1. Our Sexual and Reproductive Anatomy
Chapter 2
Our Sexual and Reproductive Anatomy

2. Body Language
Parents teach their children to identify their body parts.
What happens when they arrive at the genitals?
What are some common themes in slang terms for women’s genitals? For men’s genitals?
Why are slang terms for the genitals and for sexual behavior also used terms of general displeasure or aggression?

3. Personal Reflections
Do you use sexual slang terms (a) to refer to your genitalia, or (b) when you are upset? Why? If you do, list the terms you use, then write down the correct word next to each. Say each correct term out loud a few times. Are you comfortable doing so? Could you use these terms in normal conversation without being embarrassed or uncomfortable? If you cannot, why not?

4. External Female Genitalia
Vulva
“Vagina”
Anus
Vulva is the term used to refer to the external female genitalia, including the mons veneris, labia majora, labia minora, clitoris, vaginal opening and urethral opening.
It is common for people to say “vagina” when referring to what is between a woman’s legs but the correct term is vulva.
The anus is also between a woman’s legs but is not considered to be a part of the vulva.

5. The Vulva
The labia are parted to show the vaginal and urethral openings.

6. Feelings about one’s genitalia are related to enjoyment of sexual activity.
Mons Veneris
Labia Majora
Labia Minora
Bartholin’s Glands
Urethral opening
Perinuem
Mons Veneris – why pubic hair?
Labia Majora – protective outer lips that cover sensitive inner tissues.
Labia Minora – “Hottentot Aprons”
Bartholin’s Glands – sperm-friendly lubricators.
Urethral opening – rarely noticed, between clitoris and vagina.
Perinuem – the pelvic “floor”

7. The clitoris has as many nerve endings as an entire penis!
Clitoral hood (prepuce)
Clitoris
Clitoral circumcision
Clitoral hood (prepuce) – where the labia minora meet at the top to form a touch-sensitive covering for the clitoris.
Clitoris – a glans, a shaft and even “legs,” all containing sensitive erectile tissue develop from the same embryonic tissue as the penis.
Clitoral circumcision – female genital mutilation designed to keep women from experiencing “too much” sexual pleasure in some cultures.

8. Normal Variations of the Vulva

9. The Vaginal Opening Vestibular area Bulbocavernosus muscle Vestibular
Urethra
Vestibular area – the area between the two labia minora.
Bulbocavernosus muscle – a ring of sphincter muscles that surrounds the vaginal opening in women, or the root of the penis in men.
Vestibular bulbs – structures surrounding the vaginal opening that fill with blood during sexual arousal, resulting in swelling of the tissues and a narrowing of the vaginal opening.
Urethra – passageway from the bladder to the exterior of the body.

10. The Truth about Hymens Hymen First intercourse and hymen tearing
Hymen – the thin membrane that partially covers the vaginal opening which may have one or more openings that allow menstrual flow.
The hymen sometimes ruptures during insertion of a tampon, and in some women the opening only stretches rather than tears during first intercourse, thus there would be no bleeding at first intercourse.

11. The Breasts

12. More About Breasts Estrogen Mammary and ducts in nipple Areola
Fatty tissue between glands
Erotic in most Western cultures.
Estrogen in boys may cause gynecomastia.
15 – 20 milk producing mammary glands are in each breast, each with its own duct in the nipple, regardless of bra size.
The areola has a breastfeeding function.
Fatty tissue between the glands, determined primarily by heredity, affects breast size.

13. Some Variations in Human Breasts

14. Breast Augmentation Exercises and lotions ineffective
Cosmetic surgery and implant leaks
Leaks not been found to be linked to cancer or other disease
25% breast implants (silicone or saline) develop painful fibrous capsules
Exercises and lotions do not work.
Cosmetic surgery is still surgery.
Sooner or later most implants leak; these leaks have not been found to be linked to cancer or other disease.
25% of women who receive breast implants (silicone or saline) will develop painful fibrous capsules around the implants that make the breasts hard, tight and unnatural in appearance, requiring additional surgery

15. Personal Reflections
Do you wish you had different-sized or different-shaped breasts? How would you like to be different? Why? Should a woman’s breast size be an important factor in pleasing her partner? Why?

16. Breast Cancer and Examination
Incidence
Risk factors
Long-term hormone replacement therapy
Survival rate
Incidence: 1 in 8 women will develop breast cancer; men can develop breast cancer too.
Risk factors:
Family history of breast cancer
Being older than 50
Early menstruation and/or late menopause
Long-term hormone replacement therapy in postmenopausal women increases the risk.
96% survival rate; positive attitude and reassurance by one’s sex partner are very helpful.

17. Monthly Breast Self Exam (BSE)

18. Personal Reflections (women)
Do you regularly examine your breasts for abnormal lumps? If the answer is no, why not? The CDC reports that nearly 85% of women aged 40 or older have had a mammogram. If you are in this age group and have not had one, why not?

19. Internal Female Anatomy
Vagina
Elastic walls
Lubrication with arousal
Self-cleaning and douching
Pubococcygeus (PC) muscle.
G-Spot
Pubococcygeus (PC) muscle surrounds the vagina – practice your Kegel exercises for sexual satisfaction and urinary control.
The vaginal opening is very sensitive to touch but the inner 2/3 have very few nerve endings.
The G-Spot exception – a highly sensitive area on the anterior (front) wall of the vagina, about 1/3 of the way into the vagina; found in about 10% of women studied.

20. Side View of Internal Female Reproductive Organs

21. Frontal View of Internal Female Reproductive System

22. The Uterus: Tiny but Powerful
Cervix
Perimetrium
Myometrium
Endometrium
Cervix – the narrow end of the uterus projecting into the back of the vagina
Perimetrium – the outer layer
Myometrium – strong muscled middle layer
Endometrium – innermost layer that grows thicker between menstrual periods and sloughs off at menstruation

23. Fallopian Tubes Fingerlike fimbria Site of fertilization Cilia
Ectopic (tubal) pregnancies
Tubal ligation sterilization
Fingerlike fimbria brush against the ovary to “find” the egg at ovulation
Site of fertilization of the egg by the sperm
Cilia within the tube move the egg toward the uterus
Ectopic (tubal) pregnancies
Tubal ligation sterilization

24. The Ovaries
Female gonads produce ova (eggs) and hormones (estrogen and progesterone).
At birth a girl’s ovaries already contain all of her 300, ,000 immature ova.
Only about 400 will ever fully mature
From primary follicle to Graafian follicle to ovulation
Female gonads produce ova (eggs) and hormones (estrogen and progesterone).
At birth a girl’s ovaries already contain all of her 300, ,000 immature ova.
Only about 400 will ever fully mature
From primary follicle to Graafian follicle to ovulation

25. Gynecological Exam Things to Consider
Find a doctor with whom you are comfortable.
Ask questions.
“Pap test” is not same as a test for STIs. If you want to be tested for STIs be sure to make that clear when you make your appointment.
If you want to be tested for STIs be sure to make that clear when you make your appointment.

26. Cancer of the Cervix Causes Early detection: Pap and HPV tests
Detected early, most abnormal cervical cells can be treated effectively and do not develop into cancer
Cervical cancer is caused by certain types of the Human Papillomavirus, spread during sexual activity.
Most cervical cancer related deaths are in women who do not get regular Pap tests.
Testing for HPV directly has become more common as it is more effective than testing for abnormal cells via the Pap test.
Detected early, most abnormal cervical cells can be treated effectively and do not develop into cancer.

27. Personal Reflections
The CDC report that 91% t0 93% of women 18 years old and older have had a Pap smear test. Have you? Have you had one within the last year? If not, why not?

28. Cancer of the Endometrium and Ovaries
First symptoms of endometrial cancer Ovarian cancer is rare but deadly
The first symptom of endometrial cancer is abnormal vaginal bleeding. A sample of the endometrium will be taken by the doctor for use in diagnosis.
Ovarian cancer is rare but deadly.
Mostly found in women 50 or older
Highest risk factor is family history
The CA-125 blood test is recommended for at-risk women

29. External Male Anatomy Penis Foreskin Scrotum and testicles
Penis – reproductive, urinary and sexual
Average size flaccid – 3.75 inches x 1.2 inches
Average size erect – 6 inches x 1.5 inches
The foreskin protects the glans penis from abrasions and dryness
The scrotum holds the testicles outside of the body cavity for optimal sperm development.

30. Current incidence in U.S.
Male Circumcision
History
Religion
Culture
Hygiene
Current incidence in U.S.
History – ancient Egyptians and Greeks
Religion – Jews and Muslims
Culture – Puberty rites
Victorian Era fears about masturbation
The battle of smegma vs. soap and water
Pediatricians oppose routine circumcisions in countries where good hygiene and adequate medical care exist.
About 56% of newborn boys in the U.S. are circumcised these days. For men at risk for STIs due to unprotected sex, circumcision may be recommended.

31. Which penis is “normal” and which is “natural?” It’s a cultural thing.

32. Personal Reflections
If you should have a son, would you have him circumcised? Why or why not? Have you been experiencing any discomfort or anxiety when you first looked at the figures in this chapter? Have you been able to examine your own genitals without feelings of guilt or anxiety? If not, why do you think you have negative feelings about looking at this part of your body?

33. The penis and scrotum Penis – glans, shaft and root Peyronie’s Disease
Normal curvature
Scrotum
Penis – glans, shaft and root
Corpora cavernosa and corpus spongiosum
Tumescence (erection) and detumescence
Corona – most sensitive part of the penis
Urethra – one opening and two functions
Peyronie’s Disease
Normal curvature
Scrotum – pouch beneath the penis that holds the testicles

34. Internal Male Anatomy
Testicles
Epididymis
Vas Deferens
Ejaculatory ducts
Urethra
Testiciles - male gonads that create sperm and male hormones
Epididymis – where sperm wait for orgasm
Vas Deferens – from testicle, up and over the bladder and through the prostate gland
Vasectomy
Ejaculatory ducts – taking the sperm out to the urethra
Urethra – one passageway for two functions

35. Side View of the Internal Male Reproductive Structures

36. Inside View of the Penis and Testicles

37. Testicular Cancer and Self Examination
Incidence and age
Highest risk
Testicular cancer and masturbation
Testicular cancer is not very common, but it is the most common form of cancer in men aged 20 – 35.
Remember Lance Armstrong, Scott Hamilton and Tom Greene?
Highest risk
If testicles did not descend into the scrotum before age 10
If there has been an inguinal hernia
NO relationship between testicular cancer and masturbation!

38. Monthly Testicular Self Exam
Common sign is painless small lump or enlargement of one testicle
Testicles change from month to month
Examination best after warm shower or bath
The most common sign is a painless small lump or enlargement of one testicle.
Only you will know if your testicles change from month to month.
Examine yourself after a warm shower or bath.

39. Semen is just 1% sperm! Seminal vessicles about 70% of seminal volume
Prostate gland about 30% of semen
Cowpers (aka Bulbourethral) glands
Urethra – passageway for semen
Seminal vessicles – two little structures that contribute about 70% of seminal volume
Prostate gland – about 30% of semen
Cowpers (aka Bulbourethral) glands – two pea-sized structures that secrete an alkaline fluid to clean the urethra prior to orgasm
One reason “withdrawal” isn’t reliable
Urethra – passageway from the bladder to the exterior of the body; also the passageway for semen

40. Withdrawal is an effective form of birth control.
True or False?
Withdrawal is an effective form of birth control.
False

41. Prostate Problems and Examination
Incidence
Diagnosis
Detection and treatment
Prostatitis
Benign prostatic hyperplasia
1 in 7 men will be diagnosed with prostate cancer by age 85.
Diagnosis via PSA blood test and rectal exam.
If detected and treated early, 90% survival for at least 15 years.
Prostatitis (inflammation of the prostate) may result from untreated STIs.
Benign prostatic hyperplasia affects up to 80% of men over age 60, causing frequent and difficult urination.

42. Personal Reflections (men)
If you are over 50 years old (or 45 if you are African American), have you been to a doctor for a prostate examination? If not, why not?

43. The Brain

44. Our Sexiest Organ: The Brain
Cerebral cortex
Limbic system
Hypothalamus
Pituitary Gland
Cerebral cortex – thinking and reasoning
Limbic system – emotions and sexual desire
Hypothalamus – Sexual desire, sexual orientation, gender identity – directs the Pituitary Gland
Pituitary Gland – hormones that drive the reproductive system

45. Our Sexual Bodies Five senses Primary erogenous zones
Secondary erogenous zones
Self-concept and body image
Cultural norms
The five senses
Primary erogenous zones – because we’re human
Secondary erogenous zones – learned through experience or socialization
Self-concept and body image
Cultural norms – kissing, breasts, body fat