sexual anatomy and physiology

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sexual anatomy and physiology

• Meryl Cohen, M.Ed.,LCSW

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Introduction

• Reproductive functioning
• Sexual functioning

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Reproductive Functioning

• Male
• Urethra
• Testicle
• Epidydimis
• Vas deferens
• Cowpers, seminal vesicle, prostate

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Reproductive Functioning

• Female
• Ovaries
• Fallopian tubes
• Uterus
• Cervix
• Vagina

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Womens sexual problems are..

• Most doctors think that womens sexual problems
  are..

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DSM IV

• Sexual desire disorders Inhibited sexual desire
  and sexual aversion
• Sexual arousal disorders
• -lubrication/swelling
• -erectile disorder
• - lack of subjective sense of pleasure
• (how do you know your turned on)

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DSMIV

• Orgasm Disorder
• Female anorgasmia coital and noncoital
• Male delayed (retarded ejaculation), premature
  ejaculation (before he wishes it)
• (how do you know when sex is over)
• Sexual Pain Disorder
• -dyspareunia
• -vaginismus

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If over 40 women have these problems is it a
dysfunction?

• Pathology??
• Medicalization?
• Silver bullet?

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New Classification

• Sexual problems due to socio-culture,
  political, or economic factors
• Ignorance and anxiety due to inadequate sex
  education, lack of health services, or social
  constraints
• lack vocabulary for experience,
• lack information about biology and life-stage,
  lack of information about how gender roles
  influence expectations, beliefs, behaviors lack
  information and access to services for
  contraception, abortion, STD prevention, sexual
  trauma, and domestic violence

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• 2. Sexual avoidance due to perceived inability
  to meet cultural norms
• shame about body and sexual response
• orientation and sexual identity confusion
• 3. TIRED

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Sexual problems relating to partner and
relationships

• Inhibition, avoidance, distress because of
  betrayal, dislike, fear, unequal power and abuse,
  negative communication
• Discrepancies in desire and preference of
  activities (always high and low desire)
• Money, children, in-laws - infertility
• 4. Health concerns of partner

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Sexual problems due to psychological factors

• 1. Aversion and mistrust from past physical,
  sexual and emotional abuse
• 2. Personality problems attachment,
  rejection, etc.
• 3. Depression and anxiety
• 4. Fear of sexual act consequences pain,
  pregnancy, STD

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Medical factors

• Pain or lack of response despite supportive and
  safe interpersonal situation arising from
• Systemic medical conditions neurological,
  neurovascular, circulatory, endocrine, etc.
• Pregnancy, STD, etc.
• Drugs, medications, medical treatment

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• Masters Johnsons Sexual Response Cycle
• 4 Phase Sexual response cycle
• Excitement phase erection, lubrication, muscular
  tension, heart rate, sex flush
• Plateau phase advanced state of arousal,
  orgasmic platform builds, sex skin appears
• Orgasmic phase 3-15 contractions, rush, warmth,
  explosion, release
• Resolution phase return to pre-aroused state,
  men have refractory period unresponsive to
  stimulation, women may be re-aroused to multiple
  orgasm

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Total Stimulus Level

• Physical stimuli receivers emotional process

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Thresholds

• Arousal with TSL
• Orgasm with TSL

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DESIRE DESIRE DESIRE