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15-1




      THE REPRODUCTIVE ORGANS

•    How is a man’s body different from a wom-
an’s      body?
•    What is this sex all about?
•    How do babies happen?
•    How do we stop having babies ?

All of us are very interested in sex and this mystery of
having children. Yet, this is one topic that is not spoken
freely about.

We know about our sex organs compared to how much
we know about our hands or legs, our nose, eyes or stom-
ach .

Yet we need to know because sex and reproduction is a very
important part of our lives. It is the cause of much happi-
ness as well as of misery.

Only when we correctly understand will we be able to give
correct advice and help to others.
15-2
                     Growing Up & Changes in the Body
Girls grow up to be women and boys grow up to
be men. How does this happen? Does it happen
overnight? No, these changes do not happen over-
night.

Growing up is part of a chain of things which
happen to the body at a certain period in life.
This period when the body changes to making
boys and girls capable of having children is
called “puberty” (pyoo-ber-ti). If not for this
very troubled and confused period in a young
person’s life, a little girl would have remained
a little and a little boy would have remained a
little boy.




                      Are Puberty and Adolescence
                       (a-dawl-e-sense) the Same?
                 Puberty
                 Puberty is that time of growth in adolescence when a boy
                 and girl become capable of producing a baby. Although
                 the age for puberty is becoming lesser and lesser over the
                 years, it can vary between 9 and 14 in girls and between 10
                 and 15 in boys.

                 Adolescence
                 Often used in place of each other, adolescence is the period
                 in the life of boys and girls where they are undergoing a
                 transition to their adulthood. Puberty is just one part of
                 this process. The development of gender characteristics
                 made possible by the different hormones of the body are
                 some others.
15-3

                                     Puberty

 Girls
 1. “Menarche” – first monthly periods
 2. Appearance of breast buds.
 3. Elevation and enlargement of
 breasts.
 4. Projection of area around nipples.
 5. Adult breasts.




                                   Gender characteristics
                During Adolescence, boys and girls get certain features that
                mark them as male or as female. These are:
       Girls                                        Boys
1. Puberty like monthly periods and           1. Puberty in penis, testes, prostate, vesicles
breasts, etc.                                 2. “Adam’s apple;” deep voice.
2. Voice remains as earlier                   3. Beard, moustache and face hair; hairline re-
3. Less body/ face hair                       cedes
4. Pubic hair like inverted triangle          4. Pubic hair in pyramid form
5. Narrow shoulders, broad hips;              5. Shoulders broad, big muscles
Thighs converge, elbows diverge.
6. Skin softer, less oily.                    6. Skin thicker; more prone to pimples/acne
7. Sensitive, softer attitude                 7. Aggressive attitude



 Boys
 1. Enlargement of testes.
 2. Penis size increases
 3. Growth of the front end of
 the penis
 4. Adult genitalia
15-4
                                                     Female Sex Organs
                                 By the end of puberty, the body of a girl becomes capable of bearing
                                 children. Her sex organs would have developed enough.

                                 In women, some of the organs for reproduction can be seen –
                                 they are external or outside— and some organs are hidden inside
                                 the body, that is, they are internal or inside organs.




 Organs Outside:
                                                                External Sex Organs of Women
What can be seen just in front of the hole from
where the shit comes out, are the two outer and
two inner ‘lips.’ At the top of the vulva is the clito-
ris, which looks like a smaller version of the men’s
penis, except that no urine comes out of it. Women
have a separate opening for the urine, just above                                            clitoris
the opening where the child comes out of the womb          vaginal                      urine opening
at the end of pregnancy.                                   opening

                                                                                 anus or
                                                                                 shit hole



Organs Inside:
To carry out the task of bearing chil-
dren, each woman has:
   a. a uterus (womb),
   b. a vagina,
   c. two ovaries and
   d. their tubes.




                        How do reproductive organs work?
             Once a girl reaches 11 to 13 years of age and starts her monthly periods,
             she can bear a child. The ovaries produce the eggs and every month one
             egg is released.

             When the time is right, the brain signals the ovaries to start its work. The
             ovaries then starts making the female hormone oestrogen (ees-trow-jen).
             This hormone acts like a chemical messenger from the brain getting dif-
             ferent parts of a woman’s body to start developing “womanly features”.
             The body suddenly becomes shapely, the hips enlarge, breasts get formed
             and most important of all, the menstrual cycle starts.
15-5




1. The Ovaries
The ovaries are closely surrounded by finger like projections that eagerly wait to catch the new
egg. The finger-like projections send the egg down the attached tubes by a gentle squeezing mo-
tion, towards the uterus. Here it waits for the sperm from the male to fertilise it and grow into a
child.



2. The Uterus                                            3. Cervix (ser-viks) & Vagina
It is thick and muscular and its wall changes            In its lower part, the uterus has a long
thickness every few days. Normally about 3               neck, also called its cervix. This is not as
inches long, two inches wide and an inch deep,           muscular as the top part of the uterus.
the thickness changes with the monthly men-
strual cycle every few days.                             The cervix opens into the vagina, another
                                                         tube like organ, not very muscular, but
The lining is thinnest when the woman is                 lined with cells. The vagina receives the
bleeding. It starts putting on some thickness            penis during sex and this is also the open-
towards the middle of the cycle and gets re-             ing from where the child comes out into
ally thick when the egg is sent down to it. A            the world.
thick wall would keep a fertilised egg prop-
erly for a long period of nine months. The thick         The opening of this vagina is just in front
upper part of the uterus is also required for            of the anus and just behind the opening
squeezing the child out at the time of deliv-            for the urine. Nerve endings from the
ery!                                                     clitoris and from the vagina carry signals
                                                         to the brain. When rubbed or massaged
If the egg is not fertilised by any sperm, the           during sexual intercourse (or during mas-
uterus sheds its lining and the menstrual bleed-         turbation), the woman gets a pleasurable
ing takes place.                                         sensation.
15-6
Male Sex Organs                                               Sex Organs of Males
Like women, even men have different
external and internal sex organs.

External organs. Of the external organs,
what can be seen hanging between the
thighs are:
1. a penis (pee-nis)
2. a scrotum. (skro-tem)
                                                                                                  testes
1. The Penis                                                                  glans
The penis when limp has a thin foreskin                                               penis    scrotum
extending in front. When the foreskin is
pulled back, it cuffs around the neck of
the penis. The bulbous end of the penis is
called the glans.


 Common Opening For Sperms & Urine                        Penis Ejaculation
Men have a common opening from which                      When stimulated by repeatedly rubbing
both semen and urine come out. This slit like             against the walls of the vagina (or during
opening is at the tip of the glans. The part              masturbation), the penis pours out about
connecting the glans to the body is called the            2.5 to 3.5 ml (half a small tea spoon) se-
shaft of the penis. As short as two to three              men in a few spurts. Immediately after, it
inches and soft when normal, the penis can                again returns to its normal limp shape and
increase in length — to four to six inches –              size. It will need an hour up to a few hours
and in width when erect in an excited or                  to be able to stiffen up once again by sexual
sexually stimulated state. It also hardens up             stimulation or masturbation.
at such times, ready to enter the vagina.

Position of the Penis
The normal penis is naturally inclined to one side, either the left or the right. This becomes promi-
nent when the penis is erect and a curve may be seen in many shafts. In young age, many men
may feel anxious about the fact, and should be reassured that it is normal.




2. The Scrotum                                                   Size of the Penis Does Not
Below the penis, is a sac like structure that all men                      Matter
have and it is known as the scrotum. This has the
male counterpart of ovaries. It is called the testes.          Although the size of a man’s penis is the
                                                               focus of many a discussion, a woman’s
Sperms have to be produced at a temperature                    vagina is only four inches deep and
much lesser than the body temperature. Hence, the              hence, the smallest of men’s erect penises
testes are stored in a sack (the scrotum) that hangs           is enough to penetrate fully.
outside the body (unlike in a woman, where the
ovaries are inside the abdomen).                               This foreskin is cut off during the ritual
                                                               of circumcision in Jews and in Muslims.
Inside the scrotum are the testes (single=testis).             Some men are unable to pull the fore-
These are small oblong ball like structures found              skin back and find a tight foreskin an
inside the scrotum. The testes produces sperms                 obstruction during sex. They can get
(seed cell from the man needed to join with an egg             their foreskin removed by a surgeon.
in the woman to make a new baby).
15-7
 Internal Parts of the                      Internal Parts of the Male Reproductive System
 Male Reproductive                           ureter
       System                             - brings urine
                                          from kidneys
1. The Testes:                        urinary bladder
The testes of males has two              - stores urine
main functions:
                                      vas deferens                                                  rectum
a. Makes Male Hormone:                                                                                  -
                                      - carries sperms
The male hormone ,
testesterone is responsible for        prostrate                                                    anus
the different “male character-      - adds fluid to the                                           - shit hole
istics” - Like hair on face,              semen
deeper voice, “Adam’s apple”                                                                     testes
a rough skin, front and side              penis
                                                                                               - sperms are
balding of males, a muscular          - carries sperms
                                                                                                made here
body and for the erection and        outside the body
                                                                        scrotum
sexual stimulation as well.                                    - sac where testes is located


b. Makes Sperms :
       The sperms are produced in plenty by the testes. Only one sperm is required to fertilise or
join the ovum for a baby. But normally every ml of the semen brought out during ejaculation has
about ten crores of sperms! If this count is less than two crores per ml, the chances of producing a
child are almost nil!


3. Vas Deferens                                                            4. Prostrate Glands
The sperms along with some fluid (combined is what is                      The prostate is a round or-
semen) are sent from the two testes through the vas defer-                 gan at the junction between
ens on each side to two worm like seminal vesicles. Here,                  the base of the penis and
semen is stored and sqeeszed out at the time of stimula-                   the urinary bladder above.
tion                                                                       It surrounds the urethra for
                                                                           a short while. It produces
                                                                           much of the nourishing
Vasectomy : Cutting The Vas Deferens                                       fluid that the sperms re-
The two vas deferens are cut on either side and the cut-                   quire for their travel to the
ends are tied in the operation for permanent birth control,                woman’s tubes.
called vasectomy. This small and easy operation, unlike
the tubectomy of the woman prevents the sperms from                        Enlargement of Prostrate
reaching the semen.                                                        The prostate may enlarge
                                                                           after the age of fifty and be-
But as the testes are not touched, the blood can continue                  yond. This creates problem
to take the male hormone for male like characteristics. As                 in men by making it diffi-
the prostate and seminal vesicles continue their connec-                   cult to pass urine. The more
tion with the urethra in the penis, there is practically no                the person tries, the worse
decrease in quantity of semen as well.                                     it gets. Only if the person
                                                                           relaxes, is he able to pass
In other words, the manliness of men – of voice, hair, skin,               urine. An operation to re-
muscle and muscle power, erection and ejaculation remains                  move or decrease the size of
intact after Vasectomy. Once done, men can have sex nor-                   prostate is now much sim-
mally without fear of causing pregnancy.                                   pler and safer than the ear-
                                                                           lier days.
15-8

                           Know the Answers
                             THE REPRODUCTIVE ORGANS


Please in the blanks:

1.   Puberty refers to changes in _______________ while adolescence means changes in

     __________________, _____________________ and ____________________

2.   Egg from a woman’s ______________________ goes to the ______________ where

     it may meet the _____________ from the man. The two together may start

     developing into a baby that stays in the _____________ for 9 months.

3.   Men have _________________ sperms in every ml of their _________________.

     They are made      in the _____________ and are taken to their ______________

     vesicles through a tube called ________________.

4.   __________________ in women and _______________ in men can help us stop

     having babies permanently.

5.   An erect penis can be _____ to ______ inches long, while a woman’s vagina is

     _______     inches long.


Please mark if “right” or “wrong”:
1. Menarche means the first monthly period in girls.

2. The cervix helps to push the baby down during delivery.

3. Masturbation means stimulating onself for sex and is
   not good for health.

4. Men produce one sperm per month in their testes and this
  sperm goes to meet the egg from a woman to produce a child.
15-9




        Diseases of
THE REPRODUCTIVE ORGANS
15-10
            Diseases of Reproductive System
Many diseases can be transmitted while two people have sex with each other. There are
a range of Sexually Transmitted Diseases (STDs): simple ones that affect only the skin,
like Lice and Scabies (which spreads when people come into physical contact with each
other) to those that can affect the entire body if not treated, like Syphilis and AIDS.


Types Of STDs
Some STDs are common and can be treated by the health worker. Others are fairly serious and
maybe untreatable. They also constitute a risk to the person’s family & society and will also be
discussed.
                 Serious STDs Include:                                  Simple STDs Include:
                          1.   Gonorrhoea                               1. Hepatitis B and C
                          2.   Syphilis                                 (see Phase I Manual in diseases of
                          3.   LGV                                      digestive system)
                          4.   GI                                       2. Scabies,
                          5.   HIV/AIDS                                 3. Lice, (skin diseases) etc
                          6.   Herpes Simplex

Discharges and Sores
Usually, genital problems appear in males and               Discharge from Genital Organs
females as discharges or sores in an around
the genital areas. Rashes, warts or swollen
glands are other ways in which it is seen.

You can find out most types of STDs by
knowing what kind of discharge it is or what
kind of sore is found in which part of the
genital area.


                  Take Note
    It is recommended that all people de-
    tected to have STDs should be ad-                 Vaginal Discharge              Discharge from Penis
    vised to get their Blood checked for
    HIV.
                                                              Sores in the Genital Ar-
    Men with STD are usually found to                         eas
    have more than one sexual partner
    and women with STDs are likely to
    have husbands with more than one
    sexual partner (commercial sex
    workers would have multiple part-
    ners themselves also). All categories
    are at higher risk of getting the HIV
    infection and hence AIDS too.




                                                        Genital sore (ulcer)                Genital sore
                                                           in a woman                         in man
15-11
1. Gonorrhoea
It is a disease that is caused by very strong bacteria, Gonorrhoea affects both men and women, but
directly causes problems in men.

* Women & Gonorrhoea
When a doctor internally examines women with Gonorrhoea,
                                                                        Types of Sores in
many wounds on the inside of her vagina may be found. De-               Vagina of Women
spite the wounds in the vagina women usually do not have
any complaints, although a long time infection may result in
their being unable to bear children.

* Can infect child
But if a woman has gonorrhoea, she can pass this infection to
the child at birth. This affects the child’s eyes. The eyes get
very red and pus comes out. It may even lead to blindness.


* Men & Gonorrhoea
Men on the other hand, have serious problems. Within a few
days of getting the infection, they may get serious difficulty in
passing urine, almost like a block, and one can easily see pus
dribbling out. Asked to press the shaft of the penis results in
pus being squeezed out. Fever may also be present.


             Treatment for Gonorrhoea
            EARLY TREATMENT IS A MUST.
            If possible, refer to a doctor. If likely to take
            time to visit to a doctor, this is the treatment
            to be advised:

Adult :
   · Capsule Doxycycline 200 mg (two capsules of 100
        mg each) initially followed by 100 mg (one cap-
        sule) with /after food to eat every 12 hours for 7
        days.

Pregnant Women & Breastfeeding Women
   · As Doxycycline cannot be given to pregnant or
       breast feeding women (a woman may stop breast
       feeding for the duration of treatment until three
       days after the treatment)), Capsule Amoxycillin 3.0
       gm (six 500 mg capsules) may be given by mouth
       altogether at one time unless there is history of
       problems with Penicillin / Amoxycillin. A single
       dose of Cotrimoxazole DS 4 tablets may also be
       given instead.

Children
    · For children, Amoxycillin at 50mg per kilo body
       weight in a single dose must be given, but should
       not cross more that 3 gm at a single time.
    · For a newborn child having gonorrhoea in the eyes,
       Amoxycillin as above along with any antibiotic eye
       drops every two hours for three days can be given.
15-12
2. Syphilis
Syphilis is a disease that usually goes through three stages in a patient if not treated.

I Stage: The first stage presents usually as a single, hard but painless, round
or oval ulcer that has a red margin — called chancre (shan-ker) — and is seen
more commonly on the tip or shaft of penis. Other places are on the vulva,
vagina, breasts, lips and anus – all places that may come on contact with the
infecting partner’s syphilis. Appearing within two to three weeks (usually) of
the exposure to infection, the syphilis ulcer gets well by itself within a few            Chancre in
                                                                                           syphilis
weeks.


                                     II Stage : About a quarter (25%) of those who had the chan-
 II Stage                            cre goes into the II stage. This usually happens within a month
 Syphilis                            or two of the healing of the chancre. In this stage, the person
                                     gets non-irritating rashes – only faintly visible when seen from
                                     the side - on both sides of the body in various parts of the body,
                                     especially on the chest and arms, but specially on the palms
                                     and soles. Secondary Syphilis may also be seen as greyish
                                     white circular or irregular ulcers inside the mouth. In some,
                                     warts may be seen around the anus and in other moist parts.
                                     All the Secondary Syphilis ulcers are teeming with germs and
                                     even touching them can give a risk of contracting the germs.
               Rash in body,         The person in this stage can also get headaches at night, joint
              hands & soles of       pains and fever. Although the rash goes away, in 25% of them,
                   feet              it keeps coming back every now and then unless treated.




          III Stage: Some of these patients may go into the third stage. In this, punched
          out ulcers may be seen on the skin and inside the mouth and nose that are
          surrounded by hardness. Healing starts from the centre of the ulcer but gets
          covered only with a papery thin scar. The bones of the legs may also get thick-
          ened and irregular, while those of the nose may collapse giving a saddle nose
          appearance. This last stage of Syphilis may affect the heart and the big vessels
          that may burst to cause death or else it may affect the brain to cause confusion,
          difficulty in walking, pain and imbalance of the limbs and body paralysis and
          insanity as well.

                  Women after the first stage may get repeated abortions.


Treatment for Syphilis
       There are cheap and good Blood tests that can check Syphilis, like VDRL. However they
       may turn negative in many cases after the first year or so. Other tests are available now
       that can confirm Syphilis.

       Syphilis can be treated well at village level, but a great deal of motivation is
       required. A Capsule of Doxycycline twice day for 10 to 14 days is considered
       sufficient. The sex partner should be asked and checked for symptoms of
       Syphilis and if need be, treated all the same.

       As said earlier, people with Syphilis are more prone to HIV/AIDS and should be tested
       for HIV/AIDS.
15-13
                           3. Lymphogranuloma Venereum (LGV)
Caused by a germ that is passed through sex, LGV also                   What to do in LGV?
starts with a small, painless ulcer or boil like eruption on                        A capsule of DOXY-
the penis or vaginal lips, but usually goes unnoticed.                              CYCLINE given two
                                                                                    times a day for two to
                       The second stage of LGV is highly vis-                       three weeks is consid-
  II Stage LGV                                                                      ered good for treat-
                       ible. Lymph nodes on the groin – usu-
                       ally only on one side – swell up with            ment. The partner should be
                       the skin stretched tightly over it. The          treated at the same time to avoid
                       swelling is highly painful and the per-          the infection from coming back.
                       son may get fever with shivering also.
                       In women, usually the lymph nodes                In pregnant mothers who cannot
                       near the buttocks are involved. Very             be given Doxycycline, one CO-
 Bubos (swollen        often the swollen lymph nodes called             TRIMOXAZOLE DS tablet twice
  lymph nodes)
                       bubos burst and the ulcers formed                a day for two to three weeks
                       refuse to heal for months.                       may be given.




4. Granuloma inguinale (GI)
                       GI starts with a small boil like swelling on the penis or vulva. It starts after
                       a few weeks of exposure. In GI we can see the ulcer breaking down and then
                       continuously increasing in size. This ulcer is red, slightly raised, a little painful
                       and bleeds on touch. The ulcer keeps growing and involves nearby tissues,
                       later occupying large parts of the body, especially the groins, etc.

                       COTRIMOXAZOLE DS one tablet twice a day for ten days is the treatment
  Boil like swelling
       in penis
                       that must be given early, once the diagnosis is made.




5. Herpes Simplex
Most of us must have had a small sore on the lips or the corner of the mouth
when we had high fever. A virus called Herpes causes this Cold sore . It goes
off by itself. But if it reaches the sex organs, it gets changed into another
form. It causes some tiny red boil like eruptions on the penis or the vagina
(sometimes on the buttocks and legs too). This heals by itself but it may carry
on to the child during delivery. In some of the children, Herpes may cause
                                                                                             Sores in
severe problems with the brain, like fits and death. Although there is a treat-
                                                                                          Herpes Simplex
ment now available, the patient should be referred to the doctor.
15-14
                            6. White discharge / Leucorrhoea
  Women’s white discharge or                                      a. Normal Discharge
  Leucorrhoea is a common                                         During pregnancy, during
  complaint. Every woman of a                                     sexual excitement, around the
  village would have experi-                                      middle of the cycle and before
  enced this problem. Yet, it                                     the periods, many women
  maybe important to differen-                                    have a heavy discharge and
  tiate a normal discharge from               Vaginal discharge
                                                  in women
                                                                  all the woman needs is to be
  an abnormal one.                                                told that she is normal.




b. Abnormal Discharges (called White Discharge / Leucorrhoea)
Usually there are only three types of germs that create leucorrhoea.

1.Candidiasis: This is one of the main                             Treating Candidiasis
reasons for white discharge in our vil-                            Treatment needs
lages. Thick white discharge, often de-                            MICONAZOLE cream to be
scribed as curd like or cheesy, that also                          applied inside the vagina for
makes the woman very itchy is indica-                     three to seven days. Even painting the
tive of Candidiasis. Candida is the fun-                  vagina with Gentian Violet helps a lot,
gus responsible for it.                                   though women do not prefer it nowa-
                                                          days




2. Trichomoniasis: This is also com-                               Treating Trichomoniasis
mon. Trichomoniasis is due to a small                              METRONIDAZOLE 200 mg
germ Trichomonas and is spread                                     thrice a day for seven days
through sex. An easy way to diagnose                               needs to be given to both, the
is by asking if she had yellow or                         wife as well as the husband. Or else, five
greenish discharge and some amount                        tablets of 400 mg each can be taken at
of itching. If bubbles can be seen in the                 one go, which has some higher chances
discharge, the diagnosis is almost                        of getting nausea or vomiting.
certain.




3. Bacterial Vaginal Infection: In this                            Treating Bacterial Vaginal
case too, the patient gets thick and clear                         Infection
and white to grey discharge with little                            The person can be given seven
or no other problem. A classic problem                             days of COTRIMOXAZOLE
however is that a bad smell comes out                     DS twice a day every day, for seven
whenever the woman has sex without a                      days. Treating the husband is not con-
condom – it tells us about bacterial in-                  sidered essential.
fection of the vagina.
15-15
                              6. PID or Pelvic Inflammatory Disease.

Another common ailment of                     Treating PIDs
women, PID has the following                  • The woman must be encouraged to clean her vagina.
symptoms:                                     • A hot water bottle on the
    Pain in the lower ab-
                                              lower abdomen and back re-
    domen                                     duces the pain.
    Pain in the lower back                              • A course of
    Pain in the genital or-                             DOXYCYCLINE
    gans                                                for ten days may be
    Pain starting from the                              good to prevent relapses. Starting with two
    back and coming in                        capsules, the patient needs to give one capsule e v e r y
    front to the abdomen,                     12 hours for each of the children.
    like labour pains.                        •     Alternatively,      COTRIMOXAZOLE                or
    Some bleeding on                          AMOXYCILLIN for ten days may help. Many special-
    having sex
                                              ists may like to give METRONIDAZOLE along with
    White discharge
                                              Doxycycline for ten days.




                                             7. HIV/AIDS
AIDS (acquired immune deficiency syndrome) is caused                        AIDS has no cure
by the human immunodeficiency virus HIV). HIV                        AIDS is a disease that has no
destroys the body’s immune system, which makes it                    cure as of now. We have no
impossible to fight off disease or even minor illnesses.             vaccines to prevent AIDS. There
                                                                     are some medicines that can con-
                                                                     trol (not cure) the disease but
                                                                     even these are very costly. These
                                                                     medicines can be very harmful
                                                                     and cost more than a lakh of ru-
                                                                     pees to extend each year of life.



                                                                        Signs of HIV infection
                                                                    Many people who have HIV
                                                                    never come to know about their
                                                                    infection. However, one can sus-
                                                                    pect HIV infection if :

                                                                        o   they get fever for more than
                                                                            1 month
                                                                        o   weight loss more than 10%
                                                                            of their original weight
                                                                        o   diarrhoea for more than 1
                                                                            month

                                                                    As the body loses more of its capacity
                                                                    to fight germs, skin infections, TB
                                                                    and many other infections of the
                                                                    lungs may also be found.
15-16
                             Who is at greatest risk of getting AIDS?

a. Many sex partners : Chances of spreading the HIV virus are higher in people who have
many sex partners. Commercial sex workers (earlier called prostitutes) are at great risk of
getting HIV. Many of them when tested are found to have it in their blood. Men having sex
with them are also at risk of HIV and they pass it on to their innocent wives. People
should try to restrict their sex relationship only with one partner. At other times - if at all
- a condom must be used to prevent direct contact.

b. Drug Addicts: Drug addicts who inject heroin or other
drugs are found to have HIV. They often use old sy-
ringes and share their syringe with their friends. This
quickly helps to spread HIV. They are usually young
and are also sexually active – and hence can also pass
the virus to their sex partners.




                                                                          Reduce the risk of needle sharing
                       c. Those needing blood exchange :
                                                                       The risk of spreading HIV through sharing
                       Those people who need to take
                                                                       of needles and syringes is very high –
                       blood repeatedly are also at very
                                                                       Manipur and now Nagaland have shown
                       high risk of getting HIV. A single
                                                                       how high the risk is. It is advised that any
                       bottle of blood from a HIV posi-
                                                                       needle and syringe must be boiled for at
                       tive person can ruin a person’s life.
                                                                       least 20 minutes before using it on another
                       Now, according to Indian law, no
                                                                       person to allow the viruses to be killed. Ad-
                       blood transfusion centre can exist
                                                                       dicts who never have the time and space to
                       without a HIV testing facility. Fur-
                                                                       boil the syringe must learn to flush the sy-
                       ther, no blood can be given to an-
                                                                       ringe and needle with Liquid Bleach three
                       other person without testing the
                                                                       times before using.
                       blood for HIV.




Blood tests to check HIV infection
There are blood tests to diagnose HIV infection. ELISA test is a cheap test that is good for finding
out HIV. But one cannot confirm only with ELISA. If an ELISA test is positive i.e. it show HIV), a
surer test called Western Blot is carried out. Only if this is positive that a person can be called HIV
positive.

             Counselling is needed                                                      Treat people
              before HIV testing                                                     with HIV with love
As the tests are not so straightforward, it is                                    People, relatives, friends and
IMPORTANT and compulsory to have coun-                                            even doctors and medical
selling before and after a test is carried out.                                   personnel SHOULD NOT
                                                                                  treat people with HIV with
Counsellors need to be trained. They need to                                      shame, hate and discrimina-
help the person getting a HIV test to look at                                     tion. We need to remember
life positively, whatever the result maybe.                                       that many of them have got
Counsellors need to help remove anxiety, re-
                                                                                  the infection for no fault of
duce chances of the husband or wife getting
                                                                                  theirs and they deserve our
the infection, and to help the person in early
                                                                                  fullest sympathies, coopera-
treatment or prevention of a complication.
                                                                                  tion and love.
15-17
15-18

                            Know the Answers
                                     Diseases of the
                                   Reproductive System


a. Please mark whether “right” or “wrong”:
1. AIDS can be passed by hugging & kissing.

2. Syphilis can be treated easily with DOXYCYCLINE.

3. In initial Syphilis, we can see a small painless ulcer two to
  three weeks after getting the infection.

4. In the second stage of syphilis, heart and brain may be affected.

5. P.I.D is common in women and can be treated.

b. Please fill in the blanks:
1. P.I.D can be treated by:

      a. _____________________________________

      b. _____________________________________

      c. _____________________________________

      d. _____________________________________

2. HIV can be spread only by:

      a. _____________________________________

      b. _____________________________________

      c. _____________________________________

3. Ulcers on the penis or vagina can be because of :

      a.______________________

      b. _____________________

      c. _____________________

      d. _____________________

      e. _____________________

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15 reproductive system

  • 1. 15-1 THE REPRODUCTIVE ORGANS • How is a man’s body different from a wom- an’s body? • What is this sex all about? • How do babies happen? • How do we stop having babies ? All of us are very interested in sex and this mystery of having children. Yet, this is one topic that is not spoken freely about. We know about our sex organs compared to how much we know about our hands or legs, our nose, eyes or stom- ach . Yet we need to know because sex and reproduction is a very important part of our lives. It is the cause of much happi- ness as well as of misery. Only when we correctly understand will we be able to give correct advice and help to others.
  • 2. 15-2 Growing Up & Changes in the Body Girls grow up to be women and boys grow up to be men. How does this happen? Does it happen overnight? No, these changes do not happen over- night. Growing up is part of a chain of things which happen to the body at a certain period in life. This period when the body changes to making boys and girls capable of having children is called “puberty” (pyoo-ber-ti). If not for this very troubled and confused period in a young person’s life, a little girl would have remained a little and a little boy would have remained a little boy. Are Puberty and Adolescence (a-dawl-e-sense) the Same? Puberty Puberty is that time of growth in adolescence when a boy and girl become capable of producing a baby. Although the age for puberty is becoming lesser and lesser over the years, it can vary between 9 and 14 in girls and between 10 and 15 in boys. Adolescence Often used in place of each other, adolescence is the period in the life of boys and girls where they are undergoing a transition to their adulthood. Puberty is just one part of this process. The development of gender characteristics made possible by the different hormones of the body are some others.
  • 3. 15-3 Puberty Girls 1. “Menarche” – first monthly periods 2. Appearance of breast buds. 3. Elevation and enlargement of breasts. 4. Projection of area around nipples. 5. Adult breasts. Gender characteristics During Adolescence, boys and girls get certain features that mark them as male or as female. These are: Girls Boys 1. Puberty like monthly periods and 1. Puberty in penis, testes, prostate, vesicles breasts, etc. 2. “Adam’s apple;” deep voice. 2. Voice remains as earlier 3. Beard, moustache and face hair; hairline re- 3. Less body/ face hair cedes 4. Pubic hair like inverted triangle 4. Pubic hair in pyramid form 5. Narrow shoulders, broad hips; 5. Shoulders broad, big muscles Thighs converge, elbows diverge. 6. Skin softer, less oily. 6. Skin thicker; more prone to pimples/acne 7. Sensitive, softer attitude 7. Aggressive attitude Boys 1. Enlargement of testes. 2. Penis size increases 3. Growth of the front end of the penis 4. Adult genitalia
  • 4. 15-4 Female Sex Organs By the end of puberty, the body of a girl becomes capable of bearing children. Her sex organs would have developed enough. In women, some of the organs for reproduction can be seen – they are external or outside— and some organs are hidden inside the body, that is, they are internal or inside organs. Organs Outside: External Sex Organs of Women What can be seen just in front of the hole from where the shit comes out, are the two outer and two inner ‘lips.’ At the top of the vulva is the clito- ris, which looks like a smaller version of the men’s penis, except that no urine comes out of it. Women have a separate opening for the urine, just above clitoris the opening where the child comes out of the womb vaginal urine opening at the end of pregnancy. opening anus or shit hole Organs Inside: To carry out the task of bearing chil- dren, each woman has: a. a uterus (womb), b. a vagina, c. two ovaries and d. their tubes. How do reproductive organs work? Once a girl reaches 11 to 13 years of age and starts her monthly periods, she can bear a child. The ovaries produce the eggs and every month one egg is released. When the time is right, the brain signals the ovaries to start its work. The ovaries then starts making the female hormone oestrogen (ees-trow-jen). This hormone acts like a chemical messenger from the brain getting dif- ferent parts of a woman’s body to start developing “womanly features”. The body suddenly becomes shapely, the hips enlarge, breasts get formed and most important of all, the menstrual cycle starts.
  • 5. 15-5 1. The Ovaries The ovaries are closely surrounded by finger like projections that eagerly wait to catch the new egg. The finger-like projections send the egg down the attached tubes by a gentle squeezing mo- tion, towards the uterus. Here it waits for the sperm from the male to fertilise it and grow into a child. 2. The Uterus 3. Cervix (ser-viks) & Vagina It is thick and muscular and its wall changes In its lower part, the uterus has a long thickness every few days. Normally about 3 neck, also called its cervix. This is not as inches long, two inches wide and an inch deep, muscular as the top part of the uterus. the thickness changes with the monthly men- strual cycle every few days. The cervix opens into the vagina, another tube like organ, not very muscular, but The lining is thinnest when the woman is lined with cells. The vagina receives the bleeding. It starts putting on some thickness penis during sex and this is also the open- towards the middle of the cycle and gets re- ing from where the child comes out into ally thick when the egg is sent down to it. A the world. thick wall would keep a fertilised egg prop- erly for a long period of nine months. The thick The opening of this vagina is just in front upper part of the uterus is also required for of the anus and just behind the opening squeezing the child out at the time of deliv- for the urine. Nerve endings from the ery! clitoris and from the vagina carry signals to the brain. When rubbed or massaged If the egg is not fertilised by any sperm, the during sexual intercourse (or during mas- uterus sheds its lining and the menstrual bleed- turbation), the woman gets a pleasurable ing takes place. sensation.
  • 6. 15-6 Male Sex Organs Sex Organs of Males Like women, even men have different external and internal sex organs. External organs. Of the external organs, what can be seen hanging between the thighs are: 1. a penis (pee-nis) 2. a scrotum. (skro-tem) testes 1. The Penis glans The penis when limp has a thin foreskin penis scrotum extending in front. When the foreskin is pulled back, it cuffs around the neck of the penis. The bulbous end of the penis is called the glans. Common Opening For Sperms & Urine Penis Ejaculation Men have a common opening from which When stimulated by repeatedly rubbing both semen and urine come out. This slit like against the walls of the vagina (or during opening is at the tip of the glans. The part masturbation), the penis pours out about connecting the glans to the body is called the 2.5 to 3.5 ml (half a small tea spoon) se- shaft of the penis. As short as two to three men in a few spurts. Immediately after, it inches and soft when normal, the penis can again returns to its normal limp shape and increase in length — to four to six inches – size. It will need an hour up to a few hours and in width when erect in an excited or to be able to stiffen up once again by sexual sexually stimulated state. It also hardens up stimulation or masturbation. at such times, ready to enter the vagina. Position of the Penis The normal penis is naturally inclined to one side, either the left or the right. This becomes promi- nent when the penis is erect and a curve may be seen in many shafts. In young age, many men may feel anxious about the fact, and should be reassured that it is normal. 2. The Scrotum Size of the Penis Does Not Below the penis, is a sac like structure that all men Matter have and it is known as the scrotum. This has the male counterpart of ovaries. It is called the testes. Although the size of a man’s penis is the focus of many a discussion, a woman’s Sperms have to be produced at a temperature vagina is only four inches deep and much lesser than the body temperature. Hence, the hence, the smallest of men’s erect penises testes are stored in a sack (the scrotum) that hangs is enough to penetrate fully. outside the body (unlike in a woman, where the ovaries are inside the abdomen). This foreskin is cut off during the ritual of circumcision in Jews and in Muslims. Inside the scrotum are the testes (single=testis). Some men are unable to pull the fore- These are small oblong ball like structures found skin back and find a tight foreskin an inside the scrotum. The testes produces sperms obstruction during sex. They can get (seed cell from the man needed to join with an egg their foreskin removed by a surgeon. in the woman to make a new baby).
  • 7. 15-7 Internal Parts of the Internal Parts of the Male Reproductive System Male Reproductive ureter System - brings urine from kidneys 1. The Testes: urinary bladder The testes of males has two - stores urine main functions: vas deferens rectum a. Makes Male Hormone: - - carries sperms The male hormone , testesterone is responsible for prostrate anus the different “male character- - adds fluid to the - shit hole istics” - Like hair on face, semen deeper voice, “Adam’s apple” testes a rough skin, front and side penis - sperms are balding of males, a muscular - carries sperms made here body and for the erection and outside the body scrotum sexual stimulation as well. - sac where testes is located b. Makes Sperms : The sperms are produced in plenty by the testes. Only one sperm is required to fertilise or join the ovum for a baby. But normally every ml of the semen brought out during ejaculation has about ten crores of sperms! If this count is less than two crores per ml, the chances of producing a child are almost nil! 3. Vas Deferens 4. Prostrate Glands The sperms along with some fluid (combined is what is The prostate is a round or- semen) are sent from the two testes through the vas defer- gan at the junction between ens on each side to two worm like seminal vesicles. Here, the base of the penis and semen is stored and sqeeszed out at the time of stimula- the urinary bladder above. tion It surrounds the urethra for a short while. It produces much of the nourishing Vasectomy : Cutting The Vas Deferens fluid that the sperms re- The two vas deferens are cut on either side and the cut- quire for their travel to the ends are tied in the operation for permanent birth control, woman’s tubes. called vasectomy. This small and easy operation, unlike the tubectomy of the woman prevents the sperms from Enlargement of Prostrate reaching the semen. The prostate may enlarge after the age of fifty and be- But as the testes are not touched, the blood can continue yond. This creates problem to take the male hormone for male like characteristics. As in men by making it diffi- the prostate and seminal vesicles continue their connec- cult to pass urine. The more tion with the urethra in the penis, there is practically no the person tries, the worse decrease in quantity of semen as well. it gets. Only if the person relaxes, is he able to pass In other words, the manliness of men – of voice, hair, skin, urine. An operation to re- muscle and muscle power, erection and ejaculation remains move or decrease the size of intact after Vasectomy. Once done, men can have sex nor- prostate is now much sim- mally without fear of causing pregnancy. pler and safer than the ear- lier days.
  • 8. 15-8 Know the Answers THE REPRODUCTIVE ORGANS Please in the blanks: 1. Puberty refers to changes in _______________ while adolescence means changes in __________________, _____________________ and ____________________ 2. Egg from a woman’s ______________________ goes to the ______________ where it may meet the _____________ from the man. The two together may start developing into a baby that stays in the _____________ for 9 months. 3. Men have _________________ sperms in every ml of their _________________. They are made in the _____________ and are taken to their ______________ vesicles through a tube called ________________. 4. __________________ in women and _______________ in men can help us stop having babies permanently. 5. An erect penis can be _____ to ______ inches long, while a woman’s vagina is _______ inches long. Please mark if “right” or “wrong”: 1. Menarche means the first monthly period in girls. 2. The cervix helps to push the baby down during delivery. 3. Masturbation means stimulating onself for sex and is not good for health. 4. Men produce one sperm per month in their testes and this sperm goes to meet the egg from a woman to produce a child.
  • 9. 15-9 Diseases of THE REPRODUCTIVE ORGANS
  • 10. 15-10 Diseases of Reproductive System Many diseases can be transmitted while two people have sex with each other. There are a range of Sexually Transmitted Diseases (STDs): simple ones that affect only the skin, like Lice and Scabies (which spreads when people come into physical contact with each other) to those that can affect the entire body if not treated, like Syphilis and AIDS. Types Of STDs Some STDs are common and can be treated by the health worker. Others are fairly serious and maybe untreatable. They also constitute a risk to the person’s family & society and will also be discussed. Serious STDs Include: Simple STDs Include: 1. Gonorrhoea 1. Hepatitis B and C 2. Syphilis (see Phase I Manual in diseases of 3. LGV digestive system) 4. GI 2. Scabies, 5. HIV/AIDS 3. Lice, (skin diseases) etc 6. Herpes Simplex Discharges and Sores Usually, genital problems appear in males and Discharge from Genital Organs females as discharges or sores in an around the genital areas. Rashes, warts or swollen glands are other ways in which it is seen. You can find out most types of STDs by knowing what kind of discharge it is or what kind of sore is found in which part of the genital area. Take Note It is recommended that all people de- tected to have STDs should be ad- Vaginal Discharge Discharge from Penis vised to get their Blood checked for HIV. Sores in the Genital Ar- Men with STD are usually found to eas have more than one sexual partner and women with STDs are likely to have husbands with more than one sexual partner (commercial sex workers would have multiple part- ners themselves also). All categories are at higher risk of getting the HIV infection and hence AIDS too. Genital sore (ulcer) Genital sore in a woman in man
  • 11. 15-11 1. Gonorrhoea It is a disease that is caused by very strong bacteria, Gonorrhoea affects both men and women, but directly causes problems in men. * Women & Gonorrhoea When a doctor internally examines women with Gonorrhoea, Types of Sores in many wounds on the inside of her vagina may be found. De- Vagina of Women spite the wounds in the vagina women usually do not have any complaints, although a long time infection may result in their being unable to bear children. * Can infect child But if a woman has gonorrhoea, she can pass this infection to the child at birth. This affects the child’s eyes. The eyes get very red and pus comes out. It may even lead to blindness. * Men & Gonorrhoea Men on the other hand, have serious problems. Within a few days of getting the infection, they may get serious difficulty in passing urine, almost like a block, and one can easily see pus dribbling out. Asked to press the shaft of the penis results in pus being squeezed out. Fever may also be present. Treatment for Gonorrhoea EARLY TREATMENT IS A MUST. If possible, refer to a doctor. If likely to take time to visit to a doctor, this is the treatment to be advised: Adult : · Capsule Doxycycline 200 mg (two capsules of 100 mg each) initially followed by 100 mg (one cap- sule) with /after food to eat every 12 hours for 7 days. Pregnant Women & Breastfeeding Women · As Doxycycline cannot be given to pregnant or breast feeding women (a woman may stop breast feeding for the duration of treatment until three days after the treatment)), Capsule Amoxycillin 3.0 gm (six 500 mg capsules) may be given by mouth altogether at one time unless there is history of problems with Penicillin / Amoxycillin. A single dose of Cotrimoxazole DS 4 tablets may also be given instead. Children · For children, Amoxycillin at 50mg per kilo body weight in a single dose must be given, but should not cross more that 3 gm at a single time. · For a newborn child having gonorrhoea in the eyes, Amoxycillin as above along with any antibiotic eye drops every two hours for three days can be given.
  • 12. 15-12 2. Syphilis Syphilis is a disease that usually goes through three stages in a patient if not treated. I Stage: The first stage presents usually as a single, hard but painless, round or oval ulcer that has a red margin — called chancre (shan-ker) — and is seen more commonly on the tip or shaft of penis. Other places are on the vulva, vagina, breasts, lips and anus – all places that may come on contact with the infecting partner’s syphilis. Appearing within two to three weeks (usually) of the exposure to infection, the syphilis ulcer gets well by itself within a few Chancre in syphilis weeks. II Stage : About a quarter (25%) of those who had the chan- II Stage cre goes into the II stage. This usually happens within a month Syphilis or two of the healing of the chancre. In this stage, the person gets non-irritating rashes – only faintly visible when seen from the side - on both sides of the body in various parts of the body, especially on the chest and arms, but specially on the palms and soles. Secondary Syphilis may also be seen as greyish white circular or irregular ulcers inside the mouth. In some, warts may be seen around the anus and in other moist parts. All the Secondary Syphilis ulcers are teeming with germs and even touching them can give a risk of contracting the germs. Rash in body, The person in this stage can also get headaches at night, joint hands & soles of pains and fever. Although the rash goes away, in 25% of them, feet it keeps coming back every now and then unless treated. III Stage: Some of these patients may go into the third stage. In this, punched out ulcers may be seen on the skin and inside the mouth and nose that are surrounded by hardness. Healing starts from the centre of the ulcer but gets covered only with a papery thin scar. The bones of the legs may also get thick- ened and irregular, while those of the nose may collapse giving a saddle nose appearance. This last stage of Syphilis may affect the heart and the big vessels that may burst to cause death or else it may affect the brain to cause confusion, difficulty in walking, pain and imbalance of the limbs and body paralysis and insanity as well. Women after the first stage may get repeated abortions. Treatment for Syphilis There are cheap and good Blood tests that can check Syphilis, like VDRL. However they may turn negative in many cases after the first year or so. Other tests are available now that can confirm Syphilis. Syphilis can be treated well at village level, but a great deal of motivation is required. A Capsule of Doxycycline twice day for 10 to 14 days is considered sufficient. The sex partner should be asked and checked for symptoms of Syphilis and if need be, treated all the same. As said earlier, people with Syphilis are more prone to HIV/AIDS and should be tested for HIV/AIDS.
  • 13. 15-13 3. Lymphogranuloma Venereum (LGV) Caused by a germ that is passed through sex, LGV also What to do in LGV? starts with a small, painless ulcer or boil like eruption on A capsule of DOXY- the penis or vaginal lips, but usually goes unnoticed. CYCLINE given two times a day for two to The second stage of LGV is highly vis- three weeks is consid- II Stage LGV ered good for treat- ible. Lymph nodes on the groin – usu- ally only on one side – swell up with ment. The partner should be the skin stretched tightly over it. The treated at the same time to avoid swelling is highly painful and the per- the infection from coming back. son may get fever with shivering also. In women, usually the lymph nodes In pregnant mothers who cannot near the buttocks are involved. Very be given Doxycycline, one CO- Bubos (swollen often the swollen lymph nodes called TRIMOXAZOLE DS tablet twice lymph nodes) bubos burst and the ulcers formed a day for two to three weeks refuse to heal for months. may be given. 4. Granuloma inguinale (GI) GI starts with a small boil like swelling on the penis or vulva. It starts after a few weeks of exposure. In GI we can see the ulcer breaking down and then continuously increasing in size. This ulcer is red, slightly raised, a little painful and bleeds on touch. The ulcer keeps growing and involves nearby tissues, later occupying large parts of the body, especially the groins, etc. COTRIMOXAZOLE DS one tablet twice a day for ten days is the treatment Boil like swelling in penis that must be given early, once the diagnosis is made. 5. Herpes Simplex Most of us must have had a small sore on the lips or the corner of the mouth when we had high fever. A virus called Herpes causes this Cold sore . It goes off by itself. But if it reaches the sex organs, it gets changed into another form. It causes some tiny red boil like eruptions on the penis or the vagina (sometimes on the buttocks and legs too). This heals by itself but it may carry on to the child during delivery. In some of the children, Herpes may cause Sores in severe problems with the brain, like fits and death. Although there is a treat- Herpes Simplex ment now available, the patient should be referred to the doctor.
  • 14. 15-14 6. White discharge / Leucorrhoea Women’s white discharge or a. Normal Discharge Leucorrhoea is a common During pregnancy, during complaint. Every woman of a sexual excitement, around the village would have experi- middle of the cycle and before enced this problem. Yet, it the periods, many women maybe important to differen- have a heavy discharge and tiate a normal discharge from Vaginal discharge in women all the woman needs is to be an abnormal one. told that she is normal. b. Abnormal Discharges (called White Discharge / Leucorrhoea) Usually there are only three types of germs that create leucorrhoea. 1.Candidiasis: This is one of the main Treating Candidiasis reasons for white discharge in our vil- Treatment needs lages. Thick white discharge, often de- MICONAZOLE cream to be scribed as curd like or cheesy, that also applied inside the vagina for makes the woman very itchy is indica- three to seven days. Even painting the tive of Candidiasis. Candida is the fun- vagina with Gentian Violet helps a lot, gus responsible for it. though women do not prefer it nowa- days 2. Trichomoniasis: This is also com- Treating Trichomoniasis mon. Trichomoniasis is due to a small METRONIDAZOLE 200 mg germ Trichomonas and is spread thrice a day for seven days through sex. An easy way to diagnose needs to be given to both, the is by asking if she had yellow or wife as well as the husband. Or else, five greenish discharge and some amount tablets of 400 mg each can be taken at of itching. If bubbles can be seen in the one go, which has some higher chances discharge, the diagnosis is almost of getting nausea or vomiting. certain. 3. Bacterial Vaginal Infection: In this Treating Bacterial Vaginal case too, the patient gets thick and clear Infection and white to grey discharge with little The person can be given seven or no other problem. A classic problem days of COTRIMOXAZOLE however is that a bad smell comes out DS twice a day every day, for seven whenever the woman has sex without a days. Treating the husband is not con- condom – it tells us about bacterial in- sidered essential. fection of the vagina.
  • 15. 15-15 6. PID or Pelvic Inflammatory Disease. Another common ailment of Treating PIDs women, PID has the following • The woman must be encouraged to clean her vagina. symptoms: • A hot water bottle on the Pain in the lower ab- lower abdomen and back re- domen duces the pain. Pain in the lower back • A course of Pain in the genital or- DOXYCYCLINE gans for ten days may be Pain starting from the good to prevent relapses. Starting with two back and coming in capsules, the patient needs to give one capsule e v e r y front to the abdomen, 12 hours for each of the children. like labour pains. • Alternatively, COTRIMOXAZOLE or Some bleeding on AMOXYCILLIN for ten days may help. Many special- having sex ists may like to give METRONIDAZOLE along with White discharge Doxycycline for ten days. 7. HIV/AIDS AIDS (acquired immune deficiency syndrome) is caused AIDS has no cure by the human immunodeficiency virus HIV). HIV AIDS is a disease that has no destroys the body’s immune system, which makes it cure as of now. We have no impossible to fight off disease or even minor illnesses. vaccines to prevent AIDS. There are some medicines that can con- trol (not cure) the disease but even these are very costly. These medicines can be very harmful and cost more than a lakh of ru- pees to extend each year of life. Signs of HIV infection Many people who have HIV never come to know about their infection. However, one can sus- pect HIV infection if : o they get fever for more than 1 month o weight loss more than 10% of their original weight o diarrhoea for more than 1 month As the body loses more of its capacity to fight germs, skin infections, TB and many other infections of the lungs may also be found.
  • 16. 15-16 Who is at greatest risk of getting AIDS? a. Many sex partners : Chances of spreading the HIV virus are higher in people who have many sex partners. Commercial sex workers (earlier called prostitutes) are at great risk of getting HIV. Many of them when tested are found to have it in their blood. Men having sex with them are also at risk of HIV and they pass it on to their innocent wives. People should try to restrict their sex relationship only with one partner. At other times - if at all - a condom must be used to prevent direct contact. b. Drug Addicts: Drug addicts who inject heroin or other drugs are found to have HIV. They often use old sy- ringes and share their syringe with their friends. This quickly helps to spread HIV. They are usually young and are also sexually active – and hence can also pass the virus to their sex partners. Reduce the risk of needle sharing c. Those needing blood exchange : The risk of spreading HIV through sharing Those people who need to take of needles and syringes is very high – blood repeatedly are also at very Manipur and now Nagaland have shown high risk of getting HIV. A single how high the risk is. It is advised that any bottle of blood from a HIV posi- needle and syringe must be boiled for at tive person can ruin a person’s life. least 20 minutes before using it on another Now, according to Indian law, no person to allow the viruses to be killed. Ad- blood transfusion centre can exist dicts who never have the time and space to without a HIV testing facility. Fur- boil the syringe must learn to flush the sy- ther, no blood can be given to an- ringe and needle with Liquid Bleach three other person without testing the times before using. blood for HIV. Blood tests to check HIV infection There are blood tests to diagnose HIV infection. ELISA test is a cheap test that is good for finding out HIV. But one cannot confirm only with ELISA. If an ELISA test is positive i.e. it show HIV), a surer test called Western Blot is carried out. Only if this is positive that a person can be called HIV positive. Counselling is needed Treat people before HIV testing with HIV with love As the tests are not so straightforward, it is People, relatives, friends and IMPORTANT and compulsory to have coun- even doctors and medical selling before and after a test is carried out. personnel SHOULD NOT treat people with HIV with Counsellors need to be trained. They need to shame, hate and discrimina- help the person getting a HIV test to look at tion. We need to remember life positively, whatever the result maybe. that many of them have got Counsellors need to help remove anxiety, re- the infection for no fault of duce chances of the husband or wife getting theirs and they deserve our the infection, and to help the person in early fullest sympathies, coopera- treatment or prevention of a complication. tion and love.
  • 17. 15-17
  • 18. 15-18 Know the Answers Diseases of the Reproductive System a. Please mark whether “right” or “wrong”: 1. AIDS can be passed by hugging & kissing. 2. Syphilis can be treated easily with DOXYCYCLINE. 3. In initial Syphilis, we can see a small painless ulcer two to three weeks after getting the infection. 4. In the second stage of syphilis, heart and brain may be affected. 5. P.I.D is common in women and can be treated. b. Please fill in the blanks: 1. P.I.D can be treated by: a. _____________________________________ b. _____________________________________ c. _____________________________________ d. _____________________________________ 2. HIV can be spread only by: a. _____________________________________ b. _____________________________________ c. _____________________________________ 3. Ulcers on the penis or vagina can be because of : a.______________________ b. _____________________ c. _____________________ d. _____________________ e. _____________________