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Human Sexuality

by: Polly Padberg

Human Sexuality PSY 1463

Polly Padberg
Florida Tech
GPA 3.77

Sara Howze

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Sara Howze
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This 42 page Class Notes was uploaded by Polly Padberg on Monday October 12, 2015. The Class Notes belongs to PSY 1463 at Florida Institute of Technology taught by Sara Howze in Fall. Since its upload, it has received 48 views. For similar materials see /class/221690/psy-1463-florida-institute-of-technology in Psychlogy at Florida Institute of Technology.

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Date Created: 10/12/15
Iquot 9quot N Chapter 1 Perspectives on Sexuality Sex Sexual intelligence Understanding oneself sexually and having interpersonal sexual skills and integrity are two characteritics Acculturation Replacing traditional beliefs and behaviour pattern with those of the dominant culture also creates differences with subcultures Multiracial People descended from two or more racial groups Psychosocial Reflects our view that pschological factors and social conditioning have a crucial impact on sexual attitudes values and behaviors Psychological factors emotions attitudes motivations andsocial conditioning process by which we learn our social groups expectations and norms have a crucial impact on sexual attitudes values and behaviors Biopsychosocial orientation integrates the roles of hormones and nervous system biological components of sexual orientation theories about genetic selection and impact of specific genetic variables on an individual Procreation Masturbation oral sex anal intercourse and sex between same partners are sex for procreation Polygamy One man having multiple wives at the same time Taoism Actively promoted sexual activity oral sex sensual touching and intercourse for spiritual growth and harmony in addition to procreation Many believe thatSex and Intercourse are synonymousof each otherBut sex can be gender or identityntercoursequotreal sex reflects narrow focus amp creates performance pressures and unrealistic expectations Foreplay Any activity before the intercourse JudeoChristian Tradition Sex within marriage more than procreative profound emotional and physical experience MALLEUS MALEFICARUMsystematically to refute arguments claiming that witchcraft did not exist refute those who expressed skepticism about its reality to prove that witches were more often women than men and to educate magistrates on the procedures that could find them out and convict them Celibacy The state of being unmarried hatred and nonmarital sex in order to inherit the Kingdom of God Summa Theologica any use of human genitals for anything other than procreation was against God s will Courtly Love Women pure and above reproach Eve vs Mary contradictory views of women impacted society s view of female sexuality and women s place in society 19 Mary product of Crusades gracious compassionate protection focus of religious devotion 20 Eve Temptress in Garden of Eden heightened antagonism toward women Medieval period 1100 1550 AD incubi and succubi culminated in Witch Hunts Victorian Era Polarized women s roles to Madonna Whore Upper and middle class N women valued for delicacy and ladylike manners Denied women s sexuality Encouraged self restraint in all aspects of lives Victorian men expected to conform Gender role separation created sexual and emotional distance in marriages N N Petting Sex play short of intercourse among young unmarried people N W Sexual Revolution In 1960s feminism confronted the norms of previous decades The oral contraceptives intrauterine device morning after pills and spermicides gave women newfound security in pursuing sexual pleasure with greatly reduced fear of pregnancy 24 The Personal is Political The personal and political are truly merged when it comes to sexuality The impact of social norms on sexuality and the personal choice to determine our own sexuality to a far greater degree than previous decades 25 Shine AwardSexual Health in Entertainment It is for those in the entertainment industry who do an exemplary job incorporating accurate and honest portrayals of sexuality into their programming Sexual Intelligence Four components 1 Self understanding 2 Interpersonal sexual skills 3 Scientific knowledge 4 Critical consideration of the cultural political and legal contexts of sexual issues 1 How do psychosocial factors influence sexuality Explain Psychological factors emotions attitudes motivations and social conditioning process by which we learn our social groups expectations and norms have a crucial impact on sexual attitudes values and behaviors Biopsychosocial orientation integrates the roles of hormones and nervous system biological components of sexual orientation theories about genetic selection and impact of specific genetic variables on an individual PWN N 99 O 12 Chapter 9 Sexual Orientations Lesbian A homosexual person typically a homosexual female Gay A homosexual person typically a homosexual male Nonnormative sexuality tells us what kinds of acts are acceptable to heteronormality that39 quot sexual and marital relations are most or only fitting between a man and a woman limemm 39 39 is the normal sexual orientation and states that Sexual OrientationSexual attraction to one s own sex homosexual to other sex heterosexual or to both sexes bisexual or lack of sexual interset in either sex asexual Homosexualromantic andor sexual attraction or behavior between members of the same sex or gender BisexualitySexual attraction to both men and womenMore women than men feel sexual attraction to both sexes Women who identify themselves as straight or lesbian may actually experience a greater range of sexual attraction and arousal than they are aware of People with high sex drives suggest further variability in the way sexual orientation expresses itself Asexuality A lack of sexual attraction to either sex Kinsey ScaleSexual orientation scale based on both feelings of attraction and sexual behaviour Shows seven point continuum that Alfred Kinsey devised in his analysis of sexual orientation in American Society THE KLEIN SEXUAL ORIENTATION GRIDadapted by Keppel and Hamilton measure sexual orientation by expanding upon the earlier Kinsey scale which categorizes sexual history from 0 quot quot 39t06 quotquot quot r I Sexual Fluidity Variability in same sex and other sex attraction and involvement at different times and in different situations throughout the life span Homosexual Denial Denying excepting the homosexual orientation not coming out from closet quot L 39 39 theories 3 reqardinq the oriqin of sexual v 39 The quotBy Defaultquot Myth Unhappy heterosexual experiences cause a person to become homosexual Contrary to this myth Bell s analysis homosexual orientation reflects neither a lack of heterosexual experience nor a history of negative heterosexual experiences He also found that homosexual and heterosexual groups did not differ in their frequency of dating during high school but fewer homosexual subjects reported that they enjoyed heterosexual dating Seduction Myth Young women and men become homosexual because they have been seduced by older homosexual people or because they have caught it from someone else particiularly a well liked and respected teacher who is homosexual Contrary sexual orientation is most often established before school age and that most 13 H 4 U39I Prenatal 39 quot homosexual people have their 1St sexual experiences with someone closer to their own age Freud39s Theory Certain patterns in a person s family background Family dynamic is occasionally present in the family backgrounds of both gay and straight individuals and is absent in the family life of many homosexual individuals quot39 39 39 theories reaardina the oriain of sexual v 39 Gender Variations Identical twins originate from a single fertilized ovum that divides into two separate fetuses with identical genetic codes Any differences between the twins must be due to environmental influences Genetic Factors Physical and behavioral differences between fraternal twins may be due to genetic factors environmental influences or a combination of the twoConcordance akaalike when identical twins are more alike than same sex fraternal twins in a particular trait Gender Nonconformity A lack of conformity to stereotypical masculine and feminine behaviors Brain Structure Brain scanning technology sex atypical brain characteristics in the homosexual research subjects The brain structure related to language and emotional expression were similar for gay men and heterosexual women Patterns of finger length Tend to differ in males and females Heterosexual women s index fingers tend to be about the same length as their ring fingers but heterosexual men s ring fingers are often considerably longer than their index fingers Lesbian fingers lengths follow the typical heterosexual male pattern but homosexual men have finger length ratios that exaggerate the heterosexual male pattern Handedness Left or right handedness appears to be established before birth fetus indicate right or left handedness by thumb sucking choice and greater movement of one arm Homosexual had 39 greater odds of being left handed than heterosexuals on the brain affect sexual v 39 39 Research with women indicates that higher levels of masculinizing prenatal hormones in female fetuses are associated with lesbianism An exception daughters who were exposed to additional prenatal estrogen when their mothers used diethylstilbestrol DES while pregnant It did not prevent miscarriage did increase the incidence of cancer and infertility in daughters of the mothers who used it Prenatal exposure daughter more likely to have same sex fantasies than were women whose mothers had not used DES Higher levels of prenatal masculinizing or feminizing hormones in male fetuses associated with male homosexuality Biology as DestinyPrevaiing political culture will influence how data is used Less stigma among straights toward homosexuals ifthey believe they are quotborn that way 49 people in general population and 75 gays believe people are quotborn that way 16 Sin to SicknessBelief changed from sinner to quotmental illness Late 1800s and 1950s castration Iobotomy aversive therapies Research contradicts quotmental illness claims APA removed homosexuality from DSM Gay Affirmative Therapyproblem defined as society s negativity toward homosexuality Conversion Therapyaka Sexual Reorientation Therapy to help homosexual men and women change their sexual orientation 1 7 Impact on heterosexuals U N O NN Nl N U Homophobia Anti homosexual attitudes irrational fears of homosexual people or fear and loathing of homo feelings in oneself Homophobespherehomophobic blog on Internet both expresses and creates hate Such expressions contribute to the ongoing daily harassment of and discrimination against anyone outside acceptable heterosexual parameters and they legitimze the mind set of people who commit hate crimes directed at gays Heterosexism defined by beliefs that stigmatizes and denigrates any behaviors identities relationships and communities that are not hetero Hate crimes Assault robbery and murder and they are committed because the victim belongs to a certain race religion or ethnic group or has certain sexual orientation The lack of acceptance of racial religious and ethnic differences has effect The many religions that define homosexuality negative views Antigay hate crimes only males to date claim that homosexuality s violation of male gender norms is the primary motivation for their violence It is an attempt to deny or suppress homosexual feelings in one Causes of Homophobia and Hate Crimes History Inquisition Holocaust inability to acceptvalue differences among people Traditional Gender Role Stereotyping Denial of homosexual feelings self report contradicted by physiological measures of arousal Coming OutAcknowledging accepting and openly expressing one s homosexuality Can be personally liberating but not always adaptive Guidelines for coming out to Friends Form a support network Choose the first person to tell Practice mentally Plan in advance Rely on patience and Control your anger Disclosureouting public disclosure of someone s secret homosexual orientation by someone else vs passing Passing Presenting a false image of being heterosexual Double Minoritya person to be a minority ofa minority n otherwords the individual is considered a minority yet within that minority group the person does not quotfit the moldquot so to speak Ex gay and mexican Stonewall New York gay bar Raided by police this incident served as a catalyst for the formation of gay rights groups and activities such as Gay Pride Week and parades are held yearly to commemorate the Stonewall riot 24 Gay Rights Movement To promote rights for lesbians gays and bisexual people while others have worked against there goals Homosexual rights efforts fall into three general areas decriminalization of private sexual behavior antidiscrimination and positive rights 25 AntidiscriminationStarted by The National Gay and Lesbian Task Force in 1973 to end various kinds of discrimination against homosexuals Major quotAffectional or sexual orientation along the race creed color and sex 26 Gay MarriageThe federal government does not recognize same sex marriage in the United States but such marriages are recognized by some individual states 27 Civil Unionlegally recognized form of partnership similar to marriage 28 Rupp in her article quotEveryone s Queer 1 Sexuality differs from time to time and place to place shaped by SOCIETIES 2 NORMATIVE HETE ROSEXUALITY quotHETERONORMATIVITYquot only defined in contrast to what it is not 3 Nonnormative sexuality tells us what kinds of sexual acts are acceptable to heteronormality 29 Cross cultural gersgectives Ancient Greece between men homosexual relations considered superior intellectual and spiritual expression of love Over 50 225 Native American tribes accepted male homosexuality 17 accepted female New GuineaSambia culture requires members to engage in homosexual activities from 7 20 still have rules and restrictions hetero after marriage Cultural changes in Cuba Illegal in 70 UN nations INS in America will grant asylum for people fleeing persecution based on sexual orientation 14 countries have laws protecting homosexuals from discrimination JudeoChristian AttitudesOld Testament quotan abomination Reform Judaism Same sex marriage okayed Christianity range of convictions UUA and United Church of Christ only denominations that officially sanction blessing of same sex unions Schism in Episcopal Church 30 Portrayal of homosexuality TV show Oprah brought unknown visibility to gays lesbians and bisexual people Film Philadelphia feature to confront homophobia and AIDS Gay characters appear in Gossip Girl and Ugly Betty A bisexual woman appears in Bones 31 Comparison of Gay and Straiqht Iman study used more affection and humor more likely to remain positive less belligerence when disagreeing Sexual patterns of lesbian and hetero couples 32 Merences Between Gays and Lesbians in Sexual Attitude and BehaviorNumber of sexual partners lesbians have fewer and more monogamous relationships associate emotional closeness with sex 1980s lesbian quotradical sex subculture recreational sex anonymous sex kinky sex group sex sadomasochistic sex and role polarized sex Casual sex on the rise with gay males as AIDS less a death threat 33 Family Life 45 80 lesbians and 40 to 60 gay men are in a steady relationshipWill form family units with children 33 lesbian and 22 gay and male bisexual couples are raising children May be biological from surrogate adoptedLaws regarding adoption are ambiguous often adopt as individuals rather than as couples American Academy of Pediatrics endorses adoption by homosexual couples children may face homophobic attitudes l l 9 5quot 9quot 9 39 16 Chapter 2 Sexology Goals of Sexuality The study of sexuality Tests assumptions in a scientific way Determines truth or falsity Documents underlying relationships hard to study as sex is an intensely private experience Case Study examines either a single subject or a small group of subjects Each is studied individually and in depth Survey Research method in which people are questioned about their behaviors andor attitudes Direct Observation researchers observe and record response of participating subjects Survey Sample the methods of conducting written and oral surveys are somewhat different their intent is the same Each tries to use a relatively small Target population to draw inferencesconclusions about larger group with a particular characteristic Representative Sample aka Probability Sample Subgroups represented L proportionately to their 39 in target I I every 39 39 has a chance of being included ex selecting rep sample to assess sexual practices older American married couples Random Sample May not be the same as representative sample limited generalizability The selection is from a larger population using randomization procedures For example social scientist faculty on a rural university in the Midwest whose students are inclined to hold relatively conservative social views Survey based on experience with quothook upsquot Randomly students are selected from the roster Questionnaires and Interviews Ask participants a set of questions multiple choice truefalse discussion respond alone in private or in presence of researcher Direct Observation Researchers observe and record responses of participating subjects Volunteer Bias also known was self selection the bias introduced into research study results because of participants willingness to respond Demographic Bias a kind of sampling bias in which certain segments of society are disproportionately represented in a study population Kinsey Reports sexual behavior influenced by educational level heterohomosexuality all or nothing less predictive re coital rates among unmarried National Health and Social Life Survey Revealed effect of ethnicity on sexual behaviors number of sex partners and sexual practices Experimental Method Research conducted in precisely controlled laboratory conditions so that subjects reactions can be reliably measured 39 J I J F quot39quot under control of researcher 17 Dependent Outcome or resulting behavior that is observedrecorded but not controlled 3 primary devices used to electronically measure the human sexual response 18 Penile Strain Gauge flexible loop that looks something like a rubber band with a wire attached It is placed around the base ofthe penis 19 Penile plethysmograph a device fit around the penis and reflect small changes in it circumference used to measure male sexual arousal 20 Vaginal photoplethysmograph a device designed to measure this increased vaginal blood volume 21 Vaginal myograph are implements inserted into the vagina that measure muscular activity in the pelvic area 22 CASI computer assisted self interview CASI surveying children adolescents and adults to overcome to successful sex research Nonexperimental Research Methods for studying human sexuality Case studies survey and direct observation Case Study Definition examines either a single subject or a small group of subjects Each is studied individually and in depth Data gathering methods Direct or indirect observation questionnaires testing experimentation Subjects behave in atypical manner or have a physical or emotional disorder ExampleSpontaneous orgasm antidepressants Advantages Flexibilityampndepth explorations of behaviors thoughts feelings Disadvantages Limited generalizability Limited accuracy of datahuman memoryampNot suitable for some research questions Surveys Definition Research method in which people are questioned about their behaviors andor attitudes Can collect data from a large number of people Conduct orally through face to face or telephone interviews paper and pencil questionnaires computerized interviews Methodology Two types representative sample or random sample Advantages Cheap and quick large amounts of data anonymity honest amp less researcher bias o Disadvantages Non response Self selection volunteer bias sexual experience women vs men amp accuracy of responses distort memories produce socially desirable responses amp Demographic bias white middle class overrepresented 0 Example Kinsey Reports sexual behavior influenced by educational level heterohomosexuality all or nothing less predictive re coital rates among unmarried Direct Observation 0 Definition Researchers observe and record responses of participating subjects 0 Example is work of Masters and Johnson most often mentioned sexual research Studied physiological aspects of human sexual arousal published the Human Sexual Response in 1966 0 Advantages Superior to subjective responses can see first hand Eliminates possibility of data falsificationampRecords kept indefinitely o Disadvantages Influence of observer The Kinsey Reports The National Health and Social Life Survey Population 5300 white males 86940 0 Population representative sample of white females 4369 subjects 3 432 Not representative of American 0 Representative of American Population population Findings sexual behavior in uenced 0 Findings Revealed effect of ethnicity by educational level on sexual behaviors number of sex heterohomosexuality all or nothing partners and sexual practices less predictive re coital rates among unmarried Better educated urban Protestants 0 American people more content with eristic lives less sexually active more sexually conservative than we believed Experimental Method 0 Definition Research conducted in precisely controlled laboratory conditions so that subjects reactions can be reliably measured 0 Method Researcher manipulates variables and observes effect of manipulations on subjects behavior or physicalmental status 0 Variables I J J an iHn f under control of researcher Dependent Outcome or resulting behavior that is observedrecorded but not controlled AdvantagesDraw conclusions about causal relationships Disadvantages Lab setting is artificial ExampleRelationship between alcohol use and sexual responsiveness sexual arousal reduced by amount of alcohol consumed ComputerAssisted SelfInterview CASI Advantages Disadvantages Self administered questionnaire SAO Failure to understand written survey questions provides an alternative way to can be a significant limiting factor when overcome some of the difficulties of an people with relatively low literacy are Intertivewier administered surveyed questionnaire IAQ by providing a more private and potentially less threatening means of reporting sensitive behavior Sex Research in Cyberspace Advantages Cheaper Quicker Less influenced by social desirabilityanonymous More efficientampWider population Disadvantages Selection biasnonrepresentative demographically Low response rates amp Privacy issues WPF N 9 N 9 5 l l l l le O l l l OHU39Ib l 00 Chapter 7 Love and Communication in Intimate Relationships Attachment The need to be cared for and be with the other person Caring Valuing the other person s happiness and needs as much as your own Philia Love between friends involves concern for the others well being Passionate Love aka Romantic Love State of extreme absorption in another person Companionate loveFriendly affection and deep attachment based on extensive familiarity with the loved one Sternberg s triangular theory of love Three components passion intimacy and commitment Conceptualizing what people experience when they report being in love Transition from passionate to companionate love PassionThe motivational component of Sternberg s triangular theory of love Romantic feelings physical attraction and desire for sexual interaction Stimulation and pleasure It is characterized by intense feelings of tenderness elation anxiety sexual desire and ecstasy lntimacyThe emotional component of Sternberg s triangular theory of love The sense of being bonded with another person feeling like warmth sharing and emotional closeness Sharing private thoughts and feelings with the beloved CommitmentThe thinking component of Sternberg s triangular theory of love Conscious decision to love another and to maintain a relationship over time despite difficulties that may arise Different kinds of love Nonlove Absence of all three components of Sternberg s theory of love Friendship when only intimacy is present the experience is one of liking lnfatuation if only passion exists without intimacy or commitment Companionate love If intimacy and commitment exist without passion often happy couples who have shared many years together Fatuous Love When passion and commitment are present but without intimacy Romantic Love Love characterized by passion and intimacy but no commitment Consummate Love When all three components are present fullest kind of love which people often strive for but find difficult to achieve and sustain John Lee s Styles of loving Six different styles of loving that characterize intimate human relationships romantic game playing possessive companionate altruistic and pragmatic Romantic love style aka Eros People tend to place their emphasis on physical beauty as they search for ideal mates Romantic erotic lovers delight in the visual beauty and N N N W N 4 N RD 0 O tactile and sensual pleasures provided by their lovers body and they tend to be very affectionate and openly communicative with their partner Gameplaying love style aka Ludus Like to play the field and acquire many sexual conquests with little or no commitment Love is for fun the act of seduction is to be enjoyed and relationships are to remain casual and transitory Possessive love style aka Mania Tends to seek obsessive love relationships which are often characterized by confusion and jealousy Display affection from the lover brings happiness and the mildest slight produces painful agitation Companionate love style aka StorgeSlow to develop affection and commitment but tend to experience relationships that endure It is without fever or confusion a peaceful and quiet kind of relating that usually begins as friendship and develops over time into affection and love Altruistic love style aka Agape Selflessness and caring compassionate desire to give to another without expectation of reciprocity Such love is patient and never demanding or jealous Pragmatic love style aka Pragma Tend to select lovers based on rational practical criteria such as shared interests that are likely to lead to mutual satisfaction These individuals approach love in a businesslike fashion trying to get the best quotromantic Iquot dea by seeking partners with social educational religious and interest patterns that are compatible with their own Jealousy Negative thoughts and feelings of insecurity fear and anxiety over an anticipated loss of something that the person values particularly in reference to a human connection Jealousy often consists of a combination of presenting emotions such as anger sadness resentment and disgust It is not to be confused with envy Related more to injured pride or to people s fear of losing what they want to control or possess than to love Neurotransmitters These chemicals allow brain cells to communicate with each other and they are chemically similar to amphetamine drugs thus they produce amphetamine like effects such as euphoria giddiness and elation Liebowitz and Walsh Three brain chemicals Dopamine Phenylethylamine PEA ampNorepinephrine Dopamine Contribute to sexual arousal and feelings of being in love Oxytocin Secreted by the hypothalamus during cuddling and physical intimacy important in facilitating social attachment and in fostering feelings of being in love Endorphins The continued progression from infatuation results at least in part from the gradually stepping up production of another set of neurotransmitters Phenylethylamine PEA Elevated sexual arousal associated with new love typically does not last perhaps in part because the body eventually develops a tolerance to PEA Norepinephrine Hookups Loveless sexual liaisons that occur during a brief interval W N W 0 w 4 U3 U1 U3 0 W l W 00 0 RD 4 O 4 4 N 4 w Friends with benefits relationships FWBRs Sexual interaction between friends who do not define their relationship as romantic Factors that affect with whom we fall in love 6 of thefollowing Proximity The geographic nearness of one person to another which is an important factor in interpersonal attraction Mere exposure effect A phenomenon in which repeated exposure to novel stimuli tends to increase an individual s liking for such stimuli SimilarityThe similarity of beliefs interests and values which is a factor in attracting people to one another Homophily Similarity in personal characteristics or the tendency to form relationships with people of similar or equal status in various social and personal attributes Reciprocity The principle that when we are recipients of expressions of liking or loving we tend to respond in kind By responding warmly to people who we believe feel positively toward us we often induce them to like us even more Physical attractivenessPhysical beauty which is a powerful factor in attracting lovers to each other s These are more likely to be sought as friends and lovers and to be perceived as more likable interesting sensitive poised happy sexy competent and socially skilled than are people of average or unattractive appearance Sociobiological theory A species behavior in terms of its evolutionary needs Evaluation has biased mate preferences in humans as it has in other animals Males are attracted to young physically attractive females because these characteristics are good predictors of reproductive success Attachment Styles Intense emotional tie between two individuals such as an infant and a parent or adult lovers Two types Securely attached Used their mothers as a safe base for happily exploring the new environment and playing with the toys in the room When infants attached to mothers appeared to feel safe expressed only moderate distress over their mothers absence seemed confident that their mothers would return to provide care and protection When reunited with their mothers these infants sought contact and often resumed exploring their environments Insecurely attachednfants reacted differently They showed more apprehension and les ofa tendency to leave their mothers sides to explore They were severely distressed when their mothers left often crying loudly and when their mothers returned they often seemed angry expressing hostility or indifference Subdivision of Insecurely attached infant two types AnxiousAmbivalent attachment Infants manifesting extreme separation anxiety when their mother left 44 bbb IOHU39I 4 00 4 RD U1 0 Avoidant attachment Infants seeming to want close bodily contact with their mothers but to be reluctant to seek this apparently because they could sense their mother s detachment or indifference Instant Sexmmediate Sex Unrequited LoveUnanswered love Mutual empathy underlying knowledge that each partner in a relationship cares for the other and knows that the care is reciprocated Interpersonal Distance Personal space We tend to maintain different distances between ourselves and the people with whom we have contact depending on our relationship to them The intimate space to which we admit close friends and lovers restricts contact much less than the distance we maintain between ourselves and people we do not know or like Gottman s Constructive Communication Tactics Include leveling and editing validating and volatile dialogue Leveling and Editing Leveling involves stating our thoughts and feelings clearly simply and honestly preferably while using I language Editing means that we do not say things that we know would be hurtful to our partners and that we limit our comments to information relevant to the issue at hand Validating Involves telling our partners that given their point of view we can understand why they think or feel the way they do Validating a partners viewpoint does not mean that we invalidate our own position regarding the issue at hand Rather simply facilitating constructive dialogue by acknowledging the reasonableness of our partners concern Volatile Dialogue Couples in the early stages ofa relationship who experienced some conflicts and arguments reported less satisfaction than early stages couples who rarely or never argued However after 3 years situation reversed itself and couples who occasionally argued reported significantly more relationship satisfaction than those who avoided arguments Gottman s Destructive Communication Tacticsnclude criticism contempt defensiveness stonewalling and belligerence Criticism Different from complaining Involves expression of contempt and denigration can harm a relationship In contrast complaining can be healthy because it allows expression of frustration and identifies issues that need to be discussed and resolved Contempt Similar to criticism but it degrades communication to an even more intense level of negativity by adding insults sarcasm and even name calling to the critical commentary Defensiveness A person who feels personally attacked or victimized by a partner s criticism or contempt is likely to respond with defensiveness This involves constructing U1 U3 U1 U1 U1 0 U1 l u I n a defense rather than attempting to discuss and resolve an issue It can take the form of self protective responses such as making excuses denying responsibility or replying with a criticism of one s own Stonewalling Occurs when a person conclude that any response to a partner s criticism or complaint will not be helpful or productive and therefore decides not to respond at all Simply puts up a wall and refuse to communicate responding instead with silence by walking out ofthe roometc Belligerence Often entails a purposely provoking style of interaction intended to diminish or challenge a partner s right to influence patterns of interaction in the relationship Language Stating their needs to others This forthright approach brings the desired response more often than does a general statement Questions The best ways to discover partners need is simply to ask Most common ways YesNo Questions A question that asks for a one word answer yes or no and thus provides little opportunity for discussing an issue Openended question A question that allows a respondent to share any feelings or informative she or he thinks is relevant Eitheror question A question that allows statement of a preference SelfDisclosure Direct question often put people on the spot Personal disclosures require give and take It is much easier to share feelings about strongly emotional topics when a partner is willing to make similar disclosures Complaining Constructive expression of relationship concerns Constructive Strategies Be aware of own motivation Choose the Right Time and Place Temper Complaints with Praise Nurture Small Steps toward Change Avoid why questions Express negative emotions appropriatelyamp Limit complaints to one per discussion Receiving Complaints Empathize and Paraphrase Acknowledge complaint find something you can agree with Ask clarifying questions Express feelings Iquot messages amp Focus on future changes SAYING NO Three step approach Express appreciation Say no in clear fashion Offer alternative Avoid Sending Mixed Messages Mutual empathy underlying knowledge that each partner in a relationship cares for the other and knows that the care is reciprocated Interpersonal DistanceWe tend to maintain different distances between ourselves and the people with whom we have contact depending on our relationship actual or desired to them The intimate space to which we admit close friends and lovers as l restricts contact much less than the distance we maintain between ourselves and people we do not know or like AlexithymiaDescribe a state of deficiency in understanding processing or describing emotions Typical deficiencies may include problems identifying describing and working with one s own feelings often marked by a lack of understanding of the feelings of others difficulty distinguishing between feelings and the bodily sensations of emotional arousal PsychoeducationRefers to the education offered to people who live with a psychological disturbance Nonverbal communication Sometimes a touch or a smile can convey a great deal of information Tone of voice gestures facial expression interpersonal distance and changes in breathing are also important elements of such communication l quot PS Uquot 9 9 5quot Chapter 8 Sexual Behaviors CELIBACY a physically mature person who does not engage in sexual behavior Complete Partial Sexual Expression Complete celibacy a person neither masturbates nor has sexual contact with another person Partial celibacy An individual masturbates but does not have interpersonal sexual contact Why Women To feel free from the limitations ofthe expected gender roles of marriage and motherhood Religious or moral beliefs Maintain celibacy until their personal criterai for a good sexual relationships Disaappointment from previous relationship Nocturnal Orgasm Involuntary orgasm during sleep When occurs in males notice ejaculate known as wet dream or nocturnal emission EROTIC DREAMS can occur without conscious direction Varied Nocturnal orgasm Erotic Fantasy usually during daydreams masturbation or sexual encounters Functions ofFantasySource of pleasurearousal enhance arousal Overcome anxiety Mentally rehearseanticipate new sexual experiences Tolerable expression of quotforbidden wishes Relief from gender role expectations MaleFemale Similarities and Differences in Sexual Fantasy Similarities frequency similar wide range of content Differences 1 Men fantasies more active more focus on women s bodies Women more passive 2 Men Explicit sexual actsphysical gratification Women emotional contextromance 3 Men multiple partners and group sex 4 Men more dominance fantasies women submission Fantasies Help or HindranceHindrance Meaningpurpose for the individual important Acting out fantasies Boundaries between fantasy and real world Victim A women is in charge of her fantasies but as a victim of sexual aggression she is not in control Dominatrixmistress women who dominates sexual pleasure pain and receiving pleasure Beloveda person very dear to one Voyeura person who obtains sexual pleasure or excitement from the observation of someone undressing having intercourse etc Masturbationaka Autoeroticism Stimulation of one s own genitals to create sexual pleasure H H H N H Why Pleasure of arousal and orgasm To relieve sexual tension To get sleep at night similar feeling of relaxation encounter after actually sexaul intercourse Women to experience orgasms Men experimenting with their response patterns to increase ejaculatory control JudeoChristian Procreation was the only legitimate purpose of sexual behaviour Because maturation could not result into conception it was condemned Samuel TissotSemen was made from blood and that the loss of it was debilitating to health Sylvester Graham Promoted use of whole grains flours and wrote ejaculation reduced precious quotvital fluids Beseeched men to abstain from masturbation and even marital intercourse to avoid moral and physical degeneracy John Harvey KellogDeveloped cornflake to help prevent masturbation and sexual desire Other Techniques to Control Bandaging the genitals tying one s hand at night clitoridectomy applying carbolic acid to the clitoris and suturing foreskins shut as well as mechinal devices Freud Masturbation does not harm physical healht and they saw it as normal during childhood Masturbation in adulthood immature sexual development and inability to form good sexual relationships SelfPleasuring Techniques Use of dildo or artifical penis vibrators for woman Ring used by woman to stimulate the clitoris Sex toys Vibratort is a sex toy for self pleasuring and enhancing sexual interaction with one s partner Both men and women use it in solo and partnered sexual activities with association of using vibrator are positive sexual function Who masturbate with vibrator is comfortable talking with their partner about it and it is used as sex play Dildo Artificial penis used to enhance sexual arousal Small dildos are used for anal stimulation Hysterical Paroxysm aka orgasm the peak of the plateau phase of the sexual response cycle Maltz HierarchySexual energy is neutral but intent and consequences can lead in Positive or negative directions For sexual expression to be self affirming and relationship enhancing it needs to be experienced at one of the positive levels and congruent with the individual s value system H H H m H l H H Lo N o 5 4 LavHa Amtmlnscxunllmm Emo 39 sspn Lav s vl lom quotInnaan Sax used no express hosuum as Figure 93 The Maltz hierarchy of sexual Interactlans Positive Role Fulfillment Level 1 A welldefined gender rolethe man is initiator and the woman is the receiver Sexual interaction at this level is characterized by mutual respect a lack of coercion and resentment and strong sense of safety and predictability Making Love Level2 Emphasis mutual pleasure through individual sexual creativity and experimentation Traditional gender role behavior is set aside and sex expands to an erotic recreational experience More deeply revealed Authentic Sexual IntimacyLevel 3 Brings shared sense of deep connection both to oneself and to one39s partner with reverence toward the body in the erotic experience The enjoyment of sensual pleasure includes a profound expression of love for one another Impersonal Interaction Level 1 lack of respect and responsibility toward oneself and the other person Individuals disregard possible negative consequences forthemselves and their partners including unwanted pregnancy and exposure to STD Abusive Interaction Level2 Involves one person39s conscious domination of another by psychological pressure Include nonviolent acquaintance rape and incest and degrading forced communication Violent Interaction Level3 Occurs when sexual energy is used purposefully to express hostility Sex organs are weapons and targets Rape is the most extreme example Cunnilingus Oral stimulation of the vulva the clitoris labia minora vestibule and vaginal opening Fellatio oral stimulation of the penis and scortum Gently or vigorously N N N NN bu N U39I N 0391 N I N 9 N U licking and sucking the glans the frenulum and the penile shaft and licking or enclosing a testicle in the mouth Negative attitudes Some people Have qualms about oral genital stimulation Partner s genitals unattractive Gay and lesbian engage in oral sex so considered as homosexual activity even when experienced by heterosexual couples Engage in oral sex bc they believe cannot contract HIV Research The National Health and Social Life Survey white Americans highest to experience oral sex and African American lowest rate Anal Intercourse Anus dense group of nerve endings that can respond erotically Anus contains delicate tissues and special care needs to be taken during anal stimulation The anus contains delicate tissues special care needs to be taken Use lubrication on both anus and penis Anilingus Oral stimulation of the anus Extremely risky various intestinal infections hepatitis and ST infections can be contracted or spread through oral anal contact even with precautions ofthorough washing Careful use of dental dam helps prevent transmission of bacteria and viruses Research Women risk of contracting HIV through unprotected anal intercourse is greater than the risk of getting thru unprotected vaginal intercourse COITUS Wide range of positions Each offers varied opportunities for physical and emotional expression Desirability of one or another can change with mood age health weight pregnancy or partners Advantagesdisadvantages Three C s cooperation consideration communication Interfemoral Intercourse Intromission Insertion of the penis into the vagina Consideration for Positions Face to face side lying position can provide a particularly relaxed connection Tantric Sex An erotic act of love between a god and a goddess created the world According to this viewpoint sexual expression can become a form of spiritual meditation and a path of deep connection Males learn to control and delay his own orgasm and to redirect the sexual energy throughout his and his partners body Sexual Behaviours and its frequency Same sex partners gays lesbian sexual vaginal repertorie heterosexual models 1998 study of heterosexual styles 1983 1990s studies of lesbian styles Messages from KissingFrench kissing more sexually intense Kissing with closed months more tender and affectionate Benefits of Kissing and Touching and StimulationTouching Entire body surface is a sensory organ Breast size Lesbian and gay sexual relationships Manual Genital stimulation increase sexual arousal and orgasm Lesbian ampTribadism Rubbing one s genitals against another s body or genitals Sexual EtiquetteAsking Teaching or Telling Questions 30 Handout quot24 Things Love and Sex Experts are Dying to Tell You 1 5 Never underestimate the power of compliment I feel it is very important to tell your partner one thing you appreciate really it makes a huge difference in a relationship I feel compliment was play a positive or negative role Necessary to balance TO change you relationship change yourself I m right you re wrong and I ll try to convince you to change this statement is very wrong according to me I strongly believe if one person changes the relationship changes in a positive way Be the first to offer the olive branchNever wait for someone to take the initiative be the first one to take because it makes the relationship smooth and also makes the other person realize hisher mistake if they a wrong Don t get caught in right or wrong It s easy to fall into a power struggle of who s right and who s wrong but that prevents you from actually solving the real problem Dream a big dream for your relationship Dreaming big helps grow the relationship One is always inspired by the dreams to move forward quotHow to Talk About Sex Importance to talk about SexTalking with your child about sex is important to help him or her develop healthy attitudes toward sex and to learn responsible sexual behavior Openly discussing sex with your child also enables you to provide accurate information Functional ways PWNP WPP Equot Just Leap in Choose the Right Place and Tone Acknowledge the Problem Look Forward Not Back Stay Positive What to Talk about that there s love behind your lovemaking The meaning of sex The definition of sex That its not him Or you 10 Specific Ways to make things better quotl S P Uquot 9 N Chapter 10 Contraception Contraceptionprevention of the fusion of gametes during or after sexual activity Abortion the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo before it is viable Failure rate The number of women out of 100 who become pregnant by the end of 1 year of using a particular contraceptive Backup method Contraceptive methods used simultaneously with another method to support it OutercourseNoncoital forms of sexual intimacy kissing touching oral sex mutual masturbation anal sex No contraceptive undesirable side effects Can still spread STDs Hormone based contraception Side Effects Inhibit ovulationalter mucous lining of cervix prevent implantation Oral Contraceptives 100 million women Four typesConstant dose combination pill 19605progestin and estrogen Triphasic 1984 Fluctuations of hormones Seasonal constant dose reduce menstrual periods Progestin only pill 1973 How Oral Contraceptives Work Combo traphasic Seasonale inhibits ovulation alters cervical mucus and alters uterine lining Progestin only alters cervical mucus How to Use Oral Contraceptives Take pill at same time every day daily up to 50 miss 3 or more pills per cycle 4 types of oral contraceptives Constant dose combination gill Birth control pills that contain a constant daily dose of estrogen Triphasic gills Birth control pills that vary the dosages of estrogen and progestin during the menstrual cycle Seasonale Birth control pills that reduce menstrual periods to 4 times a year Progestin only gills Contraceptive pills that contain a small dose of progestin and no estrogen Advantages of Oral Contraception Taken at time separate from sexual activity sexual spontaneity Reversible Effective if taken correctly Eliminate Mittelschmertz Reduce amount and duration of menstrual flow Reduce PMS symptoms Relieve endometriosis Decrease incidence of benign breast disease Reduces risk of endometrial and ovarian cancer Breast enlargement Decrease in acne Progestin only reduces estrogen related side effects Disadvantages of Oral Contraceptives no protection against STDs ACHES Abdominal pain Chest pain Headaches Eye problems Severe leg pain Emotional changes May decrease sexual motivation or vaginal lubrication Decrease effectiveness of other medication Breakthrough bleeding with progestin only Barrier methods Couples incorporate their use into sex play instead of viewing them as an interruption Either partner or both can use condom insert female condom cervical barrier device or spermicide 9 5 l l i O l l UJN 4 H U39I H 0391 H l H 00 H U N O NNNN 4gtUJNH Condoms male A sheath that fits over the penis and is used for protection against unwanted pregnancy and STIs Female Made of polyurethane or latex worn internally by the woman Aflexible ring at the closed end of the sheath fits loosely against the cervix Diaphragm Dome shaped with a rim around the open side Covers the upper vaginal wall from behind the cervix to underneath the pubic bone Cervical cap Dome shape rim around the open side Fits over the cervix only Vaginal Spermicide Foam cream jelly suppositories and film that contain a chemical that kills sperm Foam White substance that resembles shaving cream Vaginal suppositoriesOval shape and the sponge is a doughnut shape spermicide containing device that absorbs and subsequently kills sperm Vaginal Contraceptive Film paper thin 2 by 2 inch sheet that is laced with spermicide It is packaged in a matchbook like container holding 10 12 sheets Vaginal ringNuvaRing and Ortho Evra Insert into vagina between Day 1 and Day 5 of menstrual period worn inside vagina for 3 weeks and then removed for 1 week Skin Patch Identify quotpatch change day wear patch for 3 weeks 1 week patch free Advantages of both Continuous low dose release of hormones Disadvantages of both Increased vaginal discharge with ring patch create irritation overweight reduces effectiveness Femcap and the Lea39s Shield have rims that rest on the vaginal wall surrounding the cervix and have removal straps Lea39s Shield one way fluid from the cervix to the vagina but prevent semen from contact with the cervix Sterilization most effective method of birth control except abstinence from sexual intercourse and its safety and permanence appeal to many who want no more children or who prefer to remain childless Tubal sterilization Female sterilization accomplished by serving or tying the fallopian tubes Transcervical sterilization A method offemale sterilization using a tiny coil that is inserted through the vagina cervix and uterus into the fallopian tubes Vasectomy Male sterilization accomplished by cutting and closing each vas deferens Vasovasotomy Surgical reconstruction of the vas deferens after a vasectomy Withdrawal Practice of removing men s penis from the vagina just before he ejaculates Douching Used as a method of birth control it is ineffective After ejaculation some sperm reach the inside of the uterus in a matter of 1 2mins The movement of the water from douching may actually help sperm reach the opening of the cervix It can also irritate vaginal tissues 25 N 0391 N I N 00 I Iquot P Intrauterine Device IUD small plastic objects inserted into the uterus Three most common Copper T Progestasert T Mirena IUD is the most common reversible contraceptuve used by women in the developing world US 80 continuation rate using 1 year after insertion Both the copper and progesterone effective in preventing fertilization How to use Tested for STIs needs to check every month after her menstrual period to see the thread in the same length AdvantagesLittIe inconvenience highly reliable Copper IUD 10 years progestrone releasing IUD 1 year Mirena for 5 years Least expensive Inserted 3 months after childbirth DisadvantagesDiscomfort cramping bleeding pain during insertion may expel during menstruation PAINS Period late abdominal pain increased temperature nasty discharge spotting May aggravate gonorrhea infections fallopian tube problems if pregnancy more chance of miscarriage perforate uterine wall Pelvic Inflammatory Diseaseinflammation of the uterus fallopian tubes andor ovaries as it progresses to scar formation with adhesions to nearby tissues and organs Emergency contraceptionHormone Pills Previn Plan B Produce impenetrable cervical mucus inhibit ovulation alter tubal transport time affect uterine lining Side effects similar to those related to birth controlPlan B most effective fewest side effects Copper IUD effective if inserted within 72 hours Fertility awareness methods aka Natural Family Planning Birth control methods that use the signs of cyclic fertility to prevent and plan conception 4 different tyges Standard Days MethodAvoid intercourse for a 12 day period during the middle of the menstrual cycle the quotfertile window Highest effectiveness rate for natural family planning methods Mucus method aka ovulation method based on determining the time of ovulation by means of the cyclic changes of cervical mucus Calendar Method aka Rhythm Method Estimate calendar time during cycle when ovulating and fertile keep chart Basal Body Temperature BBT drops slightly before ovulation rises slightly after ovulation Temperature readings indicate fertile times Advantages No side effects free increased comfort and appreciation of bodies cycles more time and motivation for noncoital sexual relating Disadvantages Restricts spontaneity requires practice commitment to record keeping difficult if cycles irregular temperature not always accurate indicator Minilaparotomy Small abdominal incision fallopian tubes tied Laparoscopy Incisions laparoscope inserted tubes tied or cauterized Immunocontraceptives birth control method that uses the body39s immune response to prevent pregnancy 32 LHRH agonist A compound that is similar to LHRH luteinizing hormone releasing hormone in structure and is able to act like it Historical and social perspective Egypt crocodile dung near cervix Greece eat the uterus testis or hoof parings ofa mule Casanova animal membrane condoms 17th century Western Europe condoms withdrawal vaginal sponges Contraception in the United States1870s Comstock Laws dissemination of info through mail prohibited as such info was obscene Comstock Laws Margaret Sanger 1915 illegal clinic distributed diaphragms imported from Europe published birth control info in her newsletter arrested for violating Comstock Laws Contraception as a 139 u y Issue95 sexually active women in Western world use contraception may need for 30 years Career issues and family planning Critical role in women s health issues Insurance issues Population control expand women s access to education and economic opportunity Cultural gender role expectations female sexuality 60 couples worldwide currently use contraception Religious mandatesissues Future in CONTRACEPTION For Men Present contraception vasectomy condoms withdrawal Possibility of a pill Pros amp Cons Needs 10 weeks to work Could impair sexual interest and function Current research Injection or implant combo progestin and testosterone full fertility after 4 or 5 month Reversible vasectomies gel ntra Vas Device plugs For Women Better pills New IUD Gynefix Spray on transdermal contraceptive Variations of female condom amp diaphragms Spermicides that are anti STD s PNF WPP Equot N H Chapter 4 Penis nerves blood vessels fibrous tissue three parallel cylinders of spongy tissue Muscles at base eject semen and urine through the urethra Root Extends internally into pelvic cavity attached to pubic bones Shaft external pendulous portion excluding head Glans Smooth acorn shaped head greatest concentration of nerve endings Cavernous bodies corpora cavernosa 2 larger of 3 cylinders running length of penis Spongy Body corpus spongiosum smaller of 3 cylinders running length of penis Crura innermost tips of cavernous bodies Foreskin aka Prepuce skin folded over and hood over glans can be retracted or removed with circumcision Circumcision surgical removal of this sleeve of skin Masters and Johnson reported finding no differene in the sensitivity of the glans of circumcised and uncircumcised men However more recent studies reported that the glans of the circumcised penis is less sensitive to touch than the glans of the uncircumcised penis Bris Practiced circumcision ceremony according to scripture as a religious rite Superincision Foreskin split lengthwise along top portion South Pacific cultures rite of passage into sexual maturity Castration Removal of testes Variety of reasons to prevent sexual activity between harem guards Eunuch and their charges mid 19th century in US as quotcurequot for masturbation treatment for insanity Current legal reasons ethical concerns Corona Rim where glans rises from shaft Frenulum thin strip of skin connecting glans to shaft on underside of penis Scrotum loose patch of skin outpocket of abdominal wall in groin area underneath penisTwo Iayers outerdarker inner tunica dartos Within scrotal sac two separate compartments each has a testistesticleMale goad inside the scrotum that produces sperm and sex hormones Spermatic cord A cord attached to the testis that contains the vas deferens blood vessels nerves and cremasteric muscle fibers Vas deferens sperm carrying tube Cremasteric muscle fibers influence position of testis in scrotal sac Cremasteric reflex strong contractions of muscle Sudden fear can also cause strong contractions of this muscle and it is possible to initiate contractions by stroking the inner thighs lnguinal canal Form inside abdomen amp migrate during fetal development through inguinal canal from abdomen to scrotum N J N U39I W O W LU Cryptorchidism failure oftestes to descend from abdomen to scrotum quothidden testisquot impact on sperm production as scrotal temp is lower than body temp undescended testes remain at internal body temp infertility could result Treatment Male genital self examination For normal average scrotal temperature is several degrees lower than body temperature and sperm production appears to be optimal at this lower temperatre Seminiferous Tubules Thin highly coiled structures Responsible for sperm production Leydig s cellsInterstitial cells source of androgen located between tubules secrete hormone products into bloodstream Epididymis Structure along the back of each testis in which sperm maturation occurs Storageripening for several weeks Selection processweed out abnormal cells Vasectomy Male sterilization procedure that involves removing a section from each vas deferens Uretha the tube through which urine passes from the bladder to the outside of the body Seminal vesicles Small glands adjacent to the terminals of the vas deferens that secrete an alkaline fluid that constitutes the greatest portion of the volume of seminal fluid released during ejaculation Ejaculatory ducts Two short ducts located within the prostate gland Prostate Gland Size and shape of walnutLocated at base of bladderEjaculatory ducts and urethra pass through Secretions are 30 seminal fluidAccelerates activity during sexual arousal Secretions flow into urethra combine with sperm and seminal vesicle secretions to form seminal fluid Secretions thin milky alkaline amp counteracts acidity of urethra and vagina Cowper39s glands Bulbourethral glands located on each side of urethraducts connect both glands directly to urethrasecrete liquid when sexually aroused alkalinedroplets can appear immediately after erection just before orgasm or never can contain active healthy sperm SemenSeminal Fluid ejaculate from seminal vesicles prostate gland Cowper s glands 1 tsp Influenced by length of time since last ejaculation duration of arousal age contains 200 500 million sperm comprised of ascorbic and citric acids water enzymes fructose bases etc Erections Process coordinated by autonomic nervous system ANS sends messages that cause expansion of arterlies leading to three erectile cylinders in penis Rate of blood flow increases rapidly accumulates in sponge like tissues of cylinders Causes erection of penis Remains erect until messages from ANS stop and inflow of blood returns to normal Capacity present at birth Nighttime erections occur during REM sleep physiological mechanism W J W 01 W 0quot W l W W L0 L0 J O J H J l Ejaculation Process by which semen expelled through penis to outside of body May not occur simultaneously with orgasm quotDry orgasms before puberty Multiple orgasms with no uid Basically a spinal reflex sexual stimulation builds neural excitation to critical level triggers internal physical events Following are the four phases Emission phase Prostate seminal vesicles and ampulla contract force secretions into ejaculatory ducts and urethra Same time both internal and external urethral sphincters close trapping seminal fluid in urethral bulb which expands quotPoint of no return Expulsion phase Collected semen expelled from penis by rhythmic contractions of muscles around urethral bulb and base of penis Additional contractions along entire urethral route External urethral sphincter relaxes amp fluid exits Internal urethral sphincter remains contracted to prevent escape of urine Intensity diminishes gradually 3 10 seconds Retrograde ejaculation Semen expelled into bladder rather than penis Reversed functioning of two urethral sphincters May be result of prostate surgery as well as illness congenital anomaly drugs Not inherently harmful but could indicate health problem Nocturnal Emissions Orgasm without direct genital stimulation Wet dreams Mechanism not known rarely from fantasy orgasm from fantasy more common among women Ampulla Upper portions ofthe vas deferens Urethral Sphincters two muscles one located where the urethra exits the bladder and the other below the prostate Urethral bulb the prostatic portion ofthe urethra between these two muscles Ejaculatory inevitability Point of no return Genital retraction syndrome GRS aka Koro Unusual culture bound phenomenon in which a male believes his penis is shrinking and retracting into his body Phimosis A condition characterized by an extremely tight penile foreskin Urology The medical specialty dealing with reproductive health and genital diseases of the male and urinary tract diseases in both sexes Smegma A cheesy substance of glandular secretions and skin cells that sometimes accumulates under the foreskin of the penis or hood of the clitoris Health care issues regarding the penis Penile cancer risk factors over age 50 a history of multiple sex partners and sexually transmitted infections genital warts poor genital hygiene being uncircumcised phimosis Destroyes entire penis and spread to lymph nodes and beyond J 00 Testicular cancer Risk factor smoking family history white race and cryptorchidism The mass feels hard or irregular to the fingertips Symptoms dull ache in groin area sensation of dragging or heaviness fever tender breasts and nipples J LO Prostatitis Prostate becomes enlarged and inflamed Caused gonococcus bacterium or protozoan Trichomonas Symptoms pain in the pelvic area or base of the penis lower abdominal ache backache aching testes urinate frequently Treatment Prescription drugs antibiotics anit inflammatory agents U1 0 Benign Prostatic Hyperplasia As men grow older the prostate gland tends to increase in size put pressure on the urethra thus decreasing urine flow Surgery or medications 51 Prostate Cancer Symptoms pain in pelvis and lower back and urinary complications Screening DRE PSA counts Treatment cryotherapy cancerous cells are destroyed by freezing and two forms of radition 52 DRE amp PSA screening group for Prostate cancer Procedures for Kegel exercises Locate the muscle by stopping the flow of urine several times while urinating The muscles you squeeze to accomplish this are the ones on which you ll concentrate If not done correctly Kegel while not urinating penises move slightly Done correctly have an erection penis move up and down Benefits stronger and more pleasurable orgasms better ejaculatory control and increased pelvic sensation during sexual arousal Male genital selfexam Hot bath causes scrotal skin to relax and the testes to descend Notice the cremasteric cycle of contraction and relaxation and experiment with initiating the cremasteric reflex Explore one testis at a time Place the thumbs on top of testis and the index and middle fingers on the upperside Apply small amount of pressure and roll the testis between fingertips Surface fairly smooth and firm is consistency Areas that appear swallow or 39feel painful presence of an infection Indicates Any irregularity such as lump or tender area in the scrotum Penis Size As society impressed with bigness Art forms perpetuate obsession May have Penile Augmentation Can contribute to poor self image Decreased sexual satisfaction can be result of self fulfilling prophecy Physiological reasons for possible discomfort during deep penetration Greatest sensitivity in vaginal canal is outer portion deep thrusting not usually required for satisfaction Penis hits cervix jars uterus and ovary similar to male being hit in testes Experiment with deeper or vigorous thrusting Gentleness consideration communication essential Size is unrelated to body shape height length offingers race or anything else Size of flaccid penis influences size of erection small ones increase more in size Women may have subjective preferences l 9quot HSquot H 0 Chapter 3 Gynecology the medical practice specializing in women s health and in diseases of the female reproductive and sexual organs VULVA Encompasses all female external genital structuresHair Folds of skin Urinary and vaginal openings Appearance varied likened amp to flowers seashells Mons Veneris Mound of Venusquot area covering pubic bone pads of fatty tissue Labia Majora quotOuter lipsquot extend on either side of vulva Labia Minora quotInner lipsquot located within the outer lips join at the prepuce extend past vaginal amp urinary openings cultural definitions of acceptable appearance vary Western labiaplasty vs African culture risks piercings Prepuce Clitoral hood The Clitoris Shaft Glans both are external covered by clitoral hood or prepuce Internal Crura roots Smegma accumulate under the hood can prevent by drawing back the hood when washing the vulva Cavernous Bodies Increases in size during several days before ovulation amp Controversy re sexual arousal and orgasm Cavernous bodies the shaft contains two small spongy structures which engorge spongy tissue of the crura that connect to the pubic bones in the pelvic cavity Female Circumcision Genital cutting aka quotfemale genital mutilation Circumcision easiest procedure remove hood Ensure Virginity before marriage Social stigma in some cultures if uncircumcised Many health risks can have reconstructive surgery Clitoris seen as a small penis These include bleeding and pain that lead to shock and death prolonged bleeding that leads to anemia and infection that causes delayed healing tetanus and gangrene Long term consequences include urinary obstruction blockage of menstrual flow and recurrent reproductive tract infections Labia cutting can lead to infertility Clitoridectomy remove clitoris Genital Infibulation remove clitoris and labia Urethra short tube connecting bladder to urinary opening Introitus Opening of vagina Hymen Tissue that partially covers introitus Hymenalplasty Surgical reconstruction Perineum Smooth skin between vaginal opening and anus Vestibular Bulbs two bulbs one on each side of the vaginal opening that engorge with blood during sexual arousalThese bulbs are similar in structure and function to the spongy tissue in the penis Compression of these tissues by the penis during intercourse causes internal sensations that some women find pleasurable N Lquot Bartholin39s Glands two small glands slightly inside the vaginal opening that secrete a few drops offluid during sexual arousal Usually not noticeable sometimes become clogged Pelvic Floor Muscles Strengthen with Kegel exercises Multiple directional deign that allows the vaginal opening to expand greatly during childbirth and to contract afterward Vagina canal that opens between labia minora and extends to cervix and uterus Unaroused 3 5 inches long changes in size and shape during sexual arousal and childbirth Three layers of tissue Mucosa moist tissue that lines certain body areas such as the penile urethra vagina and mouth Rugae the folds of tissue in the vagina Vasocongestion Network of blood vessels engorges with blood 1 aids conceptionalkalinizes normally acidic vagina amp 2 enhances sexual enjoyment Grafenberg Spot are within anterior wall of vagina system of glands Skene s glands and ducts that surround the urethra believed to be female counterpart to male prostate when stimulated may produce arousal orgasm and ejaculation of fluid amp not every woman has a G spot Douching rinsing out the vagina with plain water or a variety of solutions Hygiene Cervix use a speculum to see small end of the uterus back of vagin has mucus secreting glands 05 opening in center of cervix leads to the interior of the uterus Uterus Pear shaped organ inside pelvis 3 long 2 wide within which fetus develops Three layers Perimetrium External thin membranes covering the outside of the uterus Myometrium Longitudinal and circular muscle fibers stretch and contract Fundus at top thick of the uterus an area Endometrium Inner lining rich in blood vessels Fallopian Tubes Two tubes extending from the sides of the uterus in which the egg and the sperm travel each about 4 Fimbriae fringelike projections at outside end of each tube draws eggs into tube Cilia move egg along at 1 per 24 hrs viable 24 48 hours Ectopic Pregnancies Fertilized egg implants in fallopian tube instead of uterus Ovaries Size and shape of almonds Ends offallopian tubes amp Ligaments connect to uterus and pelvic wall Female gonads that produce ova and sex hormone Secondary sex Characteristics the physical characteristics other than genitals that indicate sexual maturity such as body hari breasts and deepened voice bl OLD J H J N J J J Lquot h m J l J W J LO U1 0 in H VI N Lquot W Lquot J U1 U1 Ovulation egg maturation and release of a mature ovum from the ovary Menstruation sloughing off of uterine linine if conception has not occurred normal physical functioning Menarche the initial onset of menstrual periods in a young woman Related to weight leptin found in fat cells supports reproductive functions Menstrual Synchrony Women who live together and have contact develop semilar menstrual cycles Menopause Cessation of menstruation as a result of the aging process or surgical removal of the ovariesRange of age 31 60s mean age 51 Menstrual Cycle regulated by relationships between hypothalamus and endocrine glands pituitary adrenal ovaries and uterus Hypothalamus monitors hormone levels in bloodstream throughout cycle amp Release chemicals that affect ovaries Hypothalamus Monitors hormone levels in the blood stream throughout the cycle releasing chemicals that stimulate the pituitary to produce hormones GnRH Gonadotropin releasing hormone release hormone to stimulate the pituitary to secrete FSH and LH into the bloodstream Pituitary gland size of a pea At the base of the brain The pituitary gland secretes nine hormones that regulate homeostasis Follicle stimulating Hormone FSH stimulates ovaries to produce estrogen and ova to mature in follicles Luteinizing Hormone LH causes ovaries to release a mature ovum amp stimulates development of corpus luteum Corpus Luteum Formed on the ovary at the site of the ruptured follicle and secretes progesterone Negativefeedback mechanism provides an internal control that regulates hormone fluctuation during the three phases of the menstrual cycle Menstrual Phase Uterus sheds lining blood mucus endometrial tissue Triggered by reduced progesterone and estrogen levels in bloodstream Hypothalamus stimulates pituitary via GnRH to release FSH amp initiates proliferative phase Proliferative Phase aka Follicular Pituitary gland increases production of FSH Developing follicles mature amp produce estrogens Endometrium thickens Ovarian estrogen peaks pituitary depresses FSH and stimulates LH Mature follicle ruptures and ovum released Mittelschmerz Experiencing a twinge cramp or pressure in the lower abdomen at ovulation Secretory Phase aka Luteal Continued secretions of LH cause ruptured follicle to become corpus luteum Corpus luteum secretes progesterone inhibits cervical mucus Progesterone and estrogen cause endometrium to thicken and engorge preparing for 0 O blastocyst Glands and ducts in endometrium develop and secrete nutrients No implantation pituitary gland responds to high estrogenprogesterone levels by shutting down FSH and LH Corpus luteum degenerates estrogenprogesterone production decreases Triggers sloughing off of endometrium Menstrual phase starts again Blastocyst Multicelled descendant of the united egg and sperm Three menstrual cycle problems Premenstrual Syndrome PMS symptoms of physical discomfort and emotional irritability that occur 2 to 12 days before menstruation Typical symptoms bloating breast swelling pain fat layers do become thicker food cravings irritability tension depression mood swings feeling of lack of emotional control Dysmenorrhea Painful or discomfort before or during menstruation Primary dysmenorrhea occurs during menstruation caused by overproduction of prostaglandins chemicals that cause uterine muscles to contract Secondary dysmennorhea Before or during menstruation constant and spasmodic lower abdominal pain that extends to back and thighs caused by something other than prostaglandins such as IUD PID tumors endometriosis Amenorrhea Absence of menstruation Primary amenorrhea Failure to begin menstruating at puberty related to problems with reproductive organs hormonal imbalances poor health or an imperforate hymen Secondary amenorrhea disruption of an established menstrual cycle absence of cycle for 3 or more months normal during pregnancy and breast feeding approaching menopause cessation of birth control pills More common among athletes decreased estrogen levels improve diet decrease training intensity gaining weight Prostaglandins Hormones that induce uterine contractions Toxic Shock Syndrome Caused by toxins produced by bacterium Staphylococcus aureus can cause death Menopause Climacteric Physiological changes that occur during transition from fertility to infertility in both sexes Women around 40 ovaries slow production of estrogen Perimenopause period before complete cessation of menstruation can last up to 10 years irregular cycles By 40 testosterone is half of what it was at 20 Permanent cessation of menstruation Earlier began periods by age 11 smoke tobacco shorter cycles and fewer pregnancies less time of oral contraceptive use Great individual variation Most acute symptoms in 2 years after cessation of periods hot flashes night sweats thinning of vaginal walls less lubrication sleep disturbance Hormone Therapy involves using supplemental hormones during and after menopause estrogen progesterone testosterone Vaginitis Inflammation of the vaginal walls caused by a variety of vaginal infections Arousal and Vaginal Lubrication 10 30 seconds after effective sexual stimulation clear liquid appears on vaginal mucosa result ofVasocongestion Network of blood vessels engorges with blood 1 aids conceptionalkalinizes normally acidic vagina amp 2 enhances sexual enjoyment Adequate lubrication important for sexual pleasure Vaginal Secretions and Chemical Balance of the Vagina White or yellowish secretions are normal amp sign of health Vary in appearance taste scent Chemical balance normally acidic Normal sign of health Douching not necessary can alter chemical balance amp increase susceptibility to infection Menstrual Physiology Lining of uterus sloughs off if no fertilization amp discharged as menstrual flow Length measured from first day to day before next flow begins typically lasts 2 6 days Cycle varies from 24 42 days longer cycle higher fertility rate Interval between ovulation and onset of menstruation is 14 days or 2 days Benefits and risks of hormone replacement therapy Controversies Heart Disease Effect related to health of blood vessels in younger vs older women protective effect in younger women amp helps maintain health of CV tissue Breast Cancer Varied results of studies Combined estrogenprogesterone HT at menopause no increased risk for 7 years Estrogen only no increased risk for 15 years If have breast cancer lower risk of dying if on HT Have to weigh benefits vs costs in making decision re HT GYNECOLOGICAL HEALTH CONCERNS 0 Urinary Tract Infections UTI s Symptoms frequent need to urinate burning sensation bloodpus in urine lower pelvic pain Causes Bacteria that enter urethral opening usually related to coitus o Vaginal Infections vaginitis Symptoms irritation or itching of the vagina and vulva redness of the introitus and labia unusual discharge and sometimes a disagreeable odor Causes Bacterial vaginosis BV found inside vagina BREASTS Secondary sex characteristics Internal composition Mammary glands fatty tissues Many sizes and shapes Breast augmentation Response to sex hormones External Nipple aureola Hysterectomy Surgical removal of the uterus Oophorectomy Surgical removal of the ovaries Impact Bleeding disorders severe pelvic infections and the presence of benign Cancer of the cervix uterus or ovaries also Hypolhalamus GnRH Hypomaiamus Pu Ty Anterlor plluitsry gland Mlacycle peak of LH hlggars ovulation Endomemum oi uterus a L a g Days at one menstrual cycle in n 5 using 28 days as l e e average duration gt1 777 7 ldfnsxru Fromeralive l Secretory phase 39 phase l phase 39 Figure 45 Changes during the menstrual cycle Breast Cancer 1 57 Squot O D The hypothalamus in the brain measures levels of hormones and release GnRH to stimulate the pituitary to secrete FSH and LH into the bloodstream Blood Levels of FSH and LH The levels of FSH red line and LH purple line vary during the complete cycle Ovary Ovarian changes during the phases of the cycle Blood Levels of Estrogen and Progesterone Fluctuations in blood levels of estrogen and progesterone produced by the ovaries Endometrium of uterus Effects of estrogen and progesterone on the lining of the uterus After ovulation the glands and ducts inside the endometrium develop and secrete nutrients that if the woman became pregnant would support the embryo Lumps 80 benign Cysts Fibroadenomas solid rounded tumors Fibrocystic Disease Malignant Tumors 190000 cases diagnosed each year kills about 40000 US women a year Risk FactorsNo pregnancies never breast fed a child menopause after age 55 obesity intact ovaries Mammography a highly sensitive X ray screening help to detect cancerous breast cells and lumps Treatment Breast Implants l Iquot P 5 Chapter 11 Conceiving Children Process and Choice Artificial Insemination A medical procedure in which semen is placed in a woman s vagina cervix or uterus lnfertilityWomen may feel more emotional distress Can have negative effect on sexuality loss of privacy spontaneity Performance anxiety In US 12 couples experience fertility problem 40 male problems 20 involve both Male and female 85 90 cases can be treated by drug therapy or surgical procedures Infertility attect Negative effects on a couple s relationship and sexual functioning Partners can also become isolated from each other and believe that the other does not really understand Each partner might feel inadequate about his or her masculinity or femininity because of problems with conceiving May feel anger and guilt and wonder llWhy mequot Congenitalcondition existing at birth and often before birth or that develops during the first month of life neonatal disease regardless of causation Varicocele A damaged or enlarged vein in the testis or vas deferens Options for conception lntracytoplasmic Sperm Injection Procedure in which a single sperm is injected into an egg Surrogate Mother Awoman who is artificially inseminated by the male partner in a childless couple carries the pregnancy to term delivers the child and gives it to the couple for adoption Assisted Reproductive Technology The techniques of extrauterine conception In Vitro Fertilization Procedure in which mature eggs are removed from a woman s ovary and fertilized by sperm in a laboratory dish Zygote Intrafallopian Transfer Procedure in which an egg is fertilized in the laboratory and then placed in a fallopian tube Gamete Intrafallopian Transfer Procedure in which the sperm and ovum are placed directly in a fallopian tube Intrauterine InseminationProcedure to place a number of washed sperm directly into the uterus Ethical leaal and personal quot39 39 with Assisted Re roductive Technology Extra embryo put up for adoption other donates the embryos for stem cell research Selling embryo or paying women for their ova and men for their sperm Some countries banned like paying women resulting in a shortage of eggs and embryos for IVF International reproductive travel Genetic alteration could give parents with a known genetic defect predisposing them Women past menopause possible to become pregnant deliver their babiesova is not visible so ova from a younger woman is fertilized in vitro with the sperm from the older woman s husband With hormonal assistance the woman uterus can maintain a pregnancy 6 9 5quot Human Chorionic Gonadotropin HCG A hormone that is detectable in the urine of a pregnant woman within 1 month of conception Sensitive blood tests for HCG detect pregnancy as early as 7 days after conception Spontaneous Abortion aka miscarriage The spontaneous expulsion the fetus from the uterus early in pregnancy before it can survive on its own Involve cramping heavy bleeding Can be a significant loss for the woman or couple Couple may need to grieve the loss for several months before pursuing another pregnancy Find it meaningful to create a memory book of the pregnancy and baby and hold a memorial ceremony of some kind Elective Abortion Medical procedure performed to terminate pregnancy IN US Recent 53 of women age 25 or younger 20 younger than 19 and 33 between 20 25 US has one of highest abortion rates in developed world 19 out of 1000 women Differences in social policies lower abortion rates including comprehensive sex education access to inexpensive birth control assistance for mothers Worldwide 1 in 5 pg ends in abortion highest in countries that restrict abortion but don t provide social services etcPsychological Reactions to Abortion Much ambivalence Emotions Timing reactions personal views relationship of partners Relief Illegal abortion 20 million unsafe abortions 97 developing nations Desperate to end unwanted pregnancy women attempt to self induce abortions by drinking turpentine bleach or tea made with livestock manure They insert herbal preparations into vagina or cervix and push a stick coat hanger or chicken bone thru cervix into the uterus Abortion illegal do not decrease the incidence of abortion Shared responsibility A couple can share responsibility for the decision about whether to have an abortion and for the abortion itself if that choice is made Important to discuss feelings about their pregnancy and each other the pros and cons of the possible choices and future plans as individuals and as a couple Pregnancy risk taking and Abortion 54 women had abortion were using contraceptive when became pregnant Not using contraceptive consistently or reliably side effects Factors that influence a woman s decision to have an abortion Decide whether to carry or not is important Women rely on practical and emotional matters to make their decisions about their dilemma Concern and responsibility for others is frequent reason for choosing to terminate the pregnancy Medical Abortion The use of medications to end a pregnancy of 7 weeks or less Suction Currettage A procedure in which the cervicakos is dilated by using graduated metal dilators or a laminaria then a small plastic tube attached to a vacuum aspirator H N H U 4 H U39I H 0391 l l 00l NNN Ni O NN U39IIgt N 0391 N l is inserted into the uterus drawing the fetal tissue placenta and built up uterine lining out ofthe uterus Dilation and Evacuation D and E An abortion procedure in which a curette and suction equipment are used Prostaglandins Hormones that are used to induce uterine contractions and fetal expulsion for second trimester abortions Late Term Abortion aka intact Dilation and EvacuationAn abortion done between 20 and 24 weeks when serious health risks to the woman or severe fetal abnormalities exist Quickeningthe initial motion ofthe fetus in the uterus as it is perceived or felt by the pregnant woman Roe v Wade Legalized a woman s right to terminate their pregnancy before the fetus has reached the age of viability Viability the fetus s ability to survive independently of the woman s body an ability that develops by the 6th or 7th month of pregnancy Voided Abortion as a criminal act for both the doctor performing the abortion and the woman undergoing the procedure Rust v Sullivanused in programs where abortion is a method of family planning ProLife aka AntiChoice Believed that once an ovum has been fertilized it is a human being whose right to life supersedes the woman s right to choose whether to continue her pregnancy Abortion is immoral and constitutes murder for a quotpre born child ProChoice Maintain safe and legal abortion if necessary and it is the last resort and oppose government control over woman s right to make her own reproductive decisions They want woman to be free from unwanted pregnancy Colostrumform of milk produced by the mammary glands of mammals in late pregnancy Zygote The single cell resulting from the union of sperm and egg cells Blastocyst Multicellular descendant of the united sperm and ovum that implants on the wall of the uterus Doppler Thalidomidesedative drug in the late 1950s that was typically used to cure morning sickness Amniocentesis aka Amniotic Fluidmedica procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections in which a small amount ofamniotic fluid which contains fetal tissues is extracted from the amnion or amniotic sac surrounding a developing fetus and the fetal DNA is examined for genetic abnormalities Chorionic Villi Samplingform of prenatal diagnosis to determine chromosomal or genetic disorders in the fetus Lamaze Philosophy Pain during childbirth stemmed from the muscle tension caused by fear To reduce anxiety they advocated education about the birth process relaxation N U U O U U N U U cu 4 36 and calm consistent support during a woman s labor breathing exercise voluntarily relaxing abdominal and perineal muscles Toxemiapresence of toxins in the blood Placenta Previaobstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix1l It can sometimes occur in the later part of the first trimester but usually during the second or third Leading cause is vaginal bleeding Effacedment Flattening and thinning ofthe cervix that occurs before and during childhood Afterbirth The placenta and amniotic sac following their expulsion through the vagina after childbirth Breech the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation The bottom down position called breech presentation presents some hazards to the baby during the process of birth and the mode of delivery vaginal versus Caesarean aka Csection baby is removed through incision in the abdominal wall and uterus is controversial in the fields of obstetrics and midwifery Postpartum depression PPD Symptoms of depression and possibly obsessive thoughts of hurting the baby Postpartum period The first several weeks after childbirth The parents can experience an increased closeness to each other as well as some troublesome feelings The time and energy demands of caring for an infant can contribute to weariness and stress Sexual interaction after childbirth Episiotomy aka perineotomy surgically planned incision on the perineum and the posterior vaginal wall during second stage of labor Lochia post partumvaginal discharge containing blood mucus and placental tissue Lochia discharge typically continues for 4 to 6 weeks after childbirth High level of sexual difficulties after childbirthFatigue is also a major factor affecting sexuality after childbirth The demands of caring for a new baby on both the woman and her partner may mean that there is not much time or energy left for sexual expression of Disadvantages Individuals and couples have much more time for themselves more and quot aparent financial resources and more spontaneity with regard to their recreational social and work patterns Woman who valued leisure more motherhood less important and vice versa Childless marriages are less stressful are happier and more satisfying than marriages with children Not having to worry about providing for the physical and psychological needs of children can make a difference because conflict about who does what for the children is a major source of disappointment for many couples U U Q Advantages The rewards of being a parent are worth it despite the costs and work it takes Children give as well as receive love and their presence can enhance the love between couples as they share in the experiences of raising their offspring Emotional and physical reactions to pregnancy Woman Factors influencing a woman s emotional reactions can include how the decision for pregnancy was made current and impending life style changes her relationship with others her financial resources her self image and hormonal changes Positive support and attention from her parent are helpful in creating in happy pregnancy 1000 women 35 loved being pregnant 40 mixed feelings 8 hated it Physical discomfort during 9 month greatly influences her feelings about being pregnant m Don t experience physical sensations as compared to woman Feel ecstatic but also fearful about the woman s and the baby s well being Common to fell frightened about impending birth and about whether he will be able to quotkeep it together Tender towards his partner and become more solicitous Sense of separateness from the woman because ofthe physical changes that only she is experiencing Sexual interaction during Pregnancy Continue sexual activity and orgasm until onset of labor Regular intercourse or orgasm reduces risk of preterm birth Women s sexual interest and responsiveness will likely change throughout the course Nausea breast tenderness and fatigue can inhibit sexual interest during 1St 3 months Partners feelings also affect reaction to woman s changing body and to the need for adjustment in the couple s sexual selection can vary from increased excitement to inhibition for the partner Prenatal Care 6 componentsmutrition general good heath adequate rest routine health care exercise chidbirth educationVernixCaseosa A waxy protective substance on the fetus s skin Placenta A disk shaped organ attached to the uterine wall and connected to the fetus by the umbilical cord Nutrients oxygen and waste products pass between mother and fetus through the cell walls ofthe placenta Fetal Alcohol Syndrome FAS Syndrome in infants caused by heavy maternal prenatal alcohol use characterized by congenital heart defects damage to the brain and nervous system numerous physical malformations of the fetus and below normal IQ Risks to Fetal development Importance of Placenta Fetal Alcohol Syndrome Tobacco Usage Medications Pregnancy after age 35 It is increasing Woman have their eggs retrieved and frozen a procedure oocyte cryopreservation when they are younger and more fertile for future use Freezing eggs does not guarantee later pregnancy 28 women become pregnant using their frozen eggs No risk No birth defects Higher rates of maternal death premature delivery C section and low birth weight babies occur 41 Process of childbirth 3 stages 4 First stage labor the initial stage of childbirth in which regular contractions begin and the cervix dilates Second stage labor the middle stage of labor in which the infant descends through the vaginal canal Third stage labor the last stage of childbirth in which the placenta separates from the uterine wall and comes out of the vagina Colostrum A thin fluid secreted by the breasts during later stages of pregnancy and the first few days after delivery Breast milk first produces colostrum which contains antibodies and proteins Pituitary hormones stimulate milk production in the breast in response to the stimulation of the infant suckling the nipples It provides a digestible food filled with antibodies and other immunity producing substances Babies who have this less distressed than other infants when experiencing stress or pain Disadvantage nursing caused reduced levels of estrogen which conditions and maintains vulvar tissue and promotes vaginal lubrication Therefore less interested in sexual activity her genitals may become sore from intercourse Breast may also be tender and sore Milk can ejected involuntarily from nipples during sexual stimulation


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