REPRODUCTIVE & SEXUAL HEALTH

NCM 107

with men, women who have sex

with women.
HUMAN PROCREATION
 Bisexual are said to achieve
 It is a biological process that sexual satisfaction from both
enables the birth of another homosexual and heterosexual
human being. It implies sexual relationships.
reproduction since the genetic  A transsexual or transgender
information of the offspring person is an individual who,
includes contributions from the although of one biologic gender,
two parents through the fusion of feels as if he or she is the
the gametes. opposite gender.
SEXUALITY & SEXUAL IDENTITY TYPES OF SEXUAL EXPRESSION
 Gender identity is a person’s  Sexual abstinence
sense of his or her masculinity or  Masturbation
femininity.  Erotic stimulation
 Gender roles are composed of  Fetishism
behaviors, attributes and attitudes  Transvestism
an individual conveys about being  Voyeurism
male or female.  Sadomasochism
 Biologic gender is the term used  Exhibitionism
to denote chromosomal sexual  Making obscene telephone calls
development: male –XY or
 Bestiality
female- XX
 Pedophilia
 Sexual orientation refers to a
person’s preference for HUMAN SEXUAL RESPONSE
heterosexual, homosexual, or
Excitement occurs with physical &
bisexual relationship.
psychological stimulation that causes
 Sexual expression refers to the
parasympathetic nerve stimulation which
activities that the individual
leads to arterial dilation and venous
chooses to give and receive
constriction in the genital area.
physical love or gratification.
Plateau stage is reached before orgasm.
TYPES OF SEXUAL ORIENTATION
Orgasm occurs when stimulation
 A heterosexual is a person who
proceeds through the plateau stage to a
finds sexual fulfillment with a
point at which the body suddenly
members of the opposite gender.
discharges accumulated sexual tension.
 A homosexual is a person who In men, muscle contractions surrounding
finds sexual fulfillment with a the seminal vessels and prostate project
member of his or her own sex; semen into the proximal urethra.
gay, lesbian, men who have sex

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

Resolution is a 30-minute period during FEMALE EXTERNAL REPRODUCTIVE

which the external and internal organs ORGAN
return to an unaroused state.

The mons pubis is a mound of fatty

tissue over the symphysis pubis that
cushions ad protects the bone.
The labia majora are longitudinal skin
folds between the labia majora.
The clitoris is erectile tissue located at
the upper end of the labia minora. It is
the primary site of sexual arousal.
The urethral meatus or orifice is small
DISORDERS OF SEXUAL opening of the urethra. It is located
FUNCTIONING between the clitoris and the vaginal
 Inhibited sexual desire orifice for the purpose of urination.
 Failure to achieve orgasm Skene or paraurethral glands are small
 Erectile Dysfunction mucus-secreting glands that open into
 Premature ejaculation posterior wall of the urinary meatus and
 Persistent sexual arousal lubricate the vagina.
syndrome
The vestibule is an almond-shaped area
Pain disorders: between the labia minora containing the
vaginal introitus, hymen and Bartholin
 Vaginismus
glands.
 Dyspareunia and vestibulitis
The vaginal introitus is the external
FEMALE REPRODUCTIVE SYSTEM opening of the vagina.
EXTERNAL STRUCTURES The hymen is a membranous tissue
ringing the introitus.
Bartholin or vulvovaginal glands are
mucus-secreting glands located on
either side of the vaginal orifice.
The perineal body is composed of
muscles and fascia that support pelvic
structures.
The perineum is the area of tissue
between the anus and vagina, an
episiotomy is performed here.

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

FEMALE INTERNAL REPRODUCTIVE  Cardinal, pubocervical, and

ORGANS uterosacral ligaments that are
suspensory and provide middle
support.
 Pelvic muscular floor ligaments
that provide lower support.
The fallopian tubes extend from the
upper outer angles of the uterus and
end near the ovary. These tubes serve
as the passageway for the ovum to
travel from the ovary to the uterus and
for the sperm to travel from the uterus to
the ovary.
The vagina is the female organ of
copulation and also serves as the birth The ovaries are female sex glands
canal. It is a tubular located on each side of the uterus. The
musculomembranous organ that lies two functions of the ovaries are
between the rectum and the urethra and  Ovulation (release of ovum)
bladder.  Secretion of hormones (estrogen
The uterus is a hollow, muscular organ and progesterone)
with three muscle layers (perimetrium, The pelvis is a bony ring in the lower
myometrium, and endometrium). It is portion of the trunk. It consists of three
located between the bladder and parts (ilium, ischium and pubis) and four
rectum, and consists of the fundus, bones (two innominate bones or
body(corpus), and cervix. Uterine hipbones, sacrum and coccyx. The
function include: pelvic bones are held together by four
 Menstruation, the sloughing away joints-symphisis pubis, two sacroiliac,
of spongy layers of endometrium and sacrococcygeal.
with bleeding from torn vessels.  Types of pelvis: gynecoid,
 Environment for pregnancy; the android, anthropoid, platypelloid
embryo and fetus develop in the  Pelvimetry: the process of
uterus after fertilization. measuring the internal or external
 Labor, consisting of powerful pelvis is performed with
contractions of the muscular radiography or by internal
uterine wall that result in examination.
expulsion of the fetus.
Internal pelvic inlet measurement
Uterine ligaments include: measures the diagonal conjugate, which
 Broad and round ligaments that is the lower margin of the symphisis
provide upper support for the pubis to the promontory of the sacrum; it
uterus is normally 11.5 cm or more.

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

Internal midpelvic outlet measurement  Adipose and fibrous tissues,

measures the distance between ischial which provide the relative size
spines and prominence or bluntness of and consistency of the breast.
spines; it is normally 10.5 cm.
 External structure include:
Internal pelvic outlet measurement is an
 The nipple, a raised, pigmented
estimation of the angle of the pubic arch,
area of the breast.
mobility of the coccyx, intertuberous
diameter 11 cm, and posterior sagittal  The areola, pigmented skin
diameter 7.5 cm. around the nipple.
FOUR TYPES OF FEMALE PELVIS  Montgomery tubercles,
sebaceous glands of the areola
 The breasts change in size and
nodularity in response to cyclic
ovarian hormonal changes,
including;
 Estrogen stimulation
 Progestrone
 Physical changes in the breast
size and activity are at a
FEMALE BREASTS minimum 5 to 7 days after
menstruation stops; this is the
 The female breasts (mammary best time to detect pathologic
glands) are specialized changes through breast self-
sebaceous glands that produce exam.
milk after childbirth(lactation)
 Internal breast include:
 Glandular tissue(parenchyma is
composed of acini milk-
producing) cells that cluster in
groups of 15 to 20 to form the
lobes of the breast.
 Lactiferous ducts or sinuses,
which form passageways from
the lobes to the nipple.
 Fibrous tissue, also called
Cooper ligaments, which provide
support to the mammary glands.

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

THE MENSTRUAL CYCLE CENTRAL NERVOUS SYSTEM (CNS)

RESPONSE
 The hypothalamus stimulates the
anterior pituitary gland by
secreting gonadotropin-releasing
hormone (GnRH). The anterior
pituitary secretes two
gonadotropins-follicle-stimulating
hormones (FSH) and luteinizing
hormone (LH).
MENSTRUATION & HORMONES  FSH prompts the ovary to
develop ovarian follicles; the
 Menarche, onset of menstruation, developing follicles secrete
typically occurs between 9 and 17 estrogen, which feeds back to the
years of age, with average age of anterior pituitary to suppress FSH
onset at 12 or 13 years. and trigger a surge of LH.
 The menstrual cycle is a monthly  LH acts with FSH to cause
pattern of ovulation and ovulation and enhance corpus
menstruation. luteum formation.

 Ovulation is the discharge of a OVARIAN RESPONSE

mature ovum from the ovary.
 An oocyte grows within the
 Menstruation is the periodic primordial follicle in two phases-
shedding of blood, mucus, and follicular and luteal.
epithelial cells from the uterus;  In the follicular phase, days 1 to
average blood loss is 30 to 80 ml. 14, the follicle matures as a result
of FSH.
 The ovaries produce mature
 In the luteal phase, days 15 to 22,
gametes and secrete the
the corpus luteum develops from
following hormones:
a ruptured follicle.
 Estrogen which contributes to
ENDOMETRIAL RESPONSE
female characteristics.
 In the menstrual phase, days 1 to
 Progesterone (hormone of
5, the estrogen level is low and
pregnancy), which decreases the
cervical mucus is scanty.
contractility of the uterus.
 In the proliferative
 Prostaglandins, which regulate (follicular)phase, days 6 to 14, the
the reproductive process by estrogen level is high, the
stimulating the contractility of endometrium and myometrium
uterine and other smooth muscle. thickens, and changes in cervical
mucosa occur. On average,

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

ovulation occurs on day 14 of a average age of menopause is 51

28-day cycle. with an age range of 40 to 55
 In the secretory phase, days 14 years.
to 26, after release of the ovum,  The earlier the age of menarche
the estrogen level drops, the the earlier menopause tends to
progesterone level is high, occur
increased uterine vascularity
MALE REPRODUCTIVE SYSTEM
occurs, and tissue glycogen
levels increase.
 In the ischemic phase, days 27 to
28, estrogen and progesterone
levels recede. Arterial vessels
constrict, the endometrium
prepares to shed, the blood
vessels rupture, and
menstruation begins.
INTERNAL STRUCTURES
CERVIX AND CERVICAL MUCUS
 The testes are two solid, ovoid
RESPONSE
organs 4 to 5 cm long, divided
 Before ovulation, estrogen levels into lobes containing
rise, causing cervical os dilation, seminiferous tubules. The two
abundant liquid mucus, high functions of the testes re
spinnbarkeit, and excellent sperm production and spermatogenesis
penetration. (sperm production)
 After ovulation, progesterone  The epididymis is a tubular sac
levels rise, resulting in cervical os located next to each testis that is
constriction, scant viscous a reservoir for sperm storage and
mucus, low spinnbarket,no maturation.
ferning, and poor sperm  The vas deferens is a duct
penetration. extending from the epididymis to
 During pregnancy, cervical the ejaculatory duct, which
circulation (blood supply) provides a passageway for
increases and a protective mucus sperm.
plug forms.  The ejaculatory duct is the canal
formed by the union of the vas
CLIMACTIC PERIOD & MENOPAUSE
deferens and the excretory duct
 The climacteric is a transitional of the seminal vesicle. It enters
period during which ovarian the urethra at the prostate gland.
function and hormonal production  The urethra is the passageway
decline. for urine and semen that extends
 Menopause refers to a woman’s from the bladder to the urethral
last menstrual period; the meatus.

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

 FSH stimulates germ cells within

the testes to manufacture sperm.
 LH stimulates the production of
testosterone in the testes.
Although LH stimulates the
Leydig cells to produce
testosterone from cholesterol,
testosterone inhibits the secretion
of LH by the anterior pituitary.
 Testosterone, one of several
androgens( and the most
SEMEN potent)produced in the testes, is
responsible for the development
 Semen is a thick, whitish fluid of secondary sex characteritics at
ejaculated by the man during puberty.
orgasm. It contains spermatozoa
and fructose-rich nutrients.  Testosterone production occurs
During ejaculation, semen in the interstitial Leydig cells in
receives contributions of fluid the seminiferous tubules. Leydig
from the seminal vesicles and the cells are abundant in the newborn
prostate gland. and the pubescent boy, and
 Semen is alkaline (average pH testosterone is abundant during
7.5) and the average amount of these periods.
semen released during  Testosterone production slows
ejaculation is 2.5 ml to 3.5 ml. after 40 years of age; by 80 years
MALE BREASTS of age, production is only about
one-fifth peak level.
 Male mammary tissue remains
dormant throughout life, but the SPERMATOGENESIS
breasts are a site sexual  Spermatogenesis occurs
excitation and arousal. continually after puberty,
 Although rare, male breast providing large numbers of sperm
cancer occurs frequently enough for unlimited ejaculations during
to warrant routine inspection of the mature life span.
the breasts for dimpling,
discharge or nipple inversion.  Spermatozoa are released from
the epithelial wall of the
Neurohormonal control of the male seminiferous tubules. Meiosis
reproductive system occurs during the process, and
 At puberty, the hypothalamus the number of chromosomes in
stimulates the pituitary gland to each cell is reduced by one-half
produce FSH and LH. (haploid number).

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REPRODUCTIVE & SEXUAL HEALTH
NCM 107

 Spermatogenesis is a heat-
sensitive process; the 2 degree to
3 degree difference between
scrotal and abdominal
temperature allows
spermatogenesis to proceed in
the cooler environment.
 The entire period of
spermatogenesis, from germinal
cell to mature sperm, takes about
75 days.