Reproductive health

Within the framework of the World Health Organization's (WHO) definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life. Reproductive health implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.

Unintended pregnancies result from unprotected sex where no children, or no more children are desired. It has been estimated that almost half of all pregnancies are unintended. Unintended pregnancy happens at all reproductive ages, with a peak in women aged 20-24 years. 45% of unintended pregnancies end via abortion, 17% end in birth and about one third are lost naturally.

Unprotected sexual intercourse (UPSI) is common: in a large European survey of over 7000 sexually active women, 30% reported having unprotected sex, at least once, in the last 12 months. These frequent acts of unprotected sexual intercourse are not happening in a distinct sub-population, but happen irrespective of age, income, education level and marital status. 

Unprotected sexual intercourse can result from a couple not using any contraception, including ‘withdrawal’. It can also happen when they consciously try to prevent it. For example UPSI can happen as a result of accidental condom problem (breakage, slippage, not on in time); oral contraceptive (OC) problems e.g. forgotten pill; a temporary break from the usual contraceptive; forgetting to apply a patch or insert a vaginal ring. UPSI can also happen as a result of non consensual intercourse (rape).

Following UPSI, only emergency contraception can help women to reduce risk of getting pregnant. Although the risk of pregnancy exists most of the time, women may underestimate the risk of pregnancy. A study has demonstrated that 61% of women terminating unplanned pregnancy in artificial abortion were not at all aware of the pregnancy risk - they didn't know that they have had unprotected, "risky" sexual intercourse. forgets tablets or makes mistakes.

It may be thought that the majority of women who request emergency contraception (EC) do not use any contraceptive method. However, research has shown that 67% of women who requested EC are using a regular method of contraception (e.g. condom or pill).  And this is not so surprising. If we do the calculation, ‘contraceptive interruption’ is inevitable in a woman’s life, where she is trying to prevent pregnancy from the time she is about 17 years old (mean age of first sexual intercourse) until she is about 50. If she is on the Pill she will need to take about 8000 tablets correctly. It is unsurprising that she sometimes

Among those biomedical fields in which a virtual explosion of new knowledge and understanding has occurred over the past decades, the physiology and pathophysiology of reproductive processes are prime examples. It is of the utmost importance to transfer new knowledge towards general population in order to improve their reproductive health competencies and to achieve more favourable population outcomes.

Not everyone knows that following UPSI sperm can survive for approximately 5 days within the female reproductive tract. This means that during the average woman’s menstrual cycle there are six days when intercourse can result in pregnancy; this ‘fertile window’ is the five days before ovulation plus the day of ovulation. However, the variability of ovulation is large – it can happen from day 11 to day 21. Ovulation can also vary from cycle to cycle. Because sperm stay viable for up to 5 days, the period over which conception is likely to occur runs from day 6 to day 21 for regularly cycling women. If the cycle is not regular, there is a risk of ovulation happening even later in the cycle. The conception risk period does not end before day 28 of their cycle. This shows that there is no such thing as a risk free period.


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