Female Sexual Anatomy and Physiology

Chapter 3

Learning Objectives• External Sex Organs• Internal Sex Organs• The Breasts• The Menstrual Cycle• Menstrual Problems

External Sex OrgansPudendum

External female genitals

Derived from a Latin work that means “something to be ashamed of”

This sets the tone for negative views of the female genitalia

External Sex OrgansVulva External female structures that includes the mons

veneris, the labia majora and labia minora, the clitoris, and the vaginal opening

Latin for “wrapper” or “covering

External Sex OrgansLabia Majora

Large folds of skin that run downward from the mons along the sides of the vulva

Shields inner genitalia

Labia Minora

Hairless, light colored membranes located between the labia majora

External Sex OrgansClitoris

Female sex organ consisting of a shaft and glans

Shaft Body of clitoris, approximately 1 inch longCopora cavernosa, spongy tissue that becomes engorged from sexual stimulation

Glans Extremely sensitive tip of clitoris

Prepuce is the fold of skin covering the glans

External Sex OrgansClitoris Female sex organ consisting of a shaft and glans

Develops from the same embryonic tissue as the penis

Shaft Body of clitoris, approximately 1 inch longCopora cavernosa, spongy tissue that becomes engorged from sexual stimulation

Glans Extremely sensitive tip of clitorisPrepuce is the fold of skin covering the glans

ClitoridectomySurgical removal of the clitoral hood• Ritualized genital mutilation considered

a “rite of passage” to womanhood in some cultures

• The removal is to ensure the girl’s chastity

• Outlawed in the US• Creates physical and emotional scarsCRITICAL THINKINGDo you believe that disapproval of clitoridectomy by Americans and other Westerners shows cultural insensitivity? Why or why not?

External Sex OrgansThe Vestibule “Entranceway” within the labia minora that

contains the openings to the vagina and urethra

The Urethral Opening

The opening through which urine passes form the bladder out of the body

Its proximity to external sex organs can pose hygienic problems for sexually active women

Cystitis is an inflammation of the urinary bladder

External Sex OrgansVaginal Opening

Introitus Larger than urethral opening

Lies below urethral opening

Hymen Fold of tissue across vaginal opening

May remain intact until intercourse

Its presence is often considered a sign of virginity

External Sex OrgansThe Perineum

Skin and tissue that lie between vaginal opening and anus

Contains many nerve endings and is very sensitive

Episiotomy is a surgical incision that may be made here during childbirth to protect the vagina from tearing

External Sex Organs

External Sex OrgansUnderlying Structures

Sphincters Ring-shaped muscles that surround body openings

Crura Attach clitoris to pubic bone

Vestibular bulbs Cavernous structures extending downward along sides of introitus

Bartholin’s glands Secrete fluid just prior to orgasm

External Sex OrgansUnderlying Structures

Internal Sex OrgansThe Vagina

Tubular female sex organ that

contains the penis during

sexual intercourse and through which a baby

is born

Extends 3-5 inches back and upward from vaginal

opening

Has three layers

Inner lining (vaginal mucosa)

Middle layer (muscular)

Outer (deeper) layer (connects vagina to other

pelvic structures

Few nerve endings

VaginitisWash vulva

and anus

Be certain your partner’s genitals are clean

Wear cotton

underwear

Avoid pants

tight in crotch

Use only water soluble lubricants

Avoid sugar and

refined carbs

Keep track of your health

Ways to prevent vaginal inflation

Internal Sex OrgansThe Cervix

Lower end of

the uterus

OrOpening in the middle of the

cervix

About the width of a strawAllows passage of menstrual blood and spermExpands to permit passage of baby (10 cm)

Pap Test

Sample of cervical cells that screens for

cervical cancer and other abnormalities

Internal Sex OrgansThe Uterus (womb)

Hollow, muscular, pear-shaped organ in which a fertilized ovum implants and

develops until birth

Fundus – uppermost

partBody –

central partCervix –

lower part

Internal Sex OrgansThe Uterus (womb)

Three Layers

Endometrium – innermost

layer

Endometriosis – growth of

endometrial tissue outside the uterus

Myometrium – muscular

second layerPerimetrium – external cover

Internal Sex OrgansThe Fallopian Tubes

Tubes that extend from the upper

uterus toward the

ovaries

Help nourish and conduct ova

to uterus

Cilia (hair-like projections) help move ova through

tube

Ectopic pregnancy

Fertilized ovum implants outside

the uterus, usually in the fallopian

tube

Risk increases with age, pelvic inflammatory disease, tubal

surgery, or the use of intrauterine devices (IUDs)

Internal Sex OrgansThe Ovaries

Two almond-shaped organs that produce ova and female sex

hormones

Estrogen

Female sex hormones that promote the development

of female sex characteristics and

regulate the menstrual cycle

Progesterone

Steroid hormone that stimulates development of

the endometrium and regulates menstruation

Follicle

Capsule within an ovary that contains an

ovum

Ovarian Cancer• More common in European American women than African

American• Over 22K diagnosed, over 15K die

Fifth leading cancer killer of women between ages of 40 & 70

• Age• Obesity• Family history• Use of certain hormones and fertility drugs

Risk factors include

• When detected early, 89-99% survival rate

Early detection is essential

Internal Sex Organs

Internal Sex Organs

HysterectomySurgical removal of the uterus

Complete hysterectomy

Surgical removal of ovaries, fallopian tubes, cervix, and uterus

Partial hysterectomy

Surgical removal of the uterus only

May be performed when women develop cancer of the uterus, ovaries, or cervix and can relieve symptoms associated with various gynecological disordersMany gynecologists believe that hysterectomies are recommended too often

Pelvic ExaminationRecommended once a year starting in late teens

External examination of genitalia

Internal exam

Speculum – instrument that holds vaginal walls open

Pap smear

Internal palpations to examine position, size, and possible growths on internal organs

Female Pelvic Examination

The BreastsSecondary sex characteristics

Traits that distinguish women from men

Are not directly involved in reproduction

Mammary glands

Milk-secreting glands

Areola – dark ring on the breast that encircles the nipple

Sensitive to stimulation

Breast Cancer• Annually 230,000 women diagnosed, 39,500 die• An estimated 410 men die each year

In the US

• Family history, genetics• High breast density• Long-term use of HRT• High body fat• Physical inactivity

Risk factors include

• Self exam, mammography• If not spread beyond breast, 5 year survival rate is about 93%

Early detection is essential

Critical ThinkingThe American Cancer

Society no longer recommends that women need to conduct breast self examinations as a

means of detecting breast cancer early.

Do you believe that this is a good idea for

women to do self-exams anyhow? Why

or why not?

Breast Cancer Detection and Treatment

Mammogram

A type of X-ray that detects cancerous lumps in the breast

Lumps in the breast

Cysts are sac-like structures filled with fluid or diseased material Benign tumors do little or no harm and are called fibroadenomasMalignant lumps are lethal, causing or likely to cause death

Lumpectomy

The surgical removal of a lump from the breast

Mastectomy The surgical removal of the entire breast

The Menstrual CycleMenstruation

Cyclical bleeding that stems from the shedding of the uterine lining (endometrium)

Regulated by estrogen and progesterone

Averages about 28 days but variations are common

Can be influenced by psychological factors

Regulation of the Menstrual Cycle

Hypothalamus Brain structure that regulates body

temperature, motivation, emotion, and hormone productionReleases gonadotropin releasing hormone (Gn-RH) which stimulates the pituitary to release gonadotropins

Pituitary hormones that stimulate the gonads

Regulation of the Menstrual Cycle

Pituitary gland

Gland that secretes growth hormone, prolactin (stimulates milk production), oxytocin (stimulates uterine contractions in labor and the ejection of milk during nursing), and gonadotropins (stimulate the ovaries)Gonadotropins Follicle-simulating hormone

(FSH) (stimulates development of follicles in the ovaries)

Luteinizing hormone (LH) (helps regulate the menstrual cycle by triggering ovulation)

Phases of the Menstrual Cycle

Proliferative

Estrogen increases

Eggs ripen

Ovulatory Ovulation occurs

Secretory or Luteal

Uterus prepares for implantation

Menstrual Shedding of uterine lining

The Menstrual Cycle• First phase • Endometrium

proliferates• Follicles develop

and prepare for ovulation

Proliferative Phase

The Menstrual Cycle• Second phase • Follicle ruptures and releases a mature ovum

OvulatoryPhase

The Menstrual Cycle• Third phase • Large amounts of

progesterone and estrogen

• Hormones signal secretion of nutrients to sustain implanted ovumSecretory

or Luteal Phase

The Menstrual Cycle• Fourth phase• Ovum not fertilized,

hormone levels decline and endometrium is removed

• Low estrogen results in release of FSH, cycle starts again

Menstrual Phase

The Menstrual Cycle

Sex during menstruation• No evidence that it is harmful• Orgasmic contractions may alleviate

cramping• Women can be sexually aroused at

any time during cycle• Research indicates this peaks at ovulation

The Menstrual CycleMenopause “Change of life”

Menstruation ceases

Perimenopause

Start of menopause

Climacteric Long-term process of decline in the reproductive capacity of the ovaries

The Menstrual Cycle

Night sweats

Headaches

Decreased vaginal

lubricationOsteoporo

sis

Symptoms resulting from estrogen loss

Hormone Replacement Therapy

Synthetic replacement of estrogen and/or

progesterone

Reduces symptoms of menopause

Mixed research findings• May increase risk of

cancer, stroke, blood clots

• May reduce/increase risk of heart disease

• Fewer women on HRT now

There are other methods to relieve

symptoms

Menstrual Problems

Amenorrhea• Absence of

menstruation

• Is a symptom of anorexia nervosa

Primary• Lack of

menstruation in a woman who has never menstruated

Secondary• Lack of

menstruation in a woman who has previously menstruated

Menstrual ProblemsPremenstrual Syndrome

Physical and psychological symptoms that may afflict

women during the four to six day interval that precedes

menstruation

Menstrual ProblemsPremenstrual Dysphoric Disorder

(PMDD)

A diagnosis used by the American Psychiatric Association to describe

cases of PMS that are characterized by severe changes in mood and impaired functioning at work or school or in social relationships

Menstrual ProblemsPMDD Symptoms

Feeling sad, hopeless, or worthless

Tension, anxiety, edginess

Frequent crying, significant mood changes

Irritability and anger causing interpersonal conflict

Decreased interest in activities and relationships

Difficulty concentrating

Fatigue, lethargy, lack of energy

Notable changes in appetite

Feeling overwhelmed or out of control