Female Sexual Anatomy and Physiology Chapter 3

Learning Objectives External Sex Organs Internal Sex Organs The Breasts The Menstrual Cycle Menstrual Problems

External Sex Organs Pudendum External female genitals Derived from a Latin work that means “something to be ashamed of” This sets the tone for negative views of the female genitalia

External Sex Organs Vulva External female structures that includes the mons veneris, the labia majora and labia minora, the clitoris, and the vaginal opening Latin for “wrapper” or “covering

External Sex Organs Labia Majora Labia Minora Large folds of skin that run downward from the mons along the sides of the vulva Shields inner genitalia Labia Minora Hairless, light colored membranes located between the labia majora

External Sex Organs Clitoris Female sex organ consisting of a shaft and glans Shaft Body of clitoris, approximately 1 inch long Copora cavernosa, spongy tissue that becomes engorged from sexual stimulation Glans Extremely sensitive tip of clitoris Prepuce is the fold of skin covering the glans

External Sex Organs Clitoris Female sex organ consisting of a shaft and glans Develops from the same embryonic tissue as the penis Shaft Body of clitoris, approximately 1 inch long Copora cavernosa, spongy tissue that becomes engorged from sexual stimulation Glans Extremely sensitive tip of clitoris Prepuce is the fold of skin covering the glans

Clitoridectomy Surgical removal of the clitoral hood CRITICAL THINKING Ritualized genital mutilation considered a “rite of passage” to womanhood in some cultures The removal is to ensure the girl’s chastity Outlawed in the US Creates physical and emotional scars CRITICAL THINKING Do you believe that disapproval of clitoridectomy by Americans and other Westerners shows cultural insensitivity? Why or why not?

External Sex Organs The Urethral Opening The Vestibule “Entranceway” within the labia minora that contains the openings to the vagina and urethra The Urethral Opening The opening through which urine passes form the bladder out of the body Its proximity to external sex organs can pose hygienic problems for sexually active women Cystitis is an inflammation of the urinary bladder

External Sex Organs Vaginal Opening Introitus Hymen Larger than urethral opening Lies below urethral opening Hymen Fold of tissue across vaginal opening May remain intact until intercourse Its presence is often considered a sign of virginity

External Sex Organs The Perineum Skin and tissue that lie between vaginal opening and anus Contains many nerve endings and is very sensitive Episiotomy is a surgical incision that may be made here during childbirth to protect the vagina from tearing

External Sex Organs

External Sex Organs Underlying Structures Sphincters Crura Ring-shaped muscles that surround body openings Crura Attach clitoris to pubic bone Vestibular bulbs Cavernous structures extending downward along sides of introitus Bartholin’s glands Secrete fluid just prior to orgasm

External Sex Organs Underlying Structures

Internal Sex Organs The Vagina Tubular female sex organ that contains the penis during sexual intercourse and through which a baby is born Extends 3-5 inches back and upward from vaginal opening Has three layers Inner lining (vaginal mucosa) Middle layer (muscular) Outer (deeper) layer (connects vagina to other pelvic structures Few nerve endings

Vaginitis Ways to prevent vaginal inflation Wash vulva and anus Be certain your partner’s genitals are clean Wear cotton underwear Avoid pants tight in crotch Use only water soluble lubricants Avoid sugar and refined carbs Keep track of your health Ways to prevent vaginal inflation

Opening in the middle of the cervix Internal Sex Organs The Cervix Lower end of the uterus Or Opening in the middle of the cervix About the width of a straw Allows passage of menstrual blood and sperm Expands to permit passage of baby (10 cm) Pap Test Sample of cervical cells that screens for cervical cancer and other abnormalities

Fundus – uppermost part Internal Sex Organs The Uterus (womb) Hollow, muscular, pear-shaped organ in which a fertilized ovum implants and develops until birth Fundus – uppermost part Body – central part Cervix – lower part

Internal Sex Organs The Uterus (womb) Three Layers Endometrium – innermost layer Endometriosis – growth of endometrial tissue outside the uterus Myometrium – muscular second layer Perimetrium – external cover

Internal Sex Organs The Fallopian Tubes Tubes that extend from the upper uterus toward the ovaries Help nourish and conduct ova to uterus Cilia (hair-like projections) help move ova through tube Ectopic pregnancy Fertilized ovum implants outside the uterus, usually in the fallopian tube Risk increases with age, pelvic inflammatory disease, tubal surgery, or the use of intrauterine devices (IUDs)

Internal Sex Organs The Ovaries Two almond-shaped organs that produce ova and female sex hormones Estrogen Female sex hormones that promote the development of female sex characteristics and regulate the menstrual cycle Progesterone Steroid hormone that stimulates development of the endometrium and regulates menstruation Follicle Capsule within an ovary that contains an ovum

Ovarian Cancer More common in European American women than African American Over 22K diagnosed, over 15K die Fifth leading cancer killer of women between ages of 40 & 70 Age Obesity Family history Use of certain hormones and fertility drugs Risk factors include When detected early, 89-99% survival rate Early detection is essential

Internal Sex Organs

Internal Sex Organs

Hysterectomy Surgical removal of the uterus Complete hysterectomy Surgical removal of ovaries, fallopian tubes, cervix, and uterus Partial hysterectomy Surgical removal of the uterus only May be performed when women develop cancer of the uterus, ovaries, or cervix and can relieve symptoms associated with various gynecological disorders Many gynecologists believe that hysterectomies are recommended too often

Pelvic Examination Recommended once a year starting in late teens External examination of genitalia Internal exam Speculum – instrument that holds vaginal walls open Pap smear Internal palpations to examine position, size, and possible growths on internal organs

Female Pelvic Examination

The Breasts Secondary sex characteristics Mammary glands Traits that distinguish women from men Are not directly involved in reproduction Mammary glands Milk-secreting glands Areola – dark ring on the breast that encircles the nipple Sensitive to stimulation

Breast Cancer Annually 230,000 women diagnosed, 39,500 die An estimated 410 men die each year In the US Family history, genetics High breast density Long-term use of HRT High body fat Physical inactivity Risk factors include Self exam, mammography If not spread beyond breast, 5 year survival rate is about 93% Early detection is essential

Critical Thinking The American Cancer Society no longer recommends that women need to conduct breast self examinations as a means of detecting breast cancer early. Do you believe that this is a good idea for women to do self-exams anyhow? Why or why not?

Breast Cancer Detection and Treatment Mammogram A type of X-ray that detects cancerous lumps in the breast Lumps in the breast Cysts are sac-like structures filled with fluid or diseased material Benign tumors do little or no harm and are called fibroadenomas Malignant lumps are lethal, causing or likely to cause death Lumpectomy The surgical removal of a lump from the breast Mastectomy The surgical removal of the entire breast

The Menstrual Cycle Menstruation Cyclical bleeding that stems from the shedding of the uterine lining (endometrium) Regulated by estrogen and progesterone Averages about 28 days but variations are common Can be influenced by psychological factors

Regulation of the Menstrual Cycle Hypothalamus Brain structure that regulates body temperature, motivation, emotion, and hormone production Releases gonadotropin releasing hormone (Gn-RH) which stimulates the pituitary to release gonadotropins Pituitary hormones that stimulate the gonads

Regulation of the Menstrual Cycle Pituitary gland Gland that secretes growth hormone, prolactin (stimulates milk production), oxytocin (stimulates uterine contractions in labor and the ejection of milk during nursing), and gonadotropins (stimulate the ovaries) Gonadotropins Follicle-simulating hormone (FSH) (stimulates development of follicles in the ovaries) Luteinizing hormone (LH) (helps regulate the menstrual cycle by triggering ovulation)

Phases of the Menstrual Cycle Proliferative Estrogen increases Eggs ripen Ovulatory Ovulation occurs Secretory or Luteal Uterus prepares for implantation Menstrual Shedding of uterine lining

The Menstrual Cycle Proliferative Phase First phase Endometrium proliferates Follicles develop and prepare for ovulation Proliferative Phase

The Menstrual Cycle Ovulatory Phase Second phase Follicle ruptures and releases a mature ovum Ovulatory Phase

The Menstrual Cycle Secretory or Luteal Phase Third phase Large amounts of progesterone and estrogen Hormones signal secretion of nutrients to sustain implanted ovum Secretory or Luteal Phase

The Menstrual Cycle Menstrual Phase Fourth phase Ovum not fertilized, hormone levels decline and endometrium is removed Low estrogen results in release of FSH, cycle starts again Menstrual Phase

The Menstrual Cycle Sex during menstruation No evidence that it is harmful Orgasmic contractions may alleviate cramping Women can be sexually aroused at any time during cycle Research indicates this peaks at ovulation

The Menstrual Cycle Menopause Perimenopause “Change of life” Menstruation ceases Perimenopause Start of menopause Climacteric Long-term process of decline in the reproductive capacity of the ovaries

Decreased vaginal lubrication The Menstrual Cycle Night sweats Headaches Decreased vaginal lubrication Osteoporosis Symptoms resulting from estrogen loss

Hormone Replacement Therapy Synthetic replacement of estrogen and/or progesterone Reduces symptoms of menopause Mixed research findings May increase risk of cancer, stroke, blood clots May reduce/increase risk of heart disease Fewer women on HRT now There are other methods to relieve symptoms

Menstrual Problems Primary Secondary Amenorrhea Absence of menstruation Is a symptom of anorexia nervosa Primary Lack of menstruation in a woman who has never menstruated Secondary Lack of menstruation in a woman who has previously menstruated

Premenstrual Syndrome Menstrual Problems Premenstrual Syndrome Physical and psychological symptoms that may afflict women during the four to six day interval that precedes menstruation

Premenstrual Dysphoric Disorder (PMDD) Menstrual Problems Premenstrual Dysphoric Disorder (PMDD) A diagnosis used by the American Psychiatric Association to describe cases of PMS that are characterized by severe changes in mood and impaired functioning at work or school or in social relationships

Menstrual Problems PMDD Symptoms Feeling sad, hopeless, or worthless Tension, anxiety, edginess Frequent crying, significant mood changes Irritability and anger causing interpersonal conflict Decreased interest in activities and relationships Difficulty concentrating Fatigue, lethargy, lack of energy Notable changes in appetite Feeling overwhelmed or out of control