REPRODUCTIVE & SEXUAL HEALTH
NCM 107
HUMAN PROCREATION
 It is a biological process that
enables the birth of another
human being. It implies sexual
reproduction since the genetic
information of the offspring
includes contributions from the
two parents through the fusion of
the gametes.
SEXUALITY & SEXUAL IDENTITY
 Gender identity is a person’s
sense of his or her masculinity or
femininity.
 Gender roles are composed of
behaviors, attributes and attitudes
an individual conveys about being
male or female.
 Biologic gender is the term used
to denote chromosomal sexual
development: male –XY or
female- XX
 Sexual orientation refers to a
person’s preference for
heterosexual, homosexual, or
bisexual relationship.
 Sexual expression refers to the
activities that the individual
chooses to give and receive
physical love or gratification.
TYPES OF SEXUAL ORIENTATION
 A heterosexual is a person who
finds sexual fulfillment with a
members of the opposite gender.
 A homosexual is a person who
finds sexual fulfillment with a
member of his or her own sex;
gay, lesbian, men who have sex
with men, women who have sex
with women.
 Bisexual are said to achieve
sexual satisfaction from both
homosexual and heterosexual
relationships.
 A transsexual or transgender
person is an individual who,
although of one biologic gender,
feels as if he or she is the
opposite gender.
TYPES OF SEXUAL EXPRESSION
 Sexual abstinence
 Masturbation
 Erotic stimulation
 Fetishism
 Transvestism
 Voyeurism
 Sadomasochism
 Exhibitionism
 Making obscene telephone calls
 Bestiality
 Pedophilia
HUMAN SEXUAL RESPONSE
Excitement occurs with physical &
psychological stimulation that causes
parasympathetic nerve stimulation which
leads to arterial dilation and venous
constriction in the genital area.
Plateau stage is reached before orgasm.
Orgasm occurs when stimulation
proceeds through the plateau stage to a
point at which the body suddenly
discharges accumulated sexual tension.
In men, muscle contractions surrounding
the seminal vessels and prostate project
semen into the proximal urethra.
1
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.

2
REPRODUCTIVE & SEXUAL HEALTH
NCM 107
FEMALE INTERNAL REPRODUCTIVE
ORGANS
The vagina is the female organ of
copulation and also serves as the birth
canal. It is a tubular
musculomembranous organ that lies
between the rectum and the urethra and
bladder.
The uterus is a hollow, muscular organ
with three muscle layers (perimetrium,
myometrium, and endometrium). It is
located between the bladder and
rectum, and consists of the fundus,
body(corpus), and cervix. Uterine
function include:
 Menstruation, the sloughing away
of spongy layers of endometrium
with bleeding from torn vessels.
 Environment for pregnancy; the
embryo and fetus develop in the
uterus after fertilization.
 Labor, consisting of powerful
contractions of the muscular
uterine wall that result in
expulsion of the fetus.
Uterine ligaments include:
 Broad and round ligaments that
provide upper support for the
uterus
 Cardinal, pubocervical, and
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 ovaries are female sex glands
located on each side of the uterus. The
two functions of the ovaries are
 Ovulation (release of ovum)
 Secretion of hormones (estrogen
and progesterone)
The pelvis is a bony ring in the lower
portion of the trunk. It consists of three
parts (ilium, ischium and pubis) and four
bones (two innominate bones or
hipbones, sacrum and coccyx. The
pelvic bones are held together by four
joints-symphisis pubis, two sacroiliac,
and sacrococcygeal.
 Types of pelvis: gynecoid,
android, anthropoid, platypelloid
 Pelvimetry: the process of
measuring the internal or external
pelvis is performed with
radiography or by internal
examination.
Internal pelvic inlet measurement
measures the diagonal conjugate, which
is the lower margin of the symphisis
pubis to the promontory of the sacrum; it
is normally 11.5 cm or more.
3
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.

4
REPRODUCTIVE & SEXUAL HEALTH
NCM 107
THE MENSTRUAL CYCLE
MENSTRUATION & HORMONES
 Menarche, onset of menstruation,
typically occurs between 9 and 17
years of age, with average age of
onset at 12 or 13 years.
 The menstrual cycle is a monthly
pattern of ovulation and
menstruation.
 Ovulation is the discharge of a
mature ovum from the ovary.
 Menstruation is the periodic
shedding of blood, mucus, and
epithelial cells from the uterus;
average blood loss is 30 to 80 ml.
 The ovaries produce mature
gametes and secrete the
following hormones:
 Estrogen which contributes to
female characteristics.
 Progesterone (hormone of
pregnancy), which decreases the
contractility of the uterus.
 Prostaglandins, which regulate
the reproductive process by
stimulating the contractility of
uterine and other smooth muscle.
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).
 FSH prompts the ovary to
develop ovarian follicles; the
developing follicles secrete
estrogen, which feeds back to the
anterior pituitary to suppress FSH
and trigger a surge of LH.
 LH acts with FSH to cause
ovulation and enhance corpus
luteum formation.
OVARIAN RESPONSE
 An oocyte grows within the
primordial follicle in two phases-
follicular and luteal.
 In the follicular phase, days 1 to
14, the follicle matures as a result
of FSH.
 In the luteal phase, days 15 to 22,
the corpus luteum develops from
a ruptured follicle.
ENDOMETRIAL RESPONSE
 In the menstrual phase, days 1 to
5, the estrogen level is low and
cervical mucus is scanty.
 In the proliferative
(follicular)phase, days 6 to 14, the
estrogen level is high, the
endometrium and myometrium
thickens, and changes in cervical
mucosa occur. On average,
5
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.

6
REPRODUCTIVE & SEXUAL HEALTH
NCM 107
SEMEN
 Semen is a thick, whitish fluid
ejaculated by the man during
orgasm. It contains spermatozoa
and fructose-rich nutrients.
During ejaculation, semen
receives contributions of fluid
from the seminal vesicles and the
prostate gland.
 Semen is alkaline (average pH
7.5) and the average amount of
semen released during
ejaculation is 2.5 ml to 3.5 ml.
MALE BREASTS
 Male mammary tissue remains
dormant throughout life, but the
breasts are a site sexual
excitation and arousal.
 Although rare, male breast
cancer occurs frequently enough
to warrant routine inspection of
the breasts for dimpling,
discharge or nipple inversion.
Neurohormonal control of the male
reproductive system
 At puberty, the hypothalamus
stimulates the pituitary gland to
produce FSH and LH.
 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
potent)produced in the testes, is
responsible for the development
of secondary sex characteritics at
puberty.
 Testosterone production occurs
in the interstitial Leydig cells in
the seminiferous tubules. Leydig
cells are abundant in the newborn
and the pubescent boy, and
testosterone is abundant during
these periods.
 Testosterone production slows
after 40 years of age; by 80 years
of age, production is only about
one-fifth peak level.
SPERMATOGENESIS
 Spermatogenesis occurs
continually after puberty,
providing large numbers of sperm
for unlimited ejaculations during
the mature life span.
 Spermatozoa are released from
the epithelial wall of the
seminiferous tubules. Meiosis
occurs during the process, and
the number of chromosomes in
each cell is reduced by one-half
(haploid number).
7
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.