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Sexuality
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Sexuality

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  1. Sexuality • Defining sexuality • Hormones involved in sexuality • Women, men and sexual arousal • The Female sexual response • Sexual problems in women • Drugs and sexuality

  2. I. Defining Sexuality A. What does SEXUALITY mean? • Sexuality involves – • Sexual desire – (libido) the desire for sexual behavior

  3. Anal sex • BDSM • Foreplay • Frotteurism and Tribadism • Fisting • Masterbation • Scrotism • Oral sex (cunnilingus, fellatio, rimming,) • Outercourse • Petting • Sexual fetishism • Vaginal sex

  4. B. social influences & social norms • Growing up, family and friends • Culture - media • Stereotypes • Religion • Laws - -http://www.geocities.com/CapitolHill/2269/CApenal9.html • IC 35-41-1-9"Deviate sexual conduct" defined     Sec. 9. "Deviate sexual conduct" means an act involving:        (1) a sex organ of one person and the mouth or anus of another person; or        (2) the penetration of the sex organ or anus of a person by an object.As added by P.L.311-1983, SEC.10. Amended by P.L.183-1984, SEC.1.

  5. C. Gender identity • M • F • Transgender – “People who were assigned a gender, usually at birth and based on their genitals, but who feel that this is a false or incomplete description of themselves.” • Transsexual – “Transsexualpeople are people who desire to have, or have achieved, a different physical sex from that which they were assigned at birth” • FTM • MTF • Genderqueer – “A genderqueer person is part of a group of people who do not think that they fit into the traditional two-gender or gender-binary system.” http://encyclopedia.thefreedictionary.com/Genderqueer

  6. D. Sexual orientation 0 1 2 3 4 5 6 Kinsey’s Scale

  7. 0 - exclusively heterosexual 1 – 2 - predominantly heterosexual, but more than incidentally homosexual 3 – 4 - predominantly homosexual, but more than incidentally heterosexual 5 - predominantly homosexual, incidentally heterosexual 6 -

  8. II. Hormones and sexuality • Hormones are directly involved in all aspects of sexuality: Desire, Excitement, Intimacy etc… Testosterone • Positive relationship between testosterone levels and masturbation but not intercourse frequency • Positive relationship between testosterone levels and sexual interest among adolescents, but found that peer relationships were a more important determinant of sexual behavior. • Estrogen • Estrogen deficiency, as occurs with menopause, causes a decrease in genital vasocongestion and lubrication and atrophy of the vaginal epithelium

  9. Hormones continued: • Progesterone • Certain oral contraceptives that increase progesterone levels throughout the female cycle have been associated with decreased sexual interest and desire • Prolactin • Oxytocin • Pheromones

  10. Neurotransmitters also play integral part • Nitric oxide • Sexual stimulation leads to NO production that in turn stimulates the release of • Guanylate cyclase converts guanosine triphosphate to cGMP and cGMP produces relaxation of the smooth muscles of the penile arteries and corpus cavernosum resulting in increased blood flow in the clitoris • Sildenafil, a drug designed to treat erectile difficulties, prolongs the action of cGMP by inhibiting the metabolism of cGMP • Epinepherine • epinephrine and norepinephrine metabolite, vanillylmandelic acid, increases prior to intercourse and continues to be elevated over baseline up to 23 hours following sexual activity

  11. III. Women, men and sexual arousal A. Generalizations • Women – • Men –

  12. B. People learn to be sexual

  13. IV. The female sexual response

  14. Overview of the female sexual response cycle: • Physiological sexual arousal in women begins with increased clitoral length and diameter, and vasocongestion of the vagina, vulva, clitoris, uterus, and possibly the urethra. • Engorgement of the genital vascular network increases pressure inside the vaginal capillaries and results in lubrication of the epithelial surface of the vaginal wall. • Orgasm is characterized by a peak in sexual pleasure that is accompanied by rhythmic contractions of the genital and reproductive organs, cardiovascular and respiratory changes, and a release of sexual tension • The body returns to its pre-aroused state

  15. A. Excitement Phase Women are less likely than men to pick up on the physiological cues of their own sexual arousal… • Heart rate • Vasocongestion – • Clitoris begins to swell - the corpora cavernosa of the clitoris consist of a fibroelastic network and bundles of smooth muscle. Pelvic nerve stimulation results in clitoral smooth muscle relaxation and arterial smooth muscle dilation. • With sexual arousal, there is an increase in clitoral cavernosal artery inflow and an increase in clitoral intracavernous pressure that leads to tumescence and extrusion of the clitoris. • \

  16. B. Plateau phase • Outer third of the vagina wall becomes swollen with blood • Labia minora also become engorged with blood • Breasts become somewhat engorged, nipple erection maintained

  17. C. Orgasm • Orgasm – • at which time the pulse rate reaches its peak • Suffusion of warmth spreads from pelvis throughout the body • Initial contraction, followed by 3 or 4 rhytmic contractions

  18. D. Resolution • Body gradually returns to its unexcited state following the orgasm • Glans emerges from the foreskin and returns to its usual size within 15-30 minutes • Respiration, pulse and blood pressure return to normal • Muscles relax

  19. Multiple orgasms in Women • Most, if not all women have the potential for more than one orgasm • May depend on the type of sexual stimulation involved

  20. In 1997, Whipple and Brash-McGreer proposed a circular sexual response pattern for women. comprises four stages Seduction (encompassing desire), sensations (excitement and plateau), surrender (orgasm), and reflection (resolution). pleasant and satisfying sexual experiences may have a reinforcing effect on a woman, leading to the seduction phase of the next sexual experience.

  21. V. Female Sexual Dysfunction • 1) Sexual desire disorders, 2) sexual arousal disorders, 3) orgasmic disorder, 4) sexual pain disorders • 1999 survey found that sexual dysfunction of some form was reported more commonly among females (43%) as compared to males (31%)

  22. A. Mechanisms of sexual dysfunction • Psychogenic • Relationship issues, depression, anxiety, self-esteem, body issues, personal loss, abuse, etc. • Iatrogenic • Medications, gynecologic surgery • Vascular • Cardiovascular disease, diabetes, hypertension, smoking… • Neurogenic • Spinal cord injury, disease of CNS, neurotransmitter dysfunction • Hormonal • Hypothalamatic-pituitary axis dysfunction, premature ovarian failure, androgen deficiency • Musculogenic • Hypertonic pelvic floor muscles, hypotonic pelvic floor muscles

  23. B. FSD Treatment • Nonphparmacologic • Pharmacologic • Hormone therapy • Antidepressants The Eros Therapy

  24. VI. Effects of drugs on sexuality • Dosage and timing important • Limited information available • Aphrodisiacs http://www.channel4.com/health/microsites/0-9/4health/drugs/dus_sex.html