The Physical and
Sexually Self
Marieb, E.N. (2001) explains that the gonads (reproductive
glands that produce the gametes; testis or ovary) begin to
form until about the eighth week of embryonic
development. During the early stages of human
development, the embryonic reproductive structures of
males and females are alike and are said to be in the
indifferent stage. When the primary reproductive structures
are formed, development of the structures and external
genitalia begins. The formation of male or female structures
depends on the presence of testosterone. Usually, once
formed, the embryonic testes release testosterone, and the
formation of the duct system and the genitalia follows. In
the case of female embryos that form ovaries, It will cause
the development of the female ducts and the external
genitalia since testosterone hormone is not produced.
Any intervention with the normal pattern of sex hormone production in the
embryo results in strange abnormalities. For instance, a genetic male
develops the female accessory structures and external genitalia if the
embryonic testes fall to produce testosterone. On the other hand, If a
genetic female is exposed to testosterone (as in the case of a mother with
androgen-producing tumor of her adrenal gland), the embryo has ovaries
but may develop male accessory ducts and glands, as well as a male
reproductive organ and an empty scrotum. As a result, pseudo
hermaphrodites are formed who are individuals having accessory
reproductive structures that do not “match” their gonads while true
hermaphrodites are individuals who possess both ovarian and testicular
tissues but this condition is rare in nature. Nowadays, many pseudo
hermaphrodites undergo sex change operations to have their outer selves
(external genitalia) fit with their inner selves (gonads).
A critical event for the development of reproductive organs takes place
about one month before birth wherein the male testes formed in the
abdominal cavity at approximately the same location as the female ovaries,
descend to enter scrotum. If this normal event fails, it may lead to
cryptorchidism. This condition usually occurs in young males and causes
sterility (which is also a risk factor for cancer of the testes) that is why
surgery is always performed during childhood to solve this problem.
Moreover, abnormal separation of chromosomes during meiosis can lead
to congenital defects of the reproductive system. For instance, males who
possess extra female sex chromosome have the normal male accessory
structures, but atrophy (to shrink) of their testes causes them to be sterile.
Other abnormalities result when a child has only one sex chromosome. An
XO female appears normal but lacks ovaries. YO males die during
development. Other much less serious conditions also affect males
primarily such as phimosis, which is due to a narrowing of the foreskin of
the male reproductive structure and misplaced urethral openings.
Puberty is the period of life, generally between the ages of 10 and 15 years
old, when the reproductive organs grow to their adult size and become
functional under the influence of rising levels of gonadal hormones
(testosterone in males and estrogen in females). After this time,
reproductive capability continues until old age in males and menopause in
females.
The changes that occur during puberty is similar in sequence in all
individuals but the age which they occur differs among individuals. In
males, as they reach the age of 13, puberty is characterized by the increase
in the size of the reproductive organs followed by the appearance of hair in
the public area, axillary, and face. The reproductive organs continue to
grow for two years until sexual maturation marked by the presence of
mature semen in the testes.
In females, the budding of their breasts usually occurring at the age of 11
signals their puberty stage. Menarche is the first menstrual period of
females which happens two years after the start of puberty. Hormones play
an important role in the regulation of ovulation and fertility of females.
DISEASE ASSOCIATED WITH THE REPRODUCTIVE SYSTEM
Infections are the most common problems associated with the
reproductive system in adults. Vaginal infections are more common in
young and elderly women and in those whose resistance to diseases is low.
The usual infections include those caused by Escherichia coli (E.coli) which
spread through the digestive tract; the sexually transmitted
microorganisms such as syphilis, gonorrhea, and herpes virus; and yeast (a
type of fungus). Vaginal infections that are left untreated may spread
throughout the female reproductive tract and may cause pelvic
inflammatory disease and sterility. Problems that involve painful or
abnormal menses may also be due to infection or hormone imbalance.
In males, the most common inflammatory conditions are prostatitis,
urethritis, and epididymitis, all of which may follow sexual contacts in
which sexually transmitted disease (STD) microorganisms are transmitted.
Orchiditis, or inflammation of the testes, is rather uncommon but is serious
because it can cause sterility. Orchiditis most commonly follows mumps in
an adult male.
Neoplasms are a major threat to reproductive organs. Tumors of the breast
and cervix are the most common reproductive cancers in adult females,
and prostate cancer (a common sequel to prostatic hypertrophy) is a
widespread problem in adult males.
The production of estrogen may still continue after menopause but the
ovaries finally stop functioning as endocrine organs. The reproductive
organs and breasts begin to atrophy or shrink if estrogen is no longer
released from the body. The vagina becomes dry that causes intercourse to
become painful (particularly if frequent), and vaginal infections become
increasingly common. Other consequences of estrogen deficiency may also
be observed including irritability and other mood changes (depression in
some); intense vasodilation of the skin’s blood vessels, which causes
uncomfortable sweat-drenching” hot flashes”; gradual thinning of the skin
and loss of bone mass; and slowly rising blood cholesterol levels, which
place postmenopausal women at risk for cardiovascular disorders. Some
physicians prescribe low-dose estrogen-progestin preparations to help
women through this usually difficult period and to prevent skeletal and
cardiovascular complications.
There is no counterpart for menopause in males. Although aging men show
a steady decline in testosterone secretion, their reproductive capability
seems unending. Healthy men are still able to father offspring well into
their 80s and beyond.
Erogenous Zones
Erogenos zones refer to parts of the body that are primarily receptive and
increase sexual arousal when touched in a sexual manner. Some of the
commonly known erogenous zones are the mouth, breasts, genetals, and
anus. Eregonous zones may vary from one person to another.Other
common areas of the body that can be aroused easily may icclude the
neck, thighs, abdomen, and feet.
HUMAN SEXUAL BEHAVIOR
Human sexual behavior is defined as any activity—solitary, between two
person, or in a group—that induces sexual arousal (Gebhard, 2017). There
are two major factors that determine human sexual behavior, the inherited
sexual response patterns that have evolved as a means of ensuring
reproduction and that become part of each individual’s genetic inheritance,
and the degree of restraint of other types of influence exerted on the
individual by society in the expression of his sexuality.
TYPES OF BEHAVIOR
The various types of human sexual behavior are usually classified according
to the gender and number of participants. There is solitary behavior
involving only one individual, and there is sociosexual behavior involving
more than one person. Sociosexual behavior is generally divided into
heterosexual behavior (male with female) and homosexual behavior (male
with male or female with female). If three or more individuals are involved,
it is, possible to have heterosexual and homosexual activity simultaneously
(Gebhard, P.H. 2017).
Solitary Behavior
1.Self-gratification
means self-stimulation that leads to sexual arousal and generally, sexual
climax. Usually, most self-gratification takes place in private as an end in
itself, but can also be done in a sociosexual relationship.
2. Sociosexual Behavior
Heterosexual is greatest amount of sociosexual behavior that
occurs between only one male and one female. It usually begins in
childhood and may be motivated by curiosity, such as showing or
examining genitalia. There is varying degree of sexual impulse and
responsiveness among children. Physical contact involving necking or
petting is considered as an ingredient of the learning process and
eventually of courtship and the selection of a marriage partner. Petting
differs from hugging, kissing, and generalized caresses of the clothed body
to practice involving stimulation of the genitals. Petting may be done as an
expression of affection and a source of pleasure, preliminary to coitus.
Petting has been regarded by others as a near-universal human experience
and is important not only in selecting the partner but as a way of learning
how to interact with another person sexually.
PHYSIOLOGY OF HUMAN RESPONSE
Sexual response follows a pattern of sequential stages or phases when
sexual activity is continued.
1.Excellent phase - it is caused by increase in pulse and blood pressure; a
sudden rise in blood supply to the surface of the body resulting in
increased skin temperature, flushing, and swelling of all distensible body
parts (particularly noticeable in the male reproductive structure and female
breasts), more rapid breathing, the secretion of genital fluids, vaginal
expansion, and a general increase in muscle tension. These symptoms of
arousal eventually increase to a near maximal physiological level that leads
to the next stage.
2.Plateau phase - it is generally of brief duration. If stimulation is
continued, orgasm usually occurs.
3. Sexual Climax - it is marked by a feeling of abrupt, intense pleasure, a
rapid increase in pulse rate and blood pressure, and spasms of the pelvic
muscles causing contractions of the female reproductive organ and
ejaculation by the male. It is also characterized by involuntary vocalizations.
Sexual climax may last for a few seconds (normally not over ten), after
which individual enters the resolution phase.
4. Resolution phase - it is the last stage that refers to the return to a normal
or subnormal physiologic state. Males and females are similar in their
response sequence. Whereas males return to normal even if stimulation
continues, but continued stimulation can produce additional orgasms in
females. Females are physically capable of repeated orgasms without the
intervening "rest period" required by males.
Vaginismus is a strong spasm of the pelvic musculature constricting the
female reproductive organ so that penetration is painful or impossible. It
can be due to anti-sexual conditioning or psychological trauma that serves
as unconscious defense against coitus. It can be treated by psychotherapy
and by gradually dilating the female reproductive organ with increasingly
large cylinders.
SEXUALLY TRANSMITTED DISEASES
Sexually transmitted disease (STDs) are infections transmitted from an
infected person to an uninfected person through sexual contract. STDs can
be caused by bacteria, viruses, or parasites, Examples include gonorrhea,
genital, herpes, human papillomavirus infection Human Immunodeficiency
Virus (HIV) acquired immunodeficiency syndrome (AIDS) chlamydia and
syphilis (national institute of allergy and Infectious Diseases of the national
institute of health of the United states 2017).
STDs are a significant global healthy priority because of their overwhelming
impact on women and infants and their infants and their inter-relationships
with HIV and AIDS. STDs and HIV are associated with biological interactions
because of infections may occur in the same populations. Infection with
certain STDs can increase the risk of getting and transmitting HIV as well as
modify the way the disease develops.
The virus attack the immune system making the individual more prone to
infections and other diseases. The virus usually target the t-cells (CD4 cells)
of the immune system. the virus survive throughout the body but may be
transmitted via fluids such as blood, semen, vaginal fluids and breastmilk.
AIDS occurs in the advance stage of HIV infection. the way the disease
develops, moreover STDs can lead to long term health problems, usually in
women and infants.
Moreover, STDs can lead to long-term health problems, usually in women
and infants. Among the health complications that arise from STDs are
pelvic inflammatory disease, infertility, tubal, or ectopic pregnancy, cervical
cancer and perinatal or conginetal infections in infants born to infected
mothers. One of the leading STDs worldwide is AIDS, which is caused by
HIV or human immunodeficiency virus. The virus attack the immune system
making the individual more prone to infections and other diseases
The virus usually target the t-cells (CD4 cells) of the immune system. the
virus survive throughout the body but may be transmitted via fluids such as
blood, semen, vaginal fluids and breastmilk. AIDS occurs in the advance
stage of HIV infection.
Aside from HIV and AIDS ,there are other sexually transmitted diseases in
humans. The ff. list of diseases is based in Sexually Transmitted Disease
surveillance 2016 of the U.S department of the health and human services
centers for disease control and prevention.
Chlamydia
In 2016, a total of 1,598,354 cases of Chlamydia Trachomatis
infection were reported to the Centers for Disease Control and
Prevention (CDC), making it the most common notifiable condition
in the United States. This case count corres[onds to a rate of 497.3
cases per 100,000 ppulation, an increase of 4.7% compared with
the rate in 2015. During 2015 to 2016, rates of reported chlamydia
increased in all regions of the United States. Rates of chlamydia
are highest among adolescent and young adult females, the
population targeted for routine chlamydia screening.
Gonorrhea
In 2016, 468,514 gonorrhea cases were reported for a rate of 145.8 cases
per 100,000 population, an increase of 18.5% from 2015. During 2015 to
2016, the rate of reported gonorrhea increased 22.2% among men and
13.8% among women. The magnitude of the increase among men suggests
either increased transmission or increased case ascertainment
(e.g.,through increased extra-genital screening) among MSM (men who
have sex with men) or both.
Syphilis
Syphilis In 2016, 27,814 Primary and Secondary (P&S) syphilis cases were
reported, representing a national rate of 8.7 cases per 100,000 population
and a 17.6% increase from 2015. From 2015 to 2016, the P&S syphilis rate
increased among both men and women in every region of the country ;
overall, the rate increased 14.7% among men and 35.7% among women.
During 2012 to 2016, P&S syphilis rates were consistently highest among
persons aged 20 to 29 years old, but rates increased in every 5-year age
group among those aged 15 to 64 years. In 2016, rates were highest among
African Americans (23.3 per 100,000 population) and Native
Hawaiian/other Pacific Islanders (13.9 per 100,000 population); however,
rates increased among all racial and ethnic groups in 2012 to 2016.
Chancroid
Chancroid is caused by infection with the bacterium Haemophilus ducreyi.
Clinical manifestations include genital ulcers and inguinal
lymphadenopathy or buboes. Reported cases of chancroid declined
steadily between 1987 and 2001. Since then, the number of reported cases
has fluctuated somewhat, while still appearing to decline overall. In 2016, a
total of 7 cases of chancroid were reported in the United States.
Human Papillomavirus
Human Papillomavirus Human papillomavirus (HPV) is the most common
sexually transmitted infection in the United States. Over 40 distinct HPV
types can infect the genital tract; although most infections are
asymptomatic and appear to resolve spontaneously within a few years, the
prevalence of genital infection with any HPV type was 42.5% among United
States adults aged 18 to 59 years during 2013 to 2014.
Persistent infection with some HPV types can cause cancer and genital
warts. HPV types 16 and 18 account for approximately 66% of cervical
cancers in the United States, and approximately 25% of low-grade and 50%
of high-grade cervical intraepithelial lesions, or dysplasia. HPV types 6 and
11 are responsible for approximately 90% of genital warts.
.Herpes Simplex Virus
Herpes simplex virus (HSV) is among the most prevalent of sexually
transmitted infections. Although most infections are subclinical, clinical
manifestations are characterized by recurrent, painful genital and/or anal
lesions. Most genital HSV infections is the United States are caused by HSV
type 2 (HSV-2), while HSV type 1 (HSV-1) infections are typically orolabial
and acquired during childhood.
Trichomonas Vaginalis
Trichomonas vaginalis is a common sexually transmitted protozoal infection
associated with adverse health outcomes such as preterm birth and
symptomatic vaginitis. It is not a nationally reportable condition, and trend
data are limited to estimates of initial physician office vissits for this
condition. Visits appear to be fairly stable since the 19990’s; the number of
initial visits for trichomonas vaginalis infection in 2015was 139,000.
NATURAL AND ARTIFICIAL METHODS OF CONTRACEPTION
The natural family planning methods do not involve any chemical or foreign
body introduction into the human body. People who are very conscious of
their religious beliefs are more inclined to use the natural way of birth
control and others follow such natural methods because they are more
cost-effective.
NATURAL METHOD
a. Abstinence
This natural method involves refraining from sexual intercourse
and is the most effective natural birth control method with ideally 0% fail
rate. It is considered to be the most effective way to avoid STIs (Sexually
Transmitted Infections). However, most people find it difficult to comply
with abstinence, so only a few use this method.
b. Calendar Method
The method is also called as the rhythm method. It entails
withholding from coitus during the days that the woman is fertile.
According to the menstrual cycle the woman is likely to concieve three or
four days before and three or four days after ovulation the woman needs
to record her menstrual cycle for six months in order to calculate the
woman’s safe days to prevent conception.
c. Basal Body Temperature
The basal body temperature (BBT) indicates the woman’s
temperature at rest. Before the day of ovulation and during ovulation, BBT
falls at 0.5°F; it increases to a full degree because of progesterone and
maintains its level thoughout the menstrual cycle. This serves as the basis
for the method. The woman must record her temperature every morning
before any activity. A slight decrease in the basal body temperature
followed by a gradual increase in the basal body temperature can be a sign
that a woman has ovulated.
d. Cervical Mucus Method
The change in the cervical mucus during ovulation is the basis for
this method. During ovulation, the cervical mucus is copious, thin, and
watery. It also exhibits the property of spinnbarkeit, wherein it can be
strectched up until at least 1 inch and is slippery. The woman is said to be
fertile as long as the cervical mucus is copious and watery. Therefore, she
must avoid coitus during those days to prevent conception.
e. Symptothermal Method
The symptothermal method is basically a combination of the BBT
method and the cervical mucus method. The woman records her
temperature every morning and also takes note of changes in her cervical
mucus. She should abstain from coitus three days after a rise in her
temperature or on the fourth day after the peak of a mucus change.
f. Ovulation Direction
The ovulation detection method uses an over-the-counter kit that
requires the urine sample of the woman. The kit can predict ovulation
through the surge of luteinizing hormone(LH) that happens 12 to 14 hours
before ovulation.
g. Coitus Interruptus
Coitus Interruptus in one of the oldest methods that prevents
conception. A couple still goes on with coitus, but the man withdraws the
moment he ejaculates to emit the spermatozoa outside of the female
reproductive organ. A disadvantage of this method is the pre-ejaculation
fluid that contains a few spermatozoa that may cause fertilization.
Artificial Method
a. Oral Contraceptives
Also known as the pill, oral contraceptives contain synthetic
estrogen and progesterone.Stimulating Hormone (FSH) and LH to prevent
ovuation. Moreover, progesterone decreases the premeability of the
cervical mucus to limit the sperm’s acces to the ova. It is suggested that the
woman takes the first pill on the first Sunday after the beginning of a
menstrual flow, or as soon as it is prescribed by the doctor.
b. Transdermal Patch
The transdermal patch contains both estrogen and progesterone.
The woman should apply one patch every week for three weeks on the
following areas: upper outer arm,upper torso, abdomen, or buttocks. At
the fourth week, no patch is applied because the menstrual flow would
then occur. The area where the patch is applied should be clean, dry, and
free of irritation.
c. Vaginal Ring
The vaginal ring releases a combination of estrogen and
progesterone and it sorrounds the cervix. This silicon ring is inserted into
the female reproductive organ and remains there for three weeks and then
removed on the fourth week, as menstrual flow would occur . The woman
becomes fertile as soon as the ring is removed.
d. Subdermal Implants
Subdermal implants are two rod-like implants inserted under the
skin of the female during her menses or on the seventh day of her
menstruaion to make sure that she will not get pregnant. The implants are
made with etonogestrel, desogestrel, and progestin and can be helpful for
three to five years.
e. Hormonal Injections
a hormonal injection contains medroxyprogesterone, a
progesterone, and is usually given once every 12 weeks intramuscularly.
The injection causes changes in the endometrium and cervical mucus and
can help prevent ovulation.
f. Intrauterine Device
An Intrauterine device (IUD) is a small, T-shaped object containing
progesterone that is inserted into the uterus via the female reproductive
organ. It prevents fertilization by creating a local sterile inflammatory
condition to prevent implantation of the zygote. The IUD is fitted only by
the physician and inserted after the woman’s menstrual flow. The device
can be effective for five to seven years.
g. Chemical Barriers
Chemical barriers such as spermicides, vaginal gels and creams,
and glycerin films are used to cause the death of sperms before they can
enter the cervix and to lower tha pH levelof the female reproductive organ
so it will not become conducive for the sperm. On the other hand; these
chemical barriers cannot prevent sexualy transmitted infections.
h. Diaphragm
It is a circular, rubber disk that fits the cervix and should be placed
before coitus. Diaphragm works by inhibiting the ntrance of the sperm into
the female reproductive organ and it works better when used together
with a spermicide. The diaphragm should be fitted only by the physician,
and should remain in place for six hours after coitus.
i. Cervical Cap
The cervical cap is made of soft rubber and fitted on the rim of the
cervix. It is shaped like a thimble with a thin rim, and could stay in place for
not more than 48hours.
j. Male Condoms
The male condom is a latex or synthetic rubber sheath that is
placed on the erect male reproductive organ before reproductive organ to
trap the sperm during ejaculation. It can prevent STIs (Sexually Transmitted
Infections) and can be bought over-the-counter. Male condoms have a
ideal fail rate of 2% and a typical fail rate of 15% due to a break in the
sheaths integrity or spilling of semen.

k. Female Condoms

Female condoms are made up of latex rubber sheats that are pre-
lubricated with spermicide .they are usually bound by two rings. The outer
ring is first inserted against the opening of the female reproductive organ
and the inner ring covers the cervix. It is used to prevent fertilization of the
egg by the sperm cells.

i. Surgical methods

During vasectomy, a small each side of the scrotum. The vas

deferens is then tied, cauterized, cut, or plugged to block the passage of
the sperm. The patient is advised to use a backup contraceptive method
until two negative sperm count results are recorded because the sperm
could remain viable in the vas deferens for six months.

In woman, tubal ligation is performed after menstruation and before

ovulation. The procedure is done through a small incision under the
woman’s umbilicus that targets the fallopian tube for cutting, cauterizing,
or blocking to inhibit the passage of both the sperm and the ova.