Female Sexual Anatomy

Mr. N. Vishwarupachar
International mental health forum
Health Supervisor(Retd.)
Health, mental health
Sexuality counselor cum trainer
 Agenda

 Discuss Female Sexual & Reproductive

System
 Describe Female Maturation Cycle
 Discuss Female Reproductive and Sexual
Health
The Female Sexual and
Reproductive System
External Sex Organs
Internal Sex Organs
Other Sex Organs
 Video: The Vagina Monologues

 What is your reaction to the video?

 External Sex Organs

 Vulva/Pudendum – entire female region of external

sex organs
 Mons Veneris
protective, fatty cushion over the pubic bone;
covered with pubic hair
 Labia Majora
outer lips;
tissue folds from mons to perineum surrounding
the rest of the female genitals;
engorge with blood if excited
 External Sex Organs
 Labia Minora
inner lips;
pink tissue folds between vestibule and labia
majora;
no hair;
many oil glands;
darken if sexually aroused
 Clitoris
small cylindrical erectile tissue beneath the
prepuce;
rich in blood supply and nerve endings;
solely to provide sexual pleasure, primarily via
indirect stimulation
 External Sex Organs

 Vestibule – region between the labia minora;

urethral and vaginal openings, Bartholin’s
glands ducts
 Urethral Meatus – between clitoris and vagina
 Perineum – between anus and vagina
The external genital structures of the mature female.
 Internal Sex Organs

 Vagina
4 inch, thin-walled accordion-like tube from
the introitus to the cervix, tilted back;
organ of intercourse and canal for menses
and babies;
lubricant secreted from vaginal wall
openings when engorged;
first 1/3 contains many nerve endings,
inner 2/3 has little nerves
 Internal Sex Organs

 Grafenberg Spot (G-spot) – dime to quarter

sized spot in the lower third of anterior
vaginal wall (2-3 inches up), just past the
pubic bone;
sensitive area;
Controversy:
Female ejaculation – powerful orgasms
and expulsion of fluid (up to 4 ounces)
due to stimulation of the G-spot in some
women;
may be Skene’s glands fluid or urine
 Internal Sex Organs

 Uterus – 1-inch thick walls, hollow, muscular

organ between the bladder and rectum;
monthly cycle of change; menstruation,
protects fetus, contractions to expel menses
and fetus; 3 inches long, 2 inches wide
3 uterine wall layers:
Perimetrium
Myometrium
Endometrium
 Internal Sex Organs

 Cervix – at bottom of the uterus; doughnut-

shaped; secretes mucus to help or impede
sperm, depending on the monthly cycle
Os – opening leading into the uterus
 Internal Sex Organs

 Fallopian Tubes (oviducts) – two 4-inch long

trumpet shaped tubes that extend from the
sides of the uterus and curve up to and
around the ovaries
Ampulla – typical site of fertilization
Infundibulum – has fimbriae surrounding
the ovaries to collect an egg upon release
 Ovaries – form of an almond shell; contain
250,000 ova each; produce estrogen
The female internal reproductive system (side view).
The female internal reproductive system (front view).
 Other Sex Organs

 Any area can be arousing depending on the

type of stimulation and the perceptions of the
recipient
 Breasts (mammary glands) – modified sweat
glands that produce milk; fatty tissue, 15 to 20
lobes, and milk-producing glands (alveoli)
Nipple, areola
Sucking stimulates pituitary gland to
release prolactin (begin milk synthesis) and
oxytocin (release of milk)
The female breast.
The Female Maturation
Cycle
Female Puberty
Menstruation
Menopause
 Female Puberty

 Begins anywhere from 8 to 15 years of age

 Earlier onset of menstruation may be due to
being overweight; can vary with race
 Puberty lasts about 3 to 5 years
 Begins when pituitary gland initiates release
of FSH and LH, which increases the ovaries
production of estrogen
 Increased size of Fallopian tubes, uterus,
vagina, breasts, buttocks, thighs
 Female Puberty

 Pelvis widens
 Pubic hair grows
 During puberty (usually 11 or 12 years),
ovulation commences
 Menarche occurs during this time as well,
although it may be a few months before or
after ovulation begins
 Menstruation

 Menstruation – uterine lining is shed if no

pregnancy; tissue and blood exit the introitus
 Menstrual cycle – lasts about 24 to 35 days,
average is 28 days
 Menstrual cycle has four phases:
Follicular phase
Ovulation phase
Luteal phase
Menstrual phase
 Menstruation: Menstrual Cycle

 Follicular phase – begins after menstruation

ends; lasts 6-13 days; ovarian follicles begin
to ripen; estrogen promotes development of
endometrium to 2-5 millimeters thick
 Ovulation phase – around day 14, an ovum is
released due to FSH and LH that have
ripened primary follicles; one follicle matures
completely (secondary follicle) and ruptures,
releasing the egg to be caught by the fimbriae
 Menstruation: Menstrual Cycle

 Luteal phase – corpus luteum forms on the

ovary where the secondary follicle ruptured; it
secretes progesterone and estrogen for 10-
12 days to further develop the endometrium
to 4-6 millimeters thick; without fertilization,
the progesterone and estrogen levels signal
to the hypothalamus to decrease LH and the
corpus luteum deteriorates and estrogen and
progesterone drop significantly
 Menstruation

 Menstrual phase – endometrial buildup is

expelled through uterine contractions for 3-7
days; volume of menses is about 2-4
tablespoons of fluid
The cycle of female hormones.
 Variations in Menstruation

 Amenorrhea – absence of menstruation

Primary amenorrhea – never begins
menstruation; physical, health, emotional
causes
Secondary amenorrhea – menses cease
before reaching menopause; pregnancy,
lifestyle, emotional, physical causes
 Menorrhagia – excessive menses; oral
contraceptives can help control
 Variations in Menstruation

 Dysfunctional uterine bleeding (DUB) –

bleeding for long periods, or intermittent
bleeding; hormonal, lifestyle, physical causes
 Dysmenorrhea – painful menstruation;
caused by inflammations, constipation,
psychological stress; recommend medication,
relaxation, yoga, massage, and stress relief
 Variations in Menstruation
 Premenstrual Syndrome (PMS) – physical or
emotional symptoms that occur during the
last few weeks of the menstrual cycle
 Premenstrual Dysphoric Disorder (PMDD) –
mood, behavioral, somatic, and cognitive
symptoms; medication (SSRIs) and lifestyle
changes provide relief
 Variations in Menstruation
Risk factors for PMS and PMDD: history of
depression, sexual abuse, PTSD, smoking
 Menstrual Manipulation and
Suppression

 Women can experience up to 450 periods

 Ways to stem growth of the endometrium:
Continuous birth control pills
Progesterone intrauterine devices
Injections
 It is possible to relieve many physical
symptoms related to menstruation
 Some see menses as indicating health
 No medical basis to avoid sex during a period
The Instead Softcup can be used during a woman’s period to make sexual activity less messy.
 Menopause

 A woman’s final menstrual period

 Climacteric – period of decreased estrogen
production and menstruation stops; 40-58
years, average 51 years
 Typically have irregular cycles, rather than a
sudden stop
 Sexual glands decrease in size
 Secondary sex characteristics change
 Menopause

 Hormonal changes – hot flashes, headaches,

sleep disturbances
 Sexual complaints
 Menopause can be induced by surgically
removing the ovaries; doctors try to keep at
least one in if surgery is necessary
 Menopause

 Hormone replacement therapy – was a

standard treatment, but there are a lot of
health risks and not typically used today
 Nutritional, vitamin, and herbal remedies are
commonly used today
Female Reproductive and
Sexual Health
Gynecological Health Concerns
Cancer of the Female Reproductive
Organs
 Female Reproductive and Sexual
Health

 Genital self-exams are recommended for

women to be familiar with their genitals and
any possible abnormalities
 Routine gynecological examinations
recommended once menstruating
Medical history and checkup
Pelvic examination (internal and external)
Breast examination
Pap smear – cervical swab
 Gynecological Health Concerns

 Most prevalent:
Endometriosis
Toxic Shock Syndrome
Uterine Fibroids
Vulvodynia
Vaginal Infections
 Endometriosis

 Endometrial cells deposit outside of the

uterus
 Will engorge/weaken with the menstrual cycle
 Symptoms: painful periods, lower abdominal
or pelvic pain, pain on defecation, pain during
intercourse
 Typically childless women between 25 and 40
 Cause is unknown
 Treatment: hormones, surgery, laser therapy
 Toxic Shock Syndrome

 Caused by prolonged use of a single tampon

which creates a buildup and subsequent
infection of bacteria
 Symptoms: fever, diarrhea, vomiting, sore
throat, muscle ache, rash,
 May cause: dizziness, respiratory distress,
kidney failure, heart failure, death
 Avoid by changing tampons regularly, using
less absorbent tampons, using sanitary pads
 Uterine Fibroids

 Hard tissue masses in the uterus; size range

 Affect 20-40% (maybe 77%) of women over
35 years
 Symptoms: pelvic pain and pressure, heavy
cramping, heavy or prolonged bleeding,
constipation, frequent urination, painful sex
 Treatment: hormones, drugs, laser therapy,
surgery, cryotherapy
 Vulvodynia

 Chronic pain and soreness of the vulva

 Symptoms: vaginal burning, itching, rawness,
stinging, stabbing of vagina/vulva
 The pain may be intermittent or constant
 Cause is unknown
 Treatment: biofeedback, drugs, dietary
changes, nerve blocks, surgery, pelvic floor
muscle strengthening
 Infections

 Non-sexually transmitted infections can occur

Bartholin’s glands
Urinary tract
 May be due to poor hygiene practices and/or
frequent intercourse
 Treated by draining infected gland (if
necessary) and use of antibiotics
 Douches change the vaginal pH level and
can increase risk of infection
Cancer Associated with
Female Reproductive
Organs
Breast
Uterine
Cervical
Endometrial
Ovarian
 Breast Cancer

 Worldwide, the most common cancer

 One in 7 American women will develop it
 Risk factors: fat intake, aging, early
menarche, prolonged estrogen, inactive
lifestyle, alcohol consumption, genetics
 Breastfeeding, early pregnancy reduces risk
 Early detection is critical: breast self-
examinations, gynecological checkups,
mammography
Breast exam (in Feature box)
 Breast Cancer

 Symptoms: breast lump, breast pain, nipple

discharge, puckering of skin, change in nipple
shape
 If untreated, the cancer will spread to other
parts of the body
 Treatment: partial/modified mastectomy,
radical mastectomy, lumpectomy, radiation,
chemotherapy
Breast Cancer : Education and Support
Groups
 Cervical Cancer

 1 in 130 American women

 Pap smear is used for detection; should be
screened every year by 21 years of age
 High cure rates
 Risk factors: early intercourse, many sexual
partners, teenage mothers, cervicitis, genital
viral infections, extended oral contraceptive
use
 Treatment: surgery, radiation, hysterectomy
 Endometrial Cancer

 Symptoms: abnormal bleeding, spotting

 Detection most successful with dilation and
curettage
 Treatment: surgery, radiation, hormones,
chemotherapy
 Over 90% survival rate
 Oral contraceptives decrease risk
 Ovarian Cancer

 Less common than breast, uterine cancers

 Most deadly
 Symptoms: few early signs, ovarian cyst,
slight abdominal discomfort, appetite loss,
indigestion, abdominal swelling, nausea,
vomiting
 Risk factors: childlessness, early menopause,
high-fat diet, higher SES, lactose-intolerant,
use talc powder on the vulva
 Ovarian Cancer

 Decreased risk with having children and

using birth control pills, tubal ligation
 Detection techniques: blood tests, pelvic
exams, ultrasound
 Unfortunately, most diagnosed after cancer
has spread beyond the ovary because of the
lack of early warning signs
 Treatment: remove ovaries, radiation,
chemotherapy