Chapter 8 Lecture

Smiles

Exploring Women’s Sexuality

External and Internal Genitalia

• Mons Pubis
• Labia Majora
• Labia Minora
• Clitoris
• Urethral Opening
• Vaginal Opening

• Perineum
• Vagina
• Cervix
• Uterus
• Fallopian Tubes
• Ovaries

Female Reproductive System

Breasts

• The function of breasts are as follows:
• Contain mammary glands for new-born nourishment
• Sex organ for arousal
• Each breast contains 15-25 clusters called lobes which connect to the nipple
• The nipple (erectile tissue) are effected by temperature, sexual stimulation, and lactation
• Breast size is determined by the following:
• Heredity
• Existing fat and glandular tissue
• Nearly 70% of women experience benign breast changes during the menstrual cycle, 85-90% of lumps are benign
• The BSE is a good way for a young woman to be aware of her breasts and changes
• The CBE should be a part of a normal health exam every 3 years
Menstruation
• Menarche is the first menstrual cycle for young girls
• The average age of onset is 10 or 11
• Genetics, socioeconomic conditions, nutritional status, obesity, and exercise can affect menarche
• 6 primary hormones are involved in regulating the reproductive system:
• Gonadotropin-releasing hormone (GnRH)
• Follicle-stimulating hormone (FSH)
• Luteinizing hormones (LH)
• Estrogen
• Progesterone
• Testosterone

Phases of the Menstrual Cycle

Day 1: Follicular phase begins. Menstral blood flow occurs for several days. Uterus is at its thinnest and estrogen is at its lowest
Day 14: Ovulation usually occurs, and Ovulatory phase begins. The largest follicle bursts, releasing a mature egg into the fallopian tubes
Day 21-24: Luteal phase causes the secretion of progesterone, preparing for implantation of the fertilized egg

Cycle is 35 total. Normal periods can last 4-8 days

Pelvic Examinations

• Pelvic exams include a visual screening to ensure that the reproductive organs look normal in size, shape, and location
• Exams should be conducted annually for 3 consecutive years until your health provider decides otherwise
• A speculum is inserted into the vagina to observe for internal organ normalcy
• A pap test and bimanual exam (physical check of the ovaries and uterus), followed by a rectal exam is common procedure for pelvic exams

Pap test

• A pap test consists of taking a sample of cells from the cervical area (squamous epithelium)
• The primary purpose is to prevent invasive squamous cell carcinoma from occurring
• The area is where 90% of all cervical cancers begin
• A brush or thin-prep is used to scrape cells from the cervix and smeared onto a slide
• Another sample is taken from the endocervical canal
• Both slides are taken to the lab for analysis

Menstrual Disorders

• Endometriosis occurs when the lining of the endometrium fragments and lodges in other parts of the body
• Dysmenorrhea describes painful menstrual cramps, believed to be a normal response to uterine contractions resulting from increased prostaglandin production
• Amenorrhea is the absence of a menstrual cycle
• Primary amenorrhea: significant physical disorder affecting young girls
• Secondary amenorrhea: due to pregnancy or the onset of menopause
Premenstrual Syndrome
• PMS is a disorder with an array of physical and psychological symptoms associated with the luteal phase of menstruation
• Most symptoms taper off with menstruation, although some women continue to experience symptoms throughout their period
• Researchers believe that the cyclical trigger are due to normal ovarian function
• The best approach to dealing with PMS is to alleviate them through non-invasive strategies such as:
• Relaxation techniques
• Biofeedback
• Nutritional changes
• Exercise

Other Medical Concerns

• Premenstrual Dysphoric Disorder (PMDD)

• Hysterectomy
Menopause
• American women (1.25 million annually) experience the normal cessation of their menstrual cycle
• Occurs normally between the ages of 40-58 years and most women experience this by age 50
• The 4 stages of menopause are:
• Premenopause: periods are beginning to become irregular
• Perimenopause: period of time (3-7 yrs.) before and after the last menstrual period during which the cycle becomes erratic and hot flashes begin
• Menopause: results from normal aging of the ovaries, when estrogen levels fall and menstruation has ceased for 1 yr.
• Postmenopause: Menstruation has ceased for over 1 yr.

Menopausal Hormone Therapy (MHT)

• The risks of using combined estrogen and progestin have been surprising based upon the findings of the National Heart, Lung and Blood Institute
• Study findings show that the increases in the following:
• 7 more women with heart attacks
• 8 more women with strokes
• 8 more women with breast cancer
• 18 more women with blood clots
• Given the recent findings, women are exploring more natural strategies such as:
• Exercise
• Nutrition

Human Sexual Response Cycle

• Masters and Johnson determined that the Human Sexual Response Cycle includes 4 predictable phases:
• Excitement
• Plateau
• Orgasm
• Resolution

Aging and Sexual Response

• Physiologically, the excitement phase takes longer for the vagina to lubricate
• The orgasmic phase is shorter in duration and contractions may be less intense
• The resolution phase has been found to take longer
• While sexual desires continue throughout the lifespan, a woman’s perceptions of relationship qualities provide a strong indicator of the level of sexual desire she attains during the aging process

Sexual Dysfunction

• 20-30% of all women express some concern about sexual functioning—“the ability to experience desire, pleasure, arousal, orgasm, and satisfaction.”

• The most common dysfunctions for women:

    • Inhibited sexual desire
    • Nonorgasmic response during partner sex
    • Painful intercourse (dyspareunia)
    • Female arousal dysfunction
    • Primary nonorgasmic response
    • Vaginismus