Chapter 3

Female Sexual Anatomy and Physiology

Genital Self-Exam

• Purposes of self exams– Increases sexual comfort– Monitor for changes related to health concerns

The Vulva

• External female genitalia

• Mons veneris

• Labia majora

• Labia minora

The Vulva

The Clitoris

• Only function is sexual arousal

• Clitoral stimulation most common way women achieve orgasm

• Female genital mutilation

The Underlying Structures of the Vulva

The Vulva

• Vestibule (inside the labia minora)– 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

Internal Structures

• Cervix• Uterus

– 3 layers and fundus • Fallopian tubes

– Fimbriae• Ovaries

– Up to 472,000 immature ova at birth– 400 mature in lifetime– Ovulation is the release of ovum

Menstruation

• Sloughing off of uterine lining

• Myths and negative attitudes

• Menarche (initial onset)– Age 11-15

– Dependent on:

• Heredity

• Health

• Altitude

Menstrual Physiology

• Flow – lasts from 2 to 6 days

• Volume – varies from 6 to 8 ounces

• Duration – varies 24 to 42 days

• Menstrual synchrony

Changes During the Menstrual Cycle

The Menstrual Cycle

• Hypothalamus releases chemicals that stimulate pituitary

• Pituitary produces– Follicle Stimulating Hormone– Lutenizing Hormone

• Negative feedback mechanism

Three Phases of The Menstrual Cycle

• Menstrual– Shedding of endometrium

• Proliferative– Thickening of endometrium, follicle maturation &

ovulation

• Secretory– Corpus luteum development, further thickening of

endometrium

Menstrual Cycle Problems

• Premenstrual syndrome– Premenstrual Dysphoric Disorder (PMDD)

• Dysmenorrhea – painful menses

• Amenorrhea – no menses

• Self-help for menstrual symptoms– Diet

– Exercise

• Toxic shock syndrome (TSS)

Menopause Terms

• Climacteric– Physiological changes during transition period of

fertility to infertility

• Perimenopause– Time before menopause

• Menopause– Permanent cessation of menstruation

Menopausal Symptoms

• Amenorrhea, then menopause• Hot flashes or warm spells• Night sweats, interrupted sleep• Headaches, poor concentration• Depression, anxiety

• Symptoms vary from mild to strong

Hormone Therapy

• Estrogen– Benefits/Problems

• Progesterone– Benefits/Problems

• Testosterone– Benefits/Problems

• Bioidentical Hormones

Gynecological Health Concerns

• Urinary tract infections• Vaginal infections• Pap smear screens for cervical cancer• Hysterectomy or oophorectomy

– Most frequently performed U.S. operation– More frequently performed on low income, less

educated women– Non-surgical options

The Breast

• Secondary sex characteristics• Mammary glands produce milk• Areola is darker area• Nipple is in center of areola & has openings for

milk

Cross-Section of Breast

Breast Exam: Part 1

Breast Exam: Part 2

Breast Health

• Breast Lumps– Cysts (fluid-filled sacs)– Fibroadenomas (solid, round, benign tumors)– Malignant tumor

• Breast cancer– Treatments– Risk factors– Reconstructive breast surgery– Benefits of early detection & treatment