HUMAN SEXUALITY

Sexuality

- a multidimensional phenomenon that includes feelings, attitudes, and actions.

- it has a biologic and cultural components.
- Behavior of being boy or girl, male or female, man or woman and is entity subjective to a
lifelong dynamic change
- Develop at the moment of conception

Biologic gender
- Used to denote chromosomal sexual development: male (XY) of female (XX)
Gender identity/ Sexual identity
- Inner sense a person has of being male or female, which may be the same as or different from
biologic gender
Gender role
- the behavior a person conveys about being male or female, which, again may or may not
be the same as biologic gender or gender identity

Human Sexual Response: PHASES

1. Excitement
- This phase usually begins within 10 to 30 seconds after erotic stimulation, and
can last anywhere from a few minutes to many hours.
- Men: The penis becomes slightly erect. A man's nipples may also become erect.
- Women: Vaginal lubrication begins. The vagina expands and lengthens. The
outer lips, inner lips, clitoris and sometimes breasts begin to swell.
- Both: Heart rate, blood pressure and breathing are all accelerated.
2. Plateau
- Stage is reached just before orgasm
- In the women, clitoris is drawn forward and retracts under the clitoral prepuce
- Increased nipple engorgement
- In males, full distention of the penis
- Both: Breathing and pulse rates quicken. A "sex flush" may appear on the
stomach, chest, shoulders, neck or face. Muscles tense in the thighs, hips, hands
and buttocks, and spasms may begin.
3. Orgasm
- This is the climax of the cycle. It is also the shortest of the four phases, usually
only lasting a few seconds.
- Vigorous contraction of muscles in the pelvic area expels or dissipates blood
and fluid from the area of congestion.
- Average contractions for the woman is 8 – 15
- In men, muscle contractions surrounding the seminal vessels and prostate
project semen into the proximal urethra.
- The contractions are followed immediately by three to seven propulsive ejaculatory
contractions.
- Both: Breathing, pulse rate and blood pressure continue to rise. Muscle
tension and blood-vessel engorgement reach a peak. Sometimes orgasm
comes with a grasping-type muscular reflex of the hands and feet
4. Resolution
- This phase is a return to the normal resting state. It can last from a few minutes
to a half-hour or longer. This stage is generally longer for women than men
- Period during which the external and internal genital organs return to an
unaroused state
Refractory Period- is usually the recovery phase after orgasm during which it is
physiologically impossible for a man to have additional orgasms.

Sexual identity/sexual orientation identity is how one thinks of oneself in terms of to whom
one is romantically or sexually attracted.
➢ Heterosexuality- is romantic attraction, sexual attraction or sexual behavior between
persons of the opposite sex or gender.
➢ Homosexuality- is romantic attraction, sexual attraction, or sexual behavior between
members of the same sex or gender.
➢ Bisexuality- is romantic attraction, sexual attraction, or sexual behavior toward both
males and females, or to more than one sex or gender.
➢ Transsexuality- a person whose gender identity is opposite the sex the person had or
was identified as having at birth.

Sexual Expression
➢ Celibacy: abstinence from sexual activity
➢ Masturbation: self- stimulation for erotic pleasure; in children bet. 2-6 yrs. Old discover
masturbation as an enjoyable activity as they explore their bodies
➢ Erotic stimulation: use of visual materials such as magazines or photographs for
sexual arousal.
➢ Sexual Fetishism or Erotic Fetishism: sexual arousal resulting from the use of certain
objects/non- living object or situations.
➢ Transvestism: individual who dresses to take on the role of the opposite sex.
➢ Voyeurism: obtaining sexual arousal by looking at another’s person’s body.
➢ Sadomasochism: inflicting pain (sadism) or receiving pain (masochism) to achieve
sexual satisfaction.

Disorders of Sexual Functioning

Sexual Desire Disorders
-Inhibited sexual desire

Sexual Arousal Disorders

-Failure to achieve orgasm

Orgasm Disorders
➢ Erectile dysfunction: formerly referred as Impotence.
Causes: physical, aging, atherosclerosis, diabetes, effects of drugs.
Drug of choice (DOC): Sirdenafil (Viagra), Vardenafil (Levitra)

➢ Premature ejaculation: ejaculation before penile-vaginal contact.

Pain Disorders
1. Vaginismus- involuntary contraction of the muscles at the outlet of the vagina when
coitus is attempted.
2. Dyspareunia/Vestibulitis-pain during coitus.
 Sexual Harassment Equal Opportunity Act 2010

➢ Unwanted, repeated sexual advances, remarks or behavior toward another

➢ Any form of unwelcome sexual behavior that’s offensive, humiliating or intimidating
Consequences: anxiety, depression, PTSD (Post Traumatic Stress Syndrome) and
substance abuse.
▪ Touching, grabbing or making other physical contact without consent
▪ Making comments that have sexual meaning
▪ Asking for sex or sexual favors
▪ Leering and staring
▪ Displaying rude and offensive material so that you and others can see it
▪ Making sexual gestures or suggestive body movements towards others.
▪ Insulting you with sexual comments
▪ Committing a criminal offence against you such as making an obscene phone
call, indecently exposing themselves or sexually assaulting you.

RESPONSIBLE PARENTHOOD

- The Responsible Parenthood and Reproductive Health Act of 2012, also known as
the Reproductive Health Law or RH Law
- Republic Act No. 10354, is a law in the Philippines, which guarantees universal
access to methods on contraception, fertility control, sexual education, and
maternal care.

PROMOTE RESPONSIBLE PARENTHOOD – FAMILY PLANNING

Natural Family Planning
The natural family planning methods not using chemical or foreign body introduction into the
human body. The natural way of birth control and more cost effective.

Abstinence
• natural method which is abstaining from sexual intercourse, the most effective
natural birth control method with ideally 0% fail rate.
• most effective way to avoid STIs.
• Few are using because it is difficult to comply with abstinenc

Calendar Method or Rhythm Method

• refraining from coitus during the days that the woman is fertile.
• Starting from the first fertile day until the last day, the woman should avoid coitus
to avoid conception.

Basal Body Temperature

 • take her temperature early every morning before any
activity, slight decrease and then an increase in her
temperature, is a sign that she has ovulated.
• abstain from coitus for the next 3 days.
Cervical Mucus Method

• To check if the woman is ovulating, the cervical

mucus must be copious, thin, and watery.
• cervical mucus must exhibit the property of
spinnbarkeit, wherein it can be stretched up until at
least 1 inch and feels slippery.

Symptothermal Method

• a combination of the BBT method and the cervical mucus method.

• takes her temperature every morning before getting up and also take note of any
changes in her cervical mucus every day.
• She abstains from coitus 3 days after a rise in her temperature or on the fourth
day after the peak of a mucus change.
Ovulation Detection

• an over-the-counter kit that can predict ovulation through the surge of luteinizing
hormone that happens 12 to 24 hours before ovulation.
• urine specimen of the woman to detect the LH.
• The kit is 98% to 99% accurate and is fast becoming the method of choice by women.

Lactation Amenorrhea Method

• exclusive breastfeeding of the infant, the woman is able to suppress ovulation .

• best to advise the woman that after 3 months of exclusive breastfeeding, she
must make plans of choosing another method of contraception.
Coitus Interruptus

• oldest method, the couple still proceeds with the coitus, but the man withdraws
the moment he ejaculates to emit the spermatozoa outside of the vagina.
• disadvantage of this method is the pre-ejaculation fluid that contains a few
spermatozoa that may cause fertilization.
• Coitus interruptus is only 75% effective.

Hormonal Contraception
Oral Contraceptives

• Also known as the pill, oral contraceptives contain

synthetic estrogen and progesterone.
• Estrogen suppresses the FSH and LH to suppress
ovulation, while progesterone decreases the
permeability of the cervical mucus to limit the
sperm’s access to the ova.
• recommended that the woman takes the first pill
on the first Sunday after the beginning of a
 menstrual flow, or the woman may choose to start the pill as soon as it is
prescribed.
• Side effects are nausea, weight gain, headache, breast tenderness,
breakthrough bleeding, vaginal infections, mild hypertension, and depression.
• Contraindications are breastfeeding, age of 35 years and above, cardiovascular
diseases, hypertension, smoking, diabetes, and cirrhosis.
Transdermal Patch

• a combination of both estrogen and

progesterone in a form of a patch.
• three weeks, the woman should apply one
patch every week on the following areas:
upper outer arm, upper torso, abdomen, or
buttocks.
• fourth week, no patch is applied because the
menstrual flow would then occur.
• area where the patch is applied should be clean, dry, free from any applications.
And without any redness or irritation.

Vaginal Ring

• releases a combination of estrogen and

progesterone and surrounds the cervix.
• inserted vaginally and remains there for 3
weeks, then removed on the fourth week as
menstrual flow would occur.
• becomes fertile as soon as the ring is removed.

Subdermal Implants

• are two rod-like implants embedded under

the skin of the woman during her menses
or on the 7th day of her menstruation to make sure that she is not pregnant.
Hormonal Injections

Depo Provera

• consists of medroxyprogesterone, a progesterone,

and given once every 12 weeks intramuscularly.
• inhibits ovulation and causes changes in the
endometrium and the cervical mucus.
 Intrauterine Device

• small, T-shaped object that is inserted into the uterus via

the vagina.
• It prevents fertilization by creating a local sterile
inflammatory condition to prevent implantation.
• inserted after the woman’s menstrual flow to be sure that
she is not pregnant.
• contains progesterone and is effective for 5 to 7 years.
• advised woman to check the flow of her menstruation
every month and the IUD string, and also to have a
pelvic examination yearly.
Chemical Barriers

• spermicides, vaginal gels and creams, and glycerin films are also used to cause
the death of sperms before they can enter the cervix and also lower the pH level
of the vagina so it will not become conducive for the sperm.
• cannot prevent sexually transmitted infections; however, they can be bought
without any prescription.
Diaphragm

• inhibitis the entrance of the sperm into the vagina.

• fits the cervix and should be placed before coitus.
• fitted only by the physician, and should remain in place for 6 hours after coitus.
• can be left in place for not more than 24 hours to avoid inflammation or irritation.
Cervical Cap

• made of soft rubber and fitted on the rim of the cervix.

• shaped like a thimble with a thin rim, and could stay in place for not more than 48 hours.
Male Condoms

• a latex or synthetic rubber sheath placed on the erect penis before vaginal
penetration to trap the sperm during ejaculation.
• prevent STIs and can be bought over-the-counter without any fitting needed.
• After sexual intercourse, the condom is removed to be disposed.
Female Condoms

• also latex rubber sheaths that are specially designed for females and
prelubricated with spermicide.
• with inner ring that covers the cervix and an outer, open ring that is placed against
the vaginal opening.
• disposable and require no prescription.

Surgical Methods

Vasectomy

• Males undergo vasectomy, which is executed through a small incision made on

each side of the scrotum.
• vas deferens is then tied, cauterized, cut, or plugged to block the passage of the sperm.
 • done with local anesthesia, so advise the patient that mild local pain can be felt
after the procedure.

Tubal Ligation

• occluding the fallopian tubes through cutting, cauterizing, or blocking to inhibit the
passage of the both the sperm and the ova.
• the procedure is done through a small incision under the woman’s umbilicus, after
menstruation and before ovulation,
• laparoscope is used to visualize the surgery, and the patient is under local
anesthesia.
• may return to her sexual activities after 2 to 3 days of the operation.
• Educate that menstrual cycle would still occur, and make sure that coitus before
ligation is protected to avoid ectopic pregnancy.