November 10, 2014 Human Reproductive Health NURS 330

Today’s Agenda Quiz #1 Review Quiz #1 Review Mid-term Review 11/3/14 In-class Assignment Grades (through 11/3/14) Lecture There is no in-class assignment

Mid-term Number of Students: 47 Average Score: = 2 students 90 ≥ 100: 17 students 90 ˂ 80: 14 students 70 ≥ 80: 8 students ˂ 70: 6 students

Grades DateAssignmentPossible Points 10/6/14In-Class #110 10/13/14In-Class #210 10/20/14In-Class #310 10/27/14Mid-term100 11/3/14In-Class #410 Total points (through 11/3/14)140 11/10/14Quiz #125 11/17/14In-Class #510 11/24/14Quiz #225 12/1/14In-Class #610 12/8/14Final Exam200

Grades A: A- : 126 B- : 112 C- : 98 D- : 84

What is Sexuality?

What factors influence Sexuality?

Sex Hormone Testosterone “Male” hormone Found in small amounts in women Affects sexual response in men and women Men – produced by the seminiferous tubules Women - produced by the ovaries Increase energy, sex drive (libido), aggression, appetite, muscle mass Increases libido in both men and women

A person’s emotional and mental states also help determine whether that person experiences arousal FACT

Sexual Response Cycle

Models of Human Sexual Response Master’s and Johnson Proposed their four-stage model of human sexual response cycle Stage I - Excitement Stage II - Plateau Stage III - Orgasm Stage IV - Resolution

EXCITEMENT- 1 ST STAGE: FEMALEMALE Transudation Vasocongestion Tenting Effect  HR, BP, RR Myotonia Penile Erection Vasocongestion Testis enlarge  HR, BP, RR Myotonia Response to stimuli RR – Respiratory Rate; BP – Blood Pressure; HR – Heart Rate

PLATEAU – 2 ND STAGE FEMALEMALE Orgasmic Platform  Tenting Effect Seminal Pool Erection is maintained ( if there is enough stimulation ) Cowper’s Gland secretes fluid

ORGASM – 3 RD STAGE FEMALEMALE Muscle spasms Involuntary Collection of semen in the urethral bulb Ejaculatory Invariability -bulbocavernosus muscle Expulsion of semen

RESOLUTION – 4 TH STAGE FEMALEMALE Return to non-aroused state Refractory Period

Comparing male and female sexual response Key difference Male has a refractory period There’s a potential for multiple orgasms in women Controversies in understanding the female orgasm Freud vaginal orgasm is true orgasm Master’s and Johnson only one kind no matter how achieved

Group Exercise

Sexual Dysfunctions The persistent impairment of the normal patterns of sexual interest or response. (WHO) Four categories Sexual Desire Disorders Sexual Arousal Disorders Orgasmic Disorders Sexual Pain Disorders

Prevalence

Sexual Desire Disorders Hypoactive sexual desire disorder Persistent deficit in sexual fantasies and desire for sex Sexual aversion disorder Extreme aversion to any form of sexual contact with a partner

Sexual Arousal Disorders Female sexual arousal disorder Difficulties becoming sexually aroused Deficient vaginal lubrication Male erectile disorder Recurrent problems in achieving or sustaining penile erection in a sexual situation Aka Impotence

Orgasmic Disorders Female orgasmic disorder (anorgasmia) Recurrent problem with reaching orgasm despite adequate erotic stimulation Male orgasmic disorder Delay or inability to reach orgasm during sexual activity Premature ejaculation Persistent or recurrent ejaculation following minimal stimulation and before the person wishes it

Sexual Pain Disorders Dyspareunia Recurrent genital pain during sexual intercourse Vaginismus Persistent involuntary spasms of vaginal muscles, which interfere with sexual intercourse

Sexual Dysfunctions - Differences in Men and Women FemaleMale Sexual Aversion Disorder Dyspareunia Dyspareunia (rare in men) VaginismusPremature Ejaculation Female Orgasmic DisorderMale Orgasmic Disorder Hypoactive Sexual Desire Disorder Female Sexual Arousal Disorder Male Erectile Disorder

General Causes Physiological/Biological Medication and illicit drugs Psychological/Emotional Anxiety Negative beliefs Sexual trauma Interpersonal/Social Relationship problems Environmental Cultural factors

Treatment of Sexual Dysfunctions Medical treatment of sexual dysfunctions Sex therapy

Rape Drugs What is a Rape Drug? A rape drug is one that is used in a drug- facilitated sexual assault.

Rape Drugs (cont) The most common rape drugs: Rohypnol GHB Ketamine Odorless, colorless Easily dissolved into drinks

Effects of Rape Drugs Drowsiness Disorientation Disinhibition Amnesia

Is alcohol a rape drug?

Important Dates 11/17/14 – Last day to submit make up assignment 11/24/14 – Quiz #2 12/8/14 - Final Exam