1. Important announcement!
This class now has a Twitter:
Go there for:
Links to download lecture slides
Interesting retweets & links

2. chapter 3: female sexual anatomy and physiology

3. Underlying Structures: Pelvic floor muscles
Often weakened/damaged by childbirth and with age
Can be strengthened by Kegel exercises
Relative position of bladder and uterus shown in next slide
Kegel: contract muscles and hold for a count of 3 then rest for 3. Do 3 sets of 10 repeats.
Helps with incontinence which affects twice as many women as men
18 again video?

4. Internal female anatomy: the vagina
Three layers of the vagina:
Mucosa on the outside
Muscle layer underneath: muscle thickest and strongest around the vaginal opening
Fibrous tissue (shown in yellow) provides structural support
Inner 2/3 of vagina is flexible, if air flows in and gets trapped by muscles, flow back out can make farting noise!

5. Internal female anatomy
The cervix is at the intersection of the vagina and the uterus
The uterus or (womb) is where a fetus develops and grows
Uterus has 3 layers like the vagina
Innermost layer is called the endometrium; this is what builds up and then sloughs off during menstruation
Some people have uterus tipped forward or back
Tipped back can make for greater menstrual discomfort

6. Internal female anatomy
Ovaries:
Release hormones, including estrogens
Produce and release eggs
Fallopian Tubes:
Eggs released from ovaries travel through fallopian tubes to the uterus
Can be the site of ectopic pregnancy

7. Internal female anatomy: the Grafenberg spot
System of glands and ducts that surround the urethra
Anatomically analogous to the male prostate gland
In the front wall of the vagina about 1/3 to ½ way up
“G spot” stimulation is rumored to elicit arousal, orgasm, and female ejaculation; some women do experience enhanced pleasure when this spot is stimulated and others do not

8. Arousal and lubrication
10-30 sec. after stimulation (may be either physical or psychological), increased blood flow to the vaginal mucosa results in secretion of a clear, slippery fluid
Two functions:
Increases sexual enjoyment; facilitates entry of penis (or whatever) into the vagina
Also changes pH of vaginal canal to make it less acidic; this improves motility and survival of sperm
Artificial lubrication can be used to replace or supplement natural lubrication
Other aspects of arousal discussed in ch 6
Oil based lubricants will dissolve condoms!

9. Other vaginal secretions
Vaginal walls and cervix both normally produce white or yellowish secretions
Appearance, consistency, and odor can vary with a woman’s menstrual cycle
Use of douches and other feminine hygiene sprays can negatively alter the chemical balance of the vagina and cause problems

10. Just add soap & water
Douching can: increase the risk of pelvic inflammatory disease, endometriosis, HIV transmission, ectopic pregnancy, and decreased fertility
Feminine hygiene sprays can cause irritation and infection
Washing the vulva with soap & water is sufficient
not good to kill off beneficial bacteria in vagina or to change pH balance

11. menstruation

12. Menstruation
Many myths about menstruation and taboos against sexual activity during menstruation
Sloughing off of uterine lining
Menarche is the initial onset of menstruation
Typically happens at age 11–15
Happens earlier today than it used to; higher body weights may explain this
Proper nutrition is essential for menarche and continued menstruation
Corsage worn by a menstruating woman will wilt

13. More about menstruation
Menstrual cycle is defined as the time from the first day of one menstrual period to the start of the next; varies from 24–42 days
Flow usually lasts 2–6 days and total volume is usually 6–8 ounces
Ovulation (release of an egg) usually happens 2 weeks before onset of menstruation

14. Changes During the Menstrual Cycle
Talk about how always call day 1 first day of period

15. What Happens During the Menstrual Cycle
The events of the menstrual cycle are controlled by hormones
Hormones are chemical messages released by one part of the body that travel to another part of the body
Master controller of hormones during the menstrual cycle is part of the brain called the hypothalamus
Hypothalamus releases a hormone, GnRH that stimulates the pituitary gland to release:
Follicle Stimulating Hormone (FSH)
Lutenizing Hormone (LH)
In men, GnRH, FSH and LH control sperm production

16. What Happens During the Menstrual Cycle
LH and FSH act on the ovary and stimulate the maturation and release of the egg; ovulation is the term for the release of the egg from its casing, called the corpus luteum
The ovaries secrete the hormone estrogen and the corpus luteum secretes progesterone, which stimulate proliferation of the endometrium in preparation for possible pregnancy
If pregnancy does not occur after ovulation, the pituitary gland shuts down release of LH and FSH, leading to a fall in estrogen and progesterone, and the initiation of menstruation

17. Sex and menstruation
Studies of women’s sexual behavior during menstruation have produced conflicting results: some have shown no change in sexual interest, others have shown increased sexual interest
Miller et al. looked at earnings of lap dancers during phases of the menstrual cycle and found that dancers made, on average:
$70/hour during ovulation
$50/hour between ovulation and menstruation
$35/hour during menstruation
Interestingly, dancers taking birth control pills made an average of $37/hour with no cycle fluctuations vs. $53/hour for women not taking the pill
Talk about whether this was bc of women or bc of customers
Were birth control and no pill groups the same?

18. Menstrual Cycle Problems
Premenstrual syndrome (PMS) affects 85–90% of women and can cause physical and psychological symptoms such as:
Bloating
Food cravings
Breast swelling
Irritability
Mood swings
Depression
Premenstrual Dysphoric Disorder (PMDD) affects <5% of women and results in more serious psychiatric symptoms that interfere with work or other normal activities
Dysmenorrhea: pain (cramps, nausea, etc.) before or during menstruation
PMS and PMDD have both been linked to the drop in estrogen that occurs before menstruation
Self-help for menstrual symptoms
Diet
Exercise
Toxic shock syndrome (TSS)

19. Treatment of menstrual cycle problems
Many women find that their PMS and dysmenorrhea can be reduced by:
Exercise
Adequate hydration
A low-salt, high-fiber diet
Oral contraceptive use

20. Amenorrhea Lack of menstruation Can be due to:
Hormone or other biological abnormalities
A low-calorie diet
Breastfeeding
Prolonged amenorrhea can result in low estrogen levels, which can decrease bone density and contribute to osteoporosis
The oral contraceptive Seasonale allows women to have only four periods a year
= ‘Annuale”

21. Menopause
Menopause: the permanent end of menstruation; occurs in late 40s to early 60s
Preceded by perimenopause: irregular periods that may have abnormal bleeding
Hormonal changes associated with menopause can have many other effects, including:
Hot flashes
Decreased vaginal lubrication
Sleep disturbances
Decreased bone density

22. Hormone Therapy in Menopause
What are some positive effects of menopause?
What are the potential benefits and risks of hormone replacement therapy?

23. Gynecological Health Concerns
Urinary tract infections: usually treatable with antibiotics; cranberry juice can suppress symptoms
Vaginal infections: can cause discomfort and discharge; includes bacterial and yeast infections
Pap smear screens for cervical cancer/HPV testing