Human Sexuality & Family Planning Methods - Concept Map
Human Sexuality & Family Planning Methods
Related concepts
Human Sexuality Concepts
Sub concepts
- Sex (biological distinction)
- Gender (socially constructed roles)
- Sexual Orientation (attraction patterns)
- Sexual Response Cycle (Masters & Johnson: Excitement, Plateau, Orgasm, Resolution)
- Lifespan Sexuality (affected by illness, medications, pregnancy, ageing, culture)
- Non-judgmental Nursing Care (PLISSIT model: Permission, Limited Information, Specific Suggestions, Intensive Therapy)
Relationship to central
Foundation for understanding reproductive health and client counseling
Contraceptive Effectiveness Principles
Sub concepts
- Perfect Use (correct, consistent use)
- Typical Use (real-world use with human error)
- Long-Acting Reversible Contraceptives (LARC) - IUD and implant
- User-Dependent Methods (hormonal, barrier)
- Informed Choice Principle (RA 10354)
- Voluntarism (no coercion, RA 10354)
Relationship to central
Core framework for method selection and counseling
Natural (Fertility Awareness-Based) Methods
Sub concepts
- Calendar (Rhythm) Method: Formula = (shortest cycle − 18) to (longest cycle − 11)
- Basal Body Temperature (BBT): Rise 0.3–0.5°C signals ovulation
- Cervical Mucus (Billings) Method: Clear, slippery, stretchy mucus indicates fertility
- Symptothermal Method: Combines BBT + mucus + other signs
- Standard Days Method: Days 8–19 of 26–32 day cycles (CycleBeads)
- Lactational Amenorrhea Method (LAM): Three conditions required (baby <6 months, exclusive breastfeeding, no menses return)
- Coitus Interruptus (Withdrawal): Lowest effectiveness, no STI protection
Relationship to central
Non-hormonal, non-device options for clients preferring natural approaches
Hormonal Contraceptive Methods
Sub concepts
- Combined Oral Contraceptives (COCs): Oestrogen + progestin; start day 1 of menses
- Missed Pill Management: If 1 pill missed take immediately; if 2+ missed use backup
- ACHES Danger Signs: Abdominal pain, Chest pain/SOB, Headache (severe), Eye problems, Severe leg pain (thromboembolism risk)
- COC Contraindications: Thromboembolism history, uncontrolled hypertension, smokers >35 years, breast cancer, active liver disease, pregnancy
- Progestin-Only Pills (POPs): Safe in breastfeeding; strict timing required
- Injectable DMPA: 150 mg IM every 3 months; bone density monitoring; delayed fertility return
- Subdermal Implant: 3–5 years duration; LARC method
- Transdermal Patch: Changed weekly
- Vaginal Ring: Changed monthly
- Oestrogen Contraindication in Early Breastfeeding: Reduces milk supply
Relationship to central
High-effectiveness options; mechanism of action and safety monitoring essential
Barrier Methods
Sub concepts
- Male Condom: Water-based lubricant only; leave reservoir tip; single use
- Female Condom: Woman-controlled; can be inserted ahead of intercourse
- Diaphragm/Cervical Cap: Used with spermicide; stay in place ≥6 hours (max 24 h diaphragm); refit after childbirth
- Spermicides (Nonoxynol-9): Low effectiveness alone; frequent use increases HIV risk
- STI/HIV Protection: Only condoms provide dual protection
Relationship to central
Only methods with dual protection against pregnancy and STIs/HIV
Intrauterine Device (IUD)
Sub concepts
- Copper IUD: Non-hormonal; spermicidal; 10–12 years duration; emergency contraception if inserted within 5 days
- Levonorgestrel-Releasing IUD: Progestin-releasing; lightens/stops menses; 3–8 years duration
- Monthly String Checks: Essential for client safety
- PAINS Warning Signs: Period abnormal, Abdominal pain/dyspareunia, Infection/abnormal discharge, Not feeling well/fever, String missing/shorter/longer
- Contraindications: Active pelvic infection, unexplained bleeding
- Emergency Contraceptive Role: Copper IUD most effective emergency method within 5 days
Relationship to central
Most effective reversible method; LARC with distinct advantages and monitoring requirements
Permanent (Surgical) Methods
Sub concepts
- Vasectomy: Vas deferens cut/tied; local anaesthesia; not immediately effective
- Vasectomy Effectiveness Timeline: Confirm azoospermia after ~20 ejaculations or ~3 months before discontinuing backup
- Vasectomy Effects: No change in erection, libido, or ejaculate volume
- Bilateral Tubal Ligation (BTL): Fallopian tubes cut/blocked; immediately effective
- BTL Outcomes: Menstruation and hormones continue normally; any post-BTL pregnancy presumed ectopic
- Informed Consent Requirements: Thorough discussion of irreversibility and alternatives
Relationship to central
Irreversible options requiring thorough informed consent; counseling critical
Emergency Contraception
Sub concepts
- Emergency Contraceptive Pills: Progestin-only levonorgestrel or combined; most effective within 72 hours (some up to 120 hours)
- Mechanism of Emergency Pills: Mainly delay ovulation; not abortifacient
- Copper IUD for Emergency: Most effective method; effective up to 5 days post-intercourse
- Ongoing Contraceptive Benefit: Copper IUD provides long-term protection after emergency use
Relationship to central
Time-sensitive intervention for prevention of unplanned pregnancy
RA 10354 (Responsible Parenthood & Reproductive Health Act, 2012) & Philippine Context
Sub concepts
- Universal Access Guarantee: Modern FP, maternal health, RH information free/subsidised in public facilities
- Core Principles: Informed choice, voluntarism, respect for client decision
- Full Range of Methods: Both natural and artificial methods available
- Age- and Development-Appropriate RH Education: Mandated by DOH and LGUs
- Informed Consent Protection: Right to refuse; no coercion
- Conscientious Objector Referral: Must refer to another provider if objecting
- DOH Programs: Integration with maternal, newborn, child health services
- Postpartum Family Planning: Common nursing role in health centers and postpartum visits
- Alignment with RA 9173: Nursing regulation and standards of practice
Relationship to central
Legal and policy framework guiding all FP services and nursing practice in the Philippines
Nursing Management & Counseling
Sub concepts
- Health History Screening: Contraindications (thromboembolism, hypertension, smoking, breastfeeding, liver disease, pregnancy)
- GATHER Approach: Greet, Ask, Tell (about methods), Help choose, Explain use, Return/refer for follow-up
- Correct Use Teaching: Method-specific instructions, timing, administration
- Side Effects vs Danger Signs: Client education to distinguish normal from urgent
- Dual Protection Education: Condom plus another method when STI risk exists
- Cultural and Religious Sensitivity: Non-judgmental presentation of all options
- Consistency Emphasis: Most failures from inconsistent/incorrect use, not method failure
- Nursing Diagnosis Examples: Deficient Knowledge, Risk for Unplanned Pregnancy, Ineffective Individual Coping related to contraceptive choice
- Client-Centred Care: Respect autonomy and decision-making authority
Relationship to central
Application of nursing process in reproductive health and FP service delivery
High-Yield NLE Examination Points
Sub concepts
- RA 10354: Full range + informed choice + voluntarism + referral obligation
- STI/HIV Protection: Condoms only (male and female)
- COC ACHES Mnemonic: Thromboembolism red flags
- IUD PAINS Mnemonic: Expulsion, infection, perforation signs
- Oestrogen Contraindication: Early breastfeeding (milk supply reduction)
- DMPA Dosing: 150 mg IM every 3 months; no site massage
- LAM Three Conditions: <6 months + exclusive breastfeeding + no menses
- Vasectomy Timeline: ~3 months or 20 ejaculations to confirm azoospermia
- Copper IUD Emergency Window: Within 5 days post-intercourse
- Emergency Pills Timeline: Within 72 hours (up to 120 hours)
- LARC Effectiveness: Removes user-dependent error
- Post-BTL Pregnancy: Presume ectopic until proven otherwise
- Calendar Method Formula: (Shortest − 18) to (Longest − 11) after tracking ≥6 cycles
Relationship to central
Critical knowledge for NLE success; commonly tested concepts
Concept connections
- RA 10354 (RH Law)Informed Choice PrincipleLegal mandate requiring that all FP methods be presented factually and clients allowed to choose freely
- Contraceptive Effectiveness PrinciplesLARC Methods (IUD & Implant)LARC methods eliminate user error, providing near-perfect effectiveness rates even with typical use
- Hormonal MethodsACHES Danger SignsACHES mnemonic identifies thromboembolism complications specific to oestrogen-containing contraceptives
- IUD MethodPAINS Warning SignsPAINS mnemonic identifies expulsion, infection, and perforation complications specific to IUD users
- Natural MethodsCalendar Method FormulaCalendar method calculation (shortest − 18 to longest − 11) requires tracking 6+ cycles for accuracy
- Barrier MethodsSTI/HIV ProtectionMale and female condoms are the ONLY methods providing dual protection against pregnancy AND STIs/HIV
- Oestrogen-Containing PillsEarly Breastfeeding ContraindicationOestrogen reduces milk production, requiring progestin-only alternatives during early postpartum breastfeeding
- VasectomyAzoospermia Confirmation TimelineVasectomy requires ~3 months or 20 ejaculations and semen analysis confirmation before discontinuing backup method
- Bilateral Tubal Ligation (BTL)Ectopic Pregnancy RiskAny pregnancy after BTL must be presumed ectopic until imaging confirms intrauterine location
- Copper IUDEmergency ContraceptionCopper IUD is the most effective emergency contraceptive method (up to 5 days) and provides ongoing protection
- Emergency Contraceptive PillsMechanism: Ovulation DelayEmergency pills work mainly by delaying ovulation and are not abortifacient; they do not disrupt established pregnancy
- Lactational Amenorrhea Method (LAM)Three Mandatory ConditionsLAM effectiveness requires ALL three: baby <6 months, exclusive breastfeeding, and no return of menses
- DMPA InjectableBone Density MonitoringLong-term DMPA use causes reversible bone density loss requiring calcium, vitamin D, and weight-bearing exercise counseling
- Nursing ManagementGATHER Counseling ApproachGATHER (Greet, Ask, Tell, Help, Explain, Return) is the structured counseling framework for FP client education
- Sexual Response CycleLifespan SexualityMasters & Johnson cycle phases are affected throughout the lifespan by illness, medications, pregnancy, ageing, and culture
- Dual Protection EducationSTI Prevention CounselingWhen STI risk exists, counseling emphasizes using condom PLUS another FP method for pregnancy and infection prevention
- Missed Pill ManagementContraceptive EffectivenessMissing 2+ COC pills requires backup method use due to increased pregnancy risk from loss of ovulation suppression
- Conscientious ObjectionRA 10354 Referral ObligationHealthcare providers with moral objections to FP must refer clients to another provider respecting RA 10354 principles
- Progestin-Only PillsBreastfeeding SafetyProgestin-only pills are safe during breastfeeding because progestin does not reduce milk supply like oestrogen
- Calendar MethodIrregular Cycle UnsuitabilityCalendar method requires regular cycles; irregular cycles make the fertile window calculation unreliable
- Cervical Mucus MethodPeak Day RecognitionPeak day (last slippery mucus day) signals approaching ovulation; abstinence begins when mucus appears and continues 4 days after peak
- Standard Days MethodCycleBeads Visual ToolCycleBeads provide tangible visual tracking of 26-32 day cycles with color coding for fertile days 8-19
- Diaphragm/Cervical CapPlacement Duration RulesDiaphragm must remain in place 6-24 hours post-intercourse; longer placement risks toxic shock syndrome
- IUD String ChecksMonthly Monitoring ProtocolClients perform monthly palpation of IUD string after menses to detect expulsion or malposition early
- Informed ConsentPermanent MethodsVasectomy and BTL require thorough counseling on irreversibility and alternatives before informed consent
- Client-Centred CareNon-judgmental AttitudePLISSIT model emphasizes permission and non-judgment as foundational to sexual and reproductive health counseling
- Postpartum Family PlanningDOH Integration with MNCHRA 10354 mandates FP counseling integrated with maternal, newborn, and child health services in public facilities
- Levonorgestrel-Releasing IUDMenstrual Suppression BenefitLevonorgestrel IUD lightens or stops menses in 40-50% of users, providing therapeutic benefit beyond contraception
- Effectiveness vs AdherenceMethod Counseling PriorityHigh-effectiveness methods (LARC) reduce contraceptive failure from inconsistent use; priority for clients with adherence concerns
Diagrams
Human Sexuality & Family Planning Methods - Complete Concept Hierarchy
Comprehensive mind map showing all major concepts in Human Sexuality & Family Planning Methods, organized hierarchically from the central concept through sexuality foundations, contraceptive method categories (natural, hormonal, barrier, IUD, permanent), Philippine legal framework (RA 10354), and nursing management principles. This visual organizes the complete chapter content to show conceptual relationships and support memorization for NLE preparation.
Contraceptive Method Selection Decision Tree & Counseling Process
Detailed flowchart illustrating the nursing counseling process for contraceptive method selection, from initial health screening through the GATHER approach to method instruction and follow-up. Shows decision points for contraindications, method exclusions, and dual protection considerations. Essential for understanding the nursing management sequence and NLE case scenarios.
Hormonal Contraceptive Safety Monitoring: ACHES Danger Signs
Flowchart detailing ACHES danger signs assessment for clients using combined oral contraceptives. Shows the mnemonic breakdown (Abdominal pain, Chest pain/SOB, Headache severe, Eye problems, Severe leg pain), the emergency actions required, and the follow-up decision pathway. Critical for NLE exam items on contraceptive complications and client safety.
IUD Safety Monitoring: PAINS Warning Signs & Client Action
Flowchart illustrating PAINS warning signs for intrauterine device users, showing the five categories (Period abnormalities, Abdominal pain/dyspareunia, Infection/discharge, Not feeling well/fever, String missing/changed) and the clinical decision pathway. Includes assessment of urgency, possible diagnoses, and management actions. Essential for NLE items on IUD complications and client monitoring.
Natural Fertility Awareness Methods: Selection & Application
Comprehensive flowchart for natural fertility awareness method selection and teaching, showing client suitability assessment, the six natural method options, specific calculation and monitoring instructions for each method, and the follow-up process. Includes the critical calendar method formula and LAM three-condition checklist. Supports NLE preparation for natural method counseling.
Effectiveness Comparison: Perfect Use vs Typical Use Failure Rates
Pie chart illustrating the distribution of failure rates across contraceptive method categories, emphasizing the gap between perfect use and typical use for user-dependent methods. Shows why LARC methods (IUD, implant) are most effective, and demonstrates the significant impact of inconsistent use on barrier and natural methods. Critical for NLE discussion on effectiveness and counseling priorities.
Emergency Contraception: Timeline and Method Selection
Flowchart detailing emergency contraception options based on time window post-intercourse, showing the copper IUD as most effective option within 5 days, and emergency pills within 72 hours (up to 120 hours). Clarifies mechanism of action (ovulation delay, not abortion) and post-emergency management including counseling, STI screening, and selection of ongoing contraceptive method. Important for NLE items on emergency FP.
Vasectomy Effectiveness Timeline: From Procedure to Confirmation
State diagram illustrating the vasectomy effectiveness timeline from initial procedure through semen analysis confirmation, showing the critical waiting period (approximately 3 months or 20 ejaculations) before backup contraception can be discontinued. Emphasizes that vasectomy is NOT immediately effective and requires laboratory confirmation of azoospermia. Important for NLE counseling questions on permanent methods.