists of three layers: endometrium, myometrium and perimetrium;
o Located in the middle of the pelvis between the urinary bladder in front and
rectum at the back;
o Has inner lining which thickens in preparation for the implantation of the
fertilized egg;
o Its lining along with unfertilized egg is shed during menstruation;
o Houses the developing offspring and enlarges to accommodate it throughout the
pregnancy;
o Its powerful muscles contract to expel the baby during childbirth

The Menstrual Cycle

o 28-day cycle also known as endometrial cycle;

o As the primary follicle matures, it secretes estrogen which acts on the
inner lining of the uterus, enabling it to proliferate after menstruation;
o At approximately day 14 of the cycle, ovulation occurs;
o The corpus luteum produces predominantly progesterone which, primed
with estrogen, prepares the lining of the uterus, for the implantation of the
fertilized egg;
o If no implantation occurs within 7 to 10 days, the corpus luteum
degenerates, its hormonal support decreases and the uterine lining is shed
as menstruation.
o Afterwards, a new cycle starts
o A few days before menstruation, as an effect of a change in hormones, a
woman may experience headache, bloated feelings, mood swings, breast
swelling and tenderness, weight gain, lower back muscle pain, insomnia,
food cravings, pimples, mild fatigue and irritability, and increased
 perspiration (premenstrual tension). These symptoms characterize what is
commonly called premenstrual syndrome (PMS). During menstruation,
a woman may feel lower abdominal discomfort (dysmenorrhea)
o Normal menstruation starts before the age of 16 years old and ends after
the age of 45 years. It lasts from 3 to 8 days and entails a blood loss of less
than 80 mL. A regular cycle ranges from 21-35 days with an average of
28 days. Menstrual blood does not clot. A prolonged abnormal bleeding
or a frequently heavy or very painful bleeding should be consulted with
the doctor.

D. Cervix

o Connects the uterus to the vagina

o The opening to the vagina is small which acts as a safety precaution against foreign
bodies entering the uterus;
o Dilates to accommodate the passage of fetus during normal delivery;
o Its dilation is a sign that labor has begun
o
o E. Vagina

o Otherwise known as birth canal;

o 7-12 cm long muscular cavity that connects the uterus to the outside (vestibule);
o Contains mucus secreted by cervical glands. This mucus becomes sticky then changes to
an egg white consistency, indicating a fertile period. Recognizing fertile mucus is a basis
for couples to abstain from sex to prevent pregnancy. During pregnancy, the mucus
thickens to a plug to protect the fetus.
o Passageway connecting the uterus to the external genitalia;
o Female organ of copulation which expands to take in the erect penis and the ejected
semen during intercourse;
o Stretches more to allow the baby to pass during childbirth;
o Provides passage to the menstrual fluid to escape from the uterus;
o Has an acidic pH and is richly colonized by bacterial flora, predominantly lactobacilli.
Both provide defense against infection. However, they are usually lacking in
prepubescent and menopausal women.
 Front View of Female Reproductive Organs

2.External reproductive organs- composed of perineum, mons pubis, labia majora, labia
minora, hymen, vestibule, clitoris as well as Bartholin’s and other accessory glands

A. Perineum

o Diamond-shaped area at the lowest end of the trunk between the vulva and the
anus;
o Divided into the anterior urogenital triangle occupied by the vulva with the
orifices of the vagina and urethra and the posterior triangle containing the opening
of the anal canal.
 o The area between the opening of the vagina and the anus, below the labia majora;
o Varies in length from almost 1 to more than 2 inches (2 to 5 centimeters).

B. Mons pubis


o a rounded mound of fatty tissue that covers the pubic bone.
o During puberty, it becomes covered with hair.
o contains oil-secreting (sebaceous) glands that release substances that are involved
in sexual attraction

C. Labia majora


o (literally, large lips) are two relatively large, fleshy folds of tissue that enclose and
protect the other external genital organs.
o They are comparable to the scrotum in males
o contain sweat and sebaceous glands, which produce lubricating secretions.
o hair appears during puberty

D. Labia minora

o
o (literally, small lips) hairless, can be very small or up to 2 inches wide;
o lie just inside the labia majora and surround the openings to the vagina and
urethra.
o A rich supply of blood vessels gives the labia minora a pink color. During sexual
stimulation, these blood vessels become engorged with blood, causing the labia
minora to swell and become more sensitive to stimulation.

E. Clitoris

o
o located between the labia minora at their upper end, is a small protrusion that
corresponds to the penis in the male.
o like the penis, is very sensitive to sexual stimulation and can become erect.
o stimulating the clitoris can result in an orgasm.
F. Vestibule

 Area enclosed by the labia minora where the openings of the urethra and vagina are
located.

When stimulated, Bartholin glands (located beside the vaginal opening) secrete a thick fluid
that supplies lubrication for intercourse.

The opening to the urethra, which carries urine from the bladder to the outside, is located above
and in front of the vaginal opening.

The vaginal opening is partially covered by a thin membrane called the hymen. This membrane
is usually present in girls who have not had intercourse. An intact hymen, as well as bleeding
from its rupture at intercourse, was formerly considered a sign of virginity. The hymen however
is pliable, may be absent or torn with previous non-sexual activity, and may not bleed with first
intercourse.

External Female Genital Organs

Breasts

o Contain mammary glands and fat which connect to ducts that drain into the
nipples with their surrounding areola;
o Each breast contain 15-25 clusters called lobes;
o Nipples are made of erectile tissue;
o Size is determined by heredity;
o Size also depends on the existing fat and glandular tissue;
o Exhibit cyclical changes including increased swelling and tenderness prior to
menstruation
 CHAPTER 2- THE MALE REPRODUCTIVE ORGANS

The male reproductive organs include:

A. Internal reproductive organs

1. Testes

Testes is plural and testis is singular.

A normal human male has two testes, also known as testicles

Males are born with their two testes hanging outside their bodies.

Each is made up of approximately 240 meters of tubules where immature sperm cells divide and
differentiate to become spermatozoa

Testes produce and store spermatozoa but young boys do not produce sperm.

During puberty the two testes release testosterone which then triggers the production of sperm,
regulates different reproductive functions and male secondary sex characteristics, and plays a
role in aging and cancer management.

The two testes are each contained in a pouch of skin called the scrotum.

2. Epididymis

Series of tubules connected with the testes where sperms continue to mature, are stored and
acquire motility.

From it, the sperms pass through the vas deferens and to the urethra

3. Sperm duct (vas deferens)

Different tubes (ducts) carry the semen from the testes to the penis;;.

The sperm duct carries the sperm from the testes to the urethra in the penis.;

During ejaculation, the smooth muscle of the walls of the vas deferens contract, propelling sperm
forward. In its way, it collects secretions from accessory glands producing semen Semen
contains sperm cells, dissolved nutrients and enzymes that nourish and protect the sperm inside
the woman's body. Every millilitre of semen can contain up to 100 million sperm cells!
 4. Ejaculatory ducts

These are small muscular ducts that carry the spermatozoa and seminal fluid to the urethra.

It connects the ducts of the seminal vesicle and the vas deferens

5. Urethra

The semen moves through the urethra to the outside during ejaculation.

It is the passageway of both urine and the semen or seminal fluid.

The urine passes through the urethra during urination, but the semen and urine do not move
through the urethra at the same time.

It is the tube that connects the urinary bladder to the outside.

B. External male reproductive organs

1.Scrotum

It is a thin-walled muscular pouch and skin located between the upper parts of the thighs and
behind the penis.

It serves as a pouch outside the trunk in which the testes are suspended keeping them at a
temperature slightly lower than that of the rest of the body or at a constant temperature of 35°C
which is essential for sperm production.

It tightens in cold temperatures and during erection

2.Penis

It is the primary male external sex organ.

It contains a spongy tissue whose vessels become engorged with blood during sexual arousal.
The engorgement causes its erection, allowing the penis to penetrate the vagina and ejaculate the
semen during sexual intercourse.

-It also serves as the passageway of urine in leaving the body because the urethra is within it.
-The head of the penis is called glans, which is covered with pink, moist tissue (mucosa).

-In uncircumcised men, the glans is further covered by the foreskin or prepuce.

-In circumcised men, the foreskin is removed. The corpus cavernosum refers to two columns of
tissue found in the dorsal part of the penis. The corpus spongiosum is a column of sponge-like
tissue located t the front of the penis. These tissues are filled with blood leading to erection.

1. Male accessory glands

2. Prostate gland

It surrounds the upper portion of the urethra.

It contracts during ejaculation and secretes a fluid which makes up around 30% of the volume of
semen

3. Seminal vesicles and Cowper’s gland

Together with the secretions of prostate gland, neutralize harmful acids and support the sperms
with needed energy to swim up into the uterus within 72 hours after ejaculation before they die.
 CHAPTER 3- OTHER SYSTEMS INVOLVED IN REPRODUCTION

No system in the body is totally independent. As such, human reproduction requires

the assistance of many other systems and organs to properly function.

The Nervous and Endocrine Systems

The brain is the most important sexual organ of the human body.

1. It coordinates the nervous and hormonal systems that regulate what happens
chemically and physically in the body’s sexual response.
2. It is also the repository of the images, thoughts and feelings that humans associate
with sex.
3. It balances human instincts and emotions with appropriate moral and cultural
behavior.

The hypothalamus is an endocrine organ as well as part of the brain.

 Alerted by the blood vessels of sex hormones (estrogen, progesterone and testosterone), it
secretes neurohormones that trigger the pituitary gland to increase or decrease its own
hormones. Sex hormones also play a role in embryonic sexual differentiation of the
gonads and external reproductive organs.
 In females, the pituitary gonadotrophic hormones- follicle-stimulating and luteinizing-
regulate the ovarian and menstrual cycles; oxytocin stimulates uterine contraction and
prolactin enables milk production and emotional bonding.
 In males, the interstitial cell-stimulating hormone prompts the testes (and to lesser extent
the adrenals) to secrete testosterone.

Other Body Systems

All body systems have specific roles and actions maintaining the physical and
functional stability of the entire body.

 The circulatory system – provides nourishment and oxygen

 The respiratory system- is involved in the exchange of oxygen and carbon dioxide
 The excretory system – eliminates body wastes
 The musculoskeletal system – provides framework, mobility, strength and protection
 The gastrointestinal system- absorbs and stores nutrients and eliminates wastes
 The immune system – provides the body with a ready supply of immune-competent cells
that protect it from infectious agents like bacteria and viruses
 The skin- protects the internal organs and maintains body temperature
 CHAPTER 4- HUMAN SEXUALITY

Sex and Gender

Sex

 refers to the distinct biological differences between male and female;

 determined by the genitals and chromosomes;
 begins at conception, programmed into the genes, and defines the individual throughout
life

Gender

 characterizes how a particular person presents oneself in a culture (gender role);

 characterizes how one identifies himself/herself based on internal awareness (gender
identity);
 socially constructed;
 usually assumed that a person is of the gender that corresponds to his/her sex: males are
masculine, females are feminine

Men are traditionally accepted to be strong, independent, dominant and aggressive.

In contrast, women are seen as passive, dependent, subordinate, and nurturing.

Parents and other adults adopt gender-laden assumptions and dress and treat children according
to their gender.

However, in some instances, the correspondence of sex and gender are not aligned. Some people
may be known as the LGBT (lesbian, gay, bisexual and transgender).

Sexuality

 the expression of the sex;

 the sphere of interpersonal behavior, especially between the male and female, most
directly associated with, leading up to, substituting for, or resulting from genital union;
 attracts a man and a woman towards each other to procreate and fulfill each other

Unlike animals which usually copulate instinctively, human sexuality is personal and moral. It
permeates the whole person with its pervasive influence and powerful effect. Likewise, its
physical, psychological, ethical and cultural dimensions often define proper behavior.
Libido or the sex drive

 It ensures the continuation of the species.

 It triggers desire, orchestrates the physiological changes in the human body to produce
egg and sperm, maintain pregnancy and foster nurturing instincts that care for and protect
the offspring.
 Libido can be a source of pleasure and fulfillment as well as heartbreak and loss, even
violence.

The Sexual Act

 The sexes, feeling both attraction and love, find the most intimate, most bodily and most
ecstatic experience in the act of sexual love.
 The sexual act or sexual intercourse is the physical union of male and female through
which human beings procreate.
 This process is characterized by the penetration or insertion of the penis into the vagina.
 It culminates in orgasm in which the penis ejaculates semen with sperms into the vagina.
Sperms then travel to the woman’s fallopian tube to fertilize the egg creating a new life.

The sexual experience and response depend on the harmonious collaboration of different
systems. The nervous system triggers the excitement, hormonal secretions, orgasm, and
ejaculation.

Meanwhile, the circulatory system causes blood to accumulate in the genital areas, making them
swell. At the same time, the muscles of thigh, buttocks, uterus and vagina contract. At
resolution, the nervous system reverses the excitement and allows blood from genitals to ebb
away, assuming normal levels. Likewise, the hormone norepinephrine is released, causing a calm
feeling of well-being and relaxation.
Attitude Towards Sex and Sexual Activity

The nature and symbolism of human sexuality make it imperative for each person to work at its
formation, discipline its power, and protect it against abuse by others as well as by oneself.

It is everyone’s duty to protect his/her sexual integrity from fancies, words, actions,
pornography, and violence that make sex trivial.

One should not allow the act of sexual intercourse and expressions of the libido to be subject to
importunate curiosity and unwarranted intrusion by others.

Sexual attraction, even satisfaction, should not be mistaken for true love. Sexuality and sexual
activity should be viewed with an attitude of reverence for life as well as for every man, woman,
and child.

Sexual activity should be performed rationally, responsibly, respectfully and consensually. Good
sex happens at the right time, with the right persons, and for the right reason-after marriage, with
the spouse to procreate and complete each other.

Heterosexual marriage is the most common adult expression of sexuality; but many alternatives
exist, including celibacy for religious reasons, singleness by choice, polygamy or same-sex
partnership. No single profile predicts a happy, healthy and fulfilling sex life. Personal
attitudes, parents, family, love, and God all contribute to achieve it.
 CHAPTER 11- THE ADOLESCENT

Physical Changes

Physical changes in both sexes include a variation in the sleep-wake pattern, a growth spurt with or without growing
pains, development of the sex organs, appearance of underarm or axillary and pubic hair, oily skin, pimples, and increased
perspiration.

In boys, the penis, testes, and scrotum enlarge. The scrotum also darkens. Face and chest hairs develop; shoulders and
chest broaden; and hands and feet grow. Meanwhile, the voice deepens and the Adam’s apple becomes prominent. Sperm
production and ejaculation takes place. Boys also experience spontaneous nocturnal emissions (wet dreams) and penile erections.

In girls, uterus and vagina grow; breasts develop; hips broaden; and menarche (onset of menstruation) occurs with
ovulation. Cycles, however, may be unovulatory and menstruation may be irregular initially. Vaginal discharge increases but pH
does not reach that of an adult so the adolescent is susceptible to sexually transmitted diseases (STDs).

Mental Changes

Adolescents still have an immature brain. It may lead to poor judgment, impulsiveness, susceptibility to peer pressure,
miscommunication and misconceptions that make risky behaviors tempting. Young adolescents have minimal ability to foresee
the consequences of their behavior and visualize themselves in the future. The maturation of the brain starts from the back,
which is reasoning and responsible for feelings and emotions, to the front which is responsible for reasoning and planning. The
need for guidance in decision-making is reduced as the adolescents begin to entertain hypothetical and abstract situations, analyze
and reason logically, and think realistically about the future. The deepening philosophical perspectives and greater capacity for
abstract thoughts provide the opportunity for self-expression, creativity and individuality.

Emotional and Social Changes

Emotionally and socially, fantasy, dreams and ideas eventually shift to concrete plans and goals. The adolescent
becomes more independent of the family. Identity issues require approval from friends and affiliation or participation in a
specific group (barkada). Competitiveness may likewise occur. Some may test boundaries by joining bad company or
developing bad habits.

Changes related to sex

The adolescent develops from solidarity with the same sex to interest in the opposite sex, dating, and feelings of love
and passion. Concerns regarding physical and sexual attractiveness to the other sex also occur. Moreover, personality may veer
from shyness to showing off as an unfamiliar emotions and urges occur. For boys, masturbation is driven by libido and
discovering one’s pattern of sex response. Erotic dry orgasms progress to wet dreams. Girls may likewise fantasize overt sexual
activity which may lead to orgasm while asleep. Both boys and girls crystallize their sexual orientation and sexual expression.

By the end of adolescence, a stable sense of one’s place in the world, an adult appreciation of one’s own sexuality, and
the maturity to enjoy it responsibly should have developed.

Parents and teachers who serve as positive role models will facilitate the transition of the confused adolescent to a
responsible adult.
 CHAPTER 12- THE ADULT AND MARRIAGE

Adulthood
With adulthood comes maturity- the opportunity to fully develop one’s physical,
psychological, social, financial, and spiritual potential. An adult has the necessary capabilities to
marry, bear children, and raise a family.
If a person chooses to marry, he/she should have the personal, physical, psychological,
social, financial and spiritual resources to meet the challenges and fulfill the responsibilities of
marriage. One should also be able to choose his/her partner rationally.

Marriage
The Universal Declaration of Human Rights states that, “ Men and women of full age,
without any limitation due to race, nationality, or religion have the right to marry and to found a
family. They are entitled to equal rights as to marriage, during marriage, and at its dissolution.”
Marriage represents the most intimate union of a man and a woman. The Catholic
tradition teaches that marriage is a natural and sacred reality: it is heterosexual, monogamous and
permanent (indissoluble). The goal of marriage is the loving union of the spouse and the
procreation and education of children. The marital act is unitive (love-giving), and procreative
(life-making). Marriage is more than just a contract; it is a covenant of love and a sacrament of
grace from and in unity with God. Couples have a serious obligation to support and strengthen
their marriage. They also have responsibilities to raise and educate their children as best as they
can.
If one finds himself/herself incompatible with his/her marriage partner despite sincere
efforts to work on their problems, legal separation of bed and board is allowed for good reason
instead of either spouse committing for example, adultery. There is no divorce in the
Philippines. When impediments to the marriage such as defective consent are discovered, then a
marriage may be declared invalid or annulled.
 CHAPTER 13- THE OLDER PERSON

The Older Woman

As the woman ages, egg expulsion and hormone secretion of ovaries slowly decrease
and menstruation ceases. At approximately 50 years of age, she undergoes menopause. The
woman may experience hot flushes, headache, insomnia, vaginal dryness, forgetfulness, aching
joints, and sudden bouts of anger. Hormone replacement therapy (HRT) may relieve some
symptoms but it should be used only for a short time because of its adverse effects.

The Older Man

Between the ages of 50 to 60 years, male andropause begins. There is a gradual
decline in testosterone secretion. The man may start to experience reduced ejaculatory
trajectory, low sperm count, less sexual interest, and difficulty maintaining erection.
Spermatogenesis, although diminished, may still persist. Testosterone therapy may help but
adverse side effects manifest. Other drugs may restore blood flow to prevent erectile
dysfunction.

Caring for the Older Person

As a person gets older, hearing and visual acuity, as well as muscle strength and
coordination decrease. Osteoporosis ensues. Fall should be prevented by good lighting, use of
accessory devices (canes, bars), and avoidance of slippery surfaces (using floor mats). Calcium
supplements and exercise should be encouraged.
As children mature and become independent, they leave home and separate from their
parents. The “ empty nest” syndrome added to the progressive disabilities of the elderly may
lead to depression.
Aging should be viewed as a time of relief from family responsibilities and an
opportunity to explore new directions and interests. Older people should remain physically,
mentally, socially and spiritually active for as long as possible. Their experience, decision-
making powers, and social influence should be utilized.
 UNIT 4 - PROMOTING REPRODUCTIVE AND SEXUAL HEALTH

Good sexual and reproductive health is defined as a “state of complete physical, mental, and social well-being in all
matters relating to the reproductive system and to its functions and processes. (UNFPA, 2016).

Any illness may lead to physical, mental, psychological, and economic suffering. Thus, everyone has a personal
responsibility to access the right information regarding health, to be aware of one’s lifestyle choices and habits, and to make a
conscious effort to be healthy. The focus of health is often on the physical condition, but all of its dimensions or aspects should
be considered. Similarly, the reproductive system is part of the whole body-what affects it also impacts the whole body; and
what distresses the whole body likewise agitates the reproductive system.

CHAPTER 14- PHYSICAL HEALTH

Good sexual and reproductive health is defined as a “state of complete physical, mental, and social well-being in all
matters relating to the reproductive system and to its functions and processes. (UNFPA, 2016).

Any illness may lead to physical, mental, psychological, and economic suffering. Thus, everyone has a personal
responsibility to access the right information regarding health, to be aware of one’s lifestyle choices and habits, and to make a
conscious effort to be healthy. The focus of health is often on the physical condition, but all of its dimensions or aspects should
be considered. Similarly, the reproductive system is part of the whole body-what affects it also impacts the whole body; and
what distresses the whole body likewise agitates the reproductive system.

Genetics accounts for about one-third of the causes of poor health. Harmful behavior and the environment account for
much more.

Measures to promote physical health

1. Regularly eating balanced nutritious meals

2. Getting enough rest and sleep
3. Engaging in physical fitness activities
4. Staying clean
5. Maintaining positive health –seeking behaviors and avoiding risky behaviors

Regularly eating balanced nutritious meals

Proper nutrition is a basic human need and a prerequisite for healthy life. Eat enough to keep your weight within
10% of the ideal limits. Seek diversity in what you eat with plenty of vegetables and fruits. Green leafy vegetable are rich
sources of vitamins and minerals. Continue to eat healthy food during menstruation and pregnancy.

An improper diet such that the body does not get the right amounts of the vitamins, minerals , and other nutrients that
it needs, leads to malnutrition. Malnutrition involves both undernutrition and overnutrition. Malnutrition leads to
reproductive, metabolic and cardiac problems.

Undernutrition refers to the consumption of less nutrients than required or the excretion of essential nutrients than
required or the excretion of essential nutrients faster than they are replaced. Common causes are excessive dieting, diarrhea,
severe illness, substance abuse and poverty. It results in poor growth and development, slow repair of tissues, and inadequate
defense against diseases.

Overnutrition, on the other hand, is the consumption of more nutrients than required. Its common causes include
overeating, lack of exercise or hormonal disorders.
Getting enough rest and sleep

Approximately eight hours of sleep every night is recommended from childhood to young adulthood. Meanwhile, six
hours may be sufficient as a person gets older.

Sleep should provide rest. It should also result in one waking up refreshed. Tossing restlessly in bed when you are
unable to sleep is useless. If this is the case, find out what keeps you awake and avoid it. Some common causes include
overstimulation from doing energetic activities or drinking coffee close to bedtime, or excessive anxiety. Relax before going to
bed.

Engaging in physical fitness activities

Regularly exercise approximately 30 minutes a day (before 10 am and after 4 pm) preferably in an unpolluted place
outdoors. Involve many muscles: head and neck, trunk, arms, and legs. Enjoy exercise with good company. Women should
continue usual activities during menstruation. However, they must ask their doctor what is allowed during pregnancy.

Staying clean

Wash your face twice a day. Bathe with soap and water daily. In addition, keep your hands and fingers away from your face.
Brush your teeth after meals and floss at bedtime.

For girls, wash and wipe your perineum from front to back after urinating or defecating. Avoid scents and sprays.
Wear undergarments made of “breathable “ fabric (i.e.cotton) and clothes that are not too tight. Normal vaginal secretions are
odorless, clear and watery, scanty or minimal, and with no associated complaints. If your secretions have a bad odor, are gray to
yellow, thick and plenty, bubbly, foamy, or cheese-like with itchiness, redness, a burning sensation, or painful urination, you
might have a problem. See your doctor.

Maintaining positive health –seeking behaviors and avoiding risky behaviors

Smoking is linked to heart attack and stroke, lung disorders, cancer, ulcers, and pregnancy risks. Nicotine and its
products have ill effects not only on the smoker but also on people close by (second-hand smokers). Residual nicotine and
chemicals can also be found in indoor surfaces (third-hand smoke). Thus, avoid smoking and stay away from smokers.

The consumption of wine and beer in low levels provides some benefits to the cardiovascular system. However, in
moderate to high levels, alcohol poses serious adverse effects, ranging from drunk-driving accidents to damage of the brain,
nerves, and internal organs especially the liver. It may cause reproductive problems and cancer. It can also lead to sex and
violence. Do not drink before engaging in activities that require your complete control such as driving, experiments, or
dangerous sports.

Limit coffee and tea to three cups per day. For pregnant women, drinking milk should be advised.

Substance use and abuse lead to drug dependence, anti-social behavior, impaired-driving, concentration problems,
serious health problems, impaired sexual activity, delinquency, criminal behavior and violence. Avoid oral, inhaled, and injected
drugs.

Allow yourself to grow and mature before any sexual encounter. Make sexual activity a responsible choice to be done
at the proper time with the right person and for the proper reason.

Until you are married and ready to be a parent, avoid intimacy which may lead to sexual arousal and intercourse. It
may bring about unwanted pregnancy with its unfortunate consequences. Teenage pregnancy impairs your successful transition
to adulthood and exposes you to sexual promiscuity, sexually transmitted diseases, social and religious condemnation; health,
education and financial harm, passing on poor health; substandard education, and often poverty. Sexual behavior is a romantic,
step-by-step progression that begins with a smile and proceeds along a continuum-from a word, to a touch, and to intercourse-
which you should be able to stop anytime. Do not put yourself in a situation in which sexual involvement is a likely and risky
accident. Avoid being alone in a secluded area, drinking, having a companion behaving suspiciously or getting aroused. Arousal
is characterized by deep breathing, increased heart rate, warm and erotic feelings, flushing of the skin, erection of the penis,
wetness of the vagina, and heightened sensation in the genital areas. Do not be easily swayed by peer pressure, media and
advertisements to have sex. The only foolproof way to sexual safety is to say “no,” stop, and not give in. Preserving your values
is more important than immediate sexual gratification.

Rape is defined as the illicit act of having sexual intercourse with someone against her/his will. It is committed by
using physical or moral force (fear, deceit, superior position) and is often accompanied by violence. Acquaintance and date rape
is frequent among adolescents. Learn how to avoid it.

Violence refers to the exertion of power and forcible manipulation of a situation. Stay away from situations which
provoke violence.

Finally, follow safety rules to prevent abuse and injury. Be drug-free, alcohol-free, mobile phone-free when driving.
Read labels of food products and beverages before eating or drinking them. Swim in the presence of companions. Avoid
unsanitary tattoos and piercing.