Tag: reproductive

  • Billions worldwide living with herpes

    Billions worldwide living with herpes

    About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show, highlighting the need to improve awareness and scale up services to prevent and treat herpes.

    About 13% of the world’s population aged 15 to 49 years were living with herpes simplex virus type 2 (HSV-2) infection in 2016, the latest year for which data is available.  HSV-2 is almost exclusively sexually transmitted, causing genital herpes. Infection can lead to recurring, often painful, genital sores in up to a third of people infected.

    Herpes simplex virus type 1 (HSV-1) is mainly transmitted by oral to oral contact to cause oral herpes infection – sometimes leading to painful sores in or around the mouth (“cold sores”). However, HSV-1 can also be transmitted to the genital area through oral sex, causing genital herpes.

    Around 67% of the world’s population aged 0 to 49 had HSV-1 infection in 2016 – an estimated 3.7 billion people. Most of these infections were oral; however, between 122 million to 192 million people were estimated to have genital HSV-1
    infection.

    Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive
    health” says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at the World Health Organization (WHO). 

    Herpes and HIV

    People with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. Thus, HSV-2 likely plays a substantial role in the spread of HIV globally. Women are more susceptible to both HSV-2 and HIV. Women living in
    the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection.

    No cure: vaccine needed

    There is no cure for herpes. Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

    Better awareness, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. In addition, development of better treatment and prevention interventions is needed, particularly
    HSV vaccines.  

    “A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
    and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

    Authored by staff at the University of Bristol, the WHO, and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization, this new study estimates the global infection prevalence and incidence of HSV-1 and HSV-2
    in 2016. 

    Billions worldwide living with herpes
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  • Massive proportion of world’s population are living with herpes infection

    Massive proportion of world’s population are living with herpes infection

    Virus causing genital herpes may put millions of people at greater risk of infection with HIV

    About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

    Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
    the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016. 

    “Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
    Officer at WHO and an author of the study.

    Prevalence and incidence

    An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
    herpes).

    An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
    HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
    HSV-1 infection, depending on the assumptions used in the estimation model.

    Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

    Health and social impacts

    Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

    When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease. 

    WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
    HSV-2, which can recur frequently over many years.

    Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

    “Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
    says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO. 

    Herpes and HIV

    A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
    infections in 2016 worldwide were likely attributable to HSV-2 infection (2). 

    Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
    In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

    Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
    and well-being. 

    For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent. 

    Neonatal herpes

    Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
    for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

    No cure – better treatment and prevention needed

    There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

    As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

    In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
    the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

    “A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
    and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

    Related publications

    WHO guidelines for the treatment of Genital Herpes Simplex Virus

    WHO preferred product characteristics for herpes simplex virus vaccines

     

    ———————-

    (1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

    (2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

    Massive proportion of world’s population are living with herpes infection
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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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  • PHYSIOLOGY OF THE FEMALE SEX ORGANISM

    PHYSIOLOGY OF THE FEMALE SEX ORGANISM

    In the preceding lesson you have been shown “just what” each one of the sex organs of the woman is. In the present lesson you will be shown “just what” each of these organs does—what its functions and offices are. The preceding lesson dealt with the anatomy of these organs; the present lesson will deal with the physiology thereof.

    Beginning with the Ovaries, the fundamental and basic sex organs of the woman, you will have explained to you the wonderful processes performed by each of these organs in turn.

    The Ovaries. The Ovaries in the woman are akin to the testicles in the man. Without the Ovaries there would be no ova or eggs, and without the ova there would be possible no reproductive purposes, and therefore no office for the sex organs at all, for reproduction is the fundamental office, function, and purpose of the entire sexual organism.

    In our consideration of the office, purposes, and functions of the Ovaries, however, we must not overlook a certain secondary phase of such functioning. While it is true that the primary purpose of both the testicles of the male, and the Ovaries of the female, is that of providing seed from which the offspring of the individual may be produced, it is likewise true that there exists a secondary purpose which may be called the “individual” purpose as contrasted with the “racial” and primary one.

    This secondary or “individual” purpose of the Ovaries is that of manufacturing certain secretions which are absorbed by the blood of the woman, and which play an important part in her physical and mental well-being and activities. These secretions begin before puberty in the woman, and continue after her menopause; whereas the manufacture of the ova begins only at puberty, and ceases with the menopause, keeping pace with the manifestation of menstruation in its beginning and its ending.

    Nature provides these chemical secretions from the Ovaries for the purpose of giving the woman her characteristic physical form and contour, her form, her breasts, her long hair, her broad pelvis, her soft voice, and other secondary sex characteristics; and also of providing for the normal development of the other sex organs. As a proof of this statement, science shows us that if a woman’s ovaries are completely removed there is usually a consequent atrophy or “drying up” of the Uterus and the Vagina, and often even of the Vulva. Moreover, the presence of this internal secretion manifests in arousing and maintaining in the woman her normal sexual desire, and her normal pleasure in the company of her mate; it being noted that if the ovaries are removed, particularly in early life, the woman is apt to lose all sexual desire and normal womanly feeling toward the other sex. And, finally, these secretions make for general physical and mental health and well-being in the woman, and contribute to her vivacity, energy, and activity in all directions. As writers on the subject have well pointed out, this is the reason that capable surgeons usually try to leave at least a portion of the Ovaries when performing an operation for the removal of those organs on account of diseased condition.

    The Ovum. The Ovum, or human egg, is a small spherical body, measuring from one two-hundred-and-fortieth to one one-hundred-and-twentieth of an inch in diameter. It has a colorless transparent envelope, the latter enclosing the yolk which consists of granules or globules of various sizes embedded in a viscid fluid. In the center of the yolk is found a very small vesicular body consisting of a tenuous transparent membrane, which is known as “the germinal vesicle;” this, in turn, contains a very tiny granular structure, opaque, of yellow color, known as “the germinal spot.”

    When the time is reached in which the ovum or egg is to be discharged, the Graafian follicle becomes enlarged by reason of the accumulation of the fluids in its interior, and exerts such a steady and increasing pressure from within, outward, that the surrounding tissue yields to it, and it finally protrudes from the Ovary, from whence it is then expelled with a gush, owing to the elasticity and reaction of the neighboring tissues.

    Following this rupture there occurs an abundant hemorrhage from the vesicles of the follicle, the cavity being filled with blood, which then coagulates and is retained in the Graafian follicle. The formation and development of the Graafian follicle begins at puberty and continues until the menopause or “change of life” of the woman. Many follicles are produced, but many do not produce ova, and so gradually atrophy. The ripening and discharge of the eggs produce a peculiar condition of congestion of the entire female sexual organism, including the Fallopian Tubes, the Uterus, the Vagina, and even of the Vulva, which results in a condition of Sexual Excitement. Among the lower animals the female will allow the male to approach her for copulation only at this period, this being the time when the egg is ready for fertilization.

    When the female infant is born, her Ovaries contain the germs of about 100,000 ova. The greater portion of these, however, disappear, until at the time of her puberty the number of germs of ova contains only about 30,000 ova. This number is far more than the woman will ever need, and is Nature’s provision against diseased portions of the Ovaries, accidents, etc. Only one ovum ripens and matures each month from puberty until menopause, so that the woman really requires only about 300 to 350 ova on the average. This liberality on the part of Nature, however, does not begin to approach her lavishness in the case of seed of the male, for in his case while only one spermatozoon is required to fertilize an ovum (and in fact only one is permitted to do so), we find that in each normal act of ejaculation of semen by the male over 250,000 spermatozoa are projected.

    The ripening and discharge of the egg from the Ovaries, and the consequent congestion above referred to, accompanied by what is called Menstruation, occurs regularly each lunar month (28 days). What is called Ovulation consists of the monthly maturing and expulsion of the ripe ovum or egg, while Menstruation (as we shall see later on) consists of the monthly discharge of blood and mucus from the inner surface of the Uterus; the two processes occur in connection with each other, yet neither can be considered as the cause of the other.

    Menstruation. It may be well to call your attention at this point to the process known as Menstruation, or “the monthly flow,” or “the courses” of women. Menstruation is the monthly flow of bloody fluid which occurs in all healthy (non-pregnant) women from puberty to the menopause or “change of life.”

    By “Puberty” is meant the age at which a woman begins her period of possible child-bearing experience. In temperate climates the average age of puberty is about fourteen years, while in tropical countries it is often a year or so earlier, and in arctic countries a year or so later. The time, however, depends materially upon the temperament, race, hygiene, and general environment of the individual girl. At this period the girl gradually changes into the young woman. Her figure changes, her bust develops, her hips broaden, and her mental and emotional nature undergoes a change. Also the menstrual flow begins to manifest at this time; at first scanty and irregular, but gradually changing into the characteristic flow each month.

    At the period of puberty, the girl undergoes marked emotional changes. She becomes very “emotional” as a rule, and quite “sensitive.” She becomes filled with strange, unaccountable longings, ideas, and “notions.” She usually manifests a great emotional interest in her girl friends, and often manifests marked jealousy in connection with these friendships. The girl is apt to indulge in day-dreaming at this period, and becomes quite romantic and “flighty.” She devours love stories, and delights in imagining herself as the heroine of similar adventures. The period from the beginning of puberty to that of the attainment of full sexual maturity is known as the period of “adolescence,” and generally extends to about the age of eighteen in the case of girls.

    By the Menopause is meant that period of the woman’s “change of life,” the average time of which is about the age of forty-five years, although this varies greatly in different individuals. As a rule, it is held that the period of the woman’s child-bearing possibility extends over an average period of thirty years. At the Menopause the woman’s reproductive activity declines and finally ends. The Ovaries diminish in size, the Graafian follicles cease to form and develop; the Fallopian Tubes atrophy; and there occur other physical, mental, and emotional changes in the woman. While the age of forty-five is held to be the average age at which the Menopause occurs in women, still it is not at all uncommon to find women who menstruate regularly up to the age of fifty, or fifty-two, or even fifty-five, while a large number of women menstruate regularly at the age of forty-eight.

    Some women undergo little or no physical or emotional disturbance at the time of the Menopause. In such cases their periods become more or less irregular, with extending intervals between periods; the flow becomes more and more scanty; then several periods are skipped altogether; and finally the periods cease entirely. Other women, however, experience more or less physical disturbance during the years of the “change.” They sometimes experience loss of appetite, or a capricious appetite, headaches, loss of weight, or else a sudden taking on of fatty tissue. They often become quite irritable and “notiony,” and often become quarrelsome and pugnacious, and in some cases manifest unreasonable jealousy. But, in the opinion of many of the best authorities, much of this trouble comes from the mental expectancy of them by the woman, resulting from the notion that a woman must have these things happen to her. The power of the mind over the body is now well known, and we have here another instance of its effect. The remedy is obvious.

    Another matter which disturbs the woman at this time, in many cases, is the common belief that after “the change” she will lose all of her sex attractiveness, and her sexual feelings, etc. This is a grave error, for the experience of all observing physicians is that no such results follow this period of the woman’s life. Many women become even more attractive to the other sex after this time, by reason of acquiring a certain maturity and “ripeness” which proves very attractive to many men—often to young men as well as older ones. Moreover, the sexual desires do not cease with the cessation of the reproductive functions. On the contrary, it often happens that such emotions and desires are increased in the woman at, and after, this time of her life. So true is this that this period has been called “The Dangerous Age” for women, and the experience of many a woman of forty-five to fifty will corroborate this statement. The woman at this time should beware of contracting unwise love affairs and entanglements, and of yielding to impulses toward men other than her mate. A word to the wise should be sufficient in this case.

    To return to the main subject of Menstruation, it may be said that the monthly flow, when once established, occurs at intervals of every twenty-eight days, on the average, although in some individual cases it occurs as often as every twenty-one days, while in others it occurs as seldom as once in every six weeks, all without exceeding the bounds of normal functioning. Menstruation ceases temporarily during pregnancy, in normal cases, and often also ceases during the period of lactation or nursing. The menstrual period lasts on an average for four or five days, the flow increasing for the first half of the period, and decreasing during the last half. At the beginning of the period there is often manifested a general congestion of all of the sexual organs of the woman, and often of the breasts as well. There is also usually found a sense of physical discomfort, from which more or less irritable feeling arises. In rare cases there are found severe cramps and pains, and in some cases the woman finds it necessary to call in medical aid, or to go to bed, or both. In such cases a cure is often worked by improving the general health, and by observing common sense hygienic rules.

    Menstruation is caused by a hypertrophy of the mucus membrane of inner surface of the Uterus, which is followed by a shedding of the hypertrophied membrane. This leaves exposed the underlying vessels, which bleed. New mucus membrane is formed after the period. The menstrual flow consists of a thin, bloody fluid, having peculiar odor, in which is combined blood, thin skin, and mucus membrane, and also mucus from the Uterus and the Vagina, the blood being light in consistency and not clotted.

    During the menstrual period the ovum, or egg, is discharged, and enters the Uterus, as we shall see presently.

    The Life-History of the Ovum. The physiology of the remaining sexual organs of the woman may perhaps best be studied by considering the story of the Life-History of the Ovum, or human egg, for the functions of such organs are concerned with such life-history of the egg, and really exist merely to create such a history, or rather, to produce the process which constitutes the basis of such history.

    The ovum, or egg, when discharged from the ovary, is at first surrounded by a few cells which serve as nourishment, but which soon disappear. It enters the Fallopian Tube and begins its journey toward the Uterus, being urged on its way by the constant movement of the lining-cells of the interior of the tube, in the direction of the Uterus. Certain changes in structure occur. Its passage to the Uterus may be interrupted, and the ovum lost and finally cast off. But the ovum that is successful finally arrives at the Uterus where it awaits impregnation or fertilization by the spermatozoon of the male.

    If copulation occurs within a reasonable time after the arrival of the ovum, it is impregnated or fertilized. Fecundation results and conception ensues, the ovum then remaining attached to the walls of the Uterus, and in time develops into the foetus. If, however, the ovum is not impregnated, because of absence of copulation or from other causes, it gradually loses its vitality, and is finally cast off with the several uterine secretions.

    It should be explained here that the “spermatozoon” of the male (the plural of the term is “spermatozoa”) is the male generative “seed.” The sperum, semen, or seminal fluid of the male is filled with hundreds of thousands of spermatozoa. Each spermatozoon is a minute living, moving creature, resembling a microscopic tadpole. It has a head, a rod-like body, and a thin hair-like tail, the latter being kept in constant motion from side to side, by means of which the tiny creature is enabled to travel rapidly from one point to another. The human spermatozoon measures about one six-hundredth of an inch in length. It is composed of protoplasm, the substance of which all living creatures are composed. The spermatozoa are believed to be developed from a parent sperm-cell, by the process of segmentation or subdivision, which process is common to all cell-life. The numerous spermatozoa dwell in a gelatinous substance, which, mingling with the other fluidic secretions of the glands of the male, constitutes the male seminal fluid, sperm, or semen, which is ejaculated by the male during the process of copulation.

    Fecundation (i. e. fertilization, impregnation; the process by which the male reproductive element is brought in contact with the female ovum or egg) is brought about by the blending of the male reproductive element (or spermatozoon) with the female reproductive element (or ovum, or egg). This blending is of course accomplished by the bringing together in mutual contact the two reproductive elements just mentioned. The sexual act which results in this “bringing together” of the two elements is known as “copulation,” or “coition.” In copulation or coition the seminal fluid of the male, containing an enormous number of spermatozoa, is ejaculated from the male intromittent organ into the receptive canal or channel of the female (the Vagina), and in this way finally comes into actual contact with the female ovum or egg which is awaiting it in the Uterus of the female.

    The spermatozoa (in the process of copulation) are deposited in the Vagina of the female, usually at its upper end, but sometimes in the lower portion; and in rare andpeculiar cases even at or about the Vaginal Orifice or outer vaginal opening. In either case they travel up the remaining portion of the Vagina and finally enter the Uterus or womb. The spermatozoa possess wonderful vitality and power of locomotion. There are cases recorded in which the spermatozoa deposited on or about the outer female genitals have managed to travel inward and upward until they have finally reached the Uterus, where conception has resulted. Such cases, of course, are rare, but they exist, well authenticated and accepted by medical science as facts.

    It must not be supposed, however, that the impregnation of the ovum occurs only in the womb proper. Cases are known in which the spermatozoa have traveled along the Fallopian Tubes and impregnated the ovum there; and in very rare cases the spermatozoon seems to have penetrated even to the Ovary itself, and there impregnated the ovum on the surface of the Ovary. Some excellent authorities, in fact, insist that all normal impregnation occurs at the end of the Fallopian Tube—the point of its entrance into the upper part of the womb, rather than in the body of the womb, or at its mouth, as the older authorities taught. But wherever the actual contact of spermatozoon and ovum occurs, the blending of the elements is performed and fertilization, impregnation, or fecundation is accomplished.

    As a result of copulation, then, the spermatozoon (or a number of spermatozoa) comes in contact with the female ovum or egg. Then one or more of them, by means of a furious lashing of the tiny tail, manages to penetrate the outer covering of the ovum, and enters the space between the outer covering and the real body of the egg. Several spermatozoa may effect an entrance into this outer space, but only one is permitted to enter the real body of the egg. [Twins are produced by the impregnation of two ova by two spermatozoa, at the same time. The presence of the two ova at the same time is unusual]. The moment that the real body of the ovum is penetrated by the successful spermatozoon, a tough covering or thick membrane forms around the ovum and thus prevents the entrance of other spermatozoa. The successful spermatozoon then loses its tail, and the remaining head and body become what is known as “the male pronucleus.”

    The authorities are uncertain as to the exact nature of the change which occurs when the ovum is penetrated by the spermatozoon. The outward manifestations of the change and transformation arising from the blending of the male and female elements are of course well known, but the “life process” eludes the power of the microscope. When Nature forms the thick membranous coating over the impregnated ovum, she draws the veil over one of her most important secrets. The first segmentation-nucleus having been formed by the blending and forging together of the male and female pronuclei, the process of segmentation begins.

    Segmentation proceeds as follows: the impregnated egg splits into halves, forming two joined cells; then into quarters, forming four joined cells; then into sixteenths, then into thirty-seconds, sixty-fourths, and so on, until the ovum consists of a combined mass of very minute granular-like cells, the whole resembling a mulberry. The segmentation of the nucleus precedes and then continues with the segmentation of the yolk. After the egg has been divided into a great number of these cells, the latter begin a centrifugal action resulting in the formation of a complete inner lining of closely packed cells, with a central cavity filled with the yolk liquid.

    In the meantime, the Uterus has been prepared for the reception of the impregnated and transformed ovum. A thick, spongy, juicy, mucus membrane forms, into whichthe changing ovum passes and attaches itself; the mucus membrane soon enveloping it and shutting it off from the rest of the Uterus. There now appears at one point on the ovum an opaque streak, which is called “the primitive trace” of the embryo—the first beginning of the young living creature. The “primitive trace” then grows in length and breadth. At this point we must leave the history of the ovum, or human egg, for the present; its further development will be related in the succeeding lesson, the subject of which is “Gestation.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • Glossary of Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

    Glossary of Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

    GLOSSARY

    AGAMIC. Unmarried; unmarriageable, sometimes non-sexed.

    AGENIC. Lacking in reproductive power; sterile.

    AMPHIMIXIS. That form of reproduction which involves the mingling of substance from two individuals so as to effect a mixture of hereditary characteristics. It includes the phenomena of conjugation and fertilization among both unicellular and multicellular organisms.

    ANABOLISM. See METABOLISM.

    ANAMNESIC. Pertaining to or aiding recollection.

    ANEMIC. Deficient in blood; bloodless.

    ANTHROPOMORPHISM. The attributing of human characteristics to natural, supernatural, or divine beings.

    ANTHROPOMETRY. Science of measurement of the human body.

    ARTIFACT. Any artificial product.

    APHASIA. Impairment or lose of the ability to understand or use speech.

    ASSOCIATIONISM. The psychological theory which regards the laws of association as the fundamental laws of mental action and development.

    ATAVISTIC. Pertaining to reversion through the influence of heredity to remote ancestral characteristics.

    ATAXIC. Pertaining to inability to coördinate voluntary movements; irregular.

    CALAMO-PAPYRUS. Reed papyrus or pen-paper.

    CATABOLISM. See METABOLISM.

    CATHARSIS. Purgation or cleansing. Aristotle’s esthetic theory that little renders immune for much.

    CEREBRATION. Brain action, conscious or unconscious.

    CHOREA. St. Vitus’s dance; a nervous disease marked by irregular and involuntary movements of the limbs and face.

    CHRESTOMATHY. A collection of extracts and choice pieces.

    CHRISTENTHUM. The Christian belief; the spirit of Christianity.

    COMMANDO EXERCISES. Gymnastic exercises whose order is dependent upon the spoken command of the director.

    CORTEX. The gray matter of the brain, mostly on its surface.

    CORTICAL. Pertaining to the cortex.

    CRANIOMETRY. The measurement of skulls.

    CRYPTOGAMOUS. Having an obscure mode of fertilization; or, of plants that do not blossom.

    CULTUS. A system of religious belief and worship.

    DEUTSCHENTHUM. The spirit of the German people.

    DIATHESIS. A constitutional predisposition.

    EPHEBIC. Pertaining to the Greek system of instruction given to young men to fit them for citizenship; adolescent.

    EPIGONI. Successors; followers who only follow.

    EPISTEMOLOGY. The theory of knowledge; that branch of logic which undertakes to explain how knowledge is possible and to define its limitations, meaning, and worth.

    EUPEPTIC. Having good digestion.

    EUPHORIA. The sense of well-being; of fullness of life.

    EVIRATION. Emasculation; loss of manly characteristics.

    FERAL. Wild by nature; untamed; undomesticated.

    FORMICARY. An artificial ants’ nest.

    GEMÜTH. Disposition; the entire affective soul and its habitual state.

    HEBETUDE. Dullness; stupidity.

    HEDONISTIC. Relating to hedonism, that form of Greek philosophy which taught that pleasure is the chief end of existence.

    HETAERA. A Greek courtesan. This class was often highly trained in music and social art, and represented the highest grade of culture among Greek women.

    HETEROGENY. (1) The spontaneous generation of animals and vegetables, low in the scale of organization, from inorganic elements. (2) That kind of generation in which the parent, whether plant or animal, produces offspring differing in structure or habit from itself, but in which after one or more generations the original form reappears.

    HETERONOMOUS. Having a different name.

    HOROLOGY. The science of measuring time and of constructing instruments for that purpose.

    HYGEIA. The Greek goddess of health; health.

    HYPERMETHODIC. Methodic to excess; overmethodic.

    HYPERTROPHY. Excessive growth.

    INDISCERPTIBLE. Incapable of being destroyed by separation of parts.

    INHIBITION. Interference with the normal result of a nervous excitement by an opposing force.

    IRRADIATION. The diffusion of nervous stimuli out of the path of normal discharge which, as a result of the excitation of a peripheral end organ may excite other central organs than those directly connected with it.

    KINESOLOGICAL. Pertaining to the science of tests and measurements of bodily strength.

    KINESOMETER. An instrument for measuring muscular strength.

    MEDULLATION. The investment of nerve fibers with a protective covering or medullary sheath, consisting of white, fat-like matter.

    MERISTIC. Pertaining to the levels or spinal and cerebral segments of the body.

    METABOLISM. The act or process by which, on the one hand, dead food is built up into living matter—anabolism, and by which, on the other, the living matter is broken down into simpler products within a cell or organism—catabolism.

    METAMORPHOSIS. Change of form or structure; transformation.

    METEMPSYCHOSIS. The doctrine of the transmigration of the soul from one body to another.

    MONOPHRASTIC. Pertaining to or consisting of a single phrase.

    MONOTECHNIC. Pertaining to a single art or craft.

    MORPHOLOGY. The science of form and structure of plants and animals without regard to function.

    MYOLOGY. The scientific knowledge of the muscular system.

    MYTHOPOEIC. Producing or having a tendency to produce myths.

    NOETIC. Of, pertaining to, or conceived by, mind.

    NUANCE. Slight shade; difference; distinction; degree.

    ORTHOGENIC. Pertaining to right beginning and development.

    ORTHOPEDIC. Relating to the art of curing deformities.

    OSSUARY. A depository of dry bones.

    PALEOPSYCHIC. Pertaining to the antiquity of the soul.

    PANTHEISTIC. Relating to that doctrine which holds that the entire phenomenal universe, including man and nature, is the ever-changing manifestation of God, who rises to self-consciousness and personality only in man.

    PATRISTICS. That department of study occupied with the doctrines and writings of the fathers of the Christian Church.

    PHOBIA. Excessive or morbid fear of anything.

    PHYLETICALLY. In accordance with the phylum or race; racially.

    PHYLETIC. Pertaining to a race or clan.

    PHYLOGENY. The history of the evolution of a species or group; tribal history; ancestral development as opposed to ontogeny or the development of the individual.

    PHYLUM. A term introduced by Haeckel to designate the great branches of the animal and vegetable kingdoms. Each phylum may include several classes.

    PICKELHAUBE. The spiked helmet of the German army.

    PLANKTON. Sea animals and plants collectively; distinguished from coast or bottom forms and floating in a great mass.

    POLYGAMIC (LOVE). Pertaining to the habit of having more than one mate of the opposite sex.

    POLYPHRASTIC. Having many phrases; pertaining to rambling, incoherent speech.

    POST-SIMIAN. Pertaining to an age later than that in which simian or monkey-like forms prevailed.

    PRENUBILE. Pertaining to the age before sexual maturity or marriageability is reached.

    PRIE DIEU. A praying desk.

    PROPEDEUTIC. Preliminary; introductory.

    PROPHYLACTIC. Any medicine or measure efficacious in preventing disease.

    PSEUDOPHOBIAC. Pertaining to a morbid condition in which the subject is continually in fear of having said something not strictly true.

    PSYCHOGENESIS. The origin and development of soul.

    PSYCHONOMIC. Pertaining to the laws of mind.

    PSYCHOSIS. Mental constitution or condition; any change in consciousness, especially if abnormal.

    PUBERTY. The age of sexual maturity.

    PUBESCENT. Relating to the dawning of puberty.

    PYGMOID. Of pygmy size and form.

    RABULIST. A chronic wrangler; one who argues about everything.

    SCHEMA. A synopsis; a summary. In the Kantian sense, a general type.

    SCHEMATISM. An outline of any systematic arrangement; an outline.

    SUPERFOETATION. A second conception some time after a prior one, by which two foetuses of different age exist together in the same female. Often used figuratively.

    TEMIBILITY. (From Italian temibile, to be feared.) The principle of adjustment of penalty to crime in just that degree necessary to prevent a repetition of the criminal act.

    TIC. A nervous affection of the muscles; a twitching.

    TRANSCENDENTAL. In the Kantian system having an a priori character, transcending experience, presupposed in and necessary to experience.

    TRAUMATA. Wounds.

    TRAUMATISM. A wound; any morbid condition produced by wounds or other external violence.

    VERBIGERATION. The continual utterance of certain words or phrases at short intervals, without reference to their meaning, as seen in insane Gedankenflucht or rapid flight of thought.

    Extract from Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

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