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1 GROWING UP
Sexually Healthy and Personally Empowered Adolescents
INTRODUCTION
Puberty signals the beginning of adolescence. It refers to the physiological or bodily

changes that result in development of sexual and reproductive capacity. It is a time of rapid
physical growth that brings about confusion, insecurities, and even fear among many
adolescents. Helping adolescents understand the bodily changes and assuring them that the
changes are normal part of becoming an adult is particularly important. It will help
adolescents become comfortable with and make decisions about their changing body.
This module begins with identification of puberty changes in males and females,
emphasizing growth spurt and sexual and reproductive maturation as the most important
changes. It continues with a detailed discussion of sexual and reproductive maturation by
illustrating how puberty prepares the body for reproduction (male and female fertility) and
how pregnancy occurs (fertilization and sexual intercourse). It advances to an examination
of the consequences of early and unprotected sexual intercourse, particularly early
childbearing and sexually transmitted infections (STIs) including HIV and AIDS, and ends
with a discussion of effective ways of preventing them.
LEARNING OBJECTIVE1
At the end of this module, participants are able to:
Knowledge Attitude Self-Efficacy

Describe the physical changes of Show positive attitude Develop a plan or list of
adolescence; towards bodily changes commitments that can be
of puberty; done to positively
Identify sexual and reproductive nurture the changes
organs and describe their functions; Show positive attitude happening in their
towards their body, bodies; and
Describe how puberty prepares the including sexual and
body for reproduction; reproductive parts; Share the learning they
gained to their fellow
Identify fertile and infertile periods of Acknowledge and respect participants.
males and females; differences in physical
appearance;
Describe how and when pregnancy
occurs and how it can be prevented; Recognize diversity in the
rate of physical
Explain the health risks of early development and
pregnancy to mother and baby; maturation;
GROWING UP 2
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Knowledge Attitude Self-Efficacy

Identify common complications of Recognize sexual
pregnancy in adolescent mothers; abstinence and use of
contraceptives or family
Discuss the different contraceptives planning methods as
or family planning methods; effective protection
against pregnancy; and
Define STIs, including HIV, and how
they are and they are not transmitted; Recognize sexual
abstinence and correct
Discuss ways to prevent transmission and consistent use of
of STIs and HIV; and condom as effective
protection against STIs
Discuss where and how to access local
including HIV.
STI and HIV testing and treatment
services.
3 GROWING UP
Opening & Materials Time
Session Title Learning Objectives Key Topics
Closing Activity Needed (Minutes)
Pretest • Describe personal • Opinion Poll • Attitude about • “Agree,” 30 minutes
values in relation to bodily changes “Neutral”
their changing bodies and
“Disagree”
Session 1.1 • Describe the physical • Body Mapping • Meaning of • Signage, 90 minutes
changes of • Pass the puberty • large sheets
Physical adolescence Rhythm • Length of puberty of paper
Changes • Show positive attitude • Body changes in • marker
LEARNING SESSION
towards bodily males and females • paper

changes at puberty; • Diversity in • coloring
• Acknowledge and physical materials
respect differences in appearance • tapes
physical appearance;
• Recognize diversity in
appearance, the rate
of physical maturation
and development.
Session 1.2• Identify sexual and • Label the Parts • Sexual and • Diagrams 90 minutes
reproductive organs • Fill in the reproductive and labels of
Female and and describe their blanks and pass parts and female
Male functions; the ball functions internal and
Fertility • Discuss how puberty • Female Fertility external
prepares the human • Male Fertilization reproductive
body for reproduction; parts, and
• Identify fertile and male
infertile periods of external
GROWING UP
males and females; reproductive
parts
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• Express positive • Envelope

attitudes towards • Scissors
their body including • Glue
sexual and;
GROWING UP
reproductive parts
• Describe how and
when pregnancy
occurs and how it can
be prevented;
• Explain the health
risks of early
pregnancy to mother
and baby;
• Identify common
complications of
pregnancy in
adolescent mothers;
• Discuss the different
contraceptive or
family planning
methods;
• Recognize sexual
abstinence and use of
contraceptive as
means of preventing
pregnancy.
Session 1.3 • Describe how and • Short Video • Conditions for •Short video 90 minutes
when pregnancy Showing pregnancy on
Teen occurs and how it can • Small Group • Signs of fertilization
Pregnancy be prevented; Discussion pregnancy •Video player
• Explain the health • Poster Making • Health risks of too like laptop
risks of early early pregnancy to or computer
pregnancy to mother mothers and baby • LCD
and baby; • Social cost of early Projector
• Identify common pregnancy •Large sheets
complications of • Sexual abstinence of paper or
pregnancy in easel sheet
adolescent mothers • Coloring
• Discuss the different materials
contraceptive or • Adhesive
family planning tape
methods; • Markers
• Recognize abstinence
and use of
contraceptive family
planning methods as
effective.
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Session 1.4 • Define STIs, including • Primetime • STIs • Copy of facts 90 minutes
HIV, and how they are • “Wildfire” • HIV and AIDS sheets on
Sexually and they are not STI and HIV
Transmitted transmitted; and AIDS
GROWING UP
Infections • Discuss ways to
prevent transmission
of STI and HIV;
• Discuss where and
how to access local STI
and HIV testing and
treatment services;
and
• Recognize sexual
abstinence and correct
and consistent use of
condom as effective
protection against
STIs including HIV.
Post-test • Describe personal • Opinion Poll • Attitude about • “Agree,” 30 minutes
values in relation to bodily changes “Neutral”
their changing bodies. and
“Disagree”
labels and
statements
MODULE OVERVIEW
Discuss the following opening messages:
1. You are all adolescents and you are undergoing bodily changes to become adults.
Many of you may be feeling confused or afraid of those changes. Some of you may be
feeling excited about the thought of becoming adults. In this module, we will talk
about your changing body and understand why the different bodily changes are
happening. We will also talk about what it means when girls begin to have periods or
menstruation, and also what it means when boys begin to have erections and wet
dreams. Lastly, we will talk about the consequences of early and unprotected sex. We
will talk about all of these in fun, interactive, and respectful ways. Let us not forget
our Ground Rules.
2. This module has four sessions:
● In Session 1.1 (PHYSICAL CHANGES), we will talk about the different bodily
changes you are all experiencing as adolescents. We will do this in a creative and
fun way. In small groups, you will create a “body map” to indicate which parts of
your body have changed or are changing. Then we will discuss what those
changes mean.
● In Session 1.2 (FEMALE AND MALE FERTILITY), we will discuss how puberty
prepares the body for reproduction. We will talk about female and male fertility
– or how females are able to bear a child and how males are able to father a child.
We will start by distinguishing sexual and reproductive parts and functions of
the male and female bodies. We will do this by labelling the parts and functions
of the female and male reproductive system. Then we will proceed to
understanding how young females and males like you become fertile.
● In Session 1.3 (TEEN PREGNANCY), we will cover a topic that you and all the
people around you are so much concerned about – teenage or adolescent
pregnancy. How does pregnancy happen? Why is it a problem for adolescents?
What are its health risks to adolescent mothers and their baby? What happens to
adolescent girls who got pregnant? What happens to the adolescent father?
What are the effective ways to prevent early and unplanned pregnancy? These
are the questions that we will answer in this session.
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● In Session 1.4 (SEXUALLY TRANSMITTED INFECTIONS), we will deal with STIs

including HIV and AIDS. STIs are common among sexually active adolescents and
youth. This is often not talked about until recently when more and more
adolescent boys are diagnosed to be infected with HIV – the virus that causes the
deadly AIDS. Roughly one third of the total number of HIV-infected people in the
country belongs to your age group and the number is increasing. Why do young
people get these infections? What are the ways to avoid getting these infections?
We will talk about them in this final session.
PRE-TEST
OBJECTIVE
Participants are able to describe and express their personal values in relation to their
changing bodies.
Duration: 30 minutes
ACTIVITY. Opinion Poll
1. Explain that this is a pretest activity and participants should not worry because they
will not be asked to provide facts and figures. Instead, they will be asked to express
their current knowledge and attitude on a set of statements by agreeing or
disagreeing with them.
2. Designate one side of the room as AGREE area and the other side of the room as
DISAGREE area.
3. Let all participants stand at the center of the room.
4. Instruct them to express their agreement or disagreement to each statement that

you will read by going to appropriate corner of the room. Those who express
neutrality about the statement (i.e. they are not sure if they fully agree or disagree),
will stay at the center of the room.
5. Inform that you will not reveal the correct answer at this point. They will find about
them as they go through the different sessions.
9 GROWING UP
6. For each statement, you may request some volunteers to expound on their responses.
Just acknowledge and let them share their responses without confirming or
commenting on them.
7. Read the following statements:
Statements Agree Neutral Disagree

a. Puberty is the time when the body physically
changes to become adult. It happens to
everybody at the same time.
b. Males and females who have not grown as tall as
their friends and classmates should worry.
Something is wrong with them. They should
consult a doctor.
c. When girls begin to have menstruation or period,
it means they have a disease and should see a
doctor at once.
d. Puberty includes growth spurt and sexual
maturation. Males begin to have erections. This
is something that adolescents should worry
about.
e. Since adolescents can already get pregnant or
impregnate, they can engage in sexual activities
as they want.
f. It is okay for adolescent girls to give-in to the
request of her boyfriend to have sex in order for
her to express her love.
g. Adolescent males are not at risk of any health

problem if they engage in sex.
h. Adolescents engaging in sexual activities for the

first time will not result to pregnancy.
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11 APPRECIATING MY BODY
SESSION OBJECTIVES
At the end of the session, participants are able to:
1. Describe the physical changes of adolescence.
2. Show positive attitude towards bodily changes at puberty.
3. Acknowledge and respect differences in physical appearance.
4. Recognize diversity in the rate of physical maturation and development.
Time Allotment Materials Needed Methodology

90 minutes • large sheets of paper • Big group activity and
• marker discussion
• coloring materials
• adhesive tape
• name tags
OPENING ACTIVITY. Body Mapping
1. Introduce the activity:
a. After the first year of your life, the next time you will grow rapidly is during
puberty. All of a sudden, you have grown taller and bigger. Your family, relatives,
and friends might have been telling you that you are now “nagbibinata”
(becoming a young man) and “nagdadalaga” (becoming a young woman or lady).
b. What does “pagbibinata” and “pagdadalaga” really mean?
c. Apart from growing taller and bigger, what other changes in your body are you
experiencing? How do you feel about the changes? What are the changes that
you like, don’t like, or don’t understand? We will talk about them in this activity.
2. Divide the group by sex (i.e. boys and girls). Allow gay or transgender participants to
join the group they can identify with or they can form their own group.
APPRECIATING MY BODY 12
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3. Ask each group to:
a. Draw on a large sheet of paper a female body (for the all-female groups) or a
male body (for the all-male groups), or trace the body of a group member by
lying down on the paper.
b. Discuss bodily changes the group members have begun to experience. Label the
different body parts where changes happen (i.e. pubic hair develops, Adam’s
apple appears, etc.).
c. Present their output (“body map”) in the big group.
4. After all the groups have presented, process the activity by engaging the participants
in a discussion through the following questions:
a. How did you feel while making your “body map”? Did you enjoy it? Why or why
not? Was it easy or hard? Why was it easy or hard?
b. What changes are common to males and females? What are your feelings about
the changes happening to your body? What are the changes that you like, don’t
like, or don’t understand?
c. What questions or specific concerns do you have about your changing bodies?
[Write answers on the board or on a large sheet of paper. Explain that you will
refer to them as you move to the next step.]
d. What have you realized from the activity?
5. Link the discussion with the key messages.
KEY MESSAGES
1. All the bodily changes you have indicated on your body maps are part of puberty. At
puberty, your bodies are changing. Understanding your changing body will help you
become comfortable with the changes.
a. What is puberty?
• The growth of your body from childhood to adulthood is known as puberty.

• Puberty is the biological changes of adolescence. It is the time in a boy’s and
a girl’s life when their body physically changes to become adults. The body
grows bigger and taller.
• Puberty happens to everybody. But it doesn’t happen to everyone at the
same time. At puberty, boys and girls experience two most important
physical changes. One is “growth spurt” and the other is “sexual maturation.”
• “Growth spurt” means the body suddenly grows at a rapid rate. Boys and
girls increase in height and weight.
• At puberty, the body achieves “sexual maturation.” This means that boys and
girls have become capable of reproduction. It also includes enlargement of
primary sex organs.
• Ito ang panahon ng inyong pagdadalaga at pagbibinata. [Show the following
diagram. Indicate the adolescence phase.]
Primary School Adolescence

(6-9 years old) (10-19 years old)
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Primary School Adolescence

(6-9 years old) (10-19 years old)
b. How does puberty start?
• About two years before you noticed the bodily changes, your brain started
the work that will eventually change you from children to adolescents.
• Two parts of the brain – the hypothalamus and the pituitary gland - start
making more growth hormones and sex hormones. The pituitary gland is
located at the base of our skull at the back of our head. [Help participants
find the location of the pituitary gland by asking them to touch the base of
their skull at the back of their head.]
• The hormones act on other parts of the body to make the changes happen.
• The hormones that tell the body to sexually mature are testosterone,
estrogen, and progesterone. Every human has all these three hormones.
Generally, females have more estrogen and progesterone while males have
more testosterone. But we all have some of each.
c. Puberty happens early for some people and later for others.
• When does puberty start?

○ Girls generally start puberty earlier than boys. Girls “growth spurt”
usually starts when they are around ten (10) years old or sometimes, as
early as eight (8).
○ For boys, the first manifestation of changes often happen a little later
than they do for girls, somewhere between 10 and 12 years.
○ Boys continue to grow three (3) to four (4) years after most girls have
finished growing until age twenty (20) or twenty-one (21).
○ The start of puberty is influenced by genes inherited from biological

parents. Genes are like instructions or codes in the body’s cells that
define, for example, a person’s eye color, height, skin color, and even the
shape of ears.
○ Start of puberty is also influenced by nutrition (type and amount of food
intake) and a host of other factors such as physical activities and
presence or absence of serious illnesses.
○ Because of genes, people are different from each other and go through
puberty at different times and at different rates. Some people seem to go
through all the changes easily and others may have a few problems.
○ Each one of us is unique. Let us respect and accept each one’s
uniqueness.
2. Some physical changes are specific to boys and girls while others are the same. Other
changes are the same for both.
Changes in Boys Changes in Girls Changes in Both

• Gaining extra weight • Bodies become curvier and • Growing taller
• Shoulders get wider hip bones widen • Changing body shape
• Muscles start to get bigger • Gaining extra weight, • Feeling “moody”
and stronger particularly on the hips, to • Getting hair on the arms
• Getting an ‘Adam’s apple’ achieve a “womanly” and legs, under the arms
(The larynx or voice box shape. [Emphasize: This and in the pubic area
gets larger and sticks out does not mean girls start a (which starts out as fine
at the front of the throat. diet to lose weight.] hair then gets thicker and
This is nothing to worry. • Muscles get bigger and darker as one gets older)
When the larynx has stronger, but they do not • Sweating more
finished growing, the voice become as big as the boys’ • Getting oilier skin and
will sound ‘normal’ again muscles often some pimples
and probably a bit deeper • Having sexual feelings
than before.) • Loss of baby fat
• Penis gets longer and
wider
• Testes (or testicles) get
larger
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Changes in Boys Changes in Girls Changes in Both

• Breasts look like they’re • Breasts start to develop
growing a little and become fuller (It
• Hair also grows on the begins with a small
face, like a beard swelling under the nipples
• Getting erections and may and then grows to become
have nocturnal emissions full breasts)
or “wet dreams” while • Menstruation or period
sleeping starts
3. One’s body image can affect self-esteem, decision-making, and behavior. You must
learn to love and take care of your bodies and should not conform to society’s
standards about bodily appearance that can affect your self-esteem. Love yourself!
4. At puberty, sexual and reproductive organs begin to mature. It’s a big deal when
your looks change but the biggest change of all during puberty are things you cannot
see. These are the things happening inside the body.
5. Most girls start to have menstruation or monthly period.
a. Beginning menstruation or “having a period” is one of the most significant

events of puberty for young women. Most girls begin menstruation between the
ages of nine (9) and sixteen (16). The average age is twelve (12) or thirteen (13).
b. It is advisable for girls who have not menstruated by 16 years old to consult with
a medical practitioner.
c. It is normal for young women to have an irregular pattern of menstrual cycles

when they first start having their period. It can take up to two or more years for
young women to establish their regular, more predictable cycles.
6. Boys begin to have erections and wet dreams or nocturnal ejaculation.
a. Ejaculation is the expulsion of semen through the penis. The sticky liquid is
semen, not urine. It contains millions of invisible sperms. Usually, about a
teaspoon of semen is released at a time. Sperms are the male reproductive cells.
b. The body continuously produces semen. Thus, if a boy does not masturbate or
have sexual intercourse, his semen may be ejaculated during sleep.
7. Physical maturity is different from emotional maturity. While your reproductive

system is already able for pregnancy, parenthood is a totally different concern that
requires emotional, financial, and social maturity which you do not still have.
8. What can be done to have an enjoyable and healthy puberty?
a. Know and be aware of the various changes that are happening in your body.
b. Puberty is a time of rapid physical growth, so taking care of the body is

especially important. Take care of yourself by eating healthy foods, exercising,
and getting plenty of rest so that your body has the energy to cope with all the
growing it still has to do.
c. Do not compare yourself with others. Each one goes through puberty at
his/her own pace. Do not be pressured by societal standards about bodily
appearance because you are unique.
d. Consult experts when experiencing unusual changes in your body.
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9. Synthesis of the key messages:
a. At puberty, your bodies are changing. Understanding your changing body will
help you become comfortable with the changes.
b. Adolescents undergo puberty at different paces or speed. You have different

body shapes, sizes, and appearances. There is no “perfect” or “normal” body type.
c. Because of genes, the kind of food you eat, the kind of physical activities you
engage in, and whether or not you have an illness, your body will reach maturity
at your own pace.
d. Physical maturity is different from emotional maturity. While your bodies may
be ready for parenthood, emotionally, you may not be prepared for the
responsibilities of parenthood.
e. Make puberty an exciting time for all of you.
CLOSING ACTIVITY. Pass the Rhythmii
1. Instruct participants to:
a. Sit in a circle.
b. In one to two minutes, recall the discussion on puberty and think of how they
will complete the statement, “Puberty means” Inform that no one is allowed to
repeat what others have said about puberty. This means that they should think
of several ways to complete the statement.
c. Establish a rhythm by tapping the thighs with your two hands twice, then
clapping the hands together twice, and then clapping the hands twice as well of
the next person on your right. The next person performs the same actions until
the action is past on the last person in the circle.
2. Start the rhythm. Pass it on to the person on your right. Once it is moving steadily
through the group, speed it up.
3. When the clap gets back to you, begin completing the statement, “Puberty means
__________” The next person you passed the rhythm to completes the statement and
passes on the rhythm to the next person who completes the statement.
4. When the rhythm gets back to you again, stop. Ask how everyone feels.
5. As a final message, say:
a. Always remember, everyone goes through puberty although not at the same
time. It can be scary if you do not understand why all the changes are happening.
It can also be exciting and even empowering to know about puberty changes. It
keeps your worries away! We will discuss more about puberty changes in the
next sessions.
6. Thank everyone for their cooperation and active participation.
FURTHER READINGS FOR FACILITATORS
 FACT SHEETS on (Page 68-71)
UNDERSTANDING MY FERTILITY 22
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SESSION OBJECTIVES
1. Identify sexual and reproductive organs and describe their functions.
2. Discuss how puberty prepares the human body for reproduction.
3. Identify fertile and infertile periods of males and females.
4. Show positive attitude towards their body, including sexual and reproductive parts.

90 minutes  diagrams and labels of internal female  Big group activity and
reproductive parts, external female discussion
reproductive parts, internal male
reproductive parts, and external male
reproductive parts (each set slipped
inside an envelope)
 scissors
 glue
OPENING ACTIVITY. Label the Parts
a. When you reach puberty, your body becomes more mature and ready for
reproduction. How is this possible? We will find about it in this session.
b. Let us begin by familiarizing ourselves with the sexual and reproductive parts of
females and males.
c. Sexual and reproductive parts are body parts that are personal or private to
each one of us. Some of you may be uncomfortable. So let’s not forget about our
Ground Rules.
d. Let us be respectful to each other when talking about sexual and reproductive
parts.
23 UNDERSTANDING MY FERTILITY
2. Form two all-female groups and two all-male groups. To make everyone feel
comfortable, put all-female groups and all-male groups in separate corners of the
room.
3. Give out to the all-female groups the female sexual and reproductive envelopes and
to the all-male groups the male sexual and reproductive envelopes.
4. Instruct groups to:
a. Open the envelope and take out the diagram and pieces of paper containing
parts and functions.
b. On the diagram, label the parts and show functions. Choose from the pieces of
paper the appropriate name and function of each numbered part.
5. In presenting group output:
a. Have the groups post their diagrams on the wall within their work area and
discuss their output among themselves.
b. Ask the groups to switch places (the all-female groups moving to the corner of
the all-male groups and vice-versa) and examine the diagrams posted on the
wall.
6. Gather all the groups and go through the different parts and functions of the male
and female sexual and reproductive systems. Discuss the following:
a. External parts and functions of female reproductive system (Reference 1 on

page 37);
b. Internal parts and functions of female reproductive system (Reference 2 on page

38);
c. External parts and functions of male reproductive system (Reference 3 on page

39); and
d. Internal parts and functions of male reproductive system (Reference 4 on page

40).
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7. Process the activity by engaging the participants in a discussion through the

following questions:
a. How did you feel while labeling the male and female sexual and reproductive
systems? Why did you feel that way?
b. Was the activity easy or difficult? Why was it easy or hard?
c. What have you realized about male and female bodies? What similarities and
differences do they have?
d. What concerns do you have about male and female bodies?
8. Synthesize the sharing by emphasizing: The sexual and reproductive parts

determine whether a person is male or female. The male is different from a female in
external and internal make-up. Getting familiar with the male and female sexual and
reproductive systems makes it easier to understand the changes brought about by
puberty.
KEY MESSAGES
1. At puberty, you become fertile and ready for reproduction.
2. For girls, fertility is the ability to conceive or become pregnant and bear
children.
3. Male fertility is the ability of males to provide healthy sperm capable of

starting a healthy pregnancy. A male is fertile if he has the ability to provide
healthy sperm capable of starting a healthy pregnancy in a female.
4. You need to be aware of your fertility to make you more responsible in

expressing your sexuality. Knowing one’s body and fertility empowers the person
to make a healthy, informed and responsible decision on his/her family life
aspirations.
5. A female is fertile only on certain days of each menstrual cycle and these are
only the days when she can become pregnant. Unlike the males who are fertile
every day throughout their life, females are fertile only on certain days of each
menstrual cycle and these are only the days when they can become pregnant. A
female’s “fertile days” are those that fall on the few days before and during
ovulation.
6. What is Ovulation?
a. Girls are born with two ovaries which both contain thousands of eggs.
b. When a girl reaches puberty, the hormone estrogen tells an ovary to release one
egg every month. Then the two ovaries take turns releasing an egg each month.
When an ovary releases an egg, the process is called ovulation.
c. Each month, only one ovary releases an egg. On rare occasions, however, both
ovaries release an egg in a month.
d. Around the time when the ovary is about to release an egg, females get a whitish
and sticky liquid from the vagina. If sexual intercourse happens around this time
and sperm is ejaculated into the female’s vagina, the sticky liquid helps sperm
travel through the cervix and uterus to meet and join the egg in the fallopian
tube.
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e. A female’s “fertile days” are days she ovulates. Sperm can survive in the fallopian
tubes for as long as five (5) days and the egg, if it is not fertilized, survives for as
long as 24 hours. It is difficult to predict the fertile days because the period from
the beginning of menstruation to ovulation may change.
f. Some females learn how to observe the changes in their secretions and body
temperature to track their fertile period. This is called the “fertility awareness”
technique.
g. If the egg is not fertilized, it leaves the body together with some tissues and
blood from the uterus through the vagina. This signals the start of menstruation
or beginning of the next menstrual cycle.
7. What is Menstruation?
a. Menstruation comes from the Latin word mensis, which means “month.” Most
females have a period each month. This is why menstruation is also called
“monthly period.”
b. Menstruation is when females release fluid, including blood, through their

vagina. It happens because the lining of uterus (called endometrium) sheds and
leaves the uterus passing through the vagina.
c. The first time menstruation happens is called “menarche.”
d. Menstruation is part of the female reproductive process just as sperm

production is part of the male reproductive process. Only females have
menstruation.
e. The beginning of menstruation is a natural and very important moment in every

girl’s life. It marks the beginning of her transition from being a “girl” to becoming
a “woman.” It also signals that her body has become capable of getting pregnant
or having a baby.
f. There is no “right” or “exact” time for menstruation to begin. Periods will start
when the body is ready. Most females, however, start to have menstruation
between the ages of 10 and 16. There are those who start to have it earlier or
later.
g. The Menstrual Cycle
 A female’s menstrual cycle starts from the first day of one period and lasts
until the beginning of the next period. Then the cycle starts again.
 A period lasts for a few days (three to seven days). This is the time when the
body sheds the ruptured uterus lining. When the period stops, one of the
ovaries gets ready to release another egg and the uterus starts to build a
thick lining again.
 The egg is then released and travels through the fallopian tube.
 For a 28-day cycle and 5–day menstrual flow, the following describes what
happens inside a female’s reproductive system:
 Menstrual Phase (Menstruation or period)

o The first day of the cycle is the first day of menstruation. A woman
experiences bleeding from her vagina during menstruation which
normally lasts from three to five days.
o The menstrual phase includes all days of menstrual bleeding.
o The bleeding experienced by the woman is actually the shedding of the
thickened uterine lining which is prepared in case there is a pregnancy.
o During menstruation, the ovaries are resting, the cervix is open allowing
the uterine lining to flow to the vagina.
o There is no cervical mucus present.
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o The basal body temperature is low, around 360 C to 35.50C when a drop
in estrogen and progesterone occurs. The period where estrogen and
progesterone levels are its lowest-- shedding of endometrial lining took
place.
 Pre-Ovulatory Phase (preparation of the egg)

o The pre-ovulatory phase includes all dry days after the menstrual
bleeding stops. The length of the pre-ovulatory phase varies. Some
women may not be able to observe dry days after menstruation,
especially women with short cycles.
o During this phase, the following changes are happening inside a
woman’s body:
■bleeding has stop;
■egg cells begin to develop and mature;
■lining of the uterus starts to thicken;
■mucus forms a plug - this mucus prevents entry of sperms;
■the cervix is firm and closed (A woman experiences dry feeling and
no mucus); and
■the pre-ovulatory phase is the relatively infertile phase which
includes all dry days after the menstrual bleeding stops.
 Ovulatory Phase
o This is the highlight of a woman’s fertility. It Occurs 12-14 days before
the onset of the next menses.
o One mature egg is released and stays in the fallopian tube. It can be
fertilized by the male sperm for only up to one day or 24 hours.
o The uterine lining continues to thicken, ready to receive the fertilized
egg.
o The cervical mucus is wet, slippery, stretchy, and clear. This mucus
helps sperm live and swim to reach the egg. It nourishes the sperms.
o The vaginal sensation is wet.
o There is a slight dip in the basal body temperature, about 0.50 Celcius.
o The cervix is soft and open.
o The estrogen drops a bit, but remains high.
o Progesterone begins to rise.
 Post-Ovulatory Phase
o No egg is present. If there is no meeting of egg and sperm, the cell
deteriorates and is absorbed. Lining of the uterus has thickened.
o The mucus forms a plug again to prevent entry of sperms.
o Women experience dry feeling with no mucus at all. If mucus is present,

it is sticky, cloudy, crumbly, or pasty.
o Because there is no pregnancy, the woman will experience menstruation
and another cycle begins
o The post-ovulatory phase is absolutely infertile phase which covers
about 14-16 days.
o It has a constant length which is approximately 14-16 days. After
ovulation, the follicle is transformed into the corpus luteum, which
produces an increasing amount of the hormone called progesterone.
h. Tracking your Menstrual Cycle
 To keep track of menstrual cycle, when they begin and end – it is helpful to
keep a personal calendar. Each month, circle or shade the days when you are
having your menstruation. If you do this for a year or two, you will see a
regular pattern of your menstruation. This will enable you to easily predict
your next period.
 Keeping a calendar will also help you to know if your period is late or early.
It will inform you whether you have to consult a doctor.
 A sample menstrual calendar is shown below.
 Using X’s, mark the days when you have your period each month. Use X
(light), XX (medium) or XXX (heavy) to show the level of flow for each day.
Count the days from the fist X of one period to the fist X of the next. This is
the length of your menstrual cycle. Try to work out when your next period
will start.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
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8. A male is considered fertile if he has the ability to provide healthy sperm capable of
starting a healthy pregnancy in female.
a. Beginning at puberty and for the rest of their life, males are fertile every day for
as long as they are healthy although fertility declines with age.
b. The main purpose of the male reproductive system is to produce the sperm that
is needed to fertilize a female’s egg. Sperm are the male reproductive cells
whereas the ova or eggs are the female’s reproductive cells. These two cells are
necessary to reproduce or to create a new life or to make a baby.
c. How are sperms produced?
 Sperm is the male sex cell. Under a very powerful lens or a high
magnification, they look like tadpoles. They appear to have a head and a long
tail.
 To produce healthy sperm, the testicles have to be slightly cooler than

normal body temperature – two to three degrees lower. This is why the
penis and scrotum hang outside the body. Notice that when it is cold, the
penis and scrotum shrink. They draw themselves closer to the body to keep
warm. When it is hot, they will hang loose away from the body.
 The testicles begin to produce sperm only during puberty. During puberty,
the level of the hormone testosterone in the male body begins to rise and
this causes the penis and testicles to get bigger, and the testicles to begin
producing sperm.
 During sexual excitement, the testicles and epididymis release sperm that
move through the sperm ducts towards the penis. Along the way, they mix
with a fluid so they can move more easily. The sperm and this fluid are now
called semen. It is whitish and quite sticky. The sperm are too tiny to see – a
drop of semen that is the size of the period at the end of this sentence would
contain roughly a million sperm. Semen leaves the penis through the urethra.
This is a tube that goes through the middle of the penis. (Urine also leaves
the body through the urethra, but never at the same time as semen).
 From the time boys had their first release of semen, called ejaculation, they
have become fertile and able to father a child for the rest of their life.
d. What are erections? Erections can occur for any number of reasons, but are
usually triggered by sexually arousing thoughts or stimulation. During arousal,
hormones, muscles, nerves, and blood vessels all work with one another to
create an erection. Nerve signals, sent from the brain to the penis, stimulate
muscles to relax. This, in turn, allows blood to flow to the tissue in the penis.
 Boys may also experience erections during their sleep, which can sometimes
result in a “wet dream,” which occurs if one ejaculates while sleeping.
e. When semen spurts out of the penis, it is called ejaculation. It happens when
muscles at the base of the penis start to expand and contract (tighten). This
pushes the semen through the urethra and out through the tip of the penis. But
this will not happen every time you have an erection. It will usually happen if
you are very sexually excited.
 For every ejaculation, a male releases millions of sperm.

 Before the ejaculation, the Cowper’s glands release a drop or two of fluid
through the tip of the penis. This is called pre-ejaculate, and it cleans the
urethra. The pre-ejaculate alone does not contain a sufficient number of
sperms that are strong enough to cause pregnancy (unless sperm from a
recent ejaculation are still present).
 Once a male ejaculates (inside a female’s vagina), he can cause a pregnancy.
9. FERTILIZATION AND PREGNANCY. When a male’s sperm unites with a female’s egg
or ovum, fertilization takes place and pregnancy may happen.
a. When a sperm joins with an egg (fertilization), an embryo may be formed. The
sex of the embryo is determined by the male’s sperm, not by the female’s egg.
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b. A pregnancy results if the embryo attaches to (is implanted in) the lining of the
uterus. It is this embryo that will develop into a fetus if the pregnancy continues.
10. Most commonly, pregnancy occurs through vaginal intercourse between a male and
a female.
a. When the male ejaculates, the semen (containing the sperm) inside the male
reproductive organs is released into the female’s vagina. An ejaculation contains
at least four million sperm.
b. The sperm swims up the vagina, then to the uterus, and move towards the
fallopian tubes.
c. Hundreds of sperm surround the egg, but only one sperm will be successful to
fertilize the egg.
d. The egg and sperm join together to form one new cell. Few hours later, this new
cell splits to create two cells. These cells continue to split until a ball of cell is
formed. This ball of cell is called a “blastocyst.” The blastocyst continues to form
more cells as it moves down the fallopian tube. It takes about seven days for the
blastocyst to reach the uterus. When in the uterus, the blastocyst attaches itself
to the soft lining.
e. The cells inside the blastocyst will grow into a baby. The cells on the outside join
the wall of the uterus and form a protective organ called the “placenta.” The
placenta provides the baby with food and oxygen from the mother.
11. Being aware of your own fertility process helps you to take care and protect
yourselves from unintended pregnancies.
a. While pregnancy can happen due to sexual maturation of adolescents, it is a

choice that needs to be made responsibly based on one’s psychological, physical,
emotional and financial preparedness.
12. Synthesis of the Key Messages:
a. At puberty, boys and girls become fertile. A female is fertile if she has the ability
to become pregnant and carry a healthy pregnancy to birth. This means that her
ovaries are able to release an egg each month, which when fertilized by sperm,
will develop into a baby and delivered after nine months.
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b. Females have “fertile days” or certain days in their menstrual cycle when they
can become pregnant. These days fall on the day of ovulation – when an ovary
releases an egg to the fallopian tube – and five days before ovulation. This period
is difficult to predict. It may vary for certain women and on certain menstrual
cycle. What is fixed is that 14 days after ovulation, menstruation begins and a
new menstrual cycle takes place.
c. A male is fertile if he has the ability to provide healthy sperm capable of starting
pregnancy in a female. This means that his testicles or testes are able to produce
healthy sperm – enough in number and able to swim up to the fallopian tubes –
that can fertilize the female’s egg.
d. Unlike females, males are fertile from the time of his first ejaculation and
through the rest of his life for as long as he is healthy.
e. Fertility declines naturally with age for both males and females, although this
decline takes place earlier in females.
f. When a male’s sperm unites with a female’s egg or ovum, fertilization takes
place and pregnancy may happen.
g. Most commonly, pregnancy occurs through sexual intercourse between a male

and a female – during which the male’s penis enters the female’s vagina and the
male ejaculates, releasing sperm.
h. While pregnancy can happen due to sexual maturation of adolescents, it is a

choice that needs to be made responsibly based on one’s psychological, physical,
emotional and financial preparedness.
CLOSING ACTIVITY. Fill in the Blanks and Pass the Ball
1. Write each of the following statements on a small piece of paper. Take one of the
papers and form a small ball out of it. Place another paper around the small ball. Do
the same for the other papers until you are able to form a cabbage-looking ball.
a. Every female is born with thousands of eggs in her _______________.

[ANSWER: ovaries]
b. The eggs are so __________ that they cannot be seen by the naked eye.
[ANSWER: small]
c. Once a girl has reached puberty, a tiny egg matures in one of her ovaries and
then travels down through the _________ on its way to the __________.
[ANSWERS: fallopian tube; uterus]
d. The release of egg from the ovary is called _________.

[ANSWER: ovulation]
e. If a girl egg cell unites with the sperm, ______takes place.

[ANSWER: fertilization]
f. The fertilized egg travels to the _______ and attaches to the lining of the uterus
and remains there for the next nine months growing into a _______.
[ANSWER: uterus; baby]
g. If the egg is not fertilized, the uterus sheds away the thick lining it has made to
protect a fertilized egg along with some blood, body fluids, and the unfertilized
egg. All of them flow through the cervix and then out of the vagina. This blood
flow is called _______.
[ANSWER: menstruation or period]
h. From puberty onwards, males continue to produce ______ in their testicles or

testes.
[ANSWER: sperm]
i. The testes are found inside the ________.

[ANSWER: scrotum]
j. As the sperm matures, they move from the testicles to the _______ where they will
remain to mature for about two weeks.
[ANSWER: epididymis]
k. From the epididymis, the sperm enters the __________.

[ANSWER: vas deferens]
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l. From the vas deferens, the sperm passes through the seminal vesicles and the
______, which releases fluids that mix with the sperm to make _______.
[ANSWER: prostate gland; semen]
m. During ________, the semen travels through the penis and out of the body by way
of the urethra, the same tube that carries urine.
[ANSWER: ejaculation]
n. The _________ is the passageway through from which a man urinates or ejaculates.
[ANSWER: urethra]
2. Ask all participants to stand in a circle and give the following mechanics:
a. Music will be played and the “cabbage ball” will be passed around the
participants.
b. When music stops, the “cabbage ball” stays with the person who last
touched it.
c. The person who holds the “cabbage ball” removes the first layer of paper,
reads the statement written on it, and fills in the blank(s) with correct
answer(s).
d. Repeat the process until the last paper of the “cabbage ball” is opened.
3. As final message, say:
a. At puberty, menstruation among females and erections among males are

perfectly normal. It means the hormones in their body are working well.
How girls handle menstruation and how boys handle erections are our
primary concerns. We will talk about them in another session.
4. Thank everyone for their enthusiasm and active participation.
 FACT SHEETS on (Page 72-79)
Reference Materials for Opening Activity of Session 1.2.
Reference 1
External Parts and Functions of Female Reproductive System
Part Description Function

1. CLITORIS The clitoris is a small organ, shaped like a Touch stimulation of the nerve endings in
flower bud with a bit of tissue forming a the clitoris produces sensations of sexual
small “hood.” It contains thousands of pleasure.
nerve endings that make it an extremely
sensitive organ
2. LABIA MINORA Pair of thin cutaneous folds that form part They function as protective structures that
of the vulva, or external female genitalia. surround the clitoris, urinary orifice, and
vaginal orifice.
3. LABIA MAJORA The labia majora or outer lips cover are a Their function is to cover and protect the
pair of rounded folds of skin and adipose inner, more delicate and sensitive
that are part of the external female structures of the vulva, such as the labia
genitalia minora, clitoris, urinary orifice, and vaginal
orifice.
4. VAGINA The vagina is an elastic canal, leading from During sexual intercourse, the vagina
the vulva to the cervix and uterus. functions as the receptacle for the penis and
carries sperm to the uterus and fallopian
tubes. During childbirth, the vagina acts as
the birth canal to conduct the fetus from the
uterus and out of the mother’s body. It also
provides a passageway for menstrual flow
from the uterus and for urine from the
bladder to exit outside the body.
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Reference 2
Internal Parts and Functions of Female Reproductive System

4. VAGINA Refer to Reference 1 above Refer to Reference 1 above
5. CERVIX The cervix is the lower part of the uterus The function of the cervix is to allow flow of
that extends to the top of vagina. menstrual blood from the uterus into the
vagina and direct the sperms into
the uterus during intercourse.
6. UTERUS The uterus is a hollow, muscular organ The fertilized ovum gets implanted into the
that rests above the bladder. It is shaped endometrium and derives nourishment
like an upside-down pear that rests above from blood vessels which develop
the bladder. exclusively for this purpose. The
uterus nurtures the fertilized ovum that
develops into the fetus.
7. FALLOPIAN The fallopian tubes are two narrow, four The tubes transport the ova from
TUBES to five inches long tubes connecting the the ovary to the uterus each month. In the
ovaries to the uterus. presence of sperm and fertilization, the
uterine tubes transport the fertilized egg to
the uterus for implantation.
8. OVARIES The ovaries are two organs, each having They produce oocytes (eggs) for
the size of an almond or a grape. fertilization and they produce the
reproductive hormones, oestrogen and
progesterone.
Reference 3
External Parts and Functions of Male Reproductive System

1. PENIS The penis corresponds to the clitoris in Its reproductive function is to deliver semen
the female. It may be filled with blood and into the vagina. It also functions to excrete
become hard, and erect in response to urine.
sexual urge.
2. TESTICLES The testicles or testes are two ball-shaped Produces sperm and the male hormone
(TESTES) glands inside the scrotum. testosterone.
3. SCROTUM The scrotum is a loose bag of skin that The scrotum has a protective function and
holds and protects the testicles. acts as a climate control system for
the testes.
4. URETHRA The urethra is a tube that runs from the It is the passageway through which semen
bladder through the penis. travels out of the body during ejaculation. It
is also the passageway of urine out of the
body.
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Reference 4
Internal Parts and Functions of Male Reproductive System

5. EPIDIDYMIS The epididymis is a long, coiled tube that It transports and stores sperm cells that are
rests on the backside of each testicle. produced in the testes. A valve at the
bottom of the bladder closes when the penis
is erect to prevent urination during
ejaculation.
6. VAS DEFERENS These are thick-walled convoluted tubes These tube transports mature sperm to the
that are continuous with the cauda urethra, the tube that carries urine or sperm
epididymis and connects it to the prostatic to outside of the body, in preparation for
urethra. ejaculation.
7. PROSTATE The prostate is a walnut-sized The urethra runs through the center of
GLANDS gland located between the bladder and the the prostate, from the bladder to the penis,
penis. The prostate is just in front of the letting urine flow out of the body.
rectum. The prostate secretes fluid that nourishes
and protects sperm.
8. SEMINAL The seminal vesicles are a pair of glands The seminal vesicles produce and store
VESICLES that are positioned below the urinary fluid that will eventually become semen.
bladder and lateral to the vas deferens.
Each vesicle consists of a single tube
folded and coiled on itself, with occasional
diverticula in its wall.
PREVENTING TEEN PREGNANCY 42

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SESSION OBJECTIVES
1. Explain the health and social risks of early pregnancy to mother and baby.
2. Identify common complications of pregnancy in adolescent mothers.
3. Describe how pregnancy can be prevented.
4. Recognize sexual abstinence and use of contraceptive or family planning as effective

protection against pregnancy.

90 minutes For Option 1  Game/competition
 Cardboard for the word (in capital
letters): TEEN PREGNANCY
 Metacards
 Markers
 Adhesive tape
For Option 2
 Metacards
 Markers
 Adhesive tape
 Easel sheet with a drawing of a large
fish bone
OPENING ACTIVITY (Option 1). Wordscapes
a. As we have learned from the previous session, our sexual maturation during
puberty enables girls to get pregnant and boys to impregnate. But, pregnancy is
something that needs full responsibilities that adolescents may not be ready for
– physically, emotionally, and financially.
43 PREVENTING TEEN PREGNANCY

b. In this session, let us further understand the implications of teen pregnancy in

your growth and development.
2. Post the cardboard with the word: TEEN PREGNANCY.
3. Divide the group into males and females groups.
4. Give the following instructions:
a. Just like the android game “Wordscapes,” each group shall form words out of the
words TEEN PREGNANCY. For example: PEN.
b. Each group shall endeavor to form as many words they can form from the given
words. The group that has the highest number of words shall win.
5. After three minutes, stop the group from their work and count the words identified
by each group. Reward the winning group.
6. Process the activity by asking:
a. What did you feel about the activity?
b. What did you learn while doing the activity?
7. Synthesize the activity:
a. TEEN PREGNANCY is such a complicated word. More than words, it denotes a

critical issue that adolescents are facing nowadays. More and more adolescents
get pregnant unintendedly and suffer its life-long consequences.
b. In this session, let us further discuss teen pregnancy – what are its implications
to your life as adolescents and how to prevent it so that it does not become a
barrier to your way of achieving your aspirations.

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OPENING ACTIVITY (Option 2). The Fish Bone
1. Introduce the activity with the introductory statements in Option 2.
2. Divide the group into two (e.g. one group for males and the other for females).
3. Give each group a drawing of the fish bone then instruct them with the following:
a. Label the head of the fish with the word TEEN PREGNANCY.
b. Think of the direct causes of teen pregnancy (e.g. unprotected sex) and post
them in the back bone of the fish.
c. For each of direct cause, identify underlying causes (e.g. peer pressure). Post the
underlying causes on the bones attached to the backbone of the fish.
6. Let each group post their outputs in a designated place.
7. Give each group time to view the outputs of the other group for five minutes.
8. Process the activity by asking:
a. What did you feel about the activity?
b. What did you learn while doing the activity?
9. Synthesize the activity:
a. TEEN PREGNANCY is such a complex reality. It is a result of several factors that

should be known and understood by adolescents so they can prevent them from
happening.
b. In this session, let us discuss further the implications of teenage pregnancy to

your life as adolescents particularly in relation to your dreams in life.

KEY MESSAGES
1. Early pregnancy among adolescents is caused by complex and interrelated factors.

Some of the factors identified by literature include the following [discuss these
factors to the outputs of the groups in Opening Activity Option 2]:
Individual Efforts Household Efforts Institutional Efforts
• Demographic Factors • Demographic Factors • Demographic Factors

• Age & Sex • Family size • Population size
• Birth order • Civil status • Population
• Marital status • Pyscho-social factors composition
• Location • Parental guidance • Population
• Pyscho-social factors • KAP on sexuality and distribution
• Gender-identity ARH • Peers and social circle
• Self-esteem/self- • Parental • Peer influence
Teenage acceptance values/principles • Normative group
• Social competence • Access to media behaviors
Pregnancy
• Access and exposure • Socio-economic • Local governance
to media/Information factors • policy and program
Communication environment
• Income
Technology (ICT) (availability of
• Educational status
• Socio-economic services)
• Health and nutrition
factors • School, church, and
• Employment
• Income other organizations
• Educational status and institutions
• Health and nutrition • Local governance
• Employment • Media
• Socio-economic
factors
2. Social norms and peer pressure influence sexual behaviors among adolescents.
However, negative peer pressure including engaging in sexual activities should be
challenged through critical thinking and assertiveness.
a. It is not because “everybody is doing it” that one should be pressured to do the
same. Critical thinking and assertiveness are needed to prevent consequences of
negative pressures from peers, media, or the society as a whole.
b. It is always okay to be different!
3. Too early pregnancy puts the young mother and her baby at risk of health
complications and even death.

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a. Motherhood at a very young age entails a risk of maternal death that is much
greater than average, and the children of young mothers have higher levels of
morbidity and mortality.
b. Pregnant adolescents are exposed to the following health risks especially when
they fail to access timely and appropriate maternal health care:
 Obstructed labor or difficult delivery. Adolescent girls are still growing and
their pelvis has not yet reached its full size. Pregnancy increases the body’s
nutritional needs and can slow down growth size. If an adolescent girl gives
birth and her pelvis is not yet at its full, she may suffer from what is called
“obstructed labor” delivery or difficult delivery.
 Obstetric fistula. A damaging complication of obstructed labor is obstetric

fistula. In this case, there is a hole between the vagina and the bladder or
rectum. A female afflicted with this condition constantly leaks urine or feces
and smells bad.
 Unsafe abortion. Overall, complications from unsafe abortion is one of the

main causes of maternal deaths. Since most of teenage pregnancies are
unintended or unplanned, and because of the shame, social stigma, and
unpreparedness of the young mother and father to bear the child, many
pregnant girls resort to unsafe abortion. Unsafe abortion can also result in
lasting and devastating consequences including, sepsis, perforation of the
uterus or intestines, hemorrhage, chronic pelvic infection, and infertility.
 Pressure to mental health. Carrying a baby and becoming a mom not only
creates physical changes. Women also go through mental changes. Young
moms face added stress from sleepless nights, arranging child care, social
stigma, and attempting to finish schooling.
c. The baby of adolescent mothers or teen moms are also exposed to medical
complications. Studies have shown that children among mothers have higher
levels of mortality and morbidity (diseases). Some of the health risks among
babies born from young mothers include:
 Babies of adolescent mothers are likely to have low birth weight;

 They may also run a higher risk of being premature; and
 Have a higher risk of dying before delivery.

4. Too early pregnancy puts you at risk of having DISRUPTED dreams and aspirations
(i.e. social cost of teenage pregnancy):
a. D – Dropping-out of school due to difficulty of balancing the physical stress of

carrying a child and completing studies;
b. I – Incapacity to assume parental and familial responsibilities further resulting

to incapacity of young couples to raise their child and family responsibly;
c. S – Social stigma and discrimination attached to negative and prevailing

assumption of social promiscuity among pregnant adolescents;
d. R – Repeat pregnancy especially resulting from continued exposure to sexual

activities with the mother’s partner;
e. U – Unemployment or underemployment – primarily due to lack of education

or training required for available or higher paying jobs;
f. P – Poverty – Without education and employment, young parents have high

vulnerability to poverty;
g. T – Taking illegal drugs or substance abuse – as a means to “escape” from or

deal with the difficulties of being a young mother or father;
h. E – Emotional instability or crisis due to the pressure and tension from taking
care of the pregnancy, social stigma, and lack of family support, among others;
and
i. D – Dependence to family and government on basic needs – as young couples

are unable to provide for their needs, they will be highly reliant to their families
and to the government.
5. Too early pregnancy also affects the adolescent father:
a. Inability to cope with the demands of fatherhood;
b. Isolation from friends;
c. Inability to relate with equally young and inexperienced wife; and

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d. Opposition or inadequate support from their family.
6. To prevent early and unwanted pregnancy, you should abstain from or delay the
debut of your sexual relations.
a. Not engaging in sex or abstinence is the safest and most effective way to prevent
pregnancy. Adolescents need the capacity to refuse, abstain, or at least delay
engagement in sexual intercourse. For this, adolescents need proper information
about their sexuality so they can be effectively guided in making responsible
decisions.
b. For sexually active adolescents, correct and consistent use of contraception (or
family planning method) can prevent pregnancy. All adolescents regardless of
age and sex are allowed by law to seek reproductive health or family planning
information from any health facility or services provider. However, the
Responsible Parenthood and Reproductive Health law requires parental consent
from adolescents below 18 years old for accessing modern methods of
contraception.
7. Mutual consent is a requirement before any sexual activity with a partner. Any
unwanted sexual activity that happens when one partner is pressured, tricked,
threatened, or forced in a nonphysical way by the other partner is sexual coercion.
a. Coercion can also make one think she/he owes sex to someone such as her
boyfriend (i.e. for fear of being abandoned).
b. Sexual coercion and harassment are violations of human rights that need to be
reported to authorities.
8. There are medically and legally safe and acceptable methods of contraception or
family planning (FP) that can prevent adolescents from getting pregnant and STIs.
Access of minors (below 18 years old) to modern methods of family planning
requires parental consent.
a. Different methods of contraception have different mechanism of action,

effectiveness rate, benefit or advantages, and side-effects. It is important for any
user to receive full information about these methods so they can decide based on
informed choice and voluntarism.

b. The various family planning or contraceptive methods available and certified as

non-abortifacient in the country are as follows:
FP Methods Description
Barrier methods  This contraceptive method offer the greatest protection against
infection. They are inserted or put on each time the partners
have sex. These are called “barrier methods” because they
create a barrier between the egg and the sperm, making
fertilization impossible.
 Condoms are the only contraceptive method that protects

Condom partners from sexually transmitted infections including HIV.
Hormonal methods
 These methods regulate or stop ovulation and prevent

pregnancy. Hormones can be introduced into the body through
Pills
various methods including pills, injections, and subdermal
implants. These methods prevent ovulation and thicken
cervical mucus, which helps block the sperm from reaching the
egg.
Injectables  These methods do not protect against STIs. Combining the use
of one of these methods with a male or female condom can
offer greater protection against both pregnancy and STIs
including HIV.
Subdermal Implants

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Long acting and  The “long acting and permanent methods” offer longer or
permanent methods permanent protection against pregnancy. These methods offer
no protection against STIs including HIV.
 They include insertion of an Intrauterine Device (IUD), Bilateral

Tubal Ligation (BTL), and No-Scalpel Vasectomy (NSV).
○ The IUD prevents sperm from meeting the egg by causing a

chemical change that damages sperm and cell before they
Bilateral Tubal Ligation
can meet. The IUD has long lasting effectiveness (12 years).
Insertion and removal of the device is done by a trained
service provider.
○ BTL is a safe and simple surgical procedure that provides

permanent contraception to women who do not want more
children. The procedure involves cutting or blocking the two
Vasectomy fallopian tubes so that eggs released from the ovaries cannot
move down the tubes, and so they do not meet with the
sperm.
o NSV is a permanent method of contraception for men that

involves tying or cutting of the vas deferens (the tube that
serves as passageway of sperm) through a small opening on
Intrauterine Device the scrotal sac.

 Users of these methods need to undergo comprehensive
counseling from trained service providers.

Fertility Awareness-  The “fertility awareness-based methods” or “modern natural
Based Methods family planning methods” involve determining the fertile and
infertile periods of females within the menstrual cycle and
observing the signs and symptoms of fertile and infertile
periods. These methods include daily observation of cervical
secretions, changes in the basal body temperature, or both
changes.
o These methods entail learning about the menstrual cycle and

to practice observing and recording cyclical changes in her
own body.
o During the fertile days of the menstrual cycle, partners may

use a contraceptive method such as the condom, or they may
avoid having vaginal intercourse.
o Younger adolescent girls often have irregular cycles, which

makes it difficult for them to use these methods effectively.
o These methods do not protect against STIs including HIV.
9. Preventing teenage pregnancy requires the participation of both male and female
adolescents. Boys can prevent teenage pregnancy by:
a. abstaining from sex;
b. communicating with his female partner and respecting his partner’s decision not
to have sex;
c. educating himself about the different contraceptive or family planning methods;
d. using condoms correctly and consistently for sexually active adolescents;
e. avoiding risky behaviors such as smoking, drinking, and taking illegal drugs; and
f. supporting his partner to finish her education towards the achievement of their
aspirations or dreams.

SHAPE
10. Synthesize the discussion with the following:
a. Engaging in unsafe sexual intercourse may lead to pregnancy. Too early

adolescent or teen pregnancy puts mother and baby at risk of health
complications. In addition, it causes adolescent mothers, and also adolescent
fathers, to stop schooling, and bear its social cost.
b. The surest way to prevent pregnancy is NOT to have sexual intercourse.

Everyone has the right to refuse sex. Everyone should respect that right.
c. People who have become sexually active but do not want a pregnancy can
choose to use contraception.
d. Contraception or family planning is any method used to prevent pregnancy.

Different methods are used in different ways and at different times.
e. Consulting a health care provider can help in choosing a suitable contraceptive

or family planning method. Those below 18 years old, however, need parental
consent to access contraceptive or family planning services.
OPENING ACTIVITY (Option 1). Role Playing
1. Explain:
a. Adolescents who are not here with us must also know about the consequences of
early, unintended pregnancy.
b. To share the information to them, you will go back to your small group.
c. In your group, create a short skit where you will use your poster to inform
adolescents in your school about the health risks and social cost of early and
unwanted pregnancy. You have 10 minutes to plan for your skit. Make sure that
each group member has a role to play.
2. Ask each group to present its short skit.

3. As a final message, say:
a. The surest way to prevent a pregnancy is not to engage in sex. Everyone has the
right to refuse sex. Everyone should respect that right.
b. If you have become sexually active and you do not want a pregnancy, you can
choose to use a contraceptive or family planning method that fits you.
c. Consult a health care provider. Remember that each person has the right to free
and informed consent regarding which family planning method to use.
 FACT SHEET on (Page 80-90)

PREVENTING SEXUALLY TRANSMITTED INFECTIONS (STIs) 56

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SESSION OBJECTIVES
1. Explain STIs, including HIV, and how they are and they are not transmitted.
2. Discuss ways to prevent transmission of STIs and HIV.
3. Recognize sexual abstinence, correct and consistent use of condom as effective

protection against STIs including HIV.
4. Discuss where and how to access local STI and HIV testing and treatment services.

 
90 minutes  Copy of fact sheets on STIs and HIV  Role playing
and AIDS  Group discussion
 For closing activity: Slips of paper (as
many as the number of participants)
Note: Write “+” on five slips of paper
and “c” on another five slips of paper,
fold all slips of paper, and place them
in a box or envelope.
OPENING ACTIVITY. Primetime (Role Playing)
a. People can experience both positive and negative consequences as a result of

sexual intercourse or sex. It can result in pleasure, intimacy, and desired
pregnancy. But sex can also lead to emotional and physical harm, unintended
pregnancy, and STIs including HIV and AIDS.
b. In this activity, we will discuss about STIs and HIV and AIDS.
2. Divide the participants into two groups. Assign each group a topic or allow them to
choose between: STIs or HIV and AIDS.
57 PREVENTING SEXUALLY TRANSMITTED INFECTIONS (STIs)

3. Explain:
a. In television, primetime refers to the time slot allocated to important programs

or issues. Today’s primetime will focus on STIs among Filipino adolescents.
b. In your group, create a five-minute talk show discussing the topic assigned to
you or you have chosen.
c. Be as thorough as possible. Include information about testing, treatment, and

prevention.
4. Distribute the fact sheets. Give the groups five (5) minutes to prepare.
5. Ask each group to present its talk show and to take questions from the other group.
6. Make sure that important facts and prevention measures are covered in the
discussion.
7. Process the activity by asking the questions:
a. What did you feel when you were doing the activity?
b. What lessons did you learn from the activity?
KEY MESSAGES
1. Sexually transmitted infections (STIs) are infections spread through sexual activity.
They are preventable.
a. There are many kinds of sexually transmitted infections (STIs). Among the STIs
that can have serious consequences are: HIV (the virus that causes AIDS),
syphilis, gonorrhea, chlamydia, trichomonas, and herpes.
b. In the early years of the HIV/AIDS epidemic (1984-1990), 62% (133 of 216
cases) of those diagnosed were female. From 1991 to present, males comprised
94% (52,539) of the 56,048 diagnosed cases in the Philippines. However, the
number of diagnosed HIV infections among females has also been increasing in
recent yearsiii.

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 The number of females diagnosed from January to June 2018 (304) was
almost three times the number of diagnosed cases compared to the same
period of 2013 (110), five years prior. 93% (3,373) of all female cases were
in the reproductive age group (15-49 years old) at the time of diagnosis.
 The predominant age group among those diagnosed has shifted from 35-49
years old between 2001 to 2005, to 25-34 years old starting from 2006 to
present.
 The proportion of HIV positive cases in the 15-24 age group increased from
25% in 2006-2010 to 29% in 2011- 2018.
c. Some STIs cause symptoms or discomfort. Others do not always have symptoms
(especially among females). Even when an infection does not produce symptoms,
it can have serious health consequences including endangering fertility or even
life.
d. For some STIs, girls are physiologically more vulnerable to infection than boys.
e. AIDS (acquired immunodeficiency syndrome) is a syndrome caused by a virus

called HIV (human immunodeficiency virus). The disease alters the immune
system, making people much more vulnerable to infections and diseases. This
susceptibility worsens if the syndrome progresses.
 HIV is found throughout all the tissues of the body but is transmitted
through the body fluids of an infected person (semen, vaginal fluids, blood,
and breast milk).
 How is HIV transmitted?
 Sexual transmission — it can happen when there is contact with

infected sexual fluids (rectal, genital, or oral mucous membranes). This
can happen while having sex without a condom, including vaginal, oral,
and anal sex.
 Perinatal transmission — an infected mother can transmit HIV to her
child during childbirth, pregnancy, and also through breastfeeding.
 Blood transmission — pertains to the risk of transmitting HIV through
blood transfusion. Among people who inject drugs, sharing and reusing
syringes contaminated with HIV-infected blood, is extremely hazardous.
2. The surest way to avoid getting or transmitting an STI is not to have sex. For sexually
active young people, they need to correctly use condom to protect themselves from

these infections. Persons infected with STIs including HIV should seek timely and
appropriate treatment from public or private health facilities.
a. Every person has the right to protect himself or herself against STIs. Likewise,
everyone has the right to refuse unsafe sex or sex that is unwanted for any
reason. This right should be respected at all times.
b. Some but not all STIs are curable. Taking proper preventive measures can
prevent re-infection. Proper treatment can often reduce symptoms and/or
dramatically slow the progress of those STIs that cannot be cured (for example,
herpes, HIV infection, and HPV).
c. For the prevention of STI and HIV/AIDS, observe A-B-C-D-E:
 A – Ayoko Muna! (Abstinence)

 B – Basta tayong dalawa lang! (Be faithful!)
 C – Condom ay laging gamitin! (Condom use)
 C – Check-up ay ugaliin! (Seek check-up, testing and timely treatment)
 D – Drugs ay iwasan! (Drug prevention)
 E – Edukasyon ay kailangan (Educate self and others about STI, HIV/AIDS
prevention)
d. Any person who is HIV-positive has the right to obtain needed services and
treatment.
 Care may include, for example, access to medications, special medical

attention during pregnancy or illness, and social services with ongoing
counseling support.
3. In real life, many people do not use protection against STIs including HIV.
a. Some people do not use protection because they lack information, skills, or basic
access to services.
b. With some people, engagement in sex is spontaneous, thus, they do not have
time to access condom. Communication between partners for protected sex can
help the prevention of STI and HIV infections.

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c. Some people do not use protection because they are in circumstances of unequal
social power. Young people, particularly girls, may feel pressured by their
partner to show their love by having sex without a condom. Moreover, a
significant age gap between partners may make it difficult for the younger
person to insist on condom use.
 Within marriage, women and girls are often obligated to have sex or to have
a child, even if they feel that it is not safe.
 Both men and women who are paid to have sex may be paid extra — or
coerced — to have sex without condoms.
 Initiating a discussion about sex or sexual health may be considered
inappropriate or taboo for women and girls.
 Some people feel that asking a partner to use condom may provoke
suspicion of sexual infidelity and may trigger conflict, anger, or violence.
Such reactions result in serious harm to many women throughout the world.
 Sex that is forced (in addition to being an act of violence) often takes place
without condoms; hence, it is more likely to carry a risk of HIV and other
STIs.
4. All people have a right to know their own HIV status and to obtain confidential
testing and counseling services. People also have a right not to be tested.
a. People living with serious and incurable STIs such as HIV infection can live a
long time and can maintain a relatively normal life, including having safe,
satisfying, and supportive sexual relationships. However, doing so requires
social and health care support and attention to the rights of people living with
HIV or AIDS.
b. People living with HIV or AIDS need counseling and support to be comfortable
speaking with others about their status.
c. Some people suffer as a result of telling their partners or family members that
they are HIV-positive. Many find that their partners and family members are
understanding and helpful.
d. People living with HIV or AIDS have the right to live free of stigma and
discrimination. Unfortunately, this right is often not respected.
5. Synthesis of the Key Messages:

a. STIs are preventable. The safest way to prevent STI is not to engage in sexual
activity. People who are sexually active can take steps to prevent themselves
from getting an STI. One of them is using a condom correctly every time they
have sex or prevent from having sex.
b. Don’t leave STIs undiagnosed and untreated to prevent affecting your future
fertility.
c. Every person has the right to protect himself or herself against STIs. This is true
whether one’s partner is of the same or the other sex.
d. HIV is one of the most serious infections that people can acquire through sex.
People who have had an unprotected vaginal or anal sex in the past six months
should take the HIV test.
e. All people have the right to know their own HIV status and to obtain confidential
testing and counseling services. People also have the right not to be tested.
f. Reach out to local peer educators or HIV counsellors for HIV testing.
g. Abstain; Be faithful; use Condom!; get Check-up and testing; prevent Drug use;
and Educate self and others.
CLOSING ACTIVITY: Wildfire
1. Ask each participant to take a slip of paper from the box and not to open it until they
are instructed to do so.
2. Give the following instructions:
a. Everyone walks around the room and say hello to each other.
b. When you hear me clap my hands, stop and shake hands with the person near
you and remember that person’s name.
c. When you hear me shout “move,” walk around again and say hello to each other.
d. When you hear me clap my hands, stop and shake hands with the person near
you, and remember that person’s name.

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e. We will do this in three rounds.
3. After the third round, ask everyone to open their slip of paper and find out what is
written on it. Then give the following instructions:
a. Those whose paper contains a “+,” please come forward and form a line.
b. Those who shook hands with these people, please form a second line.
c. Those who shook hands with the second group, please form a third line.
4. Explain that in this game:
a. Handshake represents sexual intercourse.
b. The “+” on your paper means you are HIV-positive or you have HIV infection.
c. The “c” on your paper means that you wear condom.
d. A blank paper means you have no protection against HIV and you may have
“shook hands” with somebody with a “+” or with somebody who shook hands
with a “+.”
5. Ask: How many are now infected with HIV? Who have not been infected with HIV?
6. Point out that HIV easily spreads when people who have it do not yet know they
have the virus -- show no signs and symptoms, or have not yet taken the HIV test. By
not taking action that protects oneself from getting the virus, HIV spreads easily and
quickly – like a wildfire!
7. Close the activity by emphasizing the messages for the synthesis.
 FACT SHEET on Sexually Transmitted Infections (STIs) (Page 93-97)
 FACT SHEET on HIV/AIDS (Page 98-101)

Post-Test
OBJECTIVE
Participants are able to illustrate what they have learned in the previous session under
Module 1.
Duration: 30 minutes
ACTIVITY. Opinion Poll
1. Explain that post-test will let the participants express or demonstrate the learning
that they have gained through the sessions under Module 1.
2. As in the Pre-Test the participants shall express agreements to the statements below.
3. After they finish answering, discuss the answers with the participants as also a way
to reinforce the key messages in the specific module. Draw out the answer from the
participants.

a. Puberty is the time when the Puberty happens at different paces
body physically changes to to each individual. Generally, girls
become adult. It happens to start puberty earlier than boys. The
everybody at the same time. start of puberty is influenced by
genes, nutrition, and illness.
b. Males and females who have How and when a person begins to
not grown as tall as their change physically depends on the
friends and classmates should genes they inherited from their
worry. Something is wrong with biological parents, the kind of food
them. They should consult a they eat, and other environmental
doctor. factors.
c. When girls begin to have Menstruation is a sign that a female
menstruation or period, it has become capable of getting
means they have a disease and pregnant. It is normal and nothing
should see a doctor at once. to worry about.
POST-TEST 64
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d. Puberty includes growth spurt Having erections means a boy has
and sexual maturation. Males become capable of fathering a child.
begin to have erections. This is It does not mean he has to start
something that adolescents having sex. Not all erections should
should worry about. lead to ejaculations.
e. Since adolescents can already Engaging in sexual activities entails
get pregnant or impregnate, careful consideration of its life-long
they can engage in sexual and irreversible consequences. This
activities as they want. requires emotional and physical
maturity. Adolescents should be
more responsible of their sexual
behaviors to prevent unwanted
consequences such as pregnancy
and STIs.
f. It is okay for adolescent girls to Love can be expressed in many
give-in to the request of her ways and respecting one’s decision
boyfriend to have sex in order not to engage in sex is one of them.
for her to express her love. It is okay to say no to sex!
g. Adolescent males are not at risk Without use of condom during sex,
of any health problem if they adolescent males are exposed to the
engage in sex. risk of getting an STI including HIV.
h. Adolescents engaging in sexual Having sex for the first time may
activities for the first time will result in pregnancy. Whether it is
not result to pregnancy. for the first time or number of
times, it does not matter.
4. If participants have more questions or want further clarification, take time to

address them.
5. Thank everyone for their cooperation.
65 POST-TEST
Closing Statement
1. Wrap up the whole module by saying the following:
a. After childhood, everyone goes through the adolescence phase. Adolescence is

the period in life when children turn to adults. It is a transition period, meaning a
temporary or passing state. It begins with puberty or all the physical changes
that prepare a child to become adult.
b. Puberty begins early for some people and later for others. Age of puberty is
influenced by genes, nutrition, physical activities, absence or presence of illness,
and other environmental factors unique to individuals.
c. At puberty, sexual and reproductive organs begin to mature. Females begin to

grow breast buds, grow underarm and pubic hair, have menstruation, and other
physical changes. Males begin to grow hair on their face, pubic area, and
underarm, to have wet dreams, and other physical changes. All these changes
can be both confusing and exciting.
d. At puberty, young males and females become fertile. A male is fertile if he is able
to provide healthy sperm that can make a female pregnant. A female is
considered fertile if she is able to become pregnant and carry a pregnancy to
birth. When a male’s sperm unites with a female’s egg through vaginal
intercourse, fertilization takes place and pregnancy occurs.
e. In addition, puberty brings about new feelings, which we will discuss more in
the next module. One of them is curiosity about sex. Adolescents may explore
their sexuality by themselves or with a sexual partner. If they engage in sex
without using any form of contraception, it may lead to pregnancy and/or an STI
including HIV.
f. Too early pregnancy puts the health and life of the adolescent mother and baby
at risk of problems including death. Most STIs, if left undiagnosed and untreated,
may lead to infertility in adulthood. HIV, if left undiagnosed and untreated, may
lead to the deadly AIDS. Girls who have sex during adolescence are doubly at risk
of getting the human papilloma virus (HPV) that causes cervical cancer. These
are more than enough reasons for adolescents like you to decide against
engaging in sex at this point in your life.
POST-TEST 66
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g. The surest way to prevent pregnancy is not to have sex. Everyone has the right
to refuse sex especially if it is unwanted for any reason. If you have become
sexually active, you can protect yourself against unwanted pregnancy by using a
contraceptive or family planning method that suits you. Consult your local
service provider.
h. The surest way to prevent STIs including HIV is not to engage in vaginal, anal, or
oral sex. Everyone has the right to refuse unsafe and unwanted sex. If you have
become sexually active, you can protect yourself by using a condom correctly
each time you have sex. To learn about proper condom use, consult your local
peer educators or HIV counsellors.
i. Knowing about your changing body can be exciting and empowering. It enables
you to own your body and protect it from possible harm and abuse, including
unwanted sex.
j. Learning continues in the next sessions.
67 POST-TEST
ADDITIONAL RESOURCES FOR FACILITATORS 68

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FACT SHEET 1 (for Session 1.1)
Puberty and Boys

For boys, puberty usually begins between the ages of 10 and 13, a couple of years later than
it begins for girls. Boys typically finish puberty in their late teens or early twenties, when
skeletal growth is complete.
What changes do boys experience during puberty?

Like girls, boys may find that their feelings and interests change during puberty. Physical
changes also occur. These changes are different for every person but typically occur in this
order:
• The testes and penis grow larger.
• Pubic hair begins to grow; it gradually increases in amount and becomes coarser and
curly.
• The voice begins to change and deepen, usually gradually but sometimes suddenly.
• About a year after the testes begin to grow, a boy may begin to experience
ejaculation (release of a white milky fluid called semen from the penis).
• Underarm hair grows and sweat changes scent to adult body odor.
• Facial hair develops.
Boys also experience a growth spurt and muscle growth. Skin becomes oilier, increasing the
likelihood of acne, a skin condition. About half of boys experience slight temporary breast
growth, which disappears in a year or two.
What causes erections?

Erections occur throughout life. An erection is caused by blood filing the spongy tissue in
the penis as a result of sexual stimulation; lifting or straining; dreaming; being cold;
wearing tight clothing; feeling fear or excitement; or having a full bladder on waking. An
erection may have no apparent cause, especially during puberty. Boys often get sudden or
spontaneous erections, sometimes many times a day. These are the result of high or
changing levels of the hormone testosterone.
Having an erection without ejaculation, this may cause a temporary feeling of “heaviness”
but is not harmful in any way. If an erect penis is not touched, the erection will subside by
itself.
69 ADDITIONAL RESOURCES FOR FACILITATORS

What happens during ejaculation?

Prior to ejaculation, the Cowper’s glands release a drop or two of fluid through the tip of the
penis. This is called pre-ejaculate, and it cleans the urethra. The pre-ejaculate alone does
not contain a sufficient number of sperm that are strong enough to cause pregnancy (unless
sperm from a recent ejaculation are still present). HIV may be present in the pre-ejaculate,
however. Full ejaculation involves the release of semen, which typically contains hundreds
of millions.
What are wet dreams?

Men regularly have erections during sleep, and about 80 percent of them occasionally
ejaculate. This kind of ejaculation is called a nocturnal emission or “wet dreams.”
Men regularly have “wet dream.” Wet dreams are common during puberty, but adult men
may also have them. A boy or man who masturbate or has regular sex is less likely to have
“wet dream.”
Wet dreams (and masturbation) are not harmful in any way. They may release tension and
be a source of pleasure. Nor do wet dreams “waste” sperm. The testes are continuously
making new sperm and wet dreams are one way the body rids itself of stored sperm.

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Puberty and Girls

For girls, puberty begins between the ages of eight (8) and 13, about two years earlier than
for boys. Girls typically finish puberty between the ages of 16 and 17 or around the time
that their skeletal growth is complete.
What changes do girls experience during puberty?

Changes at puberty differ from person to person. Although they may vary in timing,
sequence, and speed, girls’ bodies typically develop in this order:
• Breast growth begins, often on only one side at first. Full development takes about
two years.
• Pubic hair begins to grow, gradually increasing and becoming coarser and curly.
• Inside a girl’s body, the surface of the vagina thickens and the uterus and ovaries
increase in size.
• The first menstrual bleeding, menarche, usually occurs two to three years after
breast development begins. Many girls have irregular periods for the first couple of
years. Once a girl ovulates, she can become pregnant. [See Fact Sheet on the
Menstrual Cycle.]
• Underarm hair grows and body sweat changes, resulting in adult body odor.
• The cervix starts producing mucus that is discharged from the vagina. This mucus is
normal and is a sign of natural changes related to fertility and menstruation.
Girls also experience a growth spurt, their pelvis and hips widen, fat tissue increases, and
the skin becomes oilier, increasing the likelihood of acne. As with boys, girls’ interests and
feelings may also change with puberty. In the days before menstruation, girls commonly
experience strong feelings of different kinds, for example, joy, sadness, sensitivity, and
anger.
Managing menstruation
Menstruation is natural and part of being a healthy female. Having one’s first menstrual
period can be an exciting event, especially if the girl knows what to expect. Unfortunately,
many girls worry or are afraid when their first period comes because no one has explained
to them what it means and requires. Some parents may feel embarrassed to talk about it. Or
the girl may have absorbed messages from her culture or religion suggesting that
menstruation is somehow unclean.

Menstruation, however, is part of the body’s means of renewing itself and maintaining
fertility. During menstruation a girl can generally engage in all of her regular activities.
Bathing during menstruation is important. The vulva should be washed with water and
mild soap to remove any blood that is left.
How women take care of their menstrual flow varies in different settings. Many women use
pads to absorb the blood. In some places, women buy pads that can be thrown away after
use. In other places, they employ reusable pads made from folded cloth; these must be
washed thoroughly after each use with soap and water. Having a private place to change or
wash pads (both at home and at school) is important.
Many women and girls use tampons instead of — or in addition to — pads. A tampon is a
small mass, made of cotton (or other absorbent material), and often shaped like a finger to
fit comfortably into the vaginal canal. Tampons are inserted into the vagina to absorb the
menstrual blood. Tampons must be changed at least twice a day. Leaving a tampon in for
more than a day can cause a serious, even deadly, infection. (Inserting any unclean object
into the vagina can also cause a serious infection.)
The amount of menstrual bleeding — the menstrual flow — varies from day to day and by
person. Bleeding may be heaviest during the first days of the period. Some girls and women
also experience pain — abdominal cramping — during these days. In some cases, these
cramps are strong and include nausea. A mild painkiller such as ibuprofen helps. Taking a
bath, or placing a bottle filled with warm water on the lower belly or lower back, may also
help.
A few days before their menstrual period begins, some girls and women may experience
one or more kinds of discomfort. These include sore breasts, constipation, tiredness,
pimples, and strong feelings that are harder than usual to control. Other months they may
experience, some, other, or none of these. Many girls and women find that their
premenstrual discomfort and their menstrual cramps tend to decrease if they exercise
regularly throughout the month.
Girls commonly have questions or difficulties with menstruation. They may find that
speaking with a health care worker, female relative, or friend is helpful.

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FACT SHEET 3 (for Session 1.2.)
Sexual and Reproductive Systems for Females
What are the sexual and reproductive systems?

The sexual and reproductive systems share some but not all organs. The sexual system
consists of those organs involved in sexual activity and pleasure, whereas the female
reproductive system consists of those involved in pregnancy and birth.
What are the parts of the female sexual and reproductive systems and
their functions?
PART DESCRIPTION FUNCTION

1. CLITORIS The clitoris is a small organ, Touch stimulation of the nerve endings
shaped like a flower bud with a in the clitoris produces sensations of
bit of tissue forming a small sexual pleasure.
“hood.” It contains thousands of
nerve endings that make it an
extremely sensitive organ
2. LABIA Pair of thin cutaneous folds that They function as protective structures
MINORA form part of the vulva, or that surround the clitoris, urinary orifice,
external female genitalia. and vaginal orifice.
3. LABIA The labia majora or outer lips Their function is to cover and protect the
MAJORA cover are a pair of rounded inner, more delicate and sensitive
folds of skin and adipose that structures of the vulva, such as the labia
are part of the external female minora, clitoris, urinary orifice, and
genitalia vaginal orifice.


4. VAGINA The vagina is an elastic canal, During sexual intercourse, the vagina
leading from the vulva to the functions as the receptacle for the penis
cervix and uterus. and carries sperm to the uterus and
fallopian tubes. During childbirth, the
vagina acts as the birth canal to conduct
the fetus from the uterus and out of the
mother’s body. It also provides a
passageway for menstrual flow from the
uterus and for urine from the bladder to
exit outside the body.
5. CERVIX The cervix is the lower part of The function of the cervix is to allow flow
the uterus that extends to the of menstrual blood from the uterus into
top of vagina. the vagina, and direct the sperms into
the uterus during intercourse.
6. UTERUS The uterus is a hollow, The fertilized ovum gets implanted into
muscular organ that rests above the endometrium and derives
the bladder. It is shaped like an nourishment from blood vessels which
upside-down pear that rests develop exclusively for this purpose. The
above the bladder. uterus nurtures the fertilized ovum that
develops into the fetus.
7. FALLOPIAN The fallopian tubes are two The tubes transport the ova from
TUBES narrow, 4-to-5-inch-long tubes the ovary to the uterus each month. In
connecting the ovaries to the the presence of sperm and fertilization,
uterus. the uterine tubes transport the fertilized
egg to the uterus for implantation.
8. OVARIES The ovaries are two organs, They produce oocytes (eggs) for
each having the size of an fertilisation and they produce the
almond or a grape. reproductive hormones, oestrogen and
progesterone.

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FACT SHEET 4 (for Session 1.2.)
Sexual and Reproductive Systems for Males
What are the sexual and reproductive systems?

The sexual and reproductive systems share some but not all organs. The sexual system
consists of those organs involved in sexual activity and pleasure, whereas the female
reproductive system consists of those involved in pregnancy and birth.
What are the parts of the male sexual and reproductive systems and
their functions?

1. PENIS The penis corresponds to the Its reproductive function is to deliver
clitoris in the female. It may fill semen into the vagina. It also functions to
with blood and become hard, excrete urine.
and erect in response to sexual
urge.
2. TESTICLES The testicles or testes are two Produces sperm and the male hormone
(TESTES) ball-shaped glands inside the testosterone.
scrotum.
3. SCROTUM The scrotum is a loose bag of The scrotum has a protective function
skin that holds and protects the and acts as a climate control system for
testicles. the testes.


4. URETHRA The urethra is a tube that runs It is the passageway through which
from the bladder through the semen travels out of the body during
penis. ejaculation. It is also the passageway of
urine out of the body.
5. EPIDIDYMIS The epididymis is a long, coiled It transports and stores sperm cells that
tube that rests on the backside are produced in the testes. A valve at the
of each testicle. bottom of the bladder closes when the
penis is erect to prevent urination during
ejaculation.
6. VAS These are thick-walled These tube transports mature sperm to
DEFERENS convoluted tubes that are the urethra, the tube that carries urine or
continuous with the cauda sperm to outside of the body, in
epididymis and connects it to preparation for ejaculation.
the prostatic urethra.
7. PROSTATE The prostate is a walnut-sized The urethra runs through the center of
GLANDS gland located between the the prostate, from the bladder to the
bladder and the penis. The penis, letting urine flow out of the body.
prostate is just in front of the The prostate secretes fluid that
rectum. nourishes and protects sperm.
8. SEMINAL The seminal vesicles are a pair The seminal vesicles produce and store
VESICLES of glands that are positioned fluid that will eventually become semen.
below the urinary bladder and
lateral to the vas deferens. Each
vesicle consists of a single tube
folded and coiled on itself, with
occasional diverticula in its
wall.

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Menstrual Cycle (Ovulatory Cycle)
What is the menstrual or ovulatory cycle?

At puberty, girls begin to experience cycles of fertility. Unlike males, who are fertile
continuously from puberty onward, females can become pregnant only during certain days
of the cycle. The length of the cycle varies from person to person but is generally about one
month. During each cycle, the female body goes through many changes. The most obvious
part of the cycle is menstrual bleeding, also called menstruation or the “period.”
We often think of menstruation as the climax of the cycle, but menstruation is just one part
of an amazing array of changes that take place during the cycle. These changes are the
body’s way of preparing for a potential pregnancy. They include producing mucus at the
cervix, growing and releasing an egg, and changes in the lining of the uterus. These changes
are controlled by hormones (natural chemicals produced by glands in the body and carried
in the bloodstream).
These hormonal changes affect many parts of the female body, and also how women feel
and function. Knowing about these changes can give a girl or woman a sense of greater
comfort and control regarding her own body. A woman can learn simple techniques for
identifying when she is ovulating and when her menstrual period is due.
What changes does the body go through during the cycle?
Before Ovulation
 Menstrual bleeding — menstruation, or menstrual bleeding, signals the beginning

of a new cycle. During menstruation, blood and tissue are shed by the uterus and
flow out of the vagina. The first day of bleeding is designated as “day one” of the
cycle. Bleeding usually lasts between four and six days.
 Dryness — after menstrual bleeding ends, the vagina may feel dry because hormone
levels are low and the cervix is producing little or no mucus.

 Thick mucus discharge/thickening of the uterine lining — after a few days, as

her body releases more hormones, the woman (or girl) may notice a vaginal
discharge of mucus. At first, this mucus is cloudy-white or yellowish and may feel
sticky. At the same time, although she cannot detect it, the lining of her uterus begins
to thicken and an egg (also called the ovum) “ripens.”
Ovulation

 Clear mucus/ovulation — as the egg ripens, the mucus becomes clearer and
slippery, often similar to raw egg white. Often it can be stretched between the fingers.
This clear mucus nourishes sperm and helps them to move toward the egg. At this
time, a woman’s sexual desire may also increase.
The release of the egg from the ovary is called ovulation. The days just before and
around the time of ovulation are the time when a girl or woman can become
pregnant. These are sometimes called her “fertile days.”
The female body goes through other changes around this time as well. For example,
some women experience an increase in sexual desire and in their sense of well-being
for a few days.
Some feel a twinge or slight discomfort on one side of their abdomen at about the
time the egg pushes out of the ovary.
After ovulation
 Post Ovulation — after ovulation, the egg can live for one day. The mucus again
becomes thicker and creamy or sticky. For the next 14 days (more or less),
hormones keep the thickened lining of the uterus in place. The body temperature
also rises slightly.
 Menstrual Bleeding — if no pregnancy has occurred at the end of the 14 days, the
hormone levels fall. The lining of the uterus sheds, and the body temperature falls
back down. This shedding is menstruation, and a new cycle begins. (If a pregnancy
occurs, the body continues to produce hormones to keep the thickened lining of the
uterus in place for nine months.)

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How long is the ovulation-menstrual cycle?

During the first year or two after menarche (the first menstrual period), the length of time
from one period to the next may vary. Several months may pass between periods. Even for
adult women, the length of the cycle may vary from one woman to the next. It may also vary
from cycle to cycle for any one woman. It can be affected by things like travel, stress,
depression, malnutrition, and illness. Most commonly, however, women begin a new cycle
every 24–36 days.
The part of the cycle from the beginning of menstrual bleeding until ovulation may vary a
great deal. It can be as short as a couple of days or as long as several months or more. Most
commonly, it lasts between one and three weeks. In contrast, the part of the cycle from
ovulation to the next menstrual period does not vary; it is always close to 14 days. In other
words, once ovulation occurs, a girl or woman knows that — unless she has become
pregnant — her menstrual period is due in 14 days.
Which are the fertile days of the cycle?

The fertile period includes the day of ovulation and the five previous days. Sperm can
survive in the female genital tract for as long as five or six days, and the egg (if it is not
fertilized) survives for as long as 24 hours. Predicting the fertile days is difficult, however,
because the first phase of the cycle (from menstruation to ovulation) is the part that may
vary widely in duration.
Some women learn how to observe the changes in their mucus (and in their body
temperature) so that they can tell when they are likely to be ovulating. Some women also
feel a slight pain when they ovulate. Many women and girls use such “fertility awareness”
techniques to have a better sense of when their menstrual period is due.
Knowing which days are the fertile ones can be useful for women who are trying to become
pregnant and for those who want to avoid pregnancy. Using fertility awareness techniques
correctly, however, requires thorough instruction, follow-up, and careful ongoing
observation. [Also see Fact Sheet on Contraception for more information about fertility
awareness techniques.]

How long do women have menstrual or ovulatory cycles?
As women enter mid-life, their hormone levels change. Eventually they stop releasing eggs
and menstruation also ceases. This phase, called menopause, also signals the end of fertility.
The age of menopause varies by woman and differs in different settings, but typically it
begins in the mid-40s in developing countries and in the early 50s in developed countries.
[Also see Fact Sheet on Puberty and Girls.]
Source: The Population Council, Inc. It’s All One Curriculum: Activities and Guidelines for a Unified Approach
to Sexuality, Gender, HIV, and Human Rights Education, 2009:261-262.

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Reproduction and Pregnancy

How does pregnancy occur?
Before a pregnancy can occur, an egg and a sperm must join. This event is called
fertilization. Fertilization can occur only during the fertile phase of a woman’s menstrual
cycle. [See Fact Sheet on the Menstrual Cycle.]
During the woman’s fertile phase, one of her two ovaries releases an egg. This event is
called ovulation. Within minutes, fingerlike projections (called fimbria) at the ends of the
fallopian tube begin moving to surround the egg and draw it into the tube. Also during the
fertile phase, the woman’s cervix moves into a position that eases the sperm’s entry from
the vagina. The cervix secretes a large amount of clear cervical mucus. This mucus provides
nourishment to enable sperm to survive for several days. The mucus also provides an
environment that helps sperm swim upward toward the fallopian tube, to reach the egg.
During sexual intercourse, the sperm are ejaculated near the cervix. They enter the cervix
within seconds. If the woman is fertile, some sperm may reach the egg in the fallopian tube
within five minutes, while other sperm can survive in the clear (“fertile-type”) mucus in the
cervix. In this way, for up to five days after ejaculation, sperm continue to exit the cervix
and are available to fertilize an egg. Hence, a woman who ovulates several days after she
has unprotected sex is likely to have sperm remaining in her cervix, and these sperm may
still be able to reach the fallopian tube and fertilize the egg.
Once ovulation occurs, however, fertilization must occur within 24 hours because the egg
can survive for only that long. Fertilization takes place in the fallopian tube. Once a sperm
has fused with the egg, it creates a barrier to other sperm. The fertilized egg continues
down toward the uterus, propelled by tubal contractions and by the cilia (little hair-like
projections within the tube).
What happens after fertilization?

In the fallopian tube, the fertilized egg, or zygote, begins to divide and grow, as it moves
toward the uterus. This journey takes about five days. After it has divided once, it is called
an embryo. Within two days of reaching the uterus, the embryo attaches or implants itself
in the lining of the uterus. Implantation is the beginning of pregnancy.

How can a woman tell if she is pregnant?

Early signs of pregnancy differ from woman to woman and between pregnancies. These
include:
• a missed period;
• tender or swollen breasts;
• sensitive nipples;
• frequent urination;
• unusual fatigue;
• nausea and vomiting;
• cramps;
• feeling bloated;
• changes in appetite; and
• feeling unusually emotional.
Pregnancy can be confirmed with a pregnancy test, which may be performed by a health
care provider or purchase pregnancy test kit from a pharmacy. Some women who have
learned how to detect when their body is ovulating can predict fairly well which day
menstruation is due; therefore, they may be aware of a pregnancy as soon as their period is
late.
What happens during pregnancy?

After implantation, the embryo (at this stage called a blastocyst) also gives rise to an
amniotic sac and a placenta. The sac provides a protective fluid environment for the
growing fetus. The placenta provides the fetus with nutrients and oxygen from the mother,
and carries out waste products. An umbilical cord connects the placenta to the fetus.
Human pregnancy lasts 38 weeks after fertilization (about 40 weeks from the last
menstrual period). Pregnancy is divided into three periods of about three months each,
called trimesters.
During the first trimester, until the 12th week, all of the major organs and structures of the
body are formed: the brain, heart, lungs, eyes, ears, arms and legs. After the eighth week,
the embryo is called a fetus. Women commonly feel nauseous during the first trimester; the
nausea is sometimes called “morning sickness.”
During the second trimester, from the 13th to approximately the 27th or 28th week, the
fetus grows rapidly. Usually around the 19th week, the woman can feel fetal movement.
Most women begin to put on weight during the second trimester.

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In the third trimester, the fetus continues to gain weight, and its movements become
stronger and more frequent.
What can women do to promote a healthy pregnancy?

Is particularly important for a pregnant woman to avoid taking unnecessary medications,
drugs, and alcohol. Taking the recommended vitamins and mineral supplements (especially
iron and folic acid) is very important (including before pregnancy, if possible). She should
also visit an antenatal-care provider, from whom she can get medical check-ups, and can
learn about her pregnancy, potential danger signs, and childbirth.
Women infected with HIV should take anti-HIV medication to prevent the fetus from
becoming infected and to maintain their own health. Treatment with anti-HIV medicines
transmitting HIV to the baby. during labor and delivery is critical for reducing the risk of
transmitting HIV to the baby.

Abortion
What is abortion?
An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in
or caused by its death. This can occur spontaneously as a miscarriage, or be artificially
induced through chemical, surgical or other means. A pregnancy that ends on its own is
called a spontaneous abortion or a miscarriage. An induced abortion is an intentional
removal of the fetus from the uterus.
How common is abortion?

Abortion is very common. About one in five pregnancies ends in spontaneous abortion
(often before the woman is aware that she is pregnant). A similar number — about one in
five pregnancies — ends in induced abortion. Most abortions — whether spontaneous or
induced — take place when the pregnancy is eight weeks of gestation or earlier.
Is abortion legal?
Article II of the 1987 Philippine Constitution says, in part, "Section 12. The State recognizes
the sanctity of family life and shall protect and strengthen the family as a basic autonomous
social institution. It shall equally protect the life of the mother and the life of the unborn
from conception."
The act is criminalized by Philippine law. Articles 256, 258 and 259 of the Revised Penal
Code of the Philippines mandate imprisonment for women who undergo abortion, as well
as for any person who assists in the procedure. Article 258 further imposes a higher prison
term on the woman or her parents if the abortion is undertaken "in order to conceal [the
woman's] dishonor".
In many places, however, abortions are performed by people who lack the necessary skills.
Often they are performed in an environment that does not meet minimum medical
standards. In these situations, abortion carries great risk. Globally, nearly half of all
abortions are unsafe, and nearly all of these (95 percent) are performed in developing
countries. The risk is often greatest in rural areas. As a result, nearly 70,000 women and
girls die every year from complications of unsafe abortion. These deaths are preventable.
to Sexuality,

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Childbirth and Breastfeeding

What happens during childbirth?
When a woman is about to give birth, her body enters a stage called “labor.” Labor often
begins with one or more of the following: clear or pink-colored mucus flowing from the
vagina; amniotic fluid flowing from the vagina; and contractions of the uterus that are
perceived as a hardening of the belly. The intensity of the contractions increases during
labor. The cervix opens and the uterine contractions help push the baby through the
opened cervix and vagina. Labor generally lasts between five (5) and 18 hours, but varies
among women. It usually becomes quite painful (although the perception of pain varies
among women and may depend on the preparation the woman made during antenatal
care), exhausting, and can be anxiety provoking. However, many women experience labor
and childbirth as a wonderful and incredible experience.
What is a cesarean section?

Cesarean section, also known as C-section, is a surgical method of childbirth. During this
procedure, an incision is made through the woman’s abdomen and uterus and the baby is
removed. It is usually performed when a vaginal delivery would put the mother’s or baby’s
life or health at risk. Sometimes it is performed for the benefit of the doctor rather than for
that of the woman or baby, for example to allow the doctor to schedule a convenient time
for delivery.
Unnecessary cesarean sections may increase risks to the health of the mother and the baby,
including the risk of death.
What help do women need when giving birth?

Wherever a woman gives birth — whether at home, in a health post, or in a hospital — she
needs assistance from a trained person such as a midwife or doctor. Proper conditions and
access to emergency care are also necessary in case of complications. Conditions and
practices related to childbirth vary around the world. In some countries, all women have
access to skilled assistance, but in other places most women give birth at home without the
help of a trained attendant and lacking proper conditions and emergency backup care. In
some places, women in labor also rely on support from other women. In other places, the
woman’s husband or partner is present and can give her support. Some women give birth
alone, without any help.

What are the consequences of giving birth without skilled assistance?

Because complications occur in about 15 percent of all births, the lack of trained assistance
and access to emergency care results in preventable illness and death. Every year, more
than half a million women die and eight (8) to 15 million women suffer serious injury or
disability, such as obstetric fistula, from causes related to pregnancy and birth. Nearly all of
these deaths occur in developing countries. Almost all of these deaths could be prevented
with skilled attendance at delivery and timely emergency obstetric care for complications,
use of family planning methods to reduce unintended pregnancies, and access to safe
abortion services.
What is an obstetric fistula and how does it affect women?

An obstetric fistula is an opening between the vagina and the bladder or rectum, sometimes
in both, that allows urine and/or feces to leak continuously. When a woman experiences
blocked labor and has no access to a cesarean section procedure, the prolonged pressure of
the baby’s head on the tissue between the bladder and the vagina or rectum can cause an
opening, called a fistula.
In most cases, the baby dies because of the prolonged labor. For the woman, the ongoing
smell of leaking urine or feces, or both, is constant and humiliating; many women and girls
with this condition are abandoned by their husbands and avoided or shunned by their
family, friends, and communities. Untreated, fistula can lead to chronic medical problems,
including ulcerations, kidney disease, and nerve damage to the legs.
About 100,000 cases of obstetric fistula occur each year, mostly in sub-Saharan Africa and
Asia. Fistulas occur disproportionately among impoverished girls and women, particularly
those who have small pelvises, because their growth is not yet complete or has been
stunted by malnutrition. Fistulas can usually be surgically repaired at a hospital. However,
an estimated two million women are living with untreated fistula.
Why is breastfeeding important?

Breastmilk is the only perfect food for a baby, especially for a newborn. The first yellow-
colored milk, called colostrum, is rich in nutrients and antibodies that protect the baby from
diseases and infections. Colostrum also helps to clean the baby’s gut. Breastfeeding during
the first hour after birth helps the uterus to stop bleeding and the milk to start flowing. In
addition, breastmilk is always clean, ready, and of the right temperature. It helps the
mother and baby to feel close and it costs nothing. (The World Health Organization
recommends breastfeeding without other food for the first six months of a baby’s life. If
possible, extend breastfeeding beyond six months in combination with safe and nutritious
foods.)

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What can a pregnant woman who is HIV-positive do to reduce the chance

of passing the virus to her baby?
A pregnant HIV-positive woman can transmit the virus to her baby during pregnancy, labor,
and delivery, and through breastfeeding. If she takes no preventive drugs and breastfeeds,
she runs about a 20 to 45 percent chance of transmitting her infection to her baby.
Today, however, effective drugs can prevent the transmission of HIV from pregnancy, labor,
and delivery, and through breastfeeding. If she takes no preventive drugs and breastfeeds,
she runs about a 20 to 45 percent chance of transmitting her infection to her baby. Today,
however, effective drugs can be used when there is advice from a physician about which
drugs to take and when. HIV-positive mothers prevent the transmission of HIV from a
mother to her baby during and after should also speak with their health care providers
about appropriate feeding options for their newborn pregnancy.
An HIV-positive woman who is or wants to become pregnant should can reduce the chance
of transmission through breastmilk. In areas where a mother may not have sought the
advice of a physician about which drugs to take and when. HIV-positive regular access to
safe water and infant formula, it is better to breastfeed exclusively for the first six months.
Mothers should also speak with their health care providers about appropriate and then to
wean abruptly.
Combining breastfeeding with commercial formula or starter foods carries the greatest risk
of passing HIV infection from mother to child. By taking preventive medicines and following
the appropriate guidelines, an HIV positive mother can reduce the chance of passing HIV to
her baby.

Family Planning Methods

Fertility Awareness-Based (FAB) Methods involve techniques of becoming aware of a
woman’s fertile and infertile days within a menstrual cycle based on two naturally
occurring fertility signs - changes in cervical mucus and changes in basal body temperature.
These signs can be used to avoid and also to achieve a pregnancy.
 Types:
○ Billings Ovulation Method (BOM) entails daily observation of cervical
secretions whose amount, color, consistency, slipperiness and viscosity change
during fertile and infertile days.
○ Basal Body Temperature (BBT) involves determining a woman’s resting body
temperature (body temperature after three hours of continuous sleep), which is
lower before ovulation and rises around the time of ovulation.

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○ Symptothermal Methods (STM) combines BOM and BBT together with other
signs such as breast engorgement and unilateral abdominal pain.
○ Standard Days Method (SDM) is based on calculated fertile and infertile

periods for menstrual cycles that range from 26 to 32 days. This method uses a
device, color-coded “cycle beads” to mark the fertile and infertile days of the
menstrual cycle. The fertile days of the menstrual cycle are days eight (8) to 19,
counting from the first day of menstruation. This is the start of a woman’s cycle.
○ Two-Day Method involves observing daily the cervical secretions; if there is

secretion yesterday or today, a woman should consider herself fertile and should
avoid sexual intercourse today.
○ Lactational Amenorrhea Method (LAM) is the use of breastfeeding (exclusive)

as temporary method of preventing pregnancy; exclusive breastfeeding
temporarily prevents the release of the hormone that causes ovulation.

Three (3) conditions must be met for this method to be effective:
 Full breastfeeding;
 Menses have not returned since childbirth; and
 Baby is not more than six (6) months old.
Their effectiveness depends on the couple’s ability to identify the fertile and
infertile periods, and motivation to practice sexual abstinence when required.
 Advantages:
○ No physical side effects
○ No prescription required
○ Inexpensive; no medication involved
○ Build better understanding of the couple about their sexual physiology
and reproductive functions
○ Promote shared responsibility for family planning
○ Foster better communication between partners
 Disadvantages:
○ May inhibit sexual spontaneity
○ Except for SDM, require extensive practice –about two to three
menstrual cycles to accurately identify the fertile and infertile periods
○ Require consistent and accurate recording and close attention to body
changes
○ Require periods of abstinence from sexual intercourse, which may be
difficult for some couples
○ Offer no protection against STI including HIV
○ Hormonal Methods
○ Combined Hormonal Contraceptives (pills, injectable) are drugs that

contain hormones (estrogen and progestogen) similar to those found in
a woman’s body. These drugs prevent conception by: (a) suppressing
ovulation or release of an egg from the ovary and (b) thickening the
cervical mucus and impairing the entry of sperm to the uterus. They
may be administered orally (pills) or through injection (injectable).
They are not recommended for women who are breastfeeding because
they can reduce milk supply.

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○ Progestin-Only Contraceptives contain only the hormone progestin,

which is like the natural hormone progesterone in a woman’s body.
They work mainly to thick the cervical mucus and impair the entry of
sperm to the uterus. They may be administered orally (pills), through
injection (injectable) or subdermal implant. They are recommended for
women who are breastfeeding because they do not affect quality and
quantity of milk.
○ These contraceptives are safe, effective and reversible. These, however,

do not provide protection against STIs including HIV.
○ Long Acting and Permanent Methods
○ The Intra-Uterine Device (IUD) is a small plastic device inserted into a woman’s
uterine cavity to prevent pregnancy. It prevents pregnancy by:
 inhibiting fertilization
 inhibiting sperm transport into the upper genital tract
 inhibiting ovum transport
 IUDs have long lasting effectiveness (up to 12 years). They have no effect on
the quality and quantity of breastmilk (if insertion is made after childbirth).
They have to be inserted by a trained service provider. They provide no
protection against STIs including HIV.
○ The Bilateral Tubal Ligation (BTL) is a safe and simple surgical procedure that
provides permanent contraception for women who do not want more children. The
procedure, which is also known as ligation or female sterilization, involves cutting or
blocking the two fallopian tubes.
○ It is effective, permanent, safe, simple and an out-patient procedure. It has no
known long term side effects or health risks. It offers no protection against STIs
including HIV.
○ The No-Scalpel Vasectomy (NSV) is a permanent method of contraception for men

in which the vas deferens (the tubes that serve as passageway of sperm) are tied and
cut or blocked through a small opening on the scrotal skin. This procedure is also
known as vasectomy.
○ Three months after the procedure, sperm is absent in the seminal fluid as a
result of the blocking of the vas deferens. Hence, no fertilization can occur.

○ It is effective, permanent, safe and simple, which can only be performed by a

trained service provider. It has no long term side effects or health risks. It does
not result in loss of sexual ability. It, however, does not provide protection
against STIs including HIV.
○ Barrier Methods
○ These are devices that mechanically prevent fertilization. It includes the male
condom (there is a female condom that is not yet available in the country), a thin
sheath of latex rubber made to fit a man’s erect penis. It creates a barrier that
keeps the semen and other body fluids from entering the vagina, anus or mouth.
○ It protects against the pregnancy and transmission of STIs including HIV.
○ Its effectiveness depends on the user. Risk of pregnancy or STIs is highest if it is

not used correctly and consistently during sexual intercourse.

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Sexually Transmitted Infections (STIs)

What are sexually transmitted infections?
Sexually transmitted infections (STIs) are infections passed primarily by sexual contact,
including vaginal, oral, and anal intercourse. A variety of different organisms may cause an
STI. Certain parasites such as pubic lice and scabies also may be transmitted by sexual
contact. STIs are part of a broader group of infections known as reproductive tract
infections, or Reproductive Tract Infections (RTIs).
Are these infections transmitted only through sex?

Some STIs can be transmitted by skin-to-skin contact. Some are transmitted through the
exchange of bodily fluids. Some can be passed to a baby before it is born, during childbirth,
or through breastfeeding.
What are the consequences of STIs?

STIs can have serious health consequences for men and women. Many common STIs are
difficult to detect among women, however, and some have more serious consequences for
women than for men. For example, the spread of chlamydia or gonorrhea to the upper
reproductive organs is a common cause of infertility among women. Infection with certain
STIs increases the likelihood of acquiring or transmitting HIV infection. Some, but not all,
STIs are curable. Others, such as HIV, are not. Early treatment eliminates or reduces the
consequences of most STIs.
How can people prevent acquiring or transmitting STIs?

• Find out if you have an STI by being tested by a health care provider.
• If you have an STI, obtain treatment, and notify all of your recent sex partners so that
they can also be tested.
• Find out whether your partner has an STI, and if so, make sure that he or she is
tested and treated.
• Talk with your partner about ways to be sexually intimate that do not involve the
risk of transmitting an infection.
• Use male or female condoms and avoid sexual contact that allows transmission of an
infection. Condoms protect against most STIs (including HIV). They do not protect
against all STIs.
• Obtain a vaccination for those STIs that can be prevented. At the present time, a
vaccine exists for hepatitis B and human papilloma virus (HPV).

When should a person obtain an STI test?

A person is at risk of acquiring an STI and should be tested if he or she has one or more of
the following:
• symptoms of an STI;
• a sex partner who has an STI, or who has signs of an STI;
• more than one sexual partner;
• a new partner in the past three months;
• a partner who has or may have other sex partners; and
• a partner who lives elsewhere or travels often.
Early testing is important. A person diagnosed with an STI can obtain treatment and can
help their recent partners to be tested as well. A couple should not resume sexual activity
until both partners have been tested and have completed any necessary treatment. Because
some STIs do not show up in test results right away, a repeat test may be necessary.

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Types of STIs
Note: This information may change in response to new research, testing, and treatment
approaches. For updates and additional information see www.who.int/topics/sexually_
transmitted infections/en/.
Symptoms for Symptoms for Is there a

STI Women Men Can it be cured? vaccine?
Chancroid Painful sores on Painful sores on Yes No
the genitalia; the genitalia;
swollen lymph swollen lymph
nodes on the nodes on the
groin. Women groin.
are often
asymptomatic.
Chlamydia Most women are Often Yes. Left untreated, it No
asymptomatic. asymptomatic. can lead to pelvic
Women who do Men with inflammatory
have symptoms symptoms may disease (PID) among
might have have a pus-like women, which may
abnormal vaginal discharge from lead to infertility.
discharge or a their penis or Complications
burning burning among men are rare.
sensation when sensation when
urinating. urinating.
Gonorrhea Most women are Men often Yes. Left untreated, it No
asymptomatic; experience can lead to PID
abnormal vaginal discharge or among women, and
discharge or burning when may lead to
burning urinating. Some infertility among
sensation when men have no both women and
urinating. symptoms. men.


Hepatitis B Some people experience flu-like Although no Yes
symptoms, jaundice, and dark- medicine has been
colored urine; others experience no found that cures
symptoms. hepatitis B, in many
cases the body clears
the infection by
itself. Occasionally it
develops into a
chronic liver illness.
Small children and
infants are at a much
greater risk of
becoming chronically
infected.
Herpes Recurrent episodes of painful sores No, but symptoms No
on genitals or anus. can be controlled
through treatment.
HIV (human HIV generally has no symptoms in No, AIDS is a chronic, No

immuno- its early stages. HIV usually leads to ultimately fatal
deficiency AIDS. People with AIDS may suffer disease, but
virus) various infections, cancers, and treatment
other life-threatening ailments. (antiretroviral
therapy)
dramatically slows
the progress of the
disease.

SHAPE

Human HPV can be asymptomatic. Some No, but symptoms Yes.
papilloma virus strains cause genital warts. Others can be controlled HPV vaccines
(HPV) cause cancer. This includes head, through treatment. can protect both
males and
neck, and anal cancer; penile cancer Some cancers
females against
in men; and — most commonly — secondary to HPV many strains of
cervical cancer in women. are treatable. the virus.
Syphilis Begins with one or more painless Yes, if treated in its No

sores on the genitals, rectum, or early stages. Without
mouth. The second stage may treatment, infection
produce skin rashes, lesions on remains in the body.
mucus membranes, fever, and THe late stage of
malaise. The latent stage begins syphilis includes
when these symptoms go away. damage tointernal
organs and can be
fatal.
Trichomoniasis Women may Men are usually Yes No
(trichomonas experience asymptomatic;
or trich) frothy, yellow- sometimes mild
green vaginal discharge or
discharge with a slight burning
strong odor. May with urination or
also cause itching ejaculation.
or discomfort
during
intercourse and
urination.

FACT SHEET FACT SHEET 11 (for Session 1.3.)
HIV (Human Immunodeficiency Virus)

and AIDS (Acquired Immune Deficiency Syndrome)
What is the difference between HIV and AIDS?

HIV (human immunodeficiency virus) is a virus that attacks and breaks down a person’s
immune system. When the immune system becomes weak from HIV, the body can no longer
fight off illness and may develop serious, often life-threatening, infections and cancers. This
condition is known as AIDS (acquired immune deficiency syndrome). People with HIV may
also be diagnosed with AIDS if their blood tests show that their cells that fight diseases have
fallen below the normal level.
How is HIV transmitted?

HIV is present in the bodily fluids of persons infected with the virus. A person who is HIV
positive can pass the virus to others through their semen (including the pre-ejaculate),
vaginal secretions, breastmilk, or blood. The virus is most commonly transmitted through
the exchange of semen and vaginal secretions during sex. HIV is transmitted not only
through vaginal or anal sex between a man and a woman; it can also be transmitted through
anal sex between two men. Having a sexually transmitted infection can increase the risk of
acquiring or passing HIV during sex. HIV can also be passed to others by transfusion of
infected blood or by sharing needles with an infected individual for drug or steroid use,
body piercing, or tattooing. HIV can also be passed from an HIV-positive mother to her baby
during pregnancy, delivery, or breastfeeding. Oral sex also carries some risk for HIV
transmission.
Although using contaminated instruments during manicures, pedicures, or shaving may

carry a risk of infection, HIV transmission through these routes is highly unlikely. HIV
cannot be transmitted by touching, kissing, sneezing, coughing, or by sharing food, drink, or
utensils, or through everyday contact at work, school, or home. It is not transmitted by
using swimming pools, public toilets, or through insect bites. HIV cannot be transmitted by
saliva, tears or sweat. Urine and feces do not transmit HIV if they do not contain blood.

SHAPE
How can HIV be prevented?

Currently no vaccine or cure for HIV has been developed, so prevention is essential. Sexual
transmission can be prevented by abstaining from unprotected sexual intercourse or by
using male or female condoms for every instance of intercourse. Another approach to
prevention is to confine oneself to a single sex partner, that is, to be “faithful” or
monogamous. This approach works only if both partners are truly monogamous and if both
partners are HIV negative. Unfortunately, many people are unaware that they — or their
partner — are already infected with HIV; the only way to be certain is to be tested for HIV.
Moreover, no one can guarantee that his or her partner will never have another sex partner.
For these reasons, the “be faithful” approach carries risks for many people. For men,
circumcision offers some protection against HIV, but it does not eliminate the risk of
infection. For women there are currently no known direct benefits of male circumcision.
Therefore, circumcised males should still use condoms.
Needle transmission from sharing an infected needle can also be prevented by using only
new or sterile needles for all injections or skin piercing.
Mother-to-child transmission — Pregnant women should always be tested for HIV. HIV
positive pregnant women can take preventive medicines to reduce the chance that their
baby will be infected with HIV during pregnancy and birth. Transmission of the virus from
mother to baby can also occur after delivery through breastfeeding. HIV-positive mothers
must seek the advice of a health care provider in order to prevent transmission of the
infection during pregnancy and delivery, and also to learn appropriate feeding options for
their newborn.
Can HIV infection be cured or treated?

HIV infection cannot be cured, but it can be treated. The current treatment for HIV is called
antiretroviral therapy (ART). ART is a combination of drugs that reduces the level of HIV
virus in the blood and slows down the destruction of the immune system. ART has
improved the quality and length of life for many individuals with HIV. These drugs also
reduce illness and death due to AIDS, the most advanced stage of HIV. Not all people
respond equally to the drugs. Without treatment, however, a person infected with HIV
generally progresses to AIDS within one to ten years of becoming infected. Without
treatment, a person with AIDS may live less than a year.

How can a person know if he or she — or his or her sex partner — has
HIV?
The only way to know if you have been infected with HIV is to take an HIV test. The only
way to know if your sex partner is HIV-positive is if he or she takes an HIV test and shares
the result with you. Millions of people who are HIV-positive feel and look completely
healthy; they have no symptoms, and have no idea that they are passing the virus to others.
The HIV test detects special cells (called HIV antibodies) that are present if the person is
infected. Tests can usually detect HIV antibodies within six to eight weeks of exposure. In
rare cases, it may take as long as six months for the antibody level to be detected by a test.
A positive HIV test means that the person has HIV antibodies and is infected with the virus.
If the first test is positive, a second, different test is conducted to confirm the results.
A negative HIV test means that the person is not infected with HIV. Or it may mean that he
or she is infected but has not yet made enough HIV antibodies to test positive. Someone
who tests HIV-negative but suspects that he or she was recently exposed to the virus should
take the test again in a few months.
Why should people be tested for HIV?

Being tested for HIV is important for many reasons. Obtaining a negative test result can
bring enormous relief to a person. It can also encourage that person to practice safer sexual
behavior in the future. Those who test HIV-positive can begin to seek care and treatment.
Treatment can improve the quality of life and significantly prolong the life of an HIV-
positive person. Those who are tested can also inform and protect their sex partners. For a
woman who is — or would like to become — pregnant, knowing her HIV status is important
so that she can take action, if necessary, to reduce the risk of transmission to her baby.

SHAPE
What support do people living with HIV and AIDS need?

When people find out that they are HIV-positive, they may feel frightened, confused, and
depressed. Being infected with HIV is life-changing, and it takes time to adjust to the
knowledge. People living with HIV need a strong emotional support system, which may
include parents, their spouse or partners, other family members, friends, counselors, social
workers, other people living with HIV and AIDS, or religious or spiritual leaders.
They need to find a doctor who is caring, respectful, and knowledgeable about HIV and
AIDS, and to have access to medical treatment when they need it. They need to learn as
much as possible about HIV and AIDS, and how to protect their own health and that of their
sex partners. To stay as healthy as possible, they need to eat well, exercise regularly, rest
adequately, avoid smoking and drinking too much alcohol, and avoid using recreational
drugs. Most important, by always practicing safe sex, they can protect themselves from
other sexually transmitted infections and avoid infecting others with HIV.

References
Adapted from the “Proposed Philippine Standards by Core Topics and Grade Level,”
Comprehensive Sexuality Education Standards for the Philippines: A Proposal for
Policy Makers. Likhaan Center for Women’s Health (LIKHAAN). 2016: 47-52.
The Population Council, Inc. It’s All One Curriculum: Activities and Guidelines for a Unified
Approach to Sexuality, Gender, HIV and Human Rights Education. 2009.
International HIV and AIDS Alliance (IHHA). 100 ways to Energize Groups: Games to use in
Workshops, Meetings and the Community. International HIV and AIDS Alliance:
London, 2002.
Approach to Sexuality, Gender, HIV and Human Rights Education. 2009; Family Health
International (FHI). My Changing Body: Fertility Awareness for Young People.
Institute for Reproductive Health of Georgetown University and Family Health
International in collaboration with Elisa Knebel, 2003; Always Changing: A Co-Ed
Puberty Education Guide for Grades 5 and 6 at
http://www.phecanada.ca/alwayschanging.
World Health Organization (WHO). Orientation Programme on Adolescent Health for

Health-care Providers: Facilitator Guide New Modules. 2006.
Approach to Sexuality, Gender, HIV and Human Rights Education. 2009; National
Population Commission (POPCOM) . SHAPE Modules. 199_.
Approach to Sexuality, Gender, HIV and Human Rights Education. 2009.
ENDNOTES
1
Adapted from the “Proposed Philippine Standards by Core Topics and Grade Level,”
Comprehensive Sexuality Education Standards for the Philippines: A Proposal for Policy Makers.
Likhaan Center for Women’s Health (LIKHAAN). 2016: 47-52.
International HIV and AIDS Alliance (IHHA). 100 ways to Energize Groups: Games to use in
ii
Workshops, Meetings and the Community. International HIV and AIDS Alliance: London, 2002.
iii
HIV/AIDS and ART Registry-Philippines

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SHAPE

Puberty signals the beginning of adolescence. It refers to the physiological or bodily

At the end of this module, participants are able to:

Knowledge Attitude Self-Efficacy

Knowledge Attitude Self-Efficacy

towards bodily males and females • paper

• Express positive • Envelope

Discuss the following opening messages:

2. This module has four sessions:

● In Session 1.4 (SEXUALLY TRANSMITTED INFECTIONS), we will deal with STIs

ACTIVITY. Opinion Poll

3. Let all participants stand at the center of the room.

4. Instruct them to express their agreement or disagreement to each statement that

7. Read the following statements:

Statements Agree Neutral Disagree

g. Adolescent males are not at risk of any health

h. Adolescents engaging in sexual activities for the

At the end of the session, participants are able to:

1. Describe the physical changes of adolescence.

2. Show positive attitude towards bodily changes at puberty.

3. Acknowledge and respect differences in physical appearance.

4. Recognize diversity in the rate of physical maturation and development.

Time Allotment Materials Needed Methodology

OPENING ACTIVITY. Body Mapping

1. Introduce the activity:

b. What does “pagbibinata” and “pagdadalaga” really mean?

3. Ask each group to:

c. Present their output (“body map”) in the big group.

d. What have you realized from the activity?

5. Link the discussion with the key messages.

• The growth of your body from childhood to adulthood is known as puberty.

Primary School Adolescence

Primary School Adolescence

b. How does puberty start?

• When does puberty start?

○ The start of puberty is influenced by genes inherited from biological

Changes in Boys Changes in Girls Changes in Both

Changes in Boys Changes in Girls Changes in Both

5. Most girls start to have menstruation or monthly period.

a. Beginning menstruation or “having a period” is one of the most significant

c. It is normal for young women to have an irregular pattern of menstrual cycles

6. Boys begin to have erections and wet dreams or nocturnal ejaculation.

7. Physical maturity is different from emotional maturity. While your reproductive

8. What can be done to have an enjoyable and healthy puberty?

b. Puberty is a time of rapid physical growth, so taking care of the body is

d. Consult experts when experiencing unusual changes in your body.

9. Synthesis of the key messages:

b. Adolescents undergo puberty at different paces or speed. You have different

e. Make puberty an exciting time for all of you.

CLOSING ACTIVITY. Pass the Rhythmii

1. Instruct participants to:

5. As a final message, say:

6. Thank everyone for their cooperation and active participation.

FURTHER READINGS FOR FACILITATORS

 FACT SHEETS on (Page 68-71)

At the end of the session, participants are able to:

1. Identify sexual and reproductive organs and describe their functions.

2. Discuss how puberty prepares the human body for reproduction.

3. Identify fertile and infertile periods of males and females.

Time Allotment Materials Needed Methodology

OPENING ACTIVITY. Label the Parts

1. Introduce the activity:

4. Instruct groups to: