Reproductive Health - includes all aspects of sexuality thru life span.

Reproductive Development Begins at the moment of conception and continues throughout life. Intrauterine Development The sex of an individual is determined at the moment of conception by the chromosome information supplied by the particular ovum and sperm that joined to create new life. Gonad body organ that produces sex cells or gametes a. In Females 1. Ovaries (2) female gonads 2. Ova or Egg female sex cells produced by ovaries b. In Males 1. Testes (2)- male gonads 2. Sperm male sex cells produced by testes Pubertal Development Puberty stage of life which secondary sex changes begin.
Hypothalamus Synthesize Releases Gondadotropin Releasing factor (GnRf) Triggers Anterior Pituitary Gland Release Gondadrotropic Hormones Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) Initiates the Production of Andorgen and Estrogen, which in turn initiate Secondary Sex Characteristics.

Hypothalamus serves as gonadostat or regulation mechanism to turn on gonad functioning during puberty Role of Androgen or Androgenic Hormones Hormones responsible for muscular development, physical growth, and increase in sebaceous glands that causes acne in both boys and girls. In males, it is produced by Adrenal Cortex and Testes. In females, it is produced by Adrenal Cortex and Ovaries Levels of Androgenic hormone, TESTOSTERONE are low in Males until Puberty (Approximately 12 14 yrs old). At the time of puberty, testosterone rises to influence: a. Development of Testes, Scrotum, Penis, Prostate Gland, Seminal Vesicles b. Appearance of Pubic, Facial, and Axillary Hair c. Laryngeal Enlargement accompanied by Voice Change d. Maturation of Spermatozoa e. Closure of Long Bone Growth

Role of Estrogen When triggered during Puberty, Ovarian Follicles begin to excrete a high level of estrogen. Composed of 3 compounds a. Estrone (E1) b. Estradiole (E2) c. Estriol (E3) Increase of estrogen in females during puberty influences a. Development of fallopian tubes, uterus, and vagina b. Fat distribution and hair patterns c. Breast Development (Thelarche beginning of Breast Development) d. Closure of Epiphyses of Long Bones Secondary Sex Characteristics or Pubertal Changes in Females 1. 2. 3. 4. 5. Growth Spurt Increase in transverse diameter of pelvis Breast development Growth of Pubic Hair Onset of Menstruation (Menarche 1st menstrual period; occurs at 12.4 yrs. May occur as early as 9 and as late as 17) 6. Growth of Axillary Hair 7. Vaginal Secretions Secondary Sex Characteristics or Pubertal Changes in Males 1. 2. 3. 4. 5. 6. 7. Increase in Weight Growth of testes Growth of facial, axillary, and pubic hair Voice change Penile growth Increase in height Spermatogenesis (Production of Sperm)

Sexuality A multidimensional phenomenon that includes feelings, attitudes, and actions. Has both biologic and cultural components Encompasses and gives directions to a persons physical, emotional, social, and intellectual responses throughout life. Biologic gender denote a persons chromosomal sex: male (xy) and female (xx) Gender Role A male or female behaviour a person exhibits, w/c may be the same or different from Gender Identity. Culturally influenced (ex. In the past, women has nurturing qualities with the responsibility for childrearing and childbearing; men are viewed as financial providers) More interchangeable (ex. Women pursue all types of jobs without loss of feminity and men participate in childrearing and household chores w/o loss of masculinity)

Gender Identity or Sexual Identity Inner sense of a person has of being a male or female, w/c may be the same or different from Gender Role Develop throughout an entire lifespan May be influenced by the ff: a. Amount of testosterone secreted in utero (Sex Typing) may affect how gender develops. b. Role modelling of parents may also influence how a child envisions himself or herself. Development of Gender Identity 1. Infancy (First 12 months of life) from the day birth, female and male babies are treated differently by their parents People generally bring girls dainty dresses, treated gently and held and rocked more tha male babies. 2. Pre-school Period (3 4 yrs old) Children can distinguish between male and females as early as 2y/o By ages 3 or 4, they can say what sex they are and have absorbed cultural expectations of that sex role. a. Development of Oedipus complex (Strong emotional attachment of preschool boy for his mother and preschool girl to her father) may be overstated by Freud as a sexual bias. Oedipus Complex son to mother b. Electra Complex daughter to father 3. School Age Child (6 12 yrs old) Imitators; Imitation of Adult Roles as a way of learning gender roles Ex. Child imitates his father who is a doctor 4. Adolescent (12 18 yrs old) Begins the process of establishing sense of identity, the problem of final gender role identification rises again. Needs guidelines for safer sex to reduce risk of STIs. Stressful time for a boy who realizes that he is gay or the girl that she is lesbian. High Suicidal rate due to homosexual teenagers feels so lost. 5. Young Adult Young adults move away from home to attend college or establish their own home Change in eating pattern can increase or decrease their changes in body image Choose the way they will express their sexuality along with other life patterns Marry with a commitment to one sexual partner Establish Cohabitation (learning more about a possible marriage partner on a day to day basis in the hope that future marriage will be stronger and lasting) Conflicts in parenting occur if an individual gender doesnt meet the expectation of a family. Young couples begins childbearing 6. Middle Age Adult Sexuality has achieved a degree of stability A sense of masculinity and femininity have been established Adults allow themselves more freedom in exploring and satisfying sexual needs. Re-examination of life goals, careers, accomplishments, values, familial and social systems

7. Older Adult Both male and female continue to enjoy active sexual relationships. Some men experience less erectile firmness Some women have less vaginal secretions d/t less estrogen after menopause. 4 Stages of Human Sexual Response Cycle 1. Excitement Occurs with physical and psychological stimulation that causes parasympathetic nerve stimulation. (Ex. Sound, sight, emotion, thoughts) that leads to arterial dilatation and venous constriction in genital area. Increased blood supply leads to VASOCONGESTION a. In women Increase of the size of clitoris and mucoid fluid as lubrication Vagina widens in diameter and increases in length Nipples become erect b. In males Penile Erection Scrotal Thickening Elevation of Testes c. In Both sexes Increase in PR, HR, and BP 2. Plateau Stage Reached just before orgasm In woman, clitoris drawn forward and retracts under clitoral prepuce, lower part of vagina becomes congested (formation of orgasmic platform), & inceasednipple elevation In men, vasocongestion leads to full distention of the penis Heart Rate increases to 100 175 bpm Respiratory Rate increases to 40 bpm 3. Orgasm Body suddenly discharges accumulated sexual tension. Vigorous contraction of muscles in pelvic area expels blood and fluid from the area of congestion. Ave. No of contractions for woman is 8 15 contractions at intervals of 1 every 0.8 seconds In men, muscle contractions surrounding the seminal vesicles and prostate semen into proximal urethra. These contractions are followed immediately by 3 7 propulsive ejaculatory contractions, occurring at the same time interval as women which force semen out from the penis. The shortest stage in Sexual response Cycle; Highly Personal Experience 4. Resolution 30 minute period during which the internal and external genitals returns to an unaroused state. In males, refractory period occurs which further orgasms is impossible. Women dont go into refractory period, so its possible for women who are interested and properly stimulated to have additional orgasms immediately. Controversies about female Orgasm: The existence of the G Spot

Types of Sexual Orientation 1. Heterosexual finds sexual fulfilment with the opposite sex or gender. 2. Homosexuality finds sexual fulfilment with the same gender ; Gay and lesbians 3. Bisexuality sexual satisfaction from both homosexual and heterosexual relationships; have greater risk for HIV and STIs. 4. Transexuality or Transgender an individual who although of one biologic gender, feels as if he or she is of the opposite gender; some have sex change operations Types of Sexual Expression 1. Sexual Abstinence or Celibacy separation from sexual activity; avowed state of certain religious orders; advantage is the ability to concentrate on means of giving and receiving love other than sexual expression; most effective way to prevent pregnancy and STIs. 2. Masturbation Self stimulation for erotic pleasure; offers sexual release which may be interpreted by the person as overall tension or anxiety relief. Children between 2 6 yrs old find it enjoyable to explore their bodies. School Aged Children continue to use it for enjoyment but perform in private. Autoerotic Asphyxia practice of causing oxygen deficiency (usually by hanging) during masturbation with the goal of producing a feeling of extreme sexual excitement; act can be fatal 3. Erotic Stimulation use of visual aids such as magazines or photographs for sexual arousal 4. Fetishism sexual arousal by the use of objects or situations 5. Transvestism individual who dresses in the clothes of opposite sex; can be heterosexual, homosexual, or bisexual 6. Voyeurism sexual arousal by looking at anothers body 7. Sadomasochism involves inflicting pain (Sadism) or receiving pain (masochism) to achieve sexual satisfaction 8. Exhibitionism revealing genitals in public 9. Bestiality sexual relationships with animals 10. Pedophiles interested in sexual encounters with children; registered sex offenders Disorders of Sexual Functioning 1. Inhibited Sexual Desire lessened interest in sexual relations Normal in some situations such as death of family member divorce, stressful job, etc. Side effect on some medicines ; Obese people finds it difficult in deep penetration 2. Failure to Achieve Orgasm result of poor sexual technique, concentrating too hard or negative attitudes toward sexual relationships. 3. Erectile Dysfunction or Impotence inability of a man to produce or maintain erection long enough for vaginal penetration 4. Premature Ejaculation ejaculation before penile vaginal contact Frustrating for both partners Cause can be Psychological; Fear of Impregnating a partner 5. Persistent Sexual Arousal Syndrome (PSAS) Excessive and unrelenting sexual arousal in the absence of desire. Ask if taking Herbal Remedies such as Gingko Biloba, can have arousal effects.

Pain Disorders 1. Vaginismus involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted that prohibits penile penetration. 2. Dyspareunia pain during coitus May occur due to: a. Endometriosis (abnormal placement of endometrial tissue) b. Vestibulitis (inflammation of the vestibule) c. Vaginal Infection d. Hormonal Changes (menaupause and causes vaginal drying)