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 – 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• Follicle Stimulating Hormone • Luteinizing Hormone

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– 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– 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.)