1. Female Sexual Anatomy and Physiology
Chapter 3

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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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?

9. 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

10. 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

11. 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

12. External Sex Organs

13. 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

14. External Sex Organs
Underlying Structures

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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)

21. 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

22. 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

23. Internal Sex Organs

24. Internal Sex Organs

25. 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

26. 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

27. Female Pelvic Examination

28. 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

29. 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

30. 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?

31. 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

32. 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

33. 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

34. 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)

35. 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

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

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

38. 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

39. 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

40. 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

41. 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

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

43. 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

44. 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

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

46. 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

47. 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