Female Sexual Anatomy and Physiology

Genital Self-Exam Increases sexual comfort Monitor for changes related to health concerns

The Vulva External female genitalia Mons Veneris Labia majora & minora

The Vulva (cont.)

The Vulva (cont.) Clitoris (analogous to penis) external shaft & glans, internal crura clitoral hood only function = sexual arousal Clitoral stimulation most common way woman achieve orgasm Female genital mutilation

The Vulva (cont.)

The Vulva (cont.) Vestibule Perineum urethral opening vaginal introitus (opening) hymen Perineum episiotomy

Underlying Structures Vestibular bulbs Bartholin's glands Pelvic floor muscles Kegel exercises

Underlying Structures

Internal Structures Vagina 3 layers: mucous, muscle, fibrous Arousal and vaginal lubrication lubrication changes vaginal ph and increases pleasure Grafenberg (G) spot Secretions & chemical balance

Internal Structures (cont.)

Internal Structures (cont.) Cervix Uterus 3 layers: perimetrium, myometrium, endometrium fundus (top)

Internal Structures (cont.) Fallopian tubes fimbriae cilia (hairlike cells that move ovum) fertilization occurs when egg is still close to ovary Ectopic pregnancy

Internal Structures (cont.) Ovaries up to 472,000 immature ova at birth; 400 mature in lifetime ovulation = release of ovum

Menstruation Myths and negative attitudes Menarche (initial onset) age 11-15 related to heredity, health, altitude

Menstruation (cont.) Menstrual physiology flow lasts from 2 to 6 days volume varies (6 to 8 ounces) duration varies (24 to 42 days) menstrual synchrony

Menstruation (cont.)

Menstruation (cont.) The menstrual cycle hypothalamus releases GnRH that stimulates pituitary pituitary produces: Follicle Stimulating Hormone Luteinizing Hormone Negative feedback mechanism

Menstruation (cont.) Changes during the menstrual cycle (a) indicates the hypothalamus in the brain measuring levels of hormones and releasing GnRh to stimulate the pituitary to secrete FSH and LH into the bloodstream (b) shows how the levels of FSH (red line) and LH (purple line) vary during the complete cycle. Note the midcycle peak of LH that stimulates ovulation (c) shows the ovarian changes during the phases of the cycle and (d) shows the fluctuations in blood levels of estrogen and progesterone produced by the ovaries and (e) indicates these hormonal effects on the lining of the uterus. After ovulation, the glands and ducts inside the endometrium (drawn and vertical tubes and spirals) develop and secrete nutrients that, if a woman became pregnant, would support the embryo.

Menstruation (cont.) Three phases of menstrual cycle menstrual: shedding of endometrium proliferative: thickening of endometrium & follicle maturation, ovulation secretory: corpus luteum development further thickening of endometrium

Menstruation (cont.)

Menstruation (cont.) Fig. 4.8 The changes to the ovaries and uterus during (b) the secretory phase, and (c) the menstrual phase of the menstrual cycle.

Menstruation (cont.) Sexual activity and the menstrual cycle Menstrual cycle problems premenstrual syndrome: Premenstrual Dysphoric Disorder dysmenorrhea = painful menses amenorrhea = no menses toxic shock syndrome self-help for menstrual symptoms

Menopause Terms climacteric peri-menopause: time before menopause menopause: permanent cessation of menstruation

Menopause (cont.) Symptoms vary from mild to strong amenorrhea, then menopause hot flashes or warm spells night sweats, interrupted sleep headaches, poor concentration depression, anxiety

Menopause (cont.) Hormone replacement therapy estrogen reduces hot flashes and psychological symptoms controversies with data reporting hazardous effects increased risk of breast cancer with exclusive use of estrogen alternatives to HRT

Gynecological Health Concerns Urinary tract infections Vaginal infections Self-exams & vaginal health care

Gynecological Health Concerns (cont.) Pap smear screens for cervical cancer Hysterectomy or oophorectomy most frequently performed U.S. operation, more frequently performed on low income, less educated women nonsurgical alternatives

The Breast mammary glands produce milk areola is darker area fatty tissue determines size areola is darker area nipple is in center of areola & has openings for milk

The Breast (cont.)

The Breast (cont.) Breast exams self-exam following menstruation routine healthcare provider exams mammography

The Breast (cont.) Breast exams Fig. 4.9 It is helpful to use a chart similar to this one to keep track of lumps in the breasts.

The Breast (cont.) Breast lumps Breast cancer cysts (fluid-filled sacs) fibroadenomas (solid, round, benign tumors) malignant tumor Breast cancer treatments risk factors reconstructive breast surgery benefits of early detection & treatment

The Breast (cont.)

The Breast (cont.)