Transcript Female Male

February 27, 2012
NURS 330
Human Reproductive Health
What is Sexuality?
What factors influence
Sexuality?
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Values
Attitudes
Behaviors
Physical Appearance
Beliefs
Source: http://www.engenderhealth.org/res/onc/sexuality/introduction/index.html
The Senses and Sexuality
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Touch
Smell
Sound
Sight
Smell
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Smell
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Odors play a role in sexual arousal
Pheremones
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Perfumes
Colognes
Debate about its existence
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i.e. menstrual synchrony
Not all odors are conducive to sexual arousal
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Offensive odors
Sound
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Sound
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Auditory stimuli
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Your partner’s voice
Romantic or sexy music
Love-making sounds
Not all sounds are conducive to sexual
arousal
Sight
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Sight
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Allows us to experience many images that can
trigger feelings of sexual arousal
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Viewing an “attractive” person
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Subject to social and cultural influences
Erotic images
Sometimes even parts of one’s genitals
Which sense is this?
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Do not appear to play a significant role in
sexual arousal
Terms to know
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Erogenous zones
Kegel Exercises
Aphrodisiacs
Pheremones
Definition
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Erogenous Zones
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parts of the body that, when stimulated,
elicit sexual arousal
Kegel Exercise
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Recommended to reduce urinary
incontinence and possibly increase sexual
pleasure
Identify the muscle by stopping urination
in midstream
Definition
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Aphrodisiacs
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Agents that show any ability to enhance sexual
functioning
Pheromones
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Substances that when secreted have a
particular smell found to be sexually arousing.
Sex Hormone
Testosterone
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“Male” hormone
Found in small amounts in women
Affects sexual response in men and women
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Men – produced by the seminiferous tubules
Women - produced by the ovaries
Increase energy, sex drive (libido), aggression,
appetite, muscle mass Increases libido in both
men and women
FACT
A person’s emotional and mental states
also help determine whether that
person experiences arousal
Sexual Response Cycle
Models of Human Sexual
Response
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Master’s and Johnson
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Proposed their four-stage model of human
sexual response cycle
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Stage
Stage
Stage
Stage
I - Excitement
II - Plateau
III - Orgasm
IV - Resolution
EXCITEMENT- 1ST STAGE:
•Response to stimuli
FEMALE
MALE
Transudation
Vasocongestion
Tenting Effect
HR, BP, RR
Myotonia
Penile Erection
Vasocongestion
Testis enlarge
 HR, BP, RR
Myotonia
RR – Respiratory Rate; BP – Blood Pressure; HR – Heart Rate
PLATEAU – 2ND STAGE
FEMALE
MALE
Orgasmic Platform
Tenting Effect
Seminal Pool
Erection is maintained
(if there is enough
stimulation)
Cowper’s Gland
secretes fluid
ORGASM – 3RD STAGE
FEMALE
MALE
Muscle spasms
Involuntary
Collection of semen in the
urethral bulb
Ejaculatory Invariability
-bulbocavernosus muscle
Expulsion of semen
RESOLUTION – 4TH STAGE
FEMALE
MALE
Return to non-aroused
state
Refractory Period
Comparing male and female
sexual response
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Key difference
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Male has a refractory period
There’s a potential for multiple orgasms in
women
Controversies in understanding the female
orgasm
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Freud
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vaginal orgasm is true orgasm
Master’s and Johnson
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only one kind no matter how achieved
Sexual Dysfunctions
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Recurrent or persistent sexual problems that
interfere with normal performance and cause
distress
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Nine types of sexual disorders
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Four categories
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Sexual Desire Disorders
Sexual Arousal Disorders
Orgasmic Disorders
Sexual Pain Disorders
Prevalence
Sexual Desire Disorders
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Hypoactive sexual desire disorder
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Persistent deficit in sexual fantasies and desire for
sex
Sexual aversion disorder
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Extreme aversion to any form of sexual contact
with a partner
Sexual Arousal Disorders
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Female sexual arousal disorder
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Difficulties becoming sexually aroused
Deficient vaginal lubrication
Male erectile disorder
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Recurrent problems in achieving or sustaining penile
erection in a sexual situation
Aka Impotence
Orgasmic Disorders
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Female orgasmic disorder (anorgasmia)
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Male orgasmic disorder
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Recurrent problem with reaching orgasm despite
adequate erotic stimulation
Delay or inability to reach orgasm during sexual activity
Premature ejaculation
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Persistent or recurrent ejaculation following minimal
stimulation and before the person wishes it
Sexual Pain Disorders
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Dyspareunia
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Recurrent genital pain during sexual intercourse
Vaginismus
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Persistent involuntary spasms of vaginal muscles, which
interfere with sexual intercourse
Sexual Dysfunctions -
Differences in Men and Women
Female
Male
Sexual Aversion Disorder
Sexual Aversion Disorder
Dyspareunia
Dyspareunia (rare in men)
Vaginismus
Premature Ejaculation
Female Orgasmic Disorder
Male Orgasmic Disorder
Hypoactive Sexual Desire
Disorder
Hypoactive Sexual Desire
Disorder
Female Sexual Arousal
Disorder
Male Erectile Disorder
General Causes
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Physiological/Biological
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Psychological/Emotional
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Anxiety
Negative beliefs
Sexual trauma
Interpersonal/Social
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Medication and illicit drugs
Relationship problems
Environmental
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Cultural factors
Treatment of Sexual Dysfunctions
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Medical treatment of sexual
dysfunctions
Sex therapy
Medical Treatment
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Viagra
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FDA approval in March 1998
Prescription only
Lasts about four hours
Side effects
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Short duration
Sex Therapy
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Principles of sex therapy
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Mutual responsibility is emphasized
Information and education are integral
components
Attitudes, expectations, and sexual scripts
usually must be modified
Sexual Orientation
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Sexual orientation
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Erotic and romantic attraction to one or
both sexes
Asexual
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No erotic or romantic interest
Sexual Orientation
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Homosexual
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Heterosexual
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Same sex
Opposite sex
Bisexual
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Both sexes
Defining Terms
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Sex
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Gender
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Gender Roles
What Is Sexual Harassment?
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Sexual harassment
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Sexual advances that are unwelcome
and/or other sexually related behaviors
that are hostile, offensive, or degrading
Two types of
Sexual Harassment
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Quid pro quo harassment
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Employee is expected to exchange sexual
favors in return for keeping job or getting
promotion
Hostile environment harassment
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Unwanted behavior of a sexual nature
creates a hostile or offensive work
atmosphere
Sexual Harassment can occur
at……..
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Schools
College campuses
Workplace
Family member’s home
Public places
Examples of Harassment
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Uninvited or deliberate touching
Uninvited sexually suggestive looks or gestures
Cornering or pinching
Unwelcome sexual advances
Demands for sexual favors
Degrading sexual remarks
Groups of one sex making jokes about the
opposite sex
Persons in positions of leadership taking
advantage of their position with sexual threats
Inquiries about sexuality
What to do if you feel you are
being sexually harassed
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At work:
1. Let the person know that their behavior is inappropriate and ask them
to stop
2. Keep a written record of events
3. Notify your supervisor immediately
4. Follow the complaint process/policy
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At school/on campus:
- 1 & 2 above
- Notify appropriate individuals on campus
- Contact the public safety office on campus
- http://www.calstatela.edu/univ/police/
- (323) 343-3700
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Other resources
Rape Drugs
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What is a Rape Drug?
Rape Drugs (cont)
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The most common rape drugs:
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Rohypnol
GHB
Other common rape drugs
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Ecstasy
Ketamine
Odorless, colorless
Easily dissolved into drinks
Effects of Rape Drugs
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Drowsiness
Disorientation
Disinhibition
Amnesia
Infertility
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Definition: number of couples who have
unprotected intercourse for one year and do
not experience a pregnancy
10-15% of American couples are infertile
Causes of infertility
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Both men and women contribute to infertility
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90% of cases, cause will be known
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Remaining 10% of cases, cause remains unknown
Males
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Each gender contributes 40%
Both contribute 10%
Usually due to sperm defect
Females
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More complex
Risk Factors
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Some common risk factors
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Age
Weight
Lifestyle
Occupational and Environmental risks
Stress and Emotional factors
Genetic conditions??
Age and Infertility
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Females
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As a woman gets older, her chances of fertility declines
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Menopause
Higher risk of chromosomal abnormalities that occur in her eggs
More likely to have health problems that may interfere with fertility
However, if fertilization occurs, can carry to full term
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High risk of miscarriage
Males
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Not very clear on its impact of age and fertility in men
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Age does not appear to impact fertility in males as it does in females.
More likely to have health problems that may interfere with fertility
Chances of Pregnancy by Age
Age
Fertility %
Up until 34
90%
By age 40
Declining to 67%
By age 45
Declining to 15%
Causes of Female Infertility
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Common causes
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Blocked Fallopian Tubes
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Pelvic Inflammatory Disease
Endometriosis
Ovulation disorders
Others
Pelvic Inflammatory Disease (PID)
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Pelvic Inflammatory Disease, or PID, is the major
cause of infertility worldwide. It is an infection of a
woman's pelvic organs (uterus, fallopian tubes, and
ovaries).
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Infection of one or both fallopian tubes is known as
Salpingitis
Symptoms
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Mostly asymptomatic
Fever, chills, pelvic pain (indicating inflammation of the
entire pelvic area).
PID (cont)
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Common causes of PID
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Untreated/uncured bacterial infection
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Most common chlamydia (about 75% of cases)
Second most common cause is gonorrhea.
Endometriosis
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Lining of the uterus, instead of being expelled into the vagina, is
expelled out into the fallopian tubes and implanted in other areas of the
pelvis.
These implants respond to hormonal changes, slowly increasing in
number and size with each menstrual cycle
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Symptoms
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Eventually causes scarring and inflammation
Often causes no symptoms
Painful periods, painful sex, painful bowel movements
Cause is unknown
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Possible defects in immune system
Endometriosis and infertility
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Endometrial cysts in the fallopian tubes
may cause blockage
Scar tissue between uterus, ovaries and
fallopian tubes
Poor egg implantation
Female InfertilityOther possible causes
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Ovulation Disorders
Hormone Disorders
Ovarian Cysts
Benign Uterine Fibroids
Ectopic pregnancies, medical conditions, medications
Male Infertility
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Over 90% of cases are due to:
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Low sperm count
Poor sperm quality
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Motility
Morphology
Both
30 - 40% of cases have an unknown cause
What affects sperm count and
quality?
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Environmental and Biologic Factors
Lifestyle
Genetic Factors
Varicocele
Varicocele
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Varicose vein in the cord that
connects to the testicle.
Found in 10-15% of all men
Found in 25% - 40% of infertile men
Only varicoceles large enough to be
felt are reported to affect fertility
Testing for Infertility - males
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Sperm evaluation
Hormone tests
Ultrasound
Testing for Infertility – females
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Ovulation Assessment
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Body temperature
Cervical mucus assessment
Hormone Analysis
Laparascopy
Check vagina for naturally occurring
sperm antibodies
Infertility Treatment
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Artificial Insemination
Drug therapy
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Clomid
In Vitro Fertilization (IVF)
Infertility Treatment
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Gamete Intrafallopian Transfer (GIFT)
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Zygote Intrafallopian Transfer (ZIFT)
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Both egg and sperm inserted into Fallopian
tube
Fertilized outside body and inserted into
Fallopian tube
Intracytoplasmic Sperm Injection (ICSI)
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Direct injection of sperm into egg in lab