Reproductive Health Class 12 , Chapter 4, Biology, CBSE
Reproductive health means all the reproductive organs are well being in structure and function.
According to WHO (World Health Organisation), reproductive health means well – being in all respect of physical, emotional, behavioral and social.
Reproductive Health Problems
- Early Marriage
- Population size
- Deformities (Baby with defective structure)
- Unaware about birth control methods
- High IMR (Infant motility rate)/ MMR (Maternal motility rate)
- Sex unaquality or Sex Abuse
Strategies to overcome Reproductive Health Problems :-
- In 1951, India initiate the programme “Family Planning” which aware the people about small family.
- Government and non – government base agencies aware the people about different reproductive health problem through audio, video, media.
- India initiate RCH programme (Reproductive child and health care). In RCH programme , pre – natal and post – natal care facilities provided and aware the people about breast feeding, STD’s , passive immunization.
- We aware the people about sex inequality.
- Increase in Marriagable age. Female must be of 18 years and male of 21 years.
- Improvement in medical facilities.
- In CDRI, Lucknow – a tablet Saheli (non – steriod) is prepared i.e. used as oral contraceptive.
- Amniocentesis – It is a technique to detect genetic chromosomal and chemical disorder.
Rapid increase in population size in short time period.
The world population was about two billions in 1990 A.D. and it is 6 billions in 2000 A.D. The same trend is observed in india also; our population at the time of independence was about 350 million and it has reached one billion in 2000 A.D. , it has crossed one billion in May 2000 A.D.
Reasons behind Population Explosion
- Decrease in death rate
- Decrease in IMR/MMR
- Increase in number of individual in reproductive age group
- Unaware of birth control methods.
According to 2001 census report, it is around 1.7%, i.e., 17/1000/year and at this rate, the population is expected to double in 33 years.
Effects of Population Explosion:-
- House problem – Not get proper housing facilities.
- Rapid decline in food resources
- Increase in Pollution
- Increase in crime
Strategies for Population Explosion control
- Family Planning – Aware the people about the advantage of small family.
- Incentive provided to attract the people towards small family.
- Aware the people about birth control methods.
- Increase in Marriageable age.
Birth Control Method
Contraception – Prevention of unwanted pregnancy.
Contraceptive device – Any device i.e. used to prevent unwanted pregnancy.
Properties of an Ideal Contraceptive-
- Easily available
- User friendly
- Maximum effectiveness
- Minimum side effect
- Do not interfere with reproductive health
- Must be cheap
Natural and Traditional method of Contraception
- Parodic absence – In this method, sexual intercourse is avoided during the 10th – 27th day of Mensuration cycle, because these 7-8 days are most fertile time period days.
- Withdrawal method/ Coitus interrupt – Male withdraw its penis from the female vagina before ejaculation.
With the Cowper gland secretion, there is the chance of entry of sperm within the female body before ejaculation. So, there is the chance of failure of method.
- Lactational Amenorrhea – During high lactation period, there is no mensuration within the female.
Advantage of this contraception
There is no side effect.
Chance of failure is there.
Physical method/ Barrier method
It prevent the mating of male and female gamete.
In addition to the contraception, it also protect from STD (sexually transmitted disease)
The ovum and sperms are prevented from coming closer with the help of barriers. Condoms are the barriers mad of thin rubber latex sheath, to cover the penis in male or vagina and cervix in females .
Diaphragms, cervical caps and vaults are the barriers (made of rubber), used by females ; they are reusable.
Spermicidal creams are used along with these barriers to increase their contraceptive efficiency.
IUD (Intra Uterine Devices)
It is most widely used method in India.
- Non – Medicated – It is made up of stainless steel and inserted within the female uterus.
It increase phagocytosis of sperm within the female body.
Example – Lipper loop
- Cu – releasing IUD – These are the specific IUD that release Cu ions within the female uterus and Cu ions.
- Prevent the Capacitation of sperm and decrease fertility power of the sperm.
- Interfere with flagella movement and decrease motility of the sperm.
- Increase the phagocytosis of the sperm.
Example – Cu T, Multi log 375, Cu 7
- Hormone releasing – These are the specific IUD that release progesterone and estrogen hormone within the female body.
They prevent pregnancy by performing different functions:-
- High level of progesterone and estrogen inhibit ovulation.
- They make the uterus improper for implantation.
- Increase secretion of thick mucus of Endometrium that get accumulated within the cervical canal and act as cervical plug and it prevent entry of sperm within the female body.
They are inserted within the female uterus by the specialised doctor.
Example – LNG – 20 (Levonorgestrel)
It is a method of contraception in which we orally intake either progesterone only or progesterone estrogen combination.
Its mechanism of working is similar like Hormone releasing IUD.
Oral pills are available in two different forms:-
- Mini pills : It contain only progesterone hormone.
Saheli is the first non-steroid preparation of oral contraceptive.
It contain centremen chemical i.e. similar in function like progesterone but non-steriod in nature.
Saheli is taken once a week after the dose of twice a week for 3 month.
It have minimum side effect on the body.
- Combined pills : It contain both progesterone and estrogen.
Example – Mala D, Mala N
It is taken regularly from 1st day of mensuration cycle to the 21st day then a 7 day break is taken.
It have side effect on the body.
A device with 6 capsules that are filled with progesterone , estrogen hormone is implanted under the subcutaneous region by making a small cut.
It cause hormonal imbalance within the body.
Example – Nor plant
Estrogen – progesterone combination injected directly within the blood that cause hormonal imbalance and act as contraceptive device.
Example – Dipo – Provera
i – 72 pills/ Morning pills/ Emergency pills
High dose of estrogen – progesterone is taken orally to prevent pregnancy in the case of unprotected sex intercourse or in rape case.
Sterilization/ Surgical methods
It is a permanent method of contraception and here, chance of reversibility is minimum.
It carried out in female in which a small piece of fallopian tube is cut and tied.
In tubectomy, Mensuration occur without egg.
It carried out in male in which a small piece of vas deferens is cut.
In this, Semen is there but without sperm.
ADVANTAGE of Contraceptive Device
Maximum effectiveness is there.
DISADVANTAGES of Contraceptive Device
- Excess bleeding during Mensuration.
- Menstrual Cycle can be irregular.
- It can cause Cancer (Breast Cancer).
- Can cause Nausea.
- Cause ulcer in the uterus.
- Temperature of female body is mainly high.
(Medical Termination of Pregnancy)
Termination of the pregnancy before the full term development of foetus.
It is safe up to 12 week but can be done up to 20 week.
In India per year 40 – 50 million MTP’s are carried out that become 1/5th of total conceive per year.
In India, it is legalised in 1971 under the certain condition :-
- In the case of rape.
- In the case of failure of contraceptive device.
- In the case of genetic disorder in developing foetus.
- If further foetus develop is dangerous for the mother.
But there is a disadvantage of this i.e. it lead to female foeticide.
Technique to find the disorder in foetus –
- Amniocentesis – It is a technique to detect genetic chromosomal and chemical disorder.
Processor of Amniocentesis:-
Amniotic fluid is taken out with the help of injection and from the amniotic fluid, foetus cells isolated and the DNA is analysed for any genetic disorder.
It lead to female foeticide. So, it is ban in India.
- CVS (Chronic villi sample) – In this a small sample of chronic villi is taken and DNA of the chronic villi cells is analysed to find out any genetic disorder.
- Ultrasound – In ultrasound, we analyse the foetus organ development.
Infertility of a patient to conceive a baby after 1 – 2 year of unprotected sex.
The reasons for infertility could be physical, congenital diseases, use of drugs, immunological reactions or even physiological.
Sterility – Permanent loss of fertility power.
Reasons behind Infertility in Male :
- Decrease in level of Gonadotropin.
- Deficiency of androgen hormone.
- Access of alcohol and drugs.
- Azoospermia and many more.
Reason behind Infertility in Female :
- Deficiency of Gonadotropin.
- Fimbriae not able to catch ovum during ovulation.
- Deficiency of estrogen and progesterone.
- Ciliary movement are less in oviduct.
- Oligo ovulation.
- Improper growth of uterus.
Specialised health care units called infertility clinics could diagnose the problem and give corrective treatments for many of these problems.
Where corrective treatments are not available, there are special techniques called Assisted Reproductive Technologies (ART) to help the couple produce children; they are as follows :
Test Tube Baby Programmes
In this method, ova from the wife or a donor female and the sperms from the husband or a donor are allowed to fuse under stimulated conditions (as that of the body) in the laboratory ; it is called In vitro fertilisation (IVF).
The zygote or early embryo is transferred into the uterus or fallopian tube for further development; this process is called Embryo Transfer (ET).
Embryo transfer is of two type :
|Zygote intra fallopian transfer||Intra uterine transfer|
|Zygote or embryo up to eight blastomeres is transferred into the fallopian tube.||Embryo with more than eight blastomeres are transferred into the uterus.|
GIFT (Gamete Intra fallopian transfer)
This method involves the transfer of an ovum collected from a donor female into another female, who cannot produce ova, but can provide suitable conditions for fertilisation and further development of the foetus up to parturition.
ICSI (Intra Cytoplasmic sperm injection)
In this method, sperm is directly injected within the cytoplasm of ovum in the laboratory conditions. After ICSI, embryo is transferred within female uterus either by ZIFT or IUT.
AI (Artificial Insemination)
In this method, the semen collected from the husband or healthy donor, is artificially introduced into the vagina or into the uterus(intra uterine insemination).
It is carried out in cases where infertility is due to the inability of the male partner to inseminate the female or due to very low sperm counts in the ejaculates.
STD’s (Sexually transmitted disease)
Any disease that get transfer during the unprotected sexual intercourse.
RTI (Reproductive tract infections) – Any disease in which infection take place within the reproductive tract.
All RTI are STD as the pathogen that cause RTI get transmit through sexual intercourse from infected person to the healthy person.
STD get transform not only through sexual intercourse but it get transfer by other means also like blood transfusion, from infected mother to the foetus or through the intravenous injection.
The main age of the infection is 15 – 24 years.
Primary symptoms of STD –
- Pain in genitalia
- Vaginal and urethral discharge
Secondary symptoms of STD –
- PID (pelvic Inflammatory disease)
- Still birth
- May lead to the infertility
Way of Transmission –
- Unprotected sex
- Sex with the unknown person or with multiple partners
Example of STD
Syphils – A bacterial disease cause by Treponema Pallidum.
Its symptoms are painless ulcer, lesions on the skin, rashes, arthritis, joints swollen, paralysis, brain damage.
Gonorrhoea – Caused by sexual intercourse or mother to foetus.
Syphils and gonorrhoea can be easily curable by antibiotics.
AIDS – It leads by HIV and it is not curable.
Hepatitis B – It affects on liver and is not curable.
Genital herpes – caused by herpes simplex virus and is not curable.
Genital warts – caused by Human Papilloma virus and it is curable.
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