Sexual organs

Sexual organs
* Genitalia
* Reproductive tracts
* Glandular systems
* Nervous system

Women
* Genitalia
o Vulva
o Clitoris
o Vagina
* Reproductive tracts
o Ovaries
o Fallopian tubes
o Uterus
The vulva
* Mons pubis or mons veneris
* Labia majora
* Labia minora
* Prepuce or clitoral hood
* Bartholin’s glands
* Vaginal opening
* Skene’s glands
* Introitus or vestibule; vestibular bulbs
* Pubococcygeal muscles and Kegel exercises: close to 1 cm diameter
o Vaginismus and dyspareunia
* Perineum and episiotomy

The clitoris
* Glans
* Shaft
* Smegma
* Circumcision, clitoridectomy (excision), Pharaonic circumcision, and infibulation
* Urethra, between clitoris and vagina

The vagina
* Hymen or maidenhead
* Mucosal lining: Lubrication
* Nerve endings: Outer 1/3 of vagina
* Grafenberg spot

Vaginal health
* Self-examination with mirror, flashlight
* Do not douche or use vaginal deodorants
* Wash vulva daily, but do not scrub
o Insist that a sexual partner is also freshly clean
* Wear all-cotton panties
o Especially if taking antibiotics or perspiring
* Normal signs:
o A creamy discharge, clear to white in color
o Odor from sweet to musky, varies with hormones, medication, perspiration
* Limit tampon use: TSS, ulceration
o Avoid superabsorbent types
o Four-hour limit; no overnight use
* Change panty liners frequently
* Warning signs of vaginitis:
o Yellow or green discharge, clumps in discharge
o Foul odor
o Irritation, itching, or burning
o Urgent need to urinate

Reproductive tract
* Uterus
o Fundus and body: Perimetrium, myometrium, and endometrium: Endometriosis
o Cervix and Os
* Ovaries: Hormones and ova
o Ovarian ligaments
o Follicles and oocytes
* Fallopian tubes
* Hysterectomy

Fallopian tubes
* Fimbriae collect ova
* Infundibulum and ciliary movement
* Fertilization
* Ectopic pregnancy

Menstruation
* Menarche
* Dysmenorrhea
* Oligomenorrhea, amenorrhea, and menorrhagia
* Attitudes toward menstruation
* Sexual activity during menses: Safer sex
* PMS/PMDD: Does it exist?

The menstrual cycle
* 1. Menstrual phase, 5 days (variable)
* 2. Proliferative phase, 9- 11 days
o FSH --> Estrogen --> Endometrial growth
* 3. Ovulation, 14 days before menses
* 4. Secretory or luteal phase, 14 days
o LH --> Progesterone --> Preparation for implantation
Menopause
* Clemacteric, perimenopause, and menopause
* Decreased responsiveness of ovaries to pituitary hormones
* Perimenopausal symptoms
o Flashes, flushes, and sleep problems
o Dizziness, pains, and paresthesias
o Vaginal dryness, impaired cognition
* HRT/ERT
HRT/ERT: Increased risk of health problems counter obvious benefits
* Breast cancer:
o Estrogen alone: 15% increased risk; Estrogen + progestin: 58%; Estrogen + testosterone: 77% (all compared to no HRT) (Tamimi et al, 2006)
o The Women’s health Initiative study (2002) reported 26% increase in estrogen + progestin group—from 30/10,000 to 38/10,000

Other health risks of HRT
* Contrary to predictions, a 29% increased risk of heart attack (37/10,000 vs 30/10,000)
* 41% increased risk of stroke (29/10,000 vs. 21/10,000)
* Blood clot risk more than doubles (34/10,000 vs 16/10,000)
* Risk of ovarian cancer triples in women using estrogen for 20 or more years (NCI, 2002)
* Estrogen + progestin HRT impairs hearing (Frisina et al, 2006)

The gynecological examination
* Medical and sexual history
* External examination
* Speculum examination
* Pap smear
* Palpation
* Recto-vaginal examination
* Breast examination
o Breast self-examination
Breasts

* Secondary sex characteristics and self-esteem: Breasts vs. menstruation
* Mammary glands and ducts
* Adipose tissue
* Nipples and areolas
o Respond to stimulation: Temperature, arousal
o May be involuted
* Sensitivity varies with menstrual cycle

Sexual organs.ppt