Topic 6 : problem about sexual development of teenager

When a person become a teenager, both woman and man will have a variety of changes in physical, psychic, social and sexual development which are all part of natural human development. The important changes are wet dreams in men and menstruation in women that means that pregnancy is possible. This physical development is necessary for people, who must take good care of their personal health and understand about the human physical reproduction processin order to live a healthy life.

Menstruation, Pregnancy and Abortion

How does woman menstruate?

Menstruation is natural process which occurs in a woman because the ovaries produce ovum every month. When the ovum is mature and the body is ready to receive a fertilized ovum . The wall of the uterus will change if there is no fertilization between ovum and sperm. The wall of the uterus will peel off and along with blood that is called "Menstruation". All of this process takes about 28 days or more or less with a deviation of about 7 days and usually around 3-7 days a month. The number of Topics of blood is usually about 30-80 ml.

When a female begins the physical change from a girl into woman one important change is the onset of menstruation. Most girls have their first menstruation around 11-15 years old. The first menstruation may be early or late depending on the development of the person’s brain, heredity, and their physical and psychological health. In the earliest stage of menstruation (and in the elderly as well), the menstruation period will not stable and some months there may not be ovulation. On average, the elderly will cease to menstruate around 45-50 years old when the ovaries stop producing ovum.

Cycle of menstruation

-Ovulation

Generally occurs near the same time in each lunar cycle. The Pituitary gland will release hormones which cause the ovaries to release ovum for fertilization.

-After ovulation

After ovulation, ovum will flow into the fallopian tube to the uterus. In the meantime, the ovaries also start to produce hormones that cause the wall of the uterus to become thicker and ready to receive a fertilized ovum.

-Menstruation period

When the ovum has arrived at the uterus and is not fertilized, perhaps because there has not been sexual relations or the use of birth control, then the level of estrogen and progesterone will decrease very rapidly which causes the wall of the uterus to peel and become the menses. Woman usually menstruates for about 3-5 days.

-After the menstruation period.

After completing menstruation period, the pituitary gland always secrets hormones into the blood which will begin to stimulate the ovum in the ovaries to become mature. Meanwhile, hormones from the ovaries also begin to stimulate the wall of the uterus to increase.

Characteristics of the normal menstruation

A normal menstruation cycle will have blood flow from the vagina every 28 days, more or less 7 days. The menstruation contains mucus from the cervix, vaginal mucus, and tissue from the ovaries and blood. Most of these cannot be seen clearly because of dark blood color. The normal menstruation flow will be a dark color without blood clots or odor until it reaches the air outside of the vagina, which allows the growth of bacteria and causes an odor. A typical menstruation period usually lasts about 3-7 days. If there is some difference from this, it is abnormal.

Problems and indication that usually occur when menstruate.

Before menstruation

Before the menstrual period, most women will have some symptoms that show before menstruation. Some may have pains in their lower stomach or back. For some women this can be severe. Some may have diarrhea and feel queasy. Some women will also have a headache. For others menstruation may bring leucorrhea and pains in their breasts. Similarly, many women will feel worried, sad, or moody. This is normal and these symptoms will disappear after menstruating. According to statistics, the pain will be greater in women who are 18-24 years old. Dysmenorrheal will disappear after the women has been pregnant and given birth to a child, possibly because the cervix has expanded which causes a decline in teleneurons in that area.

There are some techniques to help abdominal pains. These can be as easy as placing a hot water bag on the stomach. Sleep may be improved by taking a paregoric medication or medicine which decreases convulsions of the uterine muscle. Getting adequate exercise can also help reduce extreme menstrual cramps.

There are other types of abnormal menstrual cramps of which women should be aware. Most occur after menstruation has continued for long time. For example, pelvic adhesive disease can be caused by a pelvic tract infection. This can cause connective tissue which sticks organs in the pelvis together. It is also possible for growth of the uterine lining in the pelvis to occur in the wrong place. There could also be a tumor in the uterine wall muscle. In these situations, there are different types of menstrual cramps. A woman might still have severe abdominal pains although her menstruation has stopped for many days already or she may experience more pain in the next menstruation. If any of these abnormal conditions exist, you should consult a doctor immediately.

When menstruate does not begin

Usually, menstruation will begin when women are 11-15 years old, though it may be late or early. If menstruation does not begin when at maturity, it should be considered to be abnormal.

Some causes of a failure to begin menstruation

- There is no uterus.

- There is no ovary.

- There is no vagina by birth.

- There are ovaries but they are abnormal.

- The hymen does not open.

- There are some abnormal of vagina.

- There are some abnormalities in the uterus.

In the case of a failure to menstruate, that is considered to be abnormal and you should consult with your doctor immediately.

Missing a menstrual period may be caused by:

- pregnancy

- using birth control pill or contraceptive injections

- after giving birth you are breast feeding a child

- too much stress

- having had an operation to remove the uterus or both sides of the ovaries

Pregnancy

Pregnancy occurs from fertilization of the ovum with a man's sperm time in which the ovum is mature. When ovum is fertilized by the sperm it will move to the endometrial which will become thicker. After that there are continued merit is for 9 months until childbirth. While pregnant, mother and child will be connected by placenta. At the beginning of pregnancy, women will observe different symptoms. Some are:

-Menstruation is missing.

The menstruations that usually occur every month will disappear completely during the period of pregnancy which lasts 38-40 weeks.

-You may feel queasy, vomit and dizzy.

These symptoms usually disappear after 3 months. They normally occur in the morning and that is called morning sickness.

-Breast is full.

The nipples and vagina will be darker than usual in the early part of pregnancy. Sometimes the breast may lactate colostrums when you press the nipple.

-Baby starts moving.

In her first pregnancy, a woman will feel the movement of her baby in or around the 20th week of pregnancy. In her next pregnancy, baby will start to move in or around the 16th week. If the baby's movement decreases, you should see a doctor immediately.

-Urination becomes more frequent.

As the uterus increases in size, it then presses on the bladder. If your urine becomes acrid or turbid, and then you should see a doctor immediately.

-Have a bad mood.

Attitudes and beliefs about menstruation

A women's experience of menstruation is perfectly natural but her beliefs, religion and culture determines the way female menstruation is perceived and how she will be treated. Many cultures have a negative attitude about menstruation. They may not allow a menstruating woman to attend worship or to get together with other people during the menstruation period etc.

Some cultures prescribe refraining from certain actions while a woman is menstruating. For example refrain from exercise, showering or washing your hair and do not have sexual relations during your period. These beliefs are not supported by fact. Some may be reasonable and some of them are not. Sexual relation during the menstruation period does not have any medical support, but it is not popular because the menstrual blood is considered dirty and it is possible to have an inflection because the Cervix is open a little bit and there are some injuries inside the uterus due to the peeling of the lining of the uterus.

Testing Pregnancy

If woman is not sure whether they are pregnant or not, they can check at either a private clinic or public clinic or buy a pregnancy test from a pharmacy. This test can detect hormones in urine and is easy, convenient and economical. The result is quite accurate for a woman who is in her 27th week of pregnancy.

To increase the efficiency of the pregnancy test, you should:

1. Stop drinking water or other beverages from 8pm and be sure to urinate before bed.

2. Keep the first urine of the morning in a clean container.

3. Do not eat any medicine for 48 hours before keeping urine.

4. If you do not perform the pregnancy test immediately, you should keep the urine in a refrigerator because the hormones in the urine of a pregnant woman will gradually disappear at room temperature.

What is extra-uterine pregnancy?

Extra-uterine pregnancy is when a fertilized ovum lodges outside of the uterus and actually grows to be a placenta and baby. This usually happens in the fallopian tube but may occur in the cervix, stomach, ovaries and other places. The main cause of extra-uterine pregnancy is the ovum flowing mechanism in the fallopian tube is abnormal so that the fertilized ovum cannot move through easily. It is usually caused by infection. The main disease is gonorrhea which causes the abnormal an abnormality of the fallopian tube wall's membrane. Infection and chronic pathology of the pelvis can also cause to the fascia around the fallopian tube to move improperly which affects the movement of the fertilized ovum.

The symptoms of this are that menstruation will disappear for a while but there will not be any obvious signs of morning sickness. When this crisis occurs, there will be acute abdominal pain on either side all the time. You will feel faint, heart shake or black out. You may bleed a bit from the vagina or maybe not. Some people may bleed a lot in the abdominal area which can irritate the diaphragm that is between lungs and the abdominal cavity which will cause a right shoulder-ache. Patients will be very pale, fidgety, sweating, have indistinct mind and memory, strongly acute symptoms and may go into shock. If they cannot be sent to a hospital in time, it may be fatal because of body ischemia.

A woman who is already sterilized may have an extra-uterine pregnancy although the risk is quite small. The cause is some of the fallopian tube is cut out by the operation but can reconnect which can allow pregnancy. According to the records less than 1 out of 1000 people experience extra-uterine pregnancy. When compared with natural pregnancy, that percentage of extra-uterine pregnancy in women who are already sterilized is high Being careful not to cause inflammation in the pelvic cavity and avoiding venereal disease are the best ways to protect against an extra-uterine pregnancy. If you find that there is too much leucorrhea or a stinging sensation while urinating, you should go to see your doctor immediately to treat this condition in the early stages because the symptoms of important venereal disease in women (especially female gonorrhea) will not be as clear as in a male

Normal symptoms while being pregnant, care, protection and procedure to relieve.

Abortion

Abortion means ending the pregnancy before the baby reaches 28 weeks of pregnancy or weighs less than 1,000 grams.

Type of Abortion

There are 2 types of abortion, which are:

1. Spontaneous abortion (miscarriage) is an abortion that happens without using medicine, tools or any technique.

2. Aborticide that can be separated into 2 types

2.1 Aborticide for health.

2.2 Illegal aborticide

The cause of spontaneous abortion

- An abnormal embryo, is usually about 60 percent of spontaneous abortions.

- An abnormality of the mo\ther, which may be caused by an abnormal uterus.

- Inflammation and infections such as syphilis which can cause an abortion.

There are many causes of abortion or miscarriage, some of them are cureless and there is nothing you can do but some can be protected against. A person who has ever had an abortion should consult with her doctor to diagnose and seek preventative measures before the next pregnancy because she may abort again. While she is pregnant, she should take special care and remain under the supervision of a doctor.

Spontaneous abortion symptoms

Normally, when a pregnant woman might be having a miscarriage, there will be bleeding from the vagina. Blood coming from the vaginal cavity is called abortion in a threatening period. It may include lower abdomen aches in the middle upper Mon pubis. Then the vagina will start to constrict As the abortion continues to the point where the pregnancy cannot continued, there will be more bleeding, more abdominal aches and finally vagina will begin to press upon the embryo or baby and the placenta will be ejected from the vaginal cavity and that is called a complete miscarriage. Most complete miscarriages usually occur less than 8 weeks after the first day of the last menstruation. If the pregnancy is more advanced than this, all ejection of pregnancy matter will be incomplete. Many times, only the baby and thrombus will be ejected but the placenta remains in the vagina.

This miscarriage is incomplete and can affect the women’s health fatally. Treatment involves scraping the uterus to remove the entire placenta.

Procedure and protection from a spontaneous abortion

1. When you find that your menstruation is missing or you suspect that you might be pregnant, you should meet with your doctor immediately and keep every appointment.

2. Tell your doctor about your record of past illnesses and hereditary diseases such as Thalassemia, Diabetes, and Hypertension etc.

3. If you are more than 35 years old you should consult your doctor.

4. If have ever had an abortion, you should notify your doctor.

5. While pregnant, if there are some abnormal symptoms such as bleeding, then you must see your doctor immediately even without an appointment.

6. Take any tonics that have been prescribed by your doctor.

7. Avoid sexual relations while bleeding or if seromucus runs from your vagina.

8. Should not be pregnant more than once every 2 years.

9. Avoid liquor, caffeine, cigarettes and drugs.

Aborticide

Under Thai law, abortion is illegal but there are some exceptions. If a doctor has determined that pregnancy would be injurious to the mother’s health or in the case of a rape victim, abortions can be performed. But they are illegal in all other conditions.

The cause of most abortions for Thai women is from undesired pregnancy. Researchers who study the causes and age groups of women having abortions found that teenagers have a high rate of undesired pregnancies. It is assumed this is because they lack knowledge of birth control while having sex. But it has also been observed that adult females who already married will have abortions, probably because of a failure of birth control.

Many women do not understand the dangers that can come from an illegal abortion including death. Especially if the pregnancy is advanced, it will be much more dangerous.

There are many complications that can result from an illegal abortion which may have long and short term implications for that woman’s life.

- Miscarriage which may bleed abnormally. If she does not receive a blood transfusion in time, it may lead to death.

- Ruptured uterus which may lead to removal of the uterus.

- Broken uterus, which leads to removal of the uterus and she will not have a chance to be pregnant again.

- Inflammation, which is caused the use of dirty equipment and carelessness in preventing the spread of inflection. Inflammation from scraping the uterus will cause other health problems that waste a lot of money on medical treatment. Since the cause inflammation is bacteria, which spread very rapidly it may take a long time to cure. If doctors cannot completely cure the inflammation, it will cause chronic pelvic inflammatory disease. Even if completely cured, this woman will face the problem of difficult pregnancy in the future.

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