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Chapter Five PowerPoint PPT Presentation

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Female Sexual Anatomy. Chapter Five. Agenda. Discuss Female Sexual & Reproductive System Describe Female Maturation Cycle Discuss Female Reproductive and Sexual Health. External Sex Organs Internal Sex Organs Other Sex Organs. The Female Sexual and Reproductive System.

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Chapter Five

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Female sexual anatomy l.jpg

Female Sexual Anatomy

Chapter Five

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  • Discuss Female Sexual & Reproductive System

  • Describe Female Maturation Cycle

  • Discuss Female Reproductive and Sexual Health

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External Sex Organs

Internal Sex Organs

Other Sex Organs

The Female Sexual and Reproductive System

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Video: The Vagina Monologues

  • What is your reaction to the video?

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External Sex Organs

  • Vulva/Pudendum – entire female region of external sex organs

  • Mons Veneris

    • protective, fatty cushion over the pubic bone;

    • covered with pubic hair

  • Labia Majora

    • outer lips;

    • tissue folds from mons to perineum surrounding the rest of the female genitals;

    • engorge with blood if excited

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External Sex Organs

  • Labia Minora

    • inner lips;

    • pink tissue folds between vestibule and labia majora;

    • no hair;

    • many oil glands;

    • darken if sexually aroused

  • Clitoris

    • small cylindrical erectile tissue beneath the prepuce;

    • rich in blood supply and nerve endings;

    • solely to provide sexual pleasure, primarily via indirect stimulation

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External Sex Organs

  • Vestibule – region between the labia minora; urethral and vaginal openings, Bartholin’s glands ducts

  • Urethral Meatus – between clitoris and vagina

  • Perineum – between anus and vagina

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The external genital structures of the mature female.

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Internal Sex Organs

  • Vagina

    • 4 inch, thin-walled accordion-like tube from the introitus to the cervix, tilted back;

    • organ of intercourse and canal for menses and babies;

    • lubricant secreted from vaginal wall openings when engorged;

    • first 1/3 contains many nerve endings,

    • inner 2/3 has little nerves

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Internal Sex Organs

  • Grafenberg Spot (G-spot) – dime to quarter sized spot in the lower third of anterior vaginal wall (2-3 inches up), just past the pubic bone;

    • sensitive area;

    • Controversy:

      • Female ejaculation – powerful orgasms and expulsion of fluid (up to 4 ounces) due to stimulation of the G-spot in some women;

      • may be Skene’s glands fluid or urine

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Internal Sex Organs

  • Uterus – 1-inch thick walls, hollow, muscular organ between the bladder and rectum; monthly cycle of change; menstruation, protects fetus, contractions to expel menses and fetus; 3 inches long, 2 inches wide

    • 3 uterine wall layers:

      • Perimetrium

      • Myometrium

      • Endometrium

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Internal Sex Organs

  • Cervix – at bottom of the uterus; doughnut-shaped; secretes mucus to help or impede sperm, depending on the monthly cycle

    • Os – opening leading into the uterus

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Internal Sex Organs

  • Fallopian Tubes (oviducts) – two 4-inch long trumpet shaped tubes that extend from the sides of the uterus and curve up to and around the ovaries

    • Ampulla – typical site of fertilization

    • Infundibulum – has fimbriae surrounding the ovaries to collect an egg upon release

  • Ovaries – form of an almond shell; contain 250,000 ova each; produce estrogen

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The female internal reproductive system (side view).

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The female internal reproductive system (front view).

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Other Sex Organs

  • Any area can be arousing depending on the type of stimulation and the perceptions of the recipient

  • Breasts (mammary glands) – modified sweat glands that produce milk; fatty tissue, 15 to 20 lobes, and milk-producing glands (alveoli)

    Nipple, areola

    • Sucking stimulates pituitary gland to release prolactin (begin milk synthesis) and oxytocin (release of milk)

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The female breast.

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Female Puberty



The Female Maturation Cycle

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Female Puberty

  • Begins anywhere from 8 to 15 years of age

  • Earlier onset of menstruation may be due to being overweight; can vary with race

  • Puberty lasts about 3 to 5 years

  • Begins when pituitary gland initiates release of FSH and LH, which increases the ovaries production of estrogen

  • Increased size of Fallopian tubes, uterus, vagina, breasts, buttocks, thighs

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Female Puberty

  • Pelvis widens

  • Pubic hair grows

  • During puberty (usually 11 or 12 years), ovulation commences

  • Menarche occurs during this time as well, although it may be a few months before or after ovulation begins

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  • Menstruation – uterine lining is shed if no pregnancy; tissue and blood exit the introitus

  • Menstrual cycle – lasts about 24 to 35 days, average is 28 days

  • Menstrual cycle has four phases:

    • Follicular phase

    • Ovulation phase

    • Luteal phase

    • Menstrual phase

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Menstruation: Menstrual Cycle

  • Follicular phase – begins after menstruation ends; lasts 6-13 days; ovarian follicles begin to ripen; estrogen promotes development of endometrium to 2-5 millimeters thick

  • Ovulation phase – around day 14, an ovum is released due to FSH and LH that have ripened primary follicles; one follicle matures completely (secondary follicle) and ruptures, releasing the egg to be caught by the fimbriae

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Menstruation: Menstrual Cycle

  • Luteal phase – corpus luteum forms on the ovary where the secondary follicle ruptured; it secretes progesterone and estrogen for 10-12 days to further develop the endometrium to 4-6 millimeters thick; without fertilization, the progesterone and estrogen levels signal to the hypothalamus to decrease LH and the corpus luteum deteriorates and estrogen and progesterone drop significantly

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  • Menstrual phase – endometrial buildup is expelled through uterine contractions for 3-7 days; volume of menses is about 2-4 tablespoons of fluid

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The cycle of female hormones.

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Variations in Menstruation

  • Amenorrhea – absence of menstruation

    • Primary amenorrhea – never begins menstruation; physical, health, emotional causes

    • Secondary amenorrhea – menses cease before reaching menopause; pregnancy, lifestyle, emotional, physical causes

  • Menorrhagia – excessive menses; oral contraceptives can help control

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Variations in Menstruation

  • Dysfunctional uterine bleeding (DUB) – bleeding for long periods, or intermittent bleeding; hormonal, lifestyle, physical causes

  • Dysmenorrhea – painful menstruation; caused by inflammations, constipation, psychological stress; recommend medication, relaxation, yoga, massage, and stress relief

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Variations in Menstruation

  • Premenstrual Syndrome (PMS) – physical or emotional symptoms that occur during the last few weeks of the menstrual cycle

  • Premenstrual Dysphoric Disorder (PMDD) – mood, behavioral, somatic, and cognitive symptoms; medication (SSRIs) and lifestyle changes provide relief

  • Variations in Menstruation

    • Risk factors for PMS and PMDD: history of depression, sexual abuse, PTSD, smoking

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Menstrual Manipulation and Suppression

  • Women can experience up to 450 periods

  • Ways to stem growth of the endometrium:

    • Continuous birth control pills

    • Progesterone intrauterine devices

    • Injections

  • It is possible to relieve many physical symptoms related to menstruation

  • Some see menses as indicating health

  • No medical basis to avoid sex during a period

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The Instead Softcup can be used during a woman’s period to make sexual activity less messy.

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  • A woman’s final menstrual period

  • Climacteric – period of decreased estrogen production and menstruation stops; 40-58 years, average 51 years

  • Typically have irregular cycles, rather than a sudden stop

  • Sexual glands decrease in size

  • Secondary sex characteristics change

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  • Hormonal changes – hot flashes, headaches, sleep disturbances

  • Sexual complaints

  • Menopause can be induced by surgically removing the ovaries; doctors try to keep at least one in if surgery is necessary

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  • Hormone replacement therapy – was a standard treatment, but there are a lot of health risks and not typically used today

  • Nutritional, vitamin, and herbal remedies are commonly used today

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Gynecological Health Concerns

Cancer of the Female Reproductive Organs

Female Reproductive and Sexual Health

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Female Reproductive and Sexual Health

  • Genital self-exams are recommended for women to be familiar with their genitals and any possible abnormalities

  • Routine gynecological examinations recommended once menstruating

    • Medical history and checkup

    • Pelvic examination (internal and external)

    • Breast examination

    • Pap smear – cervical swab

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Gynecological Health Concerns

  • Most prevalent:

    • Endometriosis

    • Toxic Shock Syndrome

    • Uterine Fibroids

    • Vulvodynia

    • Vaginal Infections

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  • Endometrial cells deposit outside of the uterus

  • Will engorge/weaken with the menstrual cycle

  • Symptoms: painful periods, lower abdominal or pelvic pain, pain on defecation, pain during intercourse

  • Typically childless women between 25 and 40

  • Cause is unknown

  • Treatment: hormones, surgery, laser therapy

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Toxic Shock Syndrome

  • Caused by prolonged use of a single tampon which creates a buildup and subsequent infection of bacteria

  • Symptoms: fever, diarrhea, vomiting, sore throat, muscle ache, rash,

  • May cause: dizziness, respiratory distress, kidney failure, heart failure, death

  • Avoid by changing tampons regularly, using less absorbent tampons, using sanitary pads

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Uterine Fibroids

  • Hard tissue masses in the uterus; size range

  • Affect 20-40% (maybe 77%) of women over 35 years

  • Symptoms: pelvic pain and pressure, heavy cramping, heavy or prolonged bleeding, constipation, frequent urination, painful sex

  • Treatment: hormones, drugs, laser therapy, surgery, cryotherapy

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  • Chronic pain and soreness of the vulva

  • Symptoms: vaginal burning, itching, rawness, stinging, stabbing of vagina/vulva

  • The pain may be intermittent or constant

  • Cause is unknown

  • Treatment: biofeedback, drugs, dietary changes, nerve blocks, surgery, pelvic floor muscle strengthening

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  • Non-sexually transmitted infections can occur

    • Bartholin’s glands

    • Urinary tract

  • May be due to poor hygiene practices and/or frequent intercourse

  • Treated by draining infected gland (if necessary) and use of antibiotics

  • Douches change the vaginal pH level and can increase risk of infection

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Cancer Associated with Female Reproductive Organs

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Breast Cancer

  • Worldwide, the most common cancer

  • One in 7 American women will develop it

  • Risk factors: fat intake, aging, early menarche, prolonged estrogen, inactive lifestyle, alcohol consumption, genetics

  • Breastfeeding, early pregnancy reduces risk

  • Early detection is critical: breast self-examinations, gynecological checkups, mammography

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Breast exam (in Feature box)

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Breast Cancer

  • Symptoms: breast lump, breast pain, nipple discharge, puckering of skin, change in nipple shape

  • If untreated, the cancer will spread to other parts of the body

  • Treatment: partial/modified mastectomy, radical mastectomy, lumpectomy, radiation, chemotherapy

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Breast Cancer : Education and Support Groups

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Cervical Cancer

  • 1 in 130 American women

  • Pap smear is used for detection; should be screened every year by 21 years of age

  • High cure rates

  • Risk factors: early intercourse, many sexual partners, teenage mothers, cervicitis, genital viral infections, extended oral contraceptive use

  • Treatment: surgery, radiation, hysterectomy

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Endometrial Cancer

  • Symptoms: abnormal bleeding, spotting

  • Detection most successful with dilation and curettage

  • Treatment: surgery, radiation, hormones, chemotherapy

  • Over 90% survival rate

  • Oral contraceptives decrease risk

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Ovarian Cancer

  • Less common than breast, uterine cancers

  • Most deadly

  • Symptoms: few early signs, ovarian cyst, slight abdominal discomfort, appetite loss, indigestion, abdominal swelling, nausea, vomiting

  • Risk factors: childlessness, early menopause, high-fat diet, higher SES, lactose-intolerant, use talc powder on the vulva

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Ovarian Cancer

  • Decreased risk with having children and using birth control pills, tubal ligation

  • Detection techniques: blood tests, pelvic exams, ultrasound

  • Unfortunately, most diagnosed after cancer has spread beyond the ovary because of the lack of early warning signs

  • Treatment: remove ovaries, radiation, chemotherapy

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