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Time O For
a Training ModulTCU/DATA
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This module was developed as part of NIDA Grant
Drug Abuse Treatment for AIDS-Risk Reduction (D
The Time Out! For Me training module and data co
used for personal, educational, research, and /or inf
mission is hereby granted to reproduce and distribut
(except reprinted passages from copyrighted sourcesand nonprofit library purposes, provided that copies
costs and that credit for author, source, and copyrigh
copy. No material may be copied, downloaded, sto
redistributed for any commercial purpose without th
sion of Texas Christian University.
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Contents
Acknowledgments
PrefaceIntroduction
Sessions
1 A New Outlook on Sexualityseeks to to increase participants’ awareness and understanding
multidimensional nature of sexuality and to improve self-estee
2 My Personal Rights
explores the basic principles of effective communication and
allows participants the opportunity to rehearse using them
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Acknowledgments
As with all projects, many people have contributed their time,
the development of this manual. Special thanks to Charlotte P
layout and design of the manual; to Dianne Nixon for her illus
anatomy and physiology; to Jim Morgan with the American C
Division, for permission to adapt and reprint instructions for b
and to Peter Brownlie with Planned Parenthood of North Texareprint the FACTS Reference Manual. Thanks also to Caroly
involvement and suggestions during the initial field testing of
DATAR counselors Frances Feist, Lara Hulin, Victoria Hinoj
Pamela Vickers for their help in fine tuning the final draft.
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Preface
The TCU/DATAR project seeks to enhance drug abuse treatm
dropout and relapse rates. Innovative cognitive mapping techn
interventions have been developed for this project including: a
information curriculum; modules for contingency management
support training, and life skills enhancement; plus an assertiven
(Time Out! For Me). A central focus of the DATAR intervenHIV risk among injection drug users, in both sexual and needl
DATAR project is being conducted by the Institute of Behavio
Christian University, in collaboration with three treatment age
Christi, Dallas, and Houston) which provide methadone mainte
Women injection drug users and their children are the fastest g
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The Time Out! For Me manual uses a step by step format to g
Materials for producing handouts and overhead transparencies
manual, along with instructions for preparing flip charts. Acti
evaluation forms, and a pretest/posttest instrument are also inc
With the exception of abstinence, a woman’s ability to choose
always linked to her ability to communicate with her partner.
sexuality, inability to discuss sexual topics, and a failure to rec
are primary hurdles that must be overcome before she can hop
implement a safer sex strategy with a sexual partner. This man
the power and the skills necessary to begin such negotiations.
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1. Participants will identify components of a definition of sexuality.
2. Participants will examine their own comfo
sexual issues.
3. Participants will explore strategies and tech
Objectives
A New Outlook on Sexuality
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Session 1
Prepare BeforeClass
One sheet of flip chart
paper labeled:
GROUP GOALS
Underneath list the fourgoals as shown at right:
To gain moour lives
To increase
understandourselves
GROU
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Prepare Before
Class
WE WILL STICK TO THE TOPIC. Th
discuss medication or treatment issues. Pl
with medication or treatment and bring thecounselor after class.
WE WILL RESPECT CONFIDENTIAL
Group Agreement Group Agreement Group Agreement Group Agreement Group Agreement
Notes Notes Notes Notes Notes
Use the BOLD statements to construct the Gro
(p. 4); use the following italicized portions to c
during the opening discussion:
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Session 1
Make copies of the following materials for each
Client Opening (pretest; Appendix D, pp. 201
Sexuality Interview (p. 20)
“ E” is for Esteem (p. 21)
Session Evaluation (pp. 22-23)
On a piece of flip chart paper, reproduce the Dimen
chart, using magic markers of various colors. (See
may reproduce the model as illustrated, or you may
or circles to enclose the various aspects of sexualit
The discussion guide for this chart begins on page
Prepare Before
Class
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Procedure
Welcome participants as they arrive and ask th
Opening Survey (pretest).
Welcome members to the group. After everymembers to pick a partner. Each member shou
name, birthday and favorite food. Go around t
introduce each other. For example, “I’d like to
to the group. Virginia was born on July 4th an
chocolate.” Virginia would then introduce her
Introduce yourself in a similar manner. Use th
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Session 1
Use the next 5-10 minutes to work toward buildand a sense of safety in the group. Work with the
POINTS to build your opening discussion:
KEY POINT: We all deserve to be happy and
our sexuality and our relationships. This workshop
some ideas and information about getting what yousex and relationships. It’s a chance to share experi
think and talk about these topics.
KEY POINT: Unfortunately, most of us were
chance to learn about sex, love and relationships w
Schools parents and society in general are often re
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Thank the group for their openness and parknow you will be available after each meeting
questions or concerns they wish to discuss.
Distribute the Sexuality Interview handouts an
quickly read over them, but not to fill them
folders. Explain that the folders can be used ascontain materials for classes. Request that the
time. After a few minutes, ask participants to
that each person is to spend about 10 minutes i
then switch roles, and let the person who was i
questions of her partner. Encourage interview
responses. Give permission for people to “p
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Session 1
What are some requirements for a good relatio
you came up with?
Can you think of ways to make this interview b
more relevant?
Thank participants for their involvement in the
Acknowledge that talking about sexuality is difficu
Point out that the group just spent 30-45 minutes
and that no one fainted or died, so it is possible. T
DiscussionGuide
(continued from
previous page)
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Body Image
We have a “mind’s eye” image of our bodies.
we feel about our bodies, how we compare our
we like and dislike about our bodies, and how w
It’s a complex, mental photograph that reflects
rather our opinion of our body.
We learn or develop our body image from our the most part, women have more severe body i
men. Our society, via television and magazine
woman’s looks or attractiveness as her most va
slimness, and beauty are promoted as all that c
A negative body image can impact our self-est
Dimensions of
Sexuality
Discussion Guide
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Session 1
Sensuality/Eroticism
Sensuality refers to how our bodies and minds resp
other bodily sensations. Sensuality, in and of itself
sexual. For example, affectionate touching and ho
closeness and intimacy and not as a prelude to inter
domain of sensuality. Each person’s sensuality ma
different ways. A body massage, relaxing in a hot
your skin, a smell of a favorite perfume, the taste othese are all examples of sensual pleasures.
Eroticism refers to our thoughts of and feelings abo
desire. In a way, it is the sexual side of our sensua
sexual fantasies, genital sensations, images that enh
and just plain “horniness ” Eroticism has a broad s
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Discussion Points
Attraction ideals may be constant or they may mature. Even in the happiest of relationships,
attraction for others who fall within the spectru
course, feeling attracted to someone doesn’t m
to act on that attraction. We can acknowledge
part of our sexuality, and at the same time reali
over how we choose to behave.
What kind of person falls within your attrac
influenced the development of your ideal?
It’s been said that if you lined up all the parhave been involved you would find some s
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Session 1
Discussion Points
A New Outlook on Sexuality
What are your earliest recollections about wanHow many children did you think you wanted t
Do you believe there is such a thing as a “matabout a “paternal instinct”?
In what ways has birth control technology oveinfluenced women’s parenting choices?
Intimacy
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Sexual Identity
Our sexual identity begins to develop almost fr
“He’s a boy,” or “she’s a girl,” is usually the fi
told. Pink booties or blue booties follow, along
clothing, and types of interaction with parents
believed that sexual identity is formed by age f
are several components of sexual identity that
Gender: Gender is the biological component
describes whether a person is male or female, b
hormones.
Sexual Orientation: Sexual orientation devel
refers to how we form sexual and emotional at
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Session 1
Self-Esteem
Self-esteem refers to the feelings, beliefs, and perce
ourselves. It is, simply put, our own opinion of ou
self (self-image, self-concept or self-esteem) is lea
period of learning is during childhood and as we gr
we are male or female, and the values that our cultu
maleness and femaleness. We learn (through being
perceive us as being good/bad, sweet/mean, helpfugrouchy, smart/stupid. We learn that we are capab
unlovable, attractive/unattractive, worthy/unworthy
If in childhood and young adulthood we learned to
things about ourselves, then we are likely to have a
If on the other hand we were taught to believe har
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nergize yourself! At least once a day
which are positive healthy thoughts abo
word “I”, and learn to cherish it. “I am
“I am worthy and strong!”; “I can decide my ow
right to love and feel good about myself!”
tomp-out negative thoughts! Whenev
thought about yourself inside your head
to rebel against the tyranny of these ne
were most likely taught to you by others. If you
thoughts like: “I can’t do anything right,” or “I’
change ” stomp them out! Inside your head rep
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Session 1
Explain that another strategy for improving selpractice affirmations. Affirmations are positive,
or statements that we make to ourselves, about our
examples of affirmations: “I can accomplish what I
accomplishing”; “I like the color of my eyes.” Poi
affirmations can help us learn to contradict feelings
replace them with positive self-esteem messages.
Distribute sheets of paper and pencils, and ask e
write out at least 15 positive statements about h
write 5 about her body, 5 about her personality,
successes and accomplishments in life. Each sta
with the word “I.” Give examples as needed. All
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Encourage members to keep their lists and Encourage them also to add to their lists eac
often difficult for women in our society to give
say and think positive thoughts about themselv
were warned in childhood not to be “conceited
be “selfish.” Remind members that developing
healthy and good — not conceited or big heade
feel good about ourselves. Practicing affirmat
Thank the group for participating. Briefly g
ask each person to share one thing they liked a
from today’s lesson
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SEXUALITY INTERVIEW
(Use this form to interview your partner. Please jot down brief answers
put names on the papers. )
1. How comfortable do you feel talking about sex and relationships? (C
reflects your feelings.)
0 1 2 3 4Very Uncomfortable
2. What topics would you like to discuss or learn more about in this wor
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nergize yourself! At least once a day practice affirm
which are positive healthy thoughts about yourself.
word “I”, and learn to cherish it. “I am lovable and
“I am worthy and strong!”; “I can decide my own destiny!”;
right to love and feel good about myself!”
tomp-out negative thoughts! Whenever you hear a n
thought about yourself inside your head, stomp it ou
to rebel against the tyranny of these negative though
were most likely taught to you by others. If you hear yourself
thoughts like: “I can’t do anything right,” or “I’ll never be ab
change,” stomp them out! Inside your head, replace those th
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INSTRUCTIONS: Please answer the following questions based on what you le
Circle 1 (True) or 2 (False) after each statement.
SITE # |__|__| CLIENT ID# |__|__|__|__|__|__| DATE: |__|__||__|__||__|__|
[5-6] [7-12] MO DAY YR [13-18
THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
SESSION EVALUATION OF “TIME OUT! FO
SESSION 1
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INSTRUCTIONS: Please take a minute to give us some feedback about how you
1. Use one word to describe your feelings about this class. ___________________
2. What is the most important thing you learned today?
Time Out! For Me
Session 1 Evaluation
Page 2
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Session 2 My Personal Rights
STEPS FOR I-MESSAGES
Use two sheets of flip chart paper to print the steps
Prepare BeforeClass
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I-MESSAGE INTERACTION
Use two sheets of flip chart paper to write out
below:
Prepare Before
Class
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Session 2 My Personal Rights
Prepare Before
Class
TIPS FOR BETTER LISTENING
On a sheet of flip chart paper, list the followin
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Make copies of the following materials for e
My Personal Rights (p. 42)
I-Message vs. You-Message (p. 45)
What Is an I-Message? (p. 43)
What Does an I-Message Sound Like? (p
Tips for Better Listening (p. 47)
I-Message Worksheet (p. 48)
Steps for I-Messages (p. 46)Role Play Scripts (p. 36-37)
Role Play Situations (p. 39)
Session Evaluations (pp. 49-50)
Prepare Before
Class
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Session 2 My Personal Rights
Discussion
Guide
Ask members to share with the group a recent rthey may have experienced. List the gist of the re
are mentioned (for example: husband doesn’t listen
help with chores; friend always wanting to borrow
getting three or four examples, ask volunteers to sh
deal with these problems. Lead a brief discussion
involved in interpersonal difficulties using the fo
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MY PERSONAL RIGH
I have the right to control my lif
I have the right to...
Ask for what I want.
To say “No” and not feel g
To decide how I spend my ow
T k i t k
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Session 2 My Personal Rights
DiscussionGuide
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Discussion
Guide
Lead a brief discussion to process this exercisepoints:
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Session 2 My Personal Rights
DiscussionGuide
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KEY POINT: We have the right to use I-
our personal rights, and to get our needs met. B
have reactions to our I-Messages. Therefore, w
listen. It is important to listen to both the word
others. Effective listening allows us to discove
needs met, while respecting the other person's
KEY POINT: Timing is an important coneffective communication. If we are very emot
or angry, taking time to “cool off” or get our em
can help improve communication effectiveness
more effective to bring up someone’s troubling
when that behavior isn’t happening. For exam
h d k it’ b bl ff ti
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Session 2 My Personal Rights
SITUATION: Joe gets off work at 9:00 p.m. Mar
up for work at 6:00 a.m. Joe likes to watch T.V. in
catching the late show. This is keeping Mary from
rest she needs.
TIMING ISSUE: Mary decides to talk to Joe on
afternoon, when they are both rested and relaxed, r
when she is irritable and trying to sleep.
I
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SITUATION: Mary has gained about 10 poun
Joe keeps making snide remarks and pressuring
TIMING ISSUE: Joe has just made a nasty respeak up about it.
JOE: I think I’ll start calling you “CRISCO,”
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Session 2 My Personal Rights
Explain the concept of role playing. Tell participallow for the rehearsal and practice of communicat
I-Messages, listening, and negotiation. Role playin
also serious. It’s important to stick to the subject,
use and practice the skills discussed. Ask participa
realistically, using their own reactions, or drawing
partners or people they know. The “key” player, o
assert herself in the scenes, should try to use the sk
session.
Ask the group members to volunteer a few inter
that are going on in their lives to see if I-Messag
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
See Appendix A for a
discussion of role
playing and tips for
introducing your
group to role plays.
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
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Mandy and Andy are a couple. Andy was supp
right after work. Instead, he shows up hours la
went out with the guys for a few beers. He is o
When will Mandy speak her mind? How will
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Session 2 My Personal Rights
Discussion
Guide
Process each role play with some of the followin
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KEY POINT: Ultimately, we don’t have
people, only ourselves. By learning effective c
increase the chances that our needs and wants w
there is no guarantee that other people will beh
even care what we want. An important goal of
communication is to help us feel good about ou
KEY POINT: All human beings have basincluding the ones we discussed today. That m
right to exercise our rights, but always with th
other people have the same rights. Often, peop
make sure that both people are getting what the
(continued from
previous page)
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Session 2 My Personal Rights
MY PERSONAL RIGHTS
I have the right to control my life, theI have the right to...
Ask for what I want.
To say “No” and not feel guilty.
To decide how I spend my own tim
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WHAT IS AN I-MESSAGE?
It is a self-controlled style of expressing
think, feel, believe, want, or need in a w
respectful of other people’s righ
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Session 2 My Personal Rights
WHAT DOES AN I-MESSAGE SOUND
I-MESSAGE YOU-ME
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Session 2 My Personal Rights
STEPS FOR I-MESSAGES
State your FEELINGS
Describe the BEHAVIOR
Explain the REASON for your feelings (as needed)
Request a CHANGE or COMPROMISE
LISTEN CAREFULLY to the person’s response
ACKNOWLEDGE the other person’s feelings/needs
RESTATE your needs/ DISCUSS BENEFITS/CONSEQ
NEGOTIATE, AS NEEDED/END ON A POSITIVE N
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TIPS FOR BETTER LISTENIN
Look at the speaker. Don’t interrupt.
Make a choice to WANT to listen.
Listen for the speaker’s total meaning. (Words an
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Session 2 My Personal Rights
I-MESSAGE WORKSHEET
An I-Message is used to express your feelings, thoughts, and needs. In reare useful for expressing your feelings about another person’s behavior an
change.
Use the Steps for I-Messages to complete the following interactions.
1. Your partner has been late for dinner for three nights in a row.
(Behavior) When you______________________________________
(Feelings) I feel__________________________________________
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INSTRUCTIONS: Please answer the following questions based on what you le
Circle 1 (True) or 2 (False) after each statement.
1. An I-Message is a respectful way of expressing your feelings about someone’s
behavior.................................................................................................................
SITE # |__|__| CLIENT ID# |__|__|__|__|__|__| DATE: |__|__||__|__||__|__|
[5-6] [7-12] MO DAY YR [13-18]
THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
SESSION EVALUATION OF “TIME OUT! FO
SESSION 2
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Session 2 My Personal Rights
INSTRUCTIONS: Please take a minute to give us some feedback about how
1. Use one word to describe your feelings about this class. ________________
2. What is the most important thing you learned today?
Time Out! For Me
Session 2 Evaluation
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1. Participants will understand how nonverba
effective communication.
2. Participants will identify roadblocks to eff
3. Participants will learn and rehearse strateg
within relationships.
Objectives
Getting Through to People
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Session 3 Getting Through to People
For the It Goes Without Saying exercise, prepare s
feeling words listed below. Use a magic marker to
each slip of paper. You will also need a basket, b
from which participants can draw out a slip of p
NERVOUS ANGR
Prepare Before
Class
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TIPS FOR EFFECTIVE REFUSAL
Use a sheet of flip chart paper to write out the t
Prepare Before
Class
S i 3 G i Th h P l
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Session 3 Getting Through to People
Procedure
Welcome members to the group as they arrive.
seated, go around the room and ask members to int
Go around the room again and ask members to sha
this question: “If you could spend one hour with a
or present, who would it be and why?” Thank mem
participation.
Ask for a volunteer to discuss the issues that we
previous session. Thank the volunteer.
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Thank members for participating. Tell them
issues that will be discussed today, starting witcommunication. Share with them the quote: “W
communicate.” Ask for their ideas about what
Explain that communication is something th
ever say a word to someone. We communica
as our words. Ask the group for some exampleby providing a few examples first, or modeling
messages and asking members to tell you the m
shaking a closed fist; turning your back on som
tongue out; shooting the finger.
S i 3 G tti Th h t P l
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Process using the following questions:
Discussion
Guide
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nails — will we really believe that she is happy
believe her because her words and body langua
When we use I-Messages to assert our needs an
language should reflect that we believe we hav
ourselves. Here are some nonverbal pointers t
Make Eye Contact
Look at the person with whom you are speakin
maintain steady, but friendly eye contact. How
down the other person. Avoid looking away, lo
hands or feet or looking to the sides. Maintain
When we use
I-Messages to
assert our needs
and feelings, our
body language
should reflect
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Encourage participants to pay close attentio
people’s body language in the coming week.
Explain that there are things that we all do f
can sabotage our efforts at effective commun
we don’t do these things intentionally. Often,
habit. These communication roadblocks resu
communication because they cause people to sangry or defensive, or in some cases, lose respe
Use overheads of Communication Roadblock
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Session 3 Getting Through to People
YELLING/SCREAMING/HITTING/USING
When we do this, the likely response is that people and use profanity back at us. This is called a fight
communication.
MORALIZING/USING “SHOULDs”/“OUG
how you felt the last time someone said to you: “Yo
more fiber.” or “You ought to try fixing your hair d
us feel like people are bossing us around, so we tun
NOT LISTENING/INTERRUPTING: This
destroys communication the fastest. When we feel
listening to us, we become frustrated and we shut d
willing to listen to others, we shouldn’t be surprise
to us
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Use the prepared flip chart of Tips for Effect
lead a discussion based on the information bhandouts (p. 78). Stress the importance of b
Messages to communicate effectively when ref
1. BEGIN WITH THE WORD “NO.”
When you begin with the word “No,” you
message. It is difficult to argue with a stra
honest and there is no confusion about you
prefer and respect a straight refusal. Occas
some requestors who feel disappointed or e
not your problem. Remember, they are en
Tips for Effective
Refusal
Discussion
Guide
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Session 3 Getting Through to People
offer an alternative suggestion. For example, “
want to baby-sit for you tonight. I’ve already mevening. I’ll be home tomorrow night, though
for you;” or “No, I don’t want to go to the party
to have you drop by on your way for a quick vi
5. ASK FOR TIME TO THINK WHEN YOU
Very few things in life require an immediate de
unsure or uneasy about a request, ask for a littl
For example, “Gee, Mary, I hadn’t really thouggoing out of town this weekend. Let me think
you back.” By asking for thinking time you ca
feelings about what you want to do. It’s impor
back in touch with the requestor, otherwise you
relationship
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DiscussionGuide
Invite members to join in some practice for
volunteers to read or “play parts” in the refusalvolunteers for Script #1 (p. 64) and two for Scr
read the scripts, stopping after each one for dis
After Script #1 is read, discuss the following p
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g g p
MARY: Hey, Joan. I was wondering if I could bo
afternoon. I have some errands to run.
JOAN: Uh..well, gee, Mary. The car isn’t very cl
now...There’s junk all over the seats.
MARY Oh h ’ k I d ’ i d ll
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MARY: Hey, Joan. Can I borrow your car th
errands to run.
JOAN: No, Mary, I need my car this afternoo
take them for a ride and I don’t want to let them
MARY Y k kid idi i
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Di i
Review the purpose of and quidelines for role pl
Ask for volunteers to suggest refusal situations theespecially past situations they have found difficult.
on the chalkboard or flip chart, and ask for 2 volun
players and one volunteer to serve as an observer.
suggested role play situations, use the ones on the f
create your own. Do 2 or 3 role plays as time allow
Ask role players and observer to review the Tips fo
chart (p. 53) and handout (p. 78). Allow the role pminutes, then stop the action. Use the following D
process each role play.
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George wants his sister Betty to baby-sit for hi
go catch a movie. Betty has plans for the nigh
baby-sit George’s 3 children.
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Thank members for their participation. Go arou
each person to tell you one thing they learned todayknow before, and one thing they learned that they t
everyday life.
Summarize the session with the following points:
KEY POINT: Effective communication is im
good relationships and increasing intimacy. We ca
own communication style, not that of others. How
become good role models within relationships by s
to communicate more effectively and positively.
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TIPS FOR EFFECTIVE REF
1. BEGIN WITH THE WORD “NO.”When you begin with the word “No,” you give a clear, straight me
to argue with an honest “No.” Most people prefer and respect a str
Occasionally, you may find some requestors who feel disappointed
but that’s not your problem. Remember, they are entitled to their f
entitled to say “No” whenever you want.
2. AVOID GIVING EXCUSES OR APOLOGIZING.There are alternatives that may work better for preserving importan
example, rather than saying, “Gosh, I’m sorry I can’t go out with y
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INSTRUCTIONS: Please answer the following questions based on what you le
Circle 1 (True) or 2 (False) after each statement.
1. You can tell a lot about someone’s feelings by paying attention to their body
l
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SESSION EVALUATION OF “TIME OUT! FO
SESSION 3
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INSTRUCTIONS: Please take a minute to give us some feedback about how y
1. Use one word to describe your feelings about this class. __________________
2. What is the most important thing you learned today?
Time Out! For Me
Session 3 Evaluation
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1. Participants will understand how sexual m
learning.
2. Participants will learn about female reprod
related healthcare issues.
3. Participants will understand and practice b
Objectives
Woman-Care Self-Care
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Prepare Before
Class
Note!
You may prefer to invite an outside speaker to assidue to the nature of the material. Appendix B prov
selecting a guest speaker.
Make copies of the following materials for each cl
Sexuality Myth Quiz and answer sheets (pp
Female Anatomy (4 views; pp. 92-95)
Prenatal Development (p. 96)
B t S lf E i ti ( 97)
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Thank members for their participation. Ask
the issues that were covered in the previous ses
volunteer.
Use flip chart sheets from the first session to br
Goals and the Group Agreement, as needed.
Explain that today’s session will focus on iss
about reproductive health. Note that it is an
about ourselves as women, and to begin to kno
secrecy” that makes talking about such matters
Explain that it is also good background inform
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Tell participants there are several important wo
that will be discussed today:
Invite members to ask questions and share expe
issues are discussed.
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Use overheads of female anatomy and prena
discuss pregnancy. Distribute handouts. Dipoints:
Thank participants for their questions and i
Distribute the handout of referrals. Note tha
sources if women want more information abou
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Introduce breast self-examination by pointing o
American women will develop breast cancer in hthat survive are those that are fortunate enough to d
before it has time to spread. Breast self-examinati
important tool in early detection of breast cancer.
Explain how to perform a monthly breast self-e
breast model. After giving verbal instructions, Self-Examination handouts (p. 97) and pass the
around. Allow each participant a chance to feel th
and irregularities, and give further instructions as n
following points:1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
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KEY POINT: Learning about taking care
health is a lifelong process. We have different
times, such as when we enter puberty, when we
reproductive lives, and when we move into me
have to overcome a lot of myths, bad informati
get to the truth. Taking care of our health is an
worth. It is a personal responsibility. The mor
healthier we can be and the more we can teach
KEY POINT: For women there are sever
that are important:1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2
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SEXUALITY MYTH QUIZ
Answer the following questions based on what you have been
QUESTION TRUE
If a woman is menstruating (having her period), she will
cause well water to go bad, if she drinks from the well.
It is possible for animals such as chimpanzees or dogs to
breed with human beings.
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SEXUALITY MYTH QUIZ
Answer Sheet
If a woman is menstruating (having her period), she will cause well water
from the well. (FALSE)
Menstruation, the female “period,” is the subject of myth and taboo. Many r
Judaism and Islam teach that women are “unclean” during their periods and muafterwards. Many ancient cultures made women stay in special “menstrual huts
They believed that if a man touched a menstruating woman, he would die. If sh
fields, all his crops would die. If she drank from the well, then the water would
superstitions probably have to do with the fact that menstruation involves blood
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Homosexuals are born that way. (FALSE/DON’T KNOW)
Research has not found an answer to why some people are homosexual. Gen
overbearing mothers, and mental illness have all been suggested at one time or
What we know is that homosexuality exists in all cultures, in all parts of the wo
recorded history. It is estimated that 15% of the world’s population is homosex
allows for speculation that it is a normal, natural phenomenon. It is also import
many people who are not “homosexual” engage in same-sex sexual encounters.
A man with a big penis is better able to satisfy a woman. (FALSE)
Maria Muldaur said it best: “It ain’t the meat, it’s the motion...” The center
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When men get older they can no longer have erections. (FALSE)
Erections are caused by blood flowing into the spongy tissue of the penis, ca
(swell). If a man stays healthy, he can have erections until the day he dies, even
Studies show that about three out of four men in the 60s and 70s have satisfacto
men in their 80s have erections; and nearly half of all men in their 90s do also.
cancer or cardiovascular (heart and circulatory) problems may interfere with er
drugs such as high blood pressure medication may reduce erection capacity. Ot
tobacco, heroin, high dose methadone, marijuana, and cocaine may also cause e
Alcohol increases sexual desire and makes you a better lover. (FALSE)
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INSTRUCTIONS: Please answer the following questions based on what you le
Circle 1 (True) or 2 (False) after each statement.
1. Our society makes it easy for people to learn factual, correct information about
sexuality. ...............................................................................................................
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THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
SESSION 4
Time Out! For Me
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INSTRUCTIONS: Please take a minute to give us some feedback about ho
1. Use one word to describe your feelings about this class. ________________
2. What is the most important thing you learned today?
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Objectives 1. Participants will understand human sexual
sexual response cycle.
2. Participants will explore their feelings andchoices.
3. Participants will understand how to use co
Choices for Today’s Woman
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Prepare Before
ClassMake copies of the following materials for each
Female Anatomy (pp. 117-118)
Male Anatomy (pp. 119-121)
Penis Shapes (p. 122)
Condoms and Safer Sex (p. 123)
Role Play situations (p. 115)
Session Evaluation (pp. 124-125)
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Prepare Before
Class
Session 5 Choices for Today’s Woman
Prepare Before
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Prepare Before
Class
Prepare Before
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Prepare Before
Class
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Procedure
Welcome participants to the workshop. When earound the room and ask members to introduce the
the room again and ask members to answer the foll
could be invisible for one hour, what would you d
Thank members for their participation. Ask forhighlight what was discussed in the previous sessio
volunteer.
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Introduce the discussion of the human sexua
pointing to the large number of words and t
sex,” etc. Despite a large and colorful vocabunderstand very little about the actual physi
when human beings have sex. Explain that m
human sexual interactions only started about 3
been learned. One of the most important findin
men and women share the same, basic sexual r
human sexual response or the human sexual
Use Male Anatomy and Female Anatomy ove
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KEY POINT: Vaginal intercourse is not the oorgasm. The clitoris is the organ of female pleasur
be stimulated in a variety of ways to produce arous
Effective communication can help us talk with our
what brings us pleasure during sex.
KEY POINT: Not all good sexual encounters
orgasm. We increase our potential for satisfaction
relationships, if we remove some of the goal-orientand demands for orgasm.
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condom demonstration model to explain prope
condoms. Stress that condoms should be used
sex. The following materials are helpful for cosex demonstration:
A variety of different brands of cond
participants can see the different sha
the overhead of Penis Shapes (p. 122)
helpful for men to try different brands
until they find one that is the most com
pleasurable.
At least one condom for each group
practice in class. Members should be
practice rolling a condom onto their finLubricants and other
d t t i i
Note!
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Discussion Points
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Discussion Points
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Discussion Points
relationship. The best recommendation is that both
stop all forms of injection drug use. If this is not p
other injection paraphernalia) must be sterilized bybleach or alcohol as a cleaning agent.
Monogamy as a true option for safer sex doesn’t ju
honesty, patience, commitment, and lots of effectiv
also requires the courage and assertiveness to insis
safer sex options, if we know or suspect that a partn
something that may put us at risk.
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Abstinence requires that we be aware of own
asserting those needs. There are times when
we are not interested in sex. For example, duare ill, or when we are feeling tired or stressed
when we believe having sex is not the right ch
don’t trust a current or prospective partner. It
practice abstinence when under the influence
person who is drunk or stoned often can’t thin
involved with sex.
Discussion Points
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Thank the group for their input. Invite the grou
plays on how to discuss each of the safer sex opt
Ask for 2 volunteers to role play, and one to serve Safer Sex
Choices charts posted so they can be use
plays. Also post the Steps for I-Messages charts
Briefly review I-Messages and listening, as needed
help you brainstorm a role play situation for eac
sex choices or use the situations on page 115:
Allow about 5 minutes for each role play. Stop
each one. Here are some possible discussion ques
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CONDOMS: Ann and George have just met
come on to each other. Ann wants to make sur
if they go home together, condoms will be used
clear before they leave the bar.
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Thank the group for their participation, and inv
session to continue exploring how to discuss sex
around the room and ask participants to share one ttoday’s session, and one thing they learned that the
Summarize using the following points:
KEY POINT: Understanding human sexual r
become more at ease with our sexuality and sensua
sexuality is multi-dimensional, there are also manyhow we respond sexually on a physical level.
KEY POINT: AIDS and other sexually transm
b d b h i j t ith
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CONDOMS AND SAFER SCondoms provide safety and protection, but they must be used properly. It is re
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COVERING ALL THE BASES
latex (latex rubber) condoms be used. Condoms made from animal skin membr
preventing diseases. Here are some tips to help make condoms more effective
Place a tiny dab of K-Y jelly or
other water-based lubricant in
the tip of the condom beforerolling it on. Keep in mind that
too much may cause the condom
to slip-off. However, a tiny dab
wallet
Be care
and jewcondom
sharp c
Putting On A Condom
A condom should be put on
when the penis becomes hard,
not before.
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INSTRUCTIONS: Please answer the following questions based on what you lea
Circle 1 (True) or 2 (False) after each statement.
1. A man may need to experiment using different brands of condoms in order to fin
the brand that is most comfortable for him. ...........................................................
SITE # |__|__| CLIENT ID# |__|__|__|__|__|__| DATE: |__|__||__|__||__|__|
[5-6] [7-12] MO DAY YR [13-18]
THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
SESSION 5
Time Out! For Me
Session 5 Evaluation
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INSTRUCTIONS: Please take a minute to give us some feedback about how
1. Use one word to describe your feelings about this class. ________________
2. What is the most important thing you learned today?
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1. Participants will identify why partners have
sexual issues.
2. Participants will review strategies for effect
3. Participants will practice using effective co
for discussing sexual issues.
Objectives
Talking About Sexuality
Talking About SexualitySession 6
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Prepare Before
Class
Assemble the following charts and overhead tran
Sessions 2 and 3.
My Personal Rights (p. 42)
Steps for I-Messages (p. 46)
I-Message vs. You-Message (p. 45)
Tips for Better Listening (p. 47)
Tips for Effective Refusal (p. 78)
Communication Roadblocks (pp. 69-77)
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Thank members for their participation. Ask
what was discussed in the previous session. Th
Use flip chart sheets from the first session to br
Goals and the Group Agreement. (As needed)
Explain that this session is the last session, anstrategies for effective communication and ho
used within intimate relationships. Note that
explore why people have such a hard time talki
Talking About SexualitySession 6
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Discussion
Guide
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Discussion
Guide
Write on the flip chart or chalkboard: TALK
Ask participants for responses. Use the respon
discussion about why many people find it difficsexual feelings, even with a partner. Use the fo
needed:
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Ask for volunteers to role play some relationship
effective communication strategies. You will wan
the scene and an observer. Ask the group to help gesituations and list them on paper or chalkboard. Al
per role play. Remind the person playing the “asser
practice the communication skills discussed. Do 3
allows. The role plays on page 133 may be used, if
Stop after each role play and process the experiefollowing questions:
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Louise likes her freedom, and isn’t ready for a s
dates three or four guys, all of them nice people
needles before. Louise always insists on condo
beaus, Willie, has complained about using cond
are alone tonight, feeling romantic. But Willie
use a condom again. Louise feels strongly enou
sexual part of the relationship if he won’t.
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Thank participants for their time and involvemen
Go around the room and ask members to state one th
one thing they plan to use from the workshop sessio
Summarize using the following points:
KEY POINT: It is sometimes difficult to talk
about sexual issues, whether they are safer sex issue
relationship issues. It takes practice. The more we
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Excerpt from NEVER LEAVE ME by Harold R
“I let her push my hand down to the table. I stared at her.
tears shining like standing diamonds in the corners of her eyes. H
parted tremulously and her long blond hair was cascading down ar
shoulders. Her breasts were jutting proudly against her bra and the
trace of moisture in the valley between. Her stomach was flat ben
and lightly rounded as it molded the silk of her slip and joined the her hips and thighs.
‘ ’ b if l S d ’ hi d
Talking About SexualitySession 6
SESSION EVALUATION OF “TIME OUT! FO
SESSION 6
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SITE # |__|__| CLIENT ID# |__|__|__|__|__|__| DATE: |__|__||__|__||__|__|
[5-6] [7-12] MO DAY YR [13-18
THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
SESSION 6
INSTRUCTIONS: Please answer the following questions based on what you lea
Circle 1 (True) or 2 (False) after each statement.
1. T.V., movies, and other media give a realistic picture of sex. ................................
Time Out! For Me
Session 6 Evaluation
Page 2
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INSTRUCTIONS: Please take a minute to give us some feedback about how
1. Use one word to describe your feelings about this class. ________________
2. What is the most important thing you learned today?
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This section has been included to help you prep
Out! For Me workshop. It includes a variety o
ideas to refresh and strengthen your presentatio
information about preparing for the workshop, l
creating handouts, charts, and overhead transpa
How to Use this Manual
Appendix A
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The workshop style is designed to be informal and p
leader should strive to create an environment that is
enhancing, open, honest, empowering, interesting, a
should be available during the workshop, since ther
built into the workshop. Depending on the rules of
(regarding smoking or going to the bathroom unatte
choose to add a break.
Your group will be more comfortable in a room tha
an open meeting area because the material covered i
often sensitive and personal. If possible, arrange th
participants can sit around a large conference table
more tables so that participants can sit classroom st
writing surface, a place to set a cup of coffee and w
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lesbian, you should adjust the role plays to be a
them also. It may be helpful to allow the wome
the issues and situations they would like to expl
Here are some things to keep in mind when lead
Use this information to prepare your introducto
playing with your group members.
1. Role play is not drama. Encourage the play
focus on helping each other create realistic
communication skills can be practiced.
2. Don’t be afraid to stop and start the role pla
plays will be effective using just one line an
Appendix A
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(e.g. “Based on what we’ve been talking about
think of another way to express your anger at y
an effective suggestion is generated, use role pl
would sound like. Thank members and look for
praise their successes and their willingness to tr
Working with group generated script play
Script play provides a format for easing participant
Script plays are often less threatening and can serverole plays. One technique for group generated scrip
group to brainstorm several situations. Write these
chart paper or a chalkboard. Next, place group me
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members to volunteer examples of difficult com
have experienced. This could include past or pr
communication problems involving partners or
suggestions on flip chart paper or on the chalkb
Ask the person presenting the situation or comm
choose a partner for role play, and ask for a vol
The member presenting the problem should role
take a few minutes to brief her co-player and th
characteristics of the person with whom she wis
set the stage for the situation. Be sure to have f
outline effective communication strategies post
situation is played, process both the use of skills
1 A k h h d h i i
Appendix A
H d Th Ti O t! d l l h ld l
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Handouts The Time Out! module also should serve as a cataly
begin discussing sexuality and communication issue
relationships. You will want to provide plenty of ha
encourage participants to share the materials with th
significant others, if they are comfortable doing so.
are clearly identified in each session. Have extra co
exercises and activities and encourage members to s
partners as well.
Here are some tips for preparing handouts:
1. Arrange materials to follow the order of present
2. Use different colored paper for different topics.
l k “f i dli ” d i h l di i i
2 U l t f l I t i i t f b
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2. Use plenty of color. Invest in a variety of b
markers in easy to read colors and vary the
3. Use large print; avoid longhand writing unl
very easy to read. Confine material on the
“bullets.” Use discussion to fill in the deta
resemble an outline emphasizing key point
charts.
4. Be creative. Charts can engender exciteme
module exercises ask the group to generate
such as listing the benefits of condom use.
chart paper may be hung around the room w
the topic. Members are offered markers an
th i li t Aft th li t t d
Appendix A
3 M t h t hi h f t f
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3. Most photocopy machines have a feature for cre
transparencies. The materials in the Time Out
simply be run through your copier if it has this
photocopy shops such as Kinko’s or Quick Prin
producing the overheads. You also can write on
using dry markers or grease pencils. This requi
legible handwriting.
4. Supplemental materials (cartoons, outlines) als
and used as overheads. The key rule for creatin
keep each transparency simple. Don’t use a lot
clutter. Use a large font print (18 pt. or larger)
overhead to no more than one or two key topics
ample space between each line. When in doubt
t d j t it J d th j ti
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Introduction This section of the Time Out! For Me manual
preparing to present information and lead discu
reproductive health issues of concern to women
information contained here, you may also want
few references are listed in Appendix A. Most will have general textbooks on human sexuality
Sessions Four and Five of the Time Out! modu
Human Sexuality
Appendix B
A woman’s reproductive and sexual anatomy is fascReproductive
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A woman s reproductive and sexual anatomy is fasc
The internal organs are small in size and located be
uterus or womb is about the size and shape of a sm
size of a woman’s closed fist.) The uterus is lined w
called the endometrium, (sometimes called the end
uterus resembles a hollow muscle, lined with the spo
of the endometrium. The function of the uterus is to
developing fetus until birth. The endometrium susta
After an egg has been fertilized by male sperm it wi
endometrium and begin to grow.
Extending from either side of the uterus are two holl
structures called the fallopian tubes. Directly belo
ovaries, which are held in place on either side of the
li t Th i h t i f ti
Reproductive
and Sexual
Anatomy
The onset of menstruationsignals the beginninThe Menstrual
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The onset of menstruation signals the beginnin
in the female (but not necessarily psycho-social
born with about 400,000 immature egg cells, ca
ovaries. As a woman enters puberty, her pituit
production of special hormones that influence th
estrogen and progesterone. This process usua
to 15; the actual age is determined primarily by
As estrogen and progesterone are produced, som
in each ovary begin to mature. The lining of th
endometrium, begins to thicken and become ric
When hormone production peaks, an egg cell is
enters the fallopian tube. The release of the egg
Ovulation is most likely to occur at the midway
If this egg cell isn’t fertili ed ithin 24 to 48 ho
The Menstrual
Cycle
Appendix B
Common
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Cramping
Many women experience menstrual cramps, which a
spasms caused by high levels of hormones called pr
Cramping is most common during the first two days
women may experience cramps that are very intense
dizziness, and nausea. Other women have never exp
cramping. For the majority of women, cramping is
treated with antiprostaglandin drugs, such as aspir(Advil, Motrin, Nuprin). These are most effective i
begin. A doctor should be consulted if menstrual cr
doesn’t respond to treatment withover the counterm
Menstrual
Problems
1 Begin and maintain a moderate exercise proRelieving PMS
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1. Begin and maintain a moderate exercise pro
exercise, three times per week.)
2. Avoid salt, caffeine, nicotine, and alcohol.
3. Eat foods that are rich in potassium and B-
bananas, leafy green vegetables, fresh fruit
vitamin supplement is sometimes recommen
4. Get plenty of rest. Find ways to reduce stre
hobbies, or other enjoyable activities.
5. Drink plenty of water. Six to eight 8 oz. gl
recommended.
Relieving PMS
Symptoms
Appendix B
Women’s reproductive organs are internal (inside thReproductive
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Women s reproductive organs are internal (inside th
and therefore require specific types of health care. P
clinicians who specialize in women’s health are goo
information and care.
Pap Test
Women should have a pelvic examination and Pap
year. During a pelvic examination, the clinician che
organs for irregularities by feeling the size and posi
fallopian tubes, and ovaries. This examination can other growths on the reproductive organs. The Pap
performed as part of a pelvic examination, involves
ll f th i d i f i ti
Reproductive
and Sexual
Health
Yeast infections are caused by a yeast-like fung
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y y g
in small amounts in the mouth and vagina. A sm
vagina is healthy. However, under some condit
overgrow. This may cause itching, burning, anvagina and labia. There may also be a thick, w
resembles cottage cheese. Fortunately, there ar
are sold over-the-counter to treat yeast infection
provide information.
Yeast infections may be caused by a number of
have nothing to do with hygiene. Birth control
exhaustion, stress, and taking certain antibioticinfections in some women. Almost anything th
chemistry can precipitate a yeast infection. Tre
amount of yeast in the vagina but not eliminate
Appendix B
People often react to STDs with fear and shame, ba
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People often react to STDs with fear and shame, ba
these diseases mark a person as being “dirty,” or “u
these diseases are no more “dirty” than any others.
cause most STDs require a warm, moist environmeThe genital tract in human beings simply provides th
for these organisms. The mode of transmission invo
therefore sexual activity becomes the mode of trans
discomfort with STDs is most likely reflecting its di
sexuality.
Most STDs are spread by people who have no idea
Many STDs cause no symptoms for months or somcases, the symptoms are vague and mild and don’t a
important to help people get beyond fear and shame
if th t t STD It i i t
Most pregnancy tests available today are able
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p g y y
pregnancy within a week of a missed period. P
on the presence of special hormones that are pro
has implanted. These hormones can be detectedurine. If a sexually active woman who is able t
period, a pregnancy test should be considered.
may cause a woman to have a missed or delayed
the early stages of pregnancy are extremely criti
fetus, a pregnancy test is recommended so that
prenatal care if she chooses to continue the preg
After implantation has occurred, the placenta bspecialized tissue that is filled with blood vessel
fetus to the mother via the umbilical cord. Thr
f t t t iti d f th th
Appendix B
For women, breast cancer is a leading cause of deatBreast Health
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, g
American women will develop breast cancer. Each
women are diagnosed with the disease and 45,000 d
develop breast cancer, although it is considered rare300 men die from the disease.
Given these statistics, it is important for women to l
monthly breast self-examination (BSE). This tech
at and feeling the breasts and underarm areas in a sy
Ninety percent of breast lumps are discovered by wo
doctor or clinician may examine a woman’s breasts
is no guarantee that a problem will be discovered. Texam helps a woman be in control of her own healt
remember that not all lumps are cancerous. In fact,
l t t t b li t M t b t l
Breast Health
and Breast
Care
The following is a recommended procedure for m Monthly Breast
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g p
examination. Women should be encouraged to
most comfortable for them, and to practice it ev
six days after the menstrual period. (Breasts arswollen right before menstruation for proper ex
no longer menstruate should establish an easily
the first of each month) as their breast exam da
examination, women should be looking for the s
previously.
Stand in front of a mirror undressed from the w
hang at your sides and look carefully at your br
b h d d t d th b t i Y
y
Examination
Instructions
Appendix B
Women should be encouraged to consult a physicia
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lump, hardened area, discharge, or change in skin te
favorable that the problem is not cancerous, but it sh
immediately.
For some lumps or hardened areas it is routine for th
biopsy, which involves removing a small amount of
area for a microscopic examination. In addition, do
mammogram, or breast X-ray to help with diagnos
or mammograms are low-dose X-rays that are quic
perform. They can detect tiny changes in the breast
lumps that are too small to be felt.
The American Cancer Society recommends that wom
35 d b i i 40
FACTS Reference Section
TABLE OF CONTENTS
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TABLE OF CONTENTS
ARTICLES
The Human Sexual Response Cycle .......................................................
Human Reproduction................................................................................
Chart: Prenatal Development ............................................................
Chart: Stages of Labor ......................................................................
ILLUSTRATIONS
The Male Sex Organs ..............................................................................The Female Sex Organs ..........................................................................
The Male and Female Sex Organs (Side View) ......................................
The External Female Reproductive Organs
Appendix C
The Human Sexual Response Cycle
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Throughout this article, the human sexual response cy
1981) is referred to in the context of penis-to-vagina simportant to understand that these responses are not di
during other sexual activities, such as masturbation, or
of vibrators or sex toys.
The physiological process that occurs during sex is sim
functions. Most people are aware of having experienc
but are at a loss when trying to describe what occurs.
It was not until the mid-1950s that scientific studies of
intercourse were carried out. Most of what we know a
What is felt during these stages is, of course, diff
but there are some amazing similarities.
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For example, during the excitement phase, the first phyexcitement appear. In males, the penis becomes erect
testicles are pulled close to the body by the muscles in
males, the vagina becomes lubricated and the part of th
uterus expands. The clitoris becomes larger and more
and some men notice that their nipples become erect a
Plateau is the second stage of the sexual response cyclflow to the testicles increases. In females, the labia (th
ing the opening of the vagina) receive more blood and
color Fluids from both male and female lubrication g
Phases of Sexual
Response
Appendix C
It is important to point out that sexual response involve
reactions. There is a lot of truth in the statement that t
i th b i ! M f t ff t h i
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organ is the brain! Many factors can affect our physic
These may include our feelings about our partner, our
sexual experiences, alcohol or drug use, religious and tion medications, stress, illness, and so on.
Obviously, it is not necessary to completely understan
sponse in order to engage in pleasurable sex. Howeve
changes experienced by men and women during sex ar
study and appreciation than any other aspect of the hum
understand our sexual responses, we are less likely to flikely to be able to deal with them in a realistic and he
H d i i i l i
Human Reproduction
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Human reproduction is a process involving so many co
biological changes that a space mission seems simple
ancient times, conception (becoming pregnant) and pre
understood. Some people thought that each male sper
person that was placed into the woman during intercou
was then fed in the womb (or uterus) until birth. Anot
miniature child was already in the woman and “activat
Today, medical researchers have shown in amazing de
pregnancy, and birth occur. The process begins with tegg cell with a male sperm cell. About 250 million sp
vagina when the male ejaculates during sexual interco
i d ith hi lik t il hi h th idl
Fertilization
andGenetic
Material
Appendix C
When the sperm and egg meet and unite, the newly pro
the zygote. As the zygote moves down the fallopian tu
divides continuously These cells move down the fallo
Pregnancy
and Prenatal
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divides continuously. These cells move down the fallo
in the wall of the uterus. The growing ball of cells is c
blastocyst, and embryo at different stages of growth. Aeighth week of development, the embryo is called the
The fetus is connected to the wall of the uterus by the
is created by specialized cells from the egg. The place
oxygen from the mother for the fetus. Food and oxyge
placenta to the fetus by a tube called the umbilical cor
born, the umbilical cord is cut and the place where it wknown as the “belly button.” The placenta is delivered
then called afterbirth.
Development
During labor, the doctor or midwife will routinely mon
both mother and fetus, as well as the position of the fe
arise a Cesarean delivery may be required During Ce
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arise a Cesarean delivery may be required. During Ce
baby is removed from the woman’s uterus through a su
just below the navel.
Traditionally, labor has been viewed with a great deal
physical discomfort that can occur. Anesthesia can eli
discomfort, and several kinds of anesthesia may be use
anesthesia (such as spinal, local, and epidural anesthes
be awake during childbirth. Some women choose to at
Lamaze, to help prepare them for what to expect durinclasses help teach different ways to lessen the discomf
rally through breathing and relaxation.
Appendix C
Prenatal Development
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TIME NAME SIZE WEIGHT DESCR
1-3 Days Zygote 1/200" 1/7 mil oz Fertilized egg begins
Basic cell division oc
Egg remains same siz
3-6 Days Morula 16 cells Solid ball of cells.
6-14 Days Blastocyst 1/100" Hollow ball of cells.
Implantation in uteru
14-21 Days Embryo Different cell layers c
The different layers a
Stages of Labor
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STAGE PHASE TIME INSTAGE OR
PHASE
LENGTH OFCONTRACTIONS
HOWAPA
1st Prodomal 6 - 15 hrs*
2 - 4 hrs**
irregular irreg
Latent 3 - 10 hrs*
1 - 7 hrs
30-45 sec 5 - 20
Appendix C
t h e p e l v i c
b e h i n d
m e n .
e s p e r m
l a n d
o s t a t e
s s i t u a t e d
n m a l e s .
o r m a l l y
u r e s m o r e
d u c t i v e
m f r o m
T h e t w o
p o r t s
t s u r i n e
t a l s o
m e s e r e c t
u n c t i o n
f u n c t i o n .
c k o f
r e d u n t i l
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D D E R — a n e x p a n d a b l e s a c - l i k e o r g a n i n t
t h a t s t o r e s u r i n e u n t i l i t i s e x p e l l e d .
N A L V E S I C L E — a m a l e g l a n d l o c
a t e d b
o s t a t e t h a t
p r o d u c e s m u c h o f t h e f l u i d
i n s e
e m i n a l v e s i c l e f l u i d s n o u r i s h a n d p r o t e c t t h e
S T A T E G L A N D — a s m a l l , w a l n u t - s i z e g l
d j u s t b e h i n d t h e b l a d d e r i n m a l e s . T
h e p r o
c e s m u c h o f t h e f l u i d c o n t e n t o f s e m e
n .
P E R ’ S G L A N D S — t w o p e a - s i z e d g l a n d s
t h e u r e t h r a j u s t b e l o w t h e p r o s t a t e g l a n d i n
s e c r e t e a n
a l k a l i n e f l u i d t o n e u t r a l i z e
t h e n o
h e m i c a l c o
n d i t i o n i n t h e u r e t h r a . T h i s a s s u
w i l l s u r v i v e t h e t r i p i n t o t h e f e m a l e r e p r o d
m .
D E F E R E N S — t h e t u b e t h a t c a r r i e s s p e r m
e s t i c l e t o t h e p r o s t a t e a n d s e m i n a l v e s i c l e .
f e r e n s m e r g e w i t h t h e u r e t h r a , w h i c h
t r a n s p
o u t s i d e t h
e b o d y d u r i n g e j a c u l a t i o n .
T H R A —
t h e t u b e - l i k e o r g a n t h a t t r a n s p o r t
h e b l a d d e r t o o u t s i d e t h e b o d y .
I n m a l e s i t
o r t s s e m e n
a n d s p e r m d u r i n g e j a c u l a t i o n .
S — t h e e x t e r n a l m a l e s e x o r g a n t h a t
b e c o m
g s e x u a l e x
c i t e m e n t . I t h a s a r e p r o d u c
t i v e f u
n a n d s p e r
m p a s s t h r o u g h i t ) a n d a u r
i n a r y
I D Y M I S — s m a l l o r g a n s l o c a t e d a t t h e b a c
m a l e t e s t i c l e w h e r e i m m a t u r e s p e r m a
r e s t o r
m b ) t h a t
e r v i x
m e n s t r u a l
c h e s t o
h e
t r u c t u r e s
w h i c h a n
y t h e
a to
r m o n e s ,
an w h e r e
o f t h e
e a t e s a
b o d y .
I t
d
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V I X — t h e
l o w e r e n d o f t h e u t e r u s ( o
r w o m
d s i n t o t h e
v a g i n a . A t i n y o p e n i n g i n
t h e c e
s p e r m t o
e n t e r t h e u t e r u s , a n d a l l o w s t h e m
o l e a v e . D
u r i n g c h i l d b i r t h ,
t h e c e r v i x
s t r e t c
p a s s a g e o f t h e i n f a n t f r o m t h e u t e r u s
i n t o t h
a . L O P I A N T
U B E S — t w o s m a l l , t u b e - l i k e s t
d i n g f r o m t h e u t e r u s t o t h e o v a r i e s t h r o u g h
l l i s t r a n s p o r t e d .
F e r t i l i z a t i o n o f t h e
e g g b y
p e r m o c c u r s i n t h e f a l l o p i a n t u b e s .
R I E S — t h e f e m a l e r e p r o d u c t i v e o r g a n s t h
c e t h e o v a
( e g g c e l l s ) a n d t h e f e m a l e
s e x h o
e n a n d p r o
g e s t e r o n e .
R U S ( w o m
b ) — a m u s c u l a r , p e a r s i z e o r g a
u s d e v e l o p s d u r i n g p r e g n a n c y .
T h e l i n i n g
i s s h e d m
o n t h l y d u r i n g m e n s t r u a t i o n .
I N A — t h e m u s c u l a r , e l a s t i c , o r g a n t h a t c r e
g e w a y f r o m
t h e u t e r u s t o t h e o u t s i d e o f t h e
h
i d
i
h
l i
Appendix C
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c l u d i n g t h e
d d i r e c t l y
a d e u p o f t h e
c l i t o r i s i s t h e
x u a l s t i m u l a -
c i t e m e n t
s p o r t s u r i n e
al e s i t a l s o
i o n .
a t c r e a t e s a
f t h e b o d y .
I t
u r s e a n d s e r v e s
h e o u t e r f o l d s
l o p e n i n g .
h a t p r o t e c t t h e
h e g e n i t a l s a n d
n d f e m a l e s ;
t h r o u g h t h i s
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U L V A —
t h e e x t e r n a l f e m a l e g e n i t a l s , i n c
b i a , t h e c l i t o r i s , a n d t h e v a g i n a l o p e n
i n g .
L I T O R I S
— a t i n y b u m p o f t i s s u e l o c a t e d
b o v e t h e u r i n a r y o p e n i n g i n f e m a l e s a
n d m
m e t y p e o
f t i s s u e a s t h e m a l e p e n i s .
T h e c
a r t o f t h e f e m a l e b o d y m o s t s e n s i t i v e
t o s e x
o n .
I t b e c o m e s e n l a r g e d d u r i n g s e x u a l e x c
R E T H R A
— t h e t u b e - l i k e o r g a n t h a
t t r a n
o m t h e b l a
d d e r t o o u t s i d e t h e b o d y . I n m a
a n s p o r t s s e m e n a n d s p e r m d u r i n g e j a c u l a t i
A G I N A —
t h e m u s c u l a r , e l a s t i c o r g a n t h a
a s s a g e w a y
f r o m t h e u t e r u s t o t h e o u t s
i d e o f
o l d s t h e p e
n i s d u r i n g h e t e r o s e x u a l i n t
e r c o u
t h e b i r t h c a n a l d u r i n g c h i l d b i r t h .
A B I A M A
J O R A / L A B I A M I N O R A
— t h
f s k i n a n d t i s s u e a r o u n d t h e f e m a l e v a g i n a l
h e l a b i a m
a j o r a a r e t h e l a r g e r o u t e r f o
l d s t h
o r e s e n s i t i v e l a b i a m i n o r a o r i n n e r f o
l d s .
E R I N E U M — t h e a r e a o f s k i n b e t w e e n t h
e a n a l o p e
n i n g .
N U S — o p e n i n g o f t h e b o w e l s i n m a
l e s a n
l i d w a s t e f r o m t h e c o l o n l e a v e s t h e b
o d y t
Appendix C
Sexual Terminology Glossary
ABORTION — the ending of a pregnancy before birth, either
ous abortion), or through medical intervention (therapeutic or i
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), g ( p
ABSTINENCE — refraining or abstaining from sexual interco
ANDROGENS — hormones produced by the adrenal glands w
sex characteristics; in women, androgens help produce estrogen
menopause.
ANUS — opening of the bowels in males and females; solid w
the body through this opening.
APHRODISIAC — foods or substances said to stimulate sexu
describe substances which supposedly produce sexual desire ag
as “Spanish fly ”
CIRCUMCISION — surgical removal of the foreskin of the m
formed shortly after birth for religious or personal reasons. Th
for routine circumcision of newborn males.
CLITORIS — a tiny bump of tissue located directly above the
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CLITORIS — a tiny bump of tissue located directly above the
females and made up of the same type of tissue as the male pen
of the female body most sensitive to sexual stimulation. It becosexual excitement
COITUS — a medical term for sexual intercourse or having se
CONCEPTION — the point at which a fertilized egg implants
ning of a pregnancy.
CONDOM — a sheath or covering made of latex or animal meover the erect penis before intercourse to prevent pregnancy or
(See Condom FACT Sheet.)
Appendix C
EJACULATION — the expulsion or release of semen from th
orgasm.
EMBRYO — the name given to a fetus in its earliest stages of
period between two weeks and two months after conception in h
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period between two weeks and two months after conception in h
ENDOMETRIOSIS — a painful condition that occurs when snormally lining the uterus (the endometrium) begin to grow out
cause of endometriosis is unknown, and the condition may resu
ity, heavy menstrual periods, and discomfort during intercourse
ENDOMETRIUM — the lining of the uterus, which thickens
month during the menstrual period.
EPIDIDYMIS — small organs located at the back of each malsperm are stored until they mature.
GENITAL HERPES — a sexually transmitted disease caused
virus (HSV). Herpes causes painful clusters of blisters in the g
females. (See Herpes FACT Sheet.)
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GENITALS — refers to the male and female reproductive org
to refer to the external organs such as the penis, testicles, vulva
GONORRHEA — a sexually transmitted disease caused by a
burning during urination and a discharge of pus in males. Fem
symptoms in the beginning, but without treatment they may de
infection. (See Gonorrhea FACT Sheet.)
GYNECOLOGIST — a doctor who specializes in the care of
system.
HERMAPHRODITE — a very rare condition in which a pers
Appendix C
LABIA MAJORA/LABIA MINORA — the outer folds of sk
female vaginal opening. The labia majora are the larger outer f
sensitive labia minora or inner folds.
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LABOR — the physiological processes which accompany chil
tions, opening of the cervix, and urgency to push, etc.
LIBIDO — refers to the hidden drive behind actions; most com
sexual desire or drive.
LUBRICATION — the release of fluids into the vagina, usual
excitement. The term also refers to cremes and gels (such as K
dryness during intercourse.
MASTURBATION — self-stimulation of one’s genitals (and
produce sexual excitement, arousal, and/or orgasm.
OVULATION — the periodic release of a mature egg cell from
cell is not fertilized in 48 hours, it disintegrates.
PAP SMEAR — a test to detect cervical cancer and infection.
the cervix during a pelvic examination, and are examined with
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g p ,
check for cancer cells.
PELVIC EXAMINATION — examination and palpation (pre
ovaries, uterus, and vagina to check for lumps, swelling, infecti
possible disease.
PELVIC INFLAMMATORY DISEASE (PID) — a severe in
tubes, ovaries, and/or uterus. PID may be caused by sexually t
as gonorrhea and chlamydia, or by other types of bacteria that i
tract. (See Pelvic Inflammatory Disease FACT Sheet.)
PENIS — the external male sex organ that becomes erect durin
Appendix C
SEMEN — fluids produced by the prostate and seminal vesicle
along with sperm cells during ejaculation.
SEMINAL VESICLE — a male gland located behind the pros
of the fluid in semen. The seminal vesicle fluids nourish and p
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p
SEXUAL DYSFUNCTION — a term used by therapists to delems that may arise in sexual functioning in men and women, in
problems related to orgasm, or inability to maintain arousal. Se
related to psychological or physiological problems, including s
SEXUAL INTERCOURSE — sexual activity between two pe
most commonly used to describe genital sex or penis-in-vagina
SEXUALLY TRANSMITTED DISEASE (STD) — an infectransmitted through sexual intercourse or close sexual contact.
sometimes called VD or venereal disease.
TUBAL LIGATION — refers to a surgical procedure use
tubes and bring about permanent birth control in females.
FACT Sheet.)
UMBILICAL CORD — a hollow structure that connects
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the spongy tissue that nourishes and removes waste during
URETHRA — the tube-like organ that transports urine fro
the body. In males it also transports semen and sperm duri
UTERUS (womb) — a muscular, pear size organ where th
pregnancy. The lining of the uterus is shed monthly during
VAGINA — the muscular, elastic organ that creates a pass
the outside of the body. It holds the penis during heterosexas the birth canal during childbirth.
Appendix C
FACT SHEET
Contraceptive Implants(e g Norplant)
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(e.g. Norplant)
WHAT IS IT? Small capsules (shaped like thin match sing the female hormone progestin. Implants are placed u
the upper arm.
HOW IT WORKS: The capsules slowly release hormon
woman’s system. The hormone interferes with ovulation
woman’s vaginal fluids thicker so sperm are unable to rea
HOW IT’S USED: Six of these small capsules are place
ki f h b d i d li i i A
FACT SHEET
Birth Control Pills
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(Oral Contraceptives)
WHAT IS IT? Female hormone pills. Most pills contai
progesterone.
HOW IT WORKS: Pills work by stopping the release o
woman’s ovaries each month. Birth control pills do not a
woman’s ability to get pregnant after she stops taking the
HOW IT’S USED: A pill is taken by mouth daily. To s
ill t h d P T t A d t
Appendix C
FACT SHEET
The Intrauterine Device
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(The IUD)
WHAT IS IT? The IUD is a small, specially shaped plas
inserted into a woman’s uterus or womb. Some IUDs con
and hormones.
HOW IT WORKS: The IUD seems to work by irritating
the uterus so a fertilized egg cannot implant.
HOW IT’S USED: The IUD is placed inside the uterus b
f il l i i i l i t t It t
FACT SHEET
The Diaphragm
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WHAT IS IT? The diaphragm is a soft latex device shaplow cup. It is inserted in the vagina before having sex.
HOW IT WORKS: The diaphragm covers the opening
This prevents sperm from being able to fertilize the woma
special creme or gel that kills sperm is used with the diap
it more effective.
HOW IT’S USED: Diaphragms come in different sizes.
family planning clinic nurse must examine you to determ
Appendix C
FACT SHEET
Condoms
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WHAT IS IT? Condoms are also called rubbers or propare made out of very thin latex rubber. Some types are m
mal tissues. Condoms are made to cover a man’s erect pe
HOW IT WORKS: The condom traps the man’s fluids a
he ejaculates (“comes”). This prevents the sperm from en
woman’s vagina and fertilizing her egg.
HOW IT’S USED: Condoms are unrolled over a man’s
before sex. Space is left at the tip of the condom to catch
FACT SHEET
Female Condom(Vaginal Pouch)
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( g )
WHAT IS IT? A soft, loose fitting birth control device slarge condom with a soft plastic ring at one end. It’s also
nal pouch.”
HOW IT WORKS: The female condom is inserted in th
end with the ring is positioned to cover the cervix, much
phragm. It protects by completely lining the vagina duri
and sperm are blocked from entering the vagina
HOW IT’S USED h f l d i i d i
Appendix C
FACT SHEET
Contraceptive Foams, Ge
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and SuppositoriesWHAT IS IT? Contraceptive foam is a foam that comes
aerosol can. Contraceptive gel comes in a tube. Contrace
tories are small waxy tablets that dissolve when placed in
HOW IT WORKS: Contraceptive foams, gels, and supptain spermicide, a special chemical that kills sperm. Whe
sex, the spermicide creates a barrier. This stops sperm fr
FACT SHEET
Vaginal Contraceptive Spo
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Vaginal Contraceptive Spo
WHAT IS IT? The sponge is a small, soft disk made of
rial that contains spermicide, a chemical that kills sperm.
HOW IT WORKS: The sponge acts as a barrier. It prev
from reaching the woman’s egg. Sperm are killed by the
contained in the sponge.
Appendix C
FACT SHEET
Vasectomy(Male Sterilization)
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WHAT IS IT? Vasectomy is a permanent method of birmen.
HOW IT WORKS: Vasectomy is a minor surgical proc
performed in a clinic or doctor’s office. A local anestheti
deaden the scrotum. A small incision is made above each
section of each vas deferens (the tube that carries sperm f
is removed and the ends are sealed. The whole operation
minutes. Most men are fully recovered within a few days
FACT SHEET
Tubal Ligation(Female Sterilization)
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WHAT IS IT? Tubal ligation is a permanent method ofwomen. It’s sometimes referred to as “having your tubes
HOW IT WORKS: Tubal ligation is an operation that i
formed in a hospital or as outpatient surgery. General an
and two small incisions are made between the navel and t
The doctor uses special instruments to look inside the abd
the fallopian tubes. The tubes are then cut and surgically
whole operation takes about 30 minutes. The woman’s o
Appendix C
FACT SHEET
Natural Family Planning(Fertility Awareness)
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WHAT IS IT? Natural Family Planning is sometimes caawareness or the “rhythm method.” It’s a method of birth
on avoiding intercourse around the time when the woman
leased.
HOW IT WORKS: A woman learns to recognize and k
monthly changes in her body that indicate her egg is abou
leased. During those fertile days, intercourse is avoided o
method of birth control is used (for example, condoms or
FACT SHEET
Sexually Transmitted Diseases
and Women’s Health
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and Women s Health
Sexually transmitted diseases (STDs) are most often caus
and viruses. These organisms prefer to invade warm, mo
so the genitals, the anus, and the mouth are common sites
You can catch an STD by having sex with an infected per
cludes vaginal sex (penis-in-vagina), anal (rectal) sex, and
(mouth-on-penis or mouth-on-vagina).
W lik l t h li ti f STD
Appendix C
FACT SHEET
Pelvic Inflammatory Disease
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WHAT IS IT? Pelvic Inflammatory Disease (PID) is a s
of a woman’s internal reproductive organs (uterus, ovarie
tubes). PID is usually caused by gonorrhea or chlamydia
spread through sex.
SYMPTOMS:
Pain in the lower abdomen; cramps
Pus or heavy discharge from the vagina
FACT SHEET
Gonorrhea
WHAT IS IT? Gonorrhea is an infection caused by a typ
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WHAT IS IT? Gonorrhea is an infection caused by a typ
This bacteria can infect the reproductive organs, anus, andthroat. Symptoms usually appear from two days to three
exposure.
SYMPTOMS:
In Women:
Milky discharge or pus from the vagina
Pain in the lower abdomen (belly), fever, chills
Painful urination or pain when you have sex
Appendix C
FACT SHEET
Syphilis
WHAT IS IT? S hili i i f ti d b b t
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WHAT IS IT? Syphilis is an infection caused by a bacte
the bloodstream. The bacteria usually enters the body thr
contact. The symptoms of syphilis appear in three stages
SYMPTOMS:
First symptoms: (Ten days to three months after infe
small, painless sore, the “chancre” (pronounced shanker)
site of infection (usually the genitals, mouth, or anus). It and disappears, but the infection is still there.
FACT SHEET
Genital Herpes
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WHAT IS IT? An infection caused by a virus that invadcells. The virus usually enters the body through sexual co
infect the genitals, anal area, and mouth. Symptoms appe
twenty days after infection.
SYMPTOMS:
Painful blisters around the genitals or anus
In women, the blisters may be inside the vagina
Swollen lymph nodes (armpit or groin area)
Appendix C
FACT SHEET
Chlamydia
WHAT IS IT? Chlamydia is an infection caused by a ty
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WHAT IS IT? Chlamydia is an infection caused by a ty
This bacteria can infect the reproductive organs and the reChlamydia is the most common STD in this country. Sym
appear one to two weeks after exposure.
SYMPTOMS:
In Women:
Most often, no symptoms or very mild symptoms
Increased discharge from the vagina
Bleeding or pain during sex
FACT SHEET
Genital Warts
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WHAT IS IT? Genital warts are caused by a virus. This
infect the genitals and the anal area. Genital warts are dif
common skin warts. Symptoms usually appear one mont
after exposure.
SYMPTOMS:
Small, painless warts or hard spots in the genital or In women, warts may appear inside the vagina.
I t i id th i
Appendix C
FACT SHEET
HIV and AIDS
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WHAT IS IT? HIV infection is caused by a virus (HIV)the immune system. When the immune system is destroy
open to many infections and cancers. When these infecti
begin to appear the disease is called AIDS. The HIV viru
the blood, semen, and vaginal fluids of infected people. S
take ten years develop. Many people with HIV infection
they have it.
SYMPTOMS
FACT SHEET
Vaginitis
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WHAT IS IT? Vaginitis is a term used to identify a numvaginal infections. These infections can be caused by a y
(different than bread yeast) or by bacteria.
SYMPTOMS:
Burning or itching in the vaginal area (between you
Unusual vaginal discharge (fluids or thick discharg
Unpleasant or “different” vaginal odor
Appendix C
FACT SHEET
Trichomonas Infection
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WHAT IS IT? Trichomonas is a type of vaginal infectiosmall organisms called protozoa ( pro-ta-zoh-ah). These
flare up in the vagina and cause problems. Trichomonas
called “trich,” for short.
SYMPTOMS:
Itching and irritation in the vaginal area (between y Unusual vaginal discharge (fluids)
U l “diff ” i l d
THIS BOX IS TO BE COMPLETED BY DATA COORDINATOR:
CLIENT SURVEY
“TIME OUT! FOR ME”
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PART ONE.
INSTRUCTIONS: Please answer the following questions based on whether yo
TRUE or FALSE Circle 1 (Tr e) or 2 (False) after each statement
SITE # |__|__| CLIENT ID# |__|__|__|__|__|__| DATE: |__|__||__|__||__|__|[5-6] [7-12] MO DAY YR [13-18
SEQUENCE: 1. PRETEST 2. POSTTEST 3. 10 WEEK 4. 6 MONTH
Appendix D
11. An I-Message is a self-centered comment that shows
a person doesn’t care about anyone else. .............................................................
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12. A woman should have a Pap test and a pelvic exam (a women’s health checkuponly when she has symptoms or thinks something is wrong. ..............................
13. The female clitoris (clit) is the main organ of sexual pleasure in women. ..........
14. In order to communicate effectively, it is more important to say things correctl
than it is to listen to what the other person has to say. .........................................
15. A woman should begin getting prenatal care as soon as she knows she is pregna
16. Body language (nonverbal communication) plays an important part
NOT S
AT ALL SLIGHTLY W
READ EACH ITEM AND CIRCLE ANSWER. TRUE TRUE
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3. I would object if my partner suggested thatwe use a condom. .................................................................. 1 2
4. In general, I am satisfied with myself. .................................. 1 2
5. I think masturbation is normal and healthy. .......................... 1 2
6. I listen carefully to what my partner has to say. .................... 1 2
7. I wish I had more respect for myself. .................................... 1 2
References
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Adams, L. (1979). Effectiveness training for w
Putnam.
Alberti, R., & Emmons, M. (1990). Your perfe
Luis Obispo, CA: Impact Publishers.
Beresford, T. (1980). How to be a trainer . (A
Parenthood of Maryland 610 North Ho
References
Ortiz, E. (1989). Your complete guide to sexual he
Cliffs, NJ: Prentice-Hall.
Petrich-Kelly B & McDermott B (1988) Intima
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Petrich Kelly, B., & McDermott, B. (1988). Intima
41 Sunshine Lane, Santa Barbara, CA 931 [email protected]
Porat, F. (1988). Self-esteem: The key to success i
Saratoga, CA: R & E Publishers.
Satir, V. (1972). Peoplemaking . Palo Alto, CA: S
Books.
Sproule, J.M. (1981). Communication today. Glen
Foresman and Company
Resources for Teaching Mat
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For information about breast models available
The American Cancer Society Headquarters
1599 Clifton Road, N.E.
Atlanta, GA 30329
Telephone: 1-800-227-2345 (toll-free)
Texas Division, 2433 Ridgepoint Dr., Suite A
Austin, TX 78754
Telephone: 1-512-919-1800http://www.cancer.org
Breast Self-Examination
Models
Resources
Many of the materials suggested for use in Session
available for sale through drug stores and pharmac
For information about materials available for loan
Safer Sex
Demonstration
Materials
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Planned Parenthood Federation Affiliates
Check your phone book for an office in your area.
Any AIDS Services or AIDS Resources organiza
Check your phone book for an office in your area.
To purchase safer sex demonstration models, condcontact:
The American Cancer Society Headquarters
1599 Clifton Road, N.E.
Atlanta, GA 30329
Telephone: 1-800-227-2345 (toll-free)
Sources for
Pamphlets and
Literature about
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p ( )
Texas Division, 2433 Ridgepoint Dr., Suite AAustin, TX 78754
Telephone: 1-512-919-1800
http://www.cancer.org
Planned Parenthood Federation Affiliates
Check your phone book for an office in your ar
Breast Cancer,Pap Tests,
Mammography
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semana después del primer día de la menstruación.Después de la menopausia (cambio de vida) o de unahisterectomía, escoja un día fácil de recordar, tal comoel primer día del mes. Haciendo este auto-exámen delos senos cada mes usted se familiarizará con el tejidode sus senos y podrá detectar algún cambio.
PORQUE DEBE HACERSE UNA
MAMOGRAFÍALa mamografía es una radiografía de los senos hechacon una dosis baja de rayos X. Puede encontrarcánceres demasiado pequeños que nos sondetectados por usted o su médico. La mamografíatambién muestra cambios en los tejidos que puedenser los primeros síntomas del cáncer de seno.Cuando se le usa junto con los exámenes de los senos,la mamografía es una forma eficaz de salvar vidas.
QUE DEBE USTED HACERSI ENCUENTRA ALGÚN CAMBIO
Si usted nota un cambio en sus senos, consulte a sumédico lo antes posible. Los cambios importantesincluyen:
* aparición de abultamientos, áreas más duras o cualquier cambio
aparición de hundimientos o arrugas
PORQUE DEBE HACERSE UN AUTO-EXÁMEN DE LOS SENOS CADA MES
El auto-exámen de los senos es un pasoimportante para la detección temprana delcáncer. Cuando el cáncer de los senos se detecta
y se trata a tiempo, la muje r puede sobrevivir. Poreso es importante que usted aprenda a hacerseun auto-exámen correcto de sus senos.
LOS TRES PASOS DEL AUTO-EXÁMEN DELOS SENOS
PRIMER PASO: FRENTE AL ESPEJO
Deje los brazos en posiciónrelajada a los costados delcuerpo y observe cada seno defrente y de lado.Observe:
* Cambios en la forma del seno
* Irregularidades en la piel, como hundimientos o arrugas
* Piel descamada alrededor
del pezón
* Algún tipo de desecho o
Figura 1
SEGUNDO PASO: A LA HORA DEL BAÑO
Cuando la piel esta mojadaes más fácil deslizar los
dedos para hacer elexámen. Use la mano izquierda para palpar el senoderecho y la mano derecha para el seno izquierdo. Al
palpar los senos usted está buscando:
* Abultamientos, áreas más duras, o cualquier cambio.
Imagine que su seno es un reloj. Comienze por la hora12 en punto y examine todo el seno en un movimientocircular en el sentido de las agujas del reloj. Coloquelos dedos en forma plana y con las yemas de los tresdedos medios palpe con presión firme todo el bordeexterior del seno. Al completar la vuelta, mueva losdedos un poco hacia el pezón, dando vuelta tras vueltahasta haber palpado todo el tejido del seno.
TERCER PASO: A COSTADA
EL EXÁMEN EN POSICIÓN ACOSTADA ES LAMEJOR FORMA DE DETECTAR ABULTAMIENTOS,ÁREAS MÁS DURAS O CUALQUIER CAMBIO.
Figura 4A
Figura 4
HAGA UN PLAN P
Haga un plan persocuidado de sus senos médico. La Sociedaddel Cáncer (ACS) reco
* un auto-exá de los senos
* exámenes re
los senos he médico
* mamografía guías estab Sociedad Am Cáncer (AC
RECOMENDACIONLOS EXÁMENES
Para la detección del senos en mujeres sin sSociedad Americana(ACS) recomienda lo s
1. Una mamografía c empezando a la eda (por indicación médi grafías pueden come
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** piel descamada alrededor del pezón
* cambios en el pezón
¡No se alarme: La mayoría de los bultos u otroscambios no son cancerosos, pero solamente unmédico puede hacer el diagnóstico!
FACTORES DE RIESGO ENEL CÁNCER DEL SENO
Los factores más importantes en el cáncer delseno son:
* ser mujer
* envejecer
* tener un familiar cercano con cáncer de los senos (madre, hermana, hija)
HAGA UN PLAN PERSONAL
Haga un plan personal para el cuidado de sussenos junto con su médico. La Sociedad Ameri-cana del Cáncer (ACS) recomienda:
secreción por el pezón o cual- quier cambio en el pezón
Levante los brazos por arriba dela cabeza y observe cada seno defrente y de lado.
Apoye sus manos en lacintura, presionándolas paracontraer los músculos del
pech o que están debaj o de los
senos. Observe los senos en elespejo de frente y de lado.
Figura 1A
Figura 2
Figura 3
Acuéstese. Para lograr una distribución más parejade los tejidos del seno, ponga una almohada o unatoalla doblada debajo del hombro derecho, y ponga sumano derecha debajo de la cabeza. Coloque los dedosen forma plana y use las yemas de los dedos con alguna
crema o talco para que elmovi-miento sea más fácil.Del mismo modo que albañarse, palpe todo el tejido
del seno con una presión firme, dandovueltas en el sentidode las agujas delreloj, desde el bordeexterior del senohasta el pezón.
Examine ambos senos de este modo.
EL MEJOR MOMENTO PARA HACERSE
EL AUTO-EXÁMEN DE LOS SENOSEl mejor momento es aproximadamente una
Figura 5
Figura 5A
2. Un exámen físico d hecho por un médi años en mujeres en años de edad y uno mujeres mayores d
3. Un auto-exámen m senos para todas la mayores de 20 año
* Estas recomendaciondetección de cáncer demujeres sin síntomas ynormal. La existenhistoria familiar de csenos y otros factores, pestas recomendacio
preguntas, consulte a s
WHY YOU SHOULD EXAMINEYOUR BREASTS EVERY MONTH:
Breast Self-Examination (BSE) is an important stepin finding breast cancer early. When breast canceris found early and treated promptly, women survive.That is why it is important for you to l earn how toexamine your breasts properly.
THE THREE STEPS OF BSE
STEP ONE:IN FRONT OF MIRROR
Let y our arms hang loosely at thesides of your body. Look at yourbreasts from the front and fromeach side. You are looking for:
* Any change in the form and shape of the breast
* Dimpling or puckering of the skin
* Scaling of the skin around the nipple
STEP TWO: AT BATH TIME
When your skin is wet,it is easy to move yourfingers over yourbreasts . Use the left
hand to examine the right breast, and the righthand to examine the left breast. As you are ex-amining your breasts you are feeling for:
* A lump, a thickened area, a hardening in the breast or anything that feels different.
Imagine your breast as the face of a clock. Exam-ine all of the breast tissue in a clockwise motionstarting at 12 o'clock. Press firmly with the sensi-tive pads of the middle three fingers starting atthe outer edge of your breast. With each clock-
wise motion, move your finge rs in toward thenipple until you have felt all of your breast tissue.
STEP THREE: LYING DOWNEXAMINING YOUR BREASTS WHILE LYING ON
Figure 1
Figure 4A
THE BEST TIME TO DO BSEDo your Breast Self-Examination about a week after the start of your menstrual period when thebreasts are usually not tender. After menopause(change of life) or after hysterectomy, choose a day that is easy to remember, such as the first day of the month. By doing BSE regularly you will becomefamiliar with how your breasts feel and will be able
to detect a change in your breast tissue.
WHY YOU SHOULD HAVEA MAMMOGRAMA mammogram is a low dose x-ray of the breast.A mammogram can find cancers too small to befelt by a woman herself, or her health care pro-vider. Mammograms can also show changes in thebreast tissue that could be a sign of very early breast cancer. When used with physical exami-nation of the breast, mammography has provento be effective in saving lives.
WHAT TO DO SHOULD YOU
FIND A CHANGEIf you notice a change in your breasts, see your doc-tor or health care provider soon. Important changesto report might include:
Figure 4
MAKE A PERSONMake a personal plan
with your doctor or heacan Cancer Society recto detect breast cance
* breast self e
* regular brea
doctor or he* mammogra
lines of the A
SCREENING GUID
The American C
recommends the
for brea st can ce
without symptoms
1. A mammogram
age 40 or over (s
lier if clinically i
l l
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* Any change in the nipple
Rai s e yo u r armsabove your head andlook at each breastfrom the front andfrom each side.
Rest your hands on your hips and press your hands down firmly totighten the muscles under thebreast. Look at each breast from
the front and from each side.
YOUR BACK IS THE MOST EFFECTIVE WAY TOCHECK YOUR BREAST FOR LUMPS, THICKENINGOR HARDENING.
Lie down on yourbed. To spread thebreast tissue moreevenly, put a pillow or bath towel under
your right shoulderand put your righthand under yourhead. Use the fin-gers of the left handto check your
breast. Use lotion or powder on the skin which willmake it easier to move your fingers over yourbreasts. Follow the same method as you did while
you were bathing, moving your fingers in a clock- wise motion, using firm pressure and feeling all of
your breast tissue from the outer edge to the nipple.Examine each breast in the same way.
Figure 1A
Figure 2
Figure 5
Fig.5A
* a lump, thickening or hardening in your breast.
* dimpling or puckering of the skin of your breast.
* scaling of the skin around the nipple
* nipple discharge
Don't be alarmed. Most breast lumps or otherchanges ar not cancer, but only your doctor canmake the diagnosis.
RISK FACTORS FOR BREASTCANCERThe most important risk factors for breastcancer are:
* being a woman
* getting older* having a close family member with breast cancer (mother, a sister, daughter) Figure 3
2. Clinical Breast E
professional eve
aged 20 to 39, an
age 40 and over.
3. Breast Self-Exam
women age 20 an
* Guidelines for sc
symptoms of breast
risk for cancer. The p
history of breast can
alter these recomme
health care provider