Glossary of Terms

Abstinence: Refraining from sexual intercourse.

Accreditation systems: Monitoring system in which outside inspectors periodically visit a service site and determine whether its performance meets preset standards.

Acetic acid: A vinegar solution that is applied to cervical tissue to facilitate identification of abnormal tissue. The acetic acid interacts with diseased cells, causing epithelial lesions to turn white.

Acquired Immune Deficiency Syndrome (AIDS): A progressive, usually fatal condition that reduces the body's ability to fight certain infections. It is caused by infection with human immunodeficiency virus (HIV).

Adenocarcinoma: A malignant cervical neoplasm primarily consisting of glandular epithelium. Adenocarcinoma accounts for approximately 5 percent of cervical cancer cases worldwide.

Adhesion: Scar tissue in the abdominal cavity, fallopian tubes, or uterus that may interfere with transport of the egg or implantation of the embryo in the uterus.

Adolescence: The transition between puberty and adulthood.

Adolescents: Youth, ages 10 to 19.

Amenorrhea: Absence of menstrual periods.

Anemia: Low levels of the oxygen-carrying material in the blood, resulting in decreased oxygen to body tissues.

Angurya: Scraping of the vagina and surrounding tissues as a part of the harmful practice of female genital cutting.

Antenatal: The period between conception and birth (same as prenatal).

Antiretroviral treatment : A substance or combination of substances used to destroy a retrovirus (for example, HIV) or suppress its replication.

Antisperm antibodies: Antibodies produced by a woman that attach to sperm and inhibit both their movement and their ability to fertilize.

Artificial insemination: Placement of sperm inside a woman's vagina, uterus, or fallopian tubes (usually by injecting them through a catheter or cannula) in order to promote fertilization.

Assisted reproductive technology (ART): Procedures used to bring about conception without sexual intercourse, including IUI, IVF, GIFT, and ZIFT.

Asymptomatic: Without signs or symptoms of disease or illness (i.e. where the patient does not complain of any symptoms).

Atypical squamous cells of undetermined significance (ASCUS): An abnormal test result from a cytological smear of the cervix. This type of abnormality is less severe than low-grade squamous intraepithelial lesion (SIL).

Automated Pap screening : Mechanical identification of Pap smear subsets, which should then be examined by cytologists.

Backup method : A family planning method such as condoms or spermicide that can be used temporarily for extra protection against pregnancy when needed.

Bacterial vaginitis: Inflammation of the vagina caused by a bacterial infection.

Bacterial vaginosis: A common vaginal condition that includes a fishy-smelling discharge caused by overgrowth of bacteria normally found in the vagina.

Balanitis: Inflammation of the head (tip) of the penis and the mucous membrane beneath it.

Bethesda classification system: Proposed in 1988 by the U.S. National Cancer Institute, this system relies on only two grades for reporting cervical cancer precursor conditions: low�grade squamous intraepithelial lesions (SIL), which include cellular atypia and CIN I, and high�grade squamous intraepithelial lesions, which include CIN II, III, and CIS. The system creates uniform terminology, includes a statement regarding the adequacy of the cytological specimen, and uses subcategories to further describe cytologic changes.

Bisophonates: A class of non-hormonal drugs that adsorbs to bone mineral and prevents osteoporosis.

Breakthrough bleeding: Vaginal bleeding between menstrual periods.

Bromocriptine: Oral medication used to lower prolactin levels.

Candidiasis: A common infection of the skin or mucous membranes caused by a yeast-like fungus (Candida albicans) that commonly causes vaginitis (vaginal burning and or itching accompanied by clumpy white discharge).

Carcinoma in situ (CIS): Cellular changes in the stratified squamous epithelium associated with invasive cervical cancer but not extending to adjacent structures. CIS is generally a recognizable precursor of invasive squamous cell cancer.

Case fatality rate: The number of fatalities (deaths) from a specific disease in a given period per 100 episodes of the disease during the same time period.

Cervical intraepithelial neoplasia (CIN) classification system: Introduced in the 1960s, the CIN classification system for reporting cytological (Pap smear) results graded the severity of cervical lesions so that mild cervical dysplasia was categorized as CIN I, moderate cervical dysplasia as CIN II, and severe cervical dysplasia as CIN III.

Cervical mucous: A thick fluid plugging the opening of the cervix. Most of the time the cervical mucous is thick enough to prevent sperm from entering the uterus. At midcycle, however, under the influence of estrogen, the mucous becomes thin and watery, and sperm can more easily pass into the uterus.

Cervical Os: The opening of the cervix

Cervical stenosis: A narrowing of the cervical canal.

Cervicitis: Inflammation of the cervix, usually caused by gonorrhea or chlamydia.

Cervicography: Technique for photographing the cervix to identify dysplasia or cancer. Photographs are then sent to a central site for evaluation.

Cervix: The lower portion of the uterus that extends into the upper vagina. Also referred to as the neck of the uterus.

Chancroid: A sexually transmitted disease caused by the rod-shaped bacteria, Hemophilus ducreyi, often causing painful sores on the penis, vagina, or anus, and swollen lymph nodes.

Chlamydia: A sexually transmitted disease caused by the bacterium chlamydia trachomatis, often causing irregular bleeding and pain during intercourse in women, burning during urination in men, and discharge in both men and women. If left untreated, chlamydia can lead to pelvic inflammatory disease.

Circumcision (female): Removal of the clitoris, clitoral shaft and/or labia minora. Now illegal in many states.

Cirrhosis: disease involving the destruction of liver cells and diminished liver function. Cirrhosis can block blood flow to the liver causing high blood pressure and/or jaundice.

Clinical diagnosis: Using clinical experience to identify the presence of a disease.

Clinical protocols: Step-by-step instructions that explain how to perform clinical tasks, such as inserting an IUD or taking blood pressure.

Clitoral adhesions: Secretions and vaginal discharges, if not cleaned, may form adhesions on the clitoris, clitoral shaft, under the clitoral hood. Proper cleaning of the clitoris involves retracting or pulling back the clitoral hood, exposing the clitoris, and washing away these secretions. Clitoral adhesions can be very painful and may need to be removed by on OB-GYN under general anesthesia.

Clitoral Glans: The tip of the clitoris, that rests at the end of the clitoral shaft. Sometimes hidden by the clitoral hood.

Clitoral hood: The portion of the labia minora that comes together at the top of the vulva, forming a hood over the clitoris and clitoral shaft that helps protect the clitoris. Some inner labia (labia minora) may merge or come together at the bottom of the clitoral glans at a point called the frenum, while other labia minora merge with the clitoral hood, and still others do both.

Clitoridectomy: Removal of part or all of the clitoris.

Clitoris: A small, pea-shaped organ composed of erectile tissues, that is on the end of the clitoral shaft, at the upper end of the vulva. The clitoris is normally hidden by the labia minora that forms a hood over the clitoris. It is highly sensitive, and can be a source of sexual pleasure and orgasm.

Clomiphene citrate (Clomid, Serophene): Drug that stimulates ovulation through the release of gonadotropins from the pituitary gland.

Colposcopy: Examination of the vagina and cervix using an endoscopic instrument (colposcope) that provides magnification to allow direct observation and study of vaginal and cervical cells in vivo.

Community-based distribution: The distribution of health services and supplies through stores, special depots, or agents other than clinics, physicians, or medical personnel.

Conception: Union of an ovum (egg) and a sperm. Also known as fertilization.

Corpus Luteum: or yellow body is in effect a tiny and temporary endocrine gland, continues to secrete reduced amounts of oestorgen which return the cervix (closes and hardens) and mucus (dries up) to their naturally infertile state.

Couple-years of protection (CYP): Number of contraceptives distributed within a program year, by type, multiplied by the average length of time they are effective.

Cryotherapy: The use of extremely low temperatures (�60� C to �90� C) to freeze and destroy abnormal tissue.

Cytology or exfoliate cytology: Commonly used to describe evaluation of endo� and ecto�cervical cells for abnormalities associated with HPV infection and SIL.

Diathermy : The generation of heat resulting from the passage of a high�frequency electric current.

Discordant couple: A couple in which one partner is HIV positive and the other is HIV negative.

Domestic violence: Violence that occurs within a family or an intimate relationship, including wife beating, husband beating and child abuse.

Douche: Cleansing of the vagina through the introduction of a liquid into the vagina that is then expelled. Sometimes used after the menstrual period to remove the remnants of uterine lining or endometrium.

Downstaging: A term used to describe visual inspection to identify early cervical cancer.

Dysmenorrhea: Painful menstrual periods.

Dyspareunia: Painful sexual intercourse.

Dysplasia of the uterine cervix: Cellular abnormality involving part of the cervical squamous epithelium.

Dystocia: Difficult birth due to abnormality in the fetus (fetal dystocia) or the mother (maternal dystocia).

Dysuria: Difficulty or pain in urination.

Eclampsia: A toxic condition of late pregnancy, labor, and the period immediately after delivery, occurring as a complication of pre-eclampsia, and characterized by convulsions. Serious cases can lead to coma and death.

Ectocervix: The external portion of the uterine cervix and os.

Ectopic pregnancy: Pregnancy outside the uterus; a life-threatening condition that can cause massive internal bleeding.

Electrocautery (electrocoagulation): The process of using an electrically heated metal probe to destroy abnormal tissue.

Electrode: The terminal of an electric circuit through which electrons pass.

Endocervix: The mucous membrane of the cervical canal.

Endometrial biopsy: Collection of a sample of the uterine lining for microscopic analysis in order to confirm ovulation and proper preparation of the endometrium to receive an egg.

Endometrium: The mucous membrane lining of the uterus. The uterine lining that is shed at menstruation.

Endometriosis: Endometriosis is a painful, chronic disease that affects 5 1/2 million women and girls in the USA and Canada, and millions more worldwide. It occurs when tissue like that which lines the uterus (tissue called the endometrium) is found outside the uterus -- usually in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity.

Epidemic: A sudden, unusual increase in cases that exceeds the number expected on the basis of experience.

Essential obstetric care: Provision of key life-saving (emergency) and non-emergency obstetric interventions including: Cesarean section; crucial medications (such as anesthesia, antibiotics, and fluid replacement); blood transfusions; manual removal of the placenta; and vacuum aspiration for incomplete abortion.

Estrogen replacement therapy: See hormone replacement therapy.

Estrogen: Hormones responsible for female sexual development. Natural estrogens, especially the hormone estradiol, are secreted by a mature ovarian follicle which surrounds the ovum (egg). Synthetic estrogens are drugs which have effects similar to those of natural estrogens. Estrogen is the female sex hormone responsible for the development and maintenance of female reproductive organs, especially breast and uterus, and the secondary sex characteristics such as distribution of fat and hair patterns.

Etiologic: Using laboratory tests or microscopy to identity a causative agent.

Excision: Removal of the clitoral hood with or without removal of part or all of the clitoris as part of the harmful practice of female genital cutting.

Fallopian tube: Either of a pair of slender ducts that connect the uterus to the region of each ovary. It carries the ovum (egg) from the ovary to the uterus, and carries the sperm from the uterus toward the ovary. Conception usually takes place in the fallopian tube.

Fecundity: The ability to become pregnant.

Female genital cutting (FGC): Partial or total removal of the female external genitalia. Also known as female genital mutilation (FGM) or female circumcision.

Fibroid (myoma, leiomyoma): A benign tumor of the uterine muscle and connective tissue.

Fistula: An abnormal opening between the vagina and the rectum, which can lead to incontinence.

Follicle: is a small secretory sac or cavity which surrounds the ovum in the ovary.

Follicle Stimulating Hormone: Known also as "FSH," this hormone stimulates cells in the ovaries to secrete estrogens, and also assist mature ovum to be released from ovary.

FSH: Follicle Stimulating Hormone stimulates cells in the ovaries to secrete estrogens, and also assist mature ovum to be released from ovary.

Forecasting: Estimating the quantity of each contraceptive or other product that will be dispensed to clients during some future period.

Fully breastfeeding: Giving a baby no food or liquid other than breast milk. To nearly fully breast feed signifies that the baby is given some additional food or liquid, but at least 85 percent of the baby's feedings are breast milk.

Gamete intrafallopian transfer (GIFT): A technique to bring about conception without sexual intercourse; eggs and sperm are combined outside of the body and immediately injected into the fallopian tubes where natural fertilization may take place.

Gender: Culturally defined roles and responsibilities for females and males that are learned, may change over time, and vary among societies.

Genital (vaginal) prolapse: A condition in which the vaginal wall or uterus descend below their normal positions; part of the bladder or rectum may protrude from the vagina.

Genital ulcer disease/syndrome: The name for the syndrome where ulcers or sores are found in the genital region, usually caused by herpes, syphilis and/or chancroid. The presence of genital ulcers may increase the risk of transmitting HIV.

Genitalia: External reproductive organs of the body (for example, vulva and clitoris).

Gishiri: Cutting of the vagina and surrounding tissues as part of the harmful practice of female genital mutilation.

Glans of the Clitoris: The tip of the clitoris, that rests at the end of the clitoral shaft. Sometimes hidden by the clitoral hood.

Gonorrhea: STD caused by the bacterium Neisseria gonorrhoea; common cause of urethral and vaginal discharge, and of discharging eyes in newborns.

Herpes: An STD caused by herpes simplex virus (HSV), a common cause of genital blisters and ulcers.

HIV (human immunodeficiency virus): An AIDS-causing virus that attacks the body's immune system, making the body unable to fight infection.

Hormone: A chemical substance formed in one organ or part of the body and carried in the blood to another organ or part. Affects the activity of other organs or parts of the body through chemical action. Hormones are a chemical substance, produced by an organ, gland or special cells, that is carried through the bloodstream to regulate the activity of certain organs.

Hormone replacement therapy (HRT): A combination of estrogen and progestin, or estrogen alone, that is given to women during the menopausal transition to offer them short-term relief from uncomfortable symptoms. It may also be given to post-menopausal women on a long-term basis to protect them from osteoporosis and other conditions related to menopause.

HPV (human papilloma virus): A sexually transmitted agent that infects the cells of the cervix and slowly causes cellular changes that can result in cancer.

Hypertension: Higher blood pressure than normal. Diastolic blood pressure from 90 to 99 mm HG is considered mild hypertension; 100-109, moderate hypertension; and 110 or greater, severe hypertension. Systolic blood pressure from 140 to 159 mm HG is considered mild hypertension; 160-179, moderate hypertension; and 180 or greater, severe hypertension.

Hypertensive disorders of pregnancy: High blood pressure occurring as a result of pregnancy.

Hysterectomy: Partial or complete removal of the female's internal reproductive organs.

Hysterosal Pingogram: X-ray examination of the pelvic organs after dye has been injected through the cervix; used to check for malformation of the uterus and blockage of the fallopian tubes.

Hysteroscopy: Insertion of a fiber-optic device into the uterus to visually check for abnormalities.

Implantation: The embedding of the embryo into tissue so it can establish contact with the mother's blood supply for nourishment. Implantation usually occurs in the endometrium (the membrane lining the inner surface of the uterus); however, in an ectopic pregnancy it may occur elsewhere in the body.

In vitro fertilization (IVF): Fertilization takes place outside of the body in a small glass dish.

Incidence: The frequency of new infections (i.e., number of infections over a given time period), expressed as a percentage of the population at risk.

Incontinence: The inability to control excretory functions, such as defecation or urination.

Incubation period : The time period between when a person is first infected with a disease-causing agent and the time when clinical manifestation of the disease occurs.

Index patient: A term used to distinguish between the original patient treated and any partners who are treated.

Indicators: Quantifiable measures of program performance and impact.

Infertility: Inability of a couple to conceive after one year of unprotected intercourse.

Infibulation: Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening, leaving a small hole for urine and menstrual flow, as part of the harmful practice of female genital mutilation.

Informed choice: The client's ability to freely choose a contraceptive method from a range of options based on accurate, useful information and an understanding of her/his own needs.

Intracytoplasmic sperm injection (ISCI): A procedure used to bring about conception without sexual intercourse in which a single sperm is injected into an egg.

Intrapartum: Within the period of labor and delivery.

Intrauterine insemination (IUI): A type of artificial insemination in which sperm are placed directly in the uterus in order to bypass the cervical mucus.

Introitus: Opening of the vagina or vaginal cavity.

Kegel exercises : Special exercises to tighten the pelvic muscles, which can relieve some forms of urinary incontinence and pelvic discomfort.

Keloid: A raised, firm, thickened red scar that may grow for a prolonged period of time. It may follow trauma or surgical incision.

Labia majora: The folds of tissue lying on either side of the vaginal opening and forming the borders of the vulva. The labia major is also referred to as the outer lips or outer labia.

Labia minora: The smaller, inside folds or lips, found inside the labia majora, that encompass the vagina (and vaginal introitus), urinary opening, extending to the top of the vulva where they join and form the hood of the clitoris, or clitoral hood, that helps to protect the clitoris. Some inner labia (labia minora) may merge or come together at the bottom of the clitoral glans at a point called the frenum, while other labia minora merge with the clitoral hood, and still others do both.

Labial adhesions: The smaller, inside folds or lips (labia minora) of the labia majora have fused together. Typically occurring in babies and prepubescent girls, can be very painful and requires immediate medical intervention as urine and vaginal discharges may be unable to escape, resulting in infection and fever.

Lactational amenorrhea method (LAM): A family planning method that relies on breastfeeding as natural protection against pregnancy for up to 6 months after childbirth. Women who use LAM must fully breastfeed or nearly fully breastfeed to protect themselves from pregnancy.

Laparoscopy: Examination of the pelvic region with a fiber-optic telescope to diagnose and treat fertility problems, including endometriosis and adhesions.

Laparotomy: Major abdominal surgery to correct abnormalities of the reproductive organs.

Lesion: A very general term denoting any abnormality on the surface of the body, whether on the skin or on a mucous membrane. Includes sores, wounds, injuries, pimples, and tumors, on the skin or elsewhere.

LH: LH or Lutenizing Hormone stimulates the ovary to release mature ovum and prepares the uterus for the implantation of a fertilized egg. It also stimulates the formation of the corpus luteum in the ovaries.

Loop electrosurgical excision procedure (LEEP): Also known as large loop excision of the transformation zone (LLETZ), LEEP is a method of outpatient excisional biopsy and treatment that is used to remove the entire transformation zone using a thin wire electrode charged with a low�voltage, high�frequency alternating current (600 kHz), producing a tissue specimen for histologic analysis.

Lutenizing Hormone: A hormone, also referred to as "LH," that stimulates the ovary to release mature ovum and prepares the uterus for the implantation of a fertilized egg. It also stimulates the formation of the corpus luteum in the ovaries.

Masturbation: Sexual stimulation usually involving the clitoris, clitoral shaft, clitoral hood and or vagina, in a pleasurable manner, that may or may not end in orgasm. Contrary to popular belief, masturbation is healthy and harmless and viewed as a normal sexual expression, or outlet. As many as 90% of all females masturbate.

Maternal mortality rate: The number of maternal deaths annually per 1,000 women of reproductive age.

Maternal mortality ratio: The number of maternal deaths per 100,000 live births, reflecting a woman's risk of dying each time she becomes pregnant.

Maternal mortality: Death of a woman while pregnant or within 42 days of termination of the pregnancy from any cause related to or aggravated by the pregnancy or its management.

Medical barriers: Practices and policies based on a medical rationale that impede or deny contraceptive use, but which cannot be scientifically justified.

Medical eligibility criteria: Standards by which the safety of contraceptive methods are judged for individual clients, depending on their age, health status, and behavior.

Menarche: the term given to the onset of menstruation in females. This occur at puberty and can be anywhere between the ages of 10 and 17, depending on the individual.

Menopausal transition: A period of about four years before menopause during which hormonal and clinical changes occur.

Menopause: The time in a woman's life when menstruation (menstrual periods) or monthly periods stop. Occurs when a woman's ovaries stop producing eggs and monthly bleeding from the uterus stops. Typically occurring from the ages of 40 - 55.

Menses inducer: Agent that once introduced in a woman's body causes the start of menstrual bleeding (for example, an antiprogestin).

Menses: Menstruation is the term given to the periodic or monthly discharge of blood, tissue fluid and mucus through the vagina, from the endometrium (lining of the uterus), that usually lasts from 3 - 5 days. Occurs in girls at the onset of menarche, or first period around ages 10 - 17, through women ages 40 - 55 at which time menstruation ends and menopause begins. Menstruation is caused by a sudden reduction in estrogens and progesterone. Can also be referred to as the menstrual phase or menstrual cycle, or menses.

Menstrual cycle: A repeating series of changes in the ovaries and endometrium that includes ovulation and about two weeks later the beginning of menstrual bleeding. In most women the cycle averages 28 days, but it may be shorter or longer.

Menstruation: Menstruation is the term given to the periodic or monthly discharge of blood, tissue fluid and mucus through the vagina, from the endometrium (lining of the uterus), that usually lasts from 3 - 5 days. Occurs in girls at the onset of menarche, or first period around ages 10 - 17, through women ages 40 - 55 at which time menstruation ends and menopause begins. Menstruation is caused by a sudden reduction in estrogens and progesterone. Can also be referred to as the menstrual phase or menstrual cycle, or menses.

Microbicides: Agent that destroys microbes (such as an antiseptic).

Microinvasion: Invasion of tissue immediately adjacent to a carcinoma in situ; the earliest stage of malignant neoplastic invasion.

Mons pubis: The fatty tissue over the pubic bone.

Myomectomy: Surgical removal of fibroid tumors from the wall of the uterus.

Neonatal death: Death of an infant within the first month of life.

Neoplasia: The formation and growth of new and usually abnormal tissue (neoplasms), such as benign or malignant tumors.

Non-gonococcal urethritis (NGU): Urethritis, manifested by urethral discharge, painful urination, or itching at the end of the urethra, is the response of the urethra to inflammation NOT due to gonococcal infection.

Nulliparous: Having never given birth to a liveborn infant.

Obstructed labor: : A labor in which delivery is prevented by mechanical factors; delivery often requires Cesarean section.

Opportunistic illnesses: Illnesses that affect people with weak immune systems.

Osteoporosis: Loss of bone mass that frequently is experienced by postmenopausal women and increases the risk of hip and other fractures.

Ovary: a female gland that produces hormones and the female reproductive or germ cell (ovum).

Ovulation: The release of an ovum or egg (egg cell) from an ovary into the fallopian tube.

Ovulation induction: The use of female hormone therapy to stimulate ovulation.

Ovum (plural) or Ova (singular) are the female reproductive, egg or germ cell that are stored in the woman's ovaries. Each month, during ovulation, an ova or egg is released from one ovary, alternating alternating each month. Sometimes more than one egg is released, and if fertilized, may result in multiple births.

Pads: Cotton, cotton/rayon or other absorbent material, typically attached to panties, and worn externally during menstruation to absorb the menstrual flow.

Pandemic: An epidemic occurring in many regions and countries.

Pap smear: A test in which a smear of vaginal or cervical secretion is examined for exfoliated cells to detect cancer in an early stage, or to evaluate hormonal condition.

Partner management: Contacting, treating, and educating sexual partners of a patient treated for STD.

Patient referral : Method of contacting sexual partners which relies on the patient informing them.

Pelvic inflammatory disease (PID): Infection in the uterine lining, uterine wall, fallopian tube, ovary, uterine membrane, broad ligaments of the uterus, or membranes lining the pelvic wall. May be caused by a variety of infectious organisms including gonorrhea and chlamydia.

Pergonal: Medication used to induce ovulation.

Perinatal transmission (also known as vertical or mother-to-child transmission) : The transmission of HIV from a woman with HIV infection to her baby before or during birth or through breastfeeding.

Pituitary Gland: A gland located in the brain that regulates a wide range of bodily activities from growth to reproduction.

Placenta: The organ that nourishes a growing fetus. Also known as "afterbirth," it is expelled from the uterus within a few minutes after the birth of the baby.

Postcoital test: Microscopic examination of the cervical mucus several hours after intercourse; used to detect causes of infertility such as sperm-mucus interaction problems, the presence of sperm antibodies, and the quality of cervical mucus.

Postpartum: The first 6 weeks after childbirth.

Post-traumatic stress disorder (PTSD): A severe anxiety reaction to a traumatic event, such as rape or war, in which individuals repeatedly relive the event, avoid stimuli associated with the trauma, and experience symptoms such as difficulty sleeping and irritability.

Pre-eclampsia: A condition in pregnancy manifested by hypertension, plus proteinuria (excess protein in urine) and/or swelling after 20 weeks of pregnancy. Can progress to eclampsia.

Prenatal: The period between conception and birth (same as antenatal).

Prevalence: The proportion of a defined population with the infection at a given point or period in time.

Preventive behaviors: Behaviors that reduce exposure to health risks and improve life. These can include behaviors such as planning ahead for condom use, seeking information or help about a reproductive health concern, or forming positive relationships among peers who are not engaging in risky behaviors.

Primary infertility: Never having conceived a child.

Progesterone: A hormone secreted chiefly by the corpus luteum, which develops in a ruptured ovarian follicle (small round structure in the ovary that contains an ovum) during the luteal phase of the menstrual cycle (after ovulation). Progesterone prepares the endometrium for possible implantation by a fertilized ovum. It also protects the embryo, enhances development of the placenta, and aids in preparing the breasts for nursing the new infant.

Progestin: A word used to cover a large group of synthetic drugs that have an effect similar to that of progesterone.

Prostate: A gland surrounding the neck of the bladder and urethra in the male that contributes a secretion to semen.

Provider referral: Method of contacting sexual partners which relies on the health care provider informing them.

Pubic hair: Hair in the genital region.

Punch biopsy: A method by which a small sample of tissue is extracted for histological analysis.

Reproductive tract infection (RTI): RTI is a general term including sexually transmitted infections, infections caused by an overgrowth of organisms normally present in the genital tract, and iatrogenic infections acquired during improperly performed medical procedures.

Risk assessment : A systematic client interview designed to elicit medical, social, and behavioral history to assist in establishing potential for risk of RTIs.

Role model: A person who serves as a example of a positive behavior.

Salpingitis: Inflammation of the fallopian tubes.

Salpingotomy: Surgery to open blocked fallopian tubes.

Secondary infertility: Inability to conceive after having previously conceived a child.

Sensitivity: In testing for a disease, the proportion of people with the disease who are correctly classified by the test as diseased. The sensitivity of a test indicates the degree to which the test is able to identify the presence of the disease.

Septic abortion: Abortion-related uterine and pelvic infection.

Selective estrogen receptor modulators (SERMs): Estrogen-like compounds, including tamoxifen and raloxifene, that are designed to influence some tissues in the body, but not others.

Seroconversion: Development of detectable antibodies to HIV in the blood serum as a result of infection. It may take several months or more after HIV transmission for antibodies to the virus to develop. After antibodies to HIV appear in the blood, a person will test positive in the standard ELISA test for HIV.

Sex: Biological differences between males and females.

Sex-role stereotype: A fixed notion of appropriate behaviors based on gender; for example, men should earn money and women should raise children.

Sexual coercion: Forcing someone to engage in sexual behavior against his/her will, through threatened or actual violence or severe social consequences.

Sexual orientation: The sex to which a person is physically and emotionally attracted. Heterosexual orientation refers to attraction to members of the opposite sex; homosexual orientation refers to attraction to members of one's own sex; and bisexual orientation refers to attraction to both sexes.

Sexuality education: The process of providing training and knowledge about sexuality; sexuality education encompasses both physical and emotional aspects of sexual and reproductive health.

Sexually transmitted disease (STD) or sexually transmitted infection (STI): Any infection that is acquired through sexual contact in a substantial number of cases.

Specificity: In testing for a disease, the proportion of people without the disease who are correctly classified by the test as free of the disease. The specificity of a test indicates the degree to which the test reacts only to that particular disease.

Speculoscopy: A magnified chemiluminescent visual inspection of the cervix.

Squamocolumnar junction: The point at which columnar cells meet ectocervical squamous cells on the cervix. This junction is located in the center of the transformation zone and is most vulnerable to abnormal changes in cervical cells.

Squamous cell: A flat, scaly epithelial cell.

Squamous intraepithelial lesion (SIL): The abnormal growth of squamous cells on the surface of the cervix. These changes generally are described as low-grade (LSIL) or high-grade (HSIL), depending on the degree of abnormality of the cells, and how much of the cervix is affected.

STD (or STI) management: The care of a client with an STD; this includes activities such as history-taking, physical examination, laboratory tests, diagnosis, treatment and health education about treatment and prevention, follow-up assessment, and referral, when indicated.

Substance abuse: Misuse of alcohol or drugs.

Sunna: Removal of the part or all of the clitoris, as part of the harmful practice of female genital mutilation. Also means a customary procedure or action dictated by tradition.

Symptoms: Health problems that a client experiences or complains of.

Syndrome: A set of signs and symptoms that tend to occur together and are clinically indicative of a particular disease state, such as AIDS.

Syphilis: STD caused by the bacterium Treponema pallidum; one of the causes of genital ulcers.

Tampon: Absorbent material made of cotton or cotton/rayon that is inserted into the vagina to catch the menstrual flow. Tampons have been linked to toxic shock syndrome. Tampons must be changed regularly to avoid toxic shock syndrome, typically, upon saturation of the tampon - but NEVER leave the same tampon in the vagina for more 4-6 hours (see manufacturers recommendations for changing tampons). Always use the minimum absorbency tampon wherein the tampon is changed more frequently, as opposed to less frequently.

Thromboembolic disorder: Abnormal clotting in the blood vessels.

Toxic shock syndrome: A devastating disease linked to tampon usage that starts out with flu-like symptoms but may become deadly. While affecting mostly women, men may also acquire toxic shock.

Traditional birth attendant (TBA): A non-medically trained community person who often is called on to help during childbirth.

Transformation zone: Located at the entrance to the endocervical canal, the transformation zone is surfaced with glandular (columnar) epithelium until the onset of puberty, when the glandular epithelium is gradually replaced by squamous epithelium, similar to the lining of the vagina. Cervical cancer generally originates in the transformation zone.

Trichomoniasis: STD caused by the bacterium Trichomonas vaginalis; one of the causes of vaginal discharge.

Tubal patency: Open, unobstructed fallopian tubes.

Ulcer: Open sore.

Unaided visual inspection (UVI): Visualization of the cervix without magnification (but with acetic acid) to screen for cervical cancer.

Universal precautions: Infection control measures that prevent the transmission of HIV between patients and health workers. They include hand washing; use of gloves and protective clothing; safe handling of sharp objects; disposal of waste materials; cleaning, disinfecting and sterilizing medical instruments; proper handling of corpses; and treating injuries at work.

Unmet need for family planning: Percentage of married, fecund women who desire to space or limit their births but are not using contraception.

Urethra: The canal for discharging urine from the bladder to the outside. In a female, it lies between the vagina and the clitoris.

Urethral discharge: The symptom or syndrome where women present with a discharge from their urethra.

Urethritis: Inflammation of the urethra, usually caused by gonorrhea or chlamydia.

Urinary frequency: Feeling the need to urinate more frequently than normal.

Urinary incontinence: Inability to control urination.

Uterine prolapse: A condition in which the uterus protrudes into, and sometimes out of, the vagina.

Uterus: a hollow, muscular organ in females that is the site of menstruation, implantation, development of the fetus, and labor. Also called the womb.

Vagina: The tube that forms the passage between the cervix/uterus and the vulva. It receives the penis during sexual intercourse and serves as the delivery passage for birth and for menstrual flow.

Vaginal discharge: The symptom or syndrome where women present with an abnormal discharge from their vagina. Can suggest a vaginal infection (candidiasis, bacterial vaginosis or trichomoniasis) or a cervical infection (gonorrhea or chlamydia).

Vaginal fistula: Openings in the birth canal that allow leakage from the bladder or rectum into the vagina.

Vaginitis: Inflammation of the vagina. May be caused by microorganisms (such as gonococci, staphylcocci, spirochetes), chemical irritation, fungus infection caused by candida albicans, protozoan infection, irritation from foreign bodies, vitamin deficiency as in pellagra, intestinal worms, or conditions involving the vulva and surrounding areas (such as uncleanliness).

Varicocele: Dilated veins in the scrotum where blood pools, thus raising scrotal temperatures.

Vasomotor symptoms: Symptoms related to the dilation or constriction of blood vessels, such as the hot flashes experienced during menopause.

Visual inspection with acetic acid (VIA): Visualization of the cervix with acetic acid to screen for cervical cancer.

Visual inspection with acetic acid and magnification (VIAM): Visualization of the cervix using a portable, low-power magnification device (as opposed to a colposcope) and acetic acid to facilitate cervical cancer screening (and/or possibly to guide biopsy and outpatient treatment of pre-invasive lesions).

Vulva: The outside portion of the female genitalia, including the labia, clitoris, and vaginal opening or "introitus."

Womb: a hollow, muscular organ in females that is the site of menstruation, implantation, development of the fetus, and labor. Also called the uterus.

Youth: Young people ages 15 to 24.

Zygote intrafallopian transfer (ZIFT): A technique that fertilizes an egg in a lab dish and then transfers the resulting zygote into a woman's fallopian tubes.