Sex Textbook PDF

Chapter 4: Female Sexual Anatomy Video 4.1 Watch journalists from The Guardian build a giant vulva, and then talk to a gynecologist, a labiaplasty surgeon, and a trans woman, to find out what vulvas really look like. 4.0 Learning Objectives L.O. 4.1 Identify the parts of the vulva and discuss the issues surrounding labiaplasty. L.O. 4.2 Describe the vaginal introitus in relationship to the inner and outer genitalia. L.O. 4.3 Understand the structure, location, and function of the vaginal canal. L.O. 4.4 Identify the anus and its characteristics. L.O. 4.5 Describe the uterus and discuss the symptoms and causes of cervical cancer and other non- cancerous conditions. L.O. 4.6 Understand the location, structure, and function of the oviducts. L.O. 4.7 Describe the location, structure, and function of the ovaries and the causes and symptoms of ovarian cancer. Introduction Many people in Western culture are too embarrassed to discuss their genitals or learn how they function. At best, this leads to ignorance and at worst to feelings of fear or even disgust toward one's own body. This can be especially true of females, who may have been taught that their genitals, like their sexuality, should always remain private and safe from self- exploration. Keep in mind that although this chapter aims to illustrate the diversity of the female form, not all self-identified women or females possess the anatomy presented below. Please note that the words person with a vulva are often used instead of female in this chapter in order to respect gender and sex diversity. We will examine some examples of intersex and transgender bodies in Chapter 6: Sex and Gender. 4.1 The Vulva L.O. 4.1 Identify the parts of the vulva and discuss the issues surrounding labiaplasty. Figure 4.1 Overview of the External Female Reproductive Anatomy Long Text Description The external female genitalia, referred to as the vulva, include the anatomical structures related to the genitals on the outside of the body. Most people are less familiar with these than they are with male external genitalia for cultural reasons as well as because they are less protrusive and obvious. As shown in Figure 4.1, the vulva consists of the labia minora (inner labia), the labia majora (outer labia), the mons pubis, the vaginal introitus, and the clitoris. The most visible part of the clitoris, the clitoral glans, is located directly under the clitoral hood. Many people mistakenly call this whole area the vagina, but the vagina is a separate and entirely internal structure. There is great diversity in the appearance of vulvas, and this mostly has to do with the length and proportion of the inner and outer labia. external female genitalia the anatomical structures related to the genitals on the outside of the body vulva the anatomical structures related to the genitals on the outside of the body labia minora (inner labia) two pairs of skin that fold down and around the vulva on the inside labia majora (outer labia) two pairs of skin that fold down and around the vulva on the outside mons pubis the area on top of the vulva covered in pubic hair (unless it has been removed) which contains a thin layer of fat to oﬀer cushioning during sex vaginal introitus the entrance to the vagina - also known as the vaginal introitus clitoris Located at the top of the vulva where the inner labia meet, the clitoris contains thousands of nerve endings. Its only function is for sexual pleasure. glans the most sensitive external part of the clitoris, which becomes engorged during sexual arousal clitoral hood located on top of the clitoris 4.1.1 The Labia The labia are the two pairs of skin that fold down and around the vulva. Whereas the outer labia (or labia majora) are filled with mostly fatty tissue and contain hair on their surface, the inner labia (or labia minora) are thin, hairless, and only fully visible after parting the outer labia. Often times the skin on the outer labia is less sensitive to erotic touch than the inner labia, and it is also usually darker in appearance. The inner labia contain more glands, blood vessels, and nerve endings than the outer labia, making them very sensitive to erotic touch. As illustrated in Video 4.1, the inner labia vary tremendously in length. Sometimes they are virtually absent, whereas in others, they hang well beneath the outer labia. What does culture dictate in terms of what is deemed attractive? Interestingly, there are huge diﬀerences. In some cultures, people with vulvas undergo medically unnecessary surgeries, called labiaplasty, to make their inner labia shorter. labiaplasty a cosmetic surgery that shortens the length of the inner labia Figure 4.2. Labiaplasty: Before and After The drive of cosmetic labiaplasty is often associated with the narrow representations of vulvas in social media and mainstream pornography (Mackenzie, 2017). There is little education about the wide variance in the female external anatomy. Other cultures in Sub-Saharan Africa practice labia stretching because large labia are considered more desirable. The lengthened labia in these cultures are thought to enhance sexual pleasure for both partners. This practice represents a stark contrast to most Western standards of attraction. It is important to remember that many of the things we find attractive can be heavily influenced by our culture. Longer labia among women can often have an impact on that person’s self-image. Figure 4.2 features images before and after labiaplasty. Refer to Video 4.2 below to learn more about labiaplasty explores the controversial aspects of labiaplasty. Video 4.2 Labiaplasty Loading... 4.1.2 The Mons Pubis Residing above the labia is the mons pubis (as shown in Figure 4.3). The mons pubis is covered with a thin layer of fat, which functions primarily as cushioning during sex. After puberty, the mons is covered in pubic hair, which is hair that appears on the genitalia of all sexes after puberty. Figure 4.3 The Mons Pubis Scientists believe that pubic hair primarily exists to trap bacteria in the region and to prevent it from entering the vagina. There is some evidence that pubic hair also vaporizes odours from sweat glands around the pubic area that are thought to contain pheromones, which are chemical substances released by all mammals that serve to attract other mammals of the same species. Despite these properties, studies of Western countries including Canada have found that anywhere from 61-97% of women remove some or all of their public hair (Caron, 2022). Aside from the risk of causing skin irritation, there is nothing problematic from a medical standpoint in removing pubic hair (so long as one safely does so) and many report that it improves or enhances their sexual functioning. The notion that it somehow makes a female "cleaner" or is required for hygienic purposes, however, is medically unfounded and an unfortunate consequence of a culture that has traditionally cast female sexuality in a dirty, shameful light. In response to this, and in an apparent pubic hair removal backlash, some people with vulvas, including celebrity Amber Rose, are choosing to celebrate their un- removed pubic hair in a very public manner (Moss, 2017). 4.1.3 The Clitoris The inner labia meet at the back and at the front of the vulva, encircling the vestibule which contains the vaginal opening, the urethral opening, and the clitoris. The size and distance of the clitoris from the vagina vary greatly from vulva to vulva. The most visible part of the clitoris, the glans, is located directly under the clitoral hood, which resides at the front of the vestibule where the inner labia meet. The shaft of the clitoris runs up from the glans toward the clitoral hood and can be felt although not easily seen. Similar to the penis, the glans and shaft become engorged with blood and erect during sexual arousal. The erectile tissue inside the glans is known as the corpus spongiosum and is responsible for making the size of the clitoris expand during sexual arousal. The erectile tissue within the shaft of the clitoris is composed of two corpora cavernosu which operate to make the clitoris erect during sexual arousal. Descending downwards and back from the clitoral shaft are the crura (singular "crus"), which are approximately three inches long and give the clitoris a wishbone-like structure. The crura wrap partially around the urethra. The vestibular bulbs are curved masses residing beneath the crura. Like the glans, they are composed of corpus spongiosum tissue that becomes erect during sexual arousal. The erection of the vestibular bulbs helps to lengthen and stiﬀen the vagina during sexual arousal. Whereas the clitoral glans, hood, and shaft are all external, the crura and vestibular bulbs are considered to be the internal structures of the clitoris. Figure 4.4 illustrates these parts of the clitoris. urethral opening the opening for where urine exits the body the most sensitive external part of the clitoris, which becomes engorged during sexual arousal clitoral hood located on top of the clitoris corpus spongiosum the erectile tissue inside the glans corpora cavernosu erectile tissue within the shaft of the clitoris crura the internal part of the clitoris which is a wishbone like structure vestibular bulbs curved masses residing beneath the crura Figure 4.4 Model of the Clitoris Long Text Description The clitoris is packed with sensory nerve fibres and its only function is to provide sexual pleasure. Stimulation of the clitoris is the typical way most vulva owners achieve orgasm. For some vulva owners, direct stimulation of the clitoris may feel too intense and stimulation of the clitoris through the hood is more apt to feel pleasurable. The clitoris is more erotically sensitive in its erect versus flaccid state. After orgasm, people with vulvas often feel that their clitoris is temporarily too sensitive for touch. Many people know little or nothing about the structure, function, or appearance of their clitoris. It was not until 1981 that the Federation of Feminist Women's Health Clinics published anatomically correct images of the clitoris. In 2009 the first 3-D sonography of the stimulated clitoris was recorded by French researchers. Even today, it is frequently misrepresented in medical textbooks and downplayed in importance in medical fields. To combat ignorance, a social movement known as cliteracy (developed by conceptual artist Sophia Wallace) has taken root, aiming to educate people about the clitoris. There is now even an interactive video game, called "Clit- Me," which can be downloaded as an app onto your phone and teaches the anatomy and functionality of the clitoris (Ubelacker, 2019). Video 4.3 discusses the significance of cliteracy. cliteracy social movement, developed by conceptual artist Sophia Wallace, aiming to educate people about the clitoris Video 4.3 The Importance of Being Cliterate Loading... Question 4.3 Review Mark as: None Important Confusing None Match the part of the clitoris with its correct description. Drag and drop options on the right-hand side and submit. For keyboard navigation...SHOW MORE Press space or enter to grab becomes engorged and enlarges during sexual arousal Glans becomes engorged and enlarges during sexual arousal Press space or enter to grab internal structure that creates a wishbone structure Crura internal structure that creates a wishbone structure Press space or enter to grab composed of corpus spongiosum tissue that becomes erect during sexual arousal Vestibular bulbs composed of corpus spongiosum tissue that becomes erect during sexual arousal Press space or enter to grab connects the glans to the more internal structures of the clitoris Shaft connects the glans to the more internal structures of the clitoris Your answer Submitted: Show Submitted Answer This is your recorded answer from classroom or homework Show Correct Answer Check My Answer Please enter a new answer to submit. 4.2 The Vaginal Introitus L.O. 4.2 Describe the vaginal introitus in relationship to the inner and outer genitalia. Figure 4.5 The Vaginal Opening As shown in Figure 4.5, at the rear of the vestibule is the vaginal introitus (or vaginal opening). The vaginal opening is the connecting point between the interior and exterior genitalia. This opening, which is covered by the labia and sometimes the hymen, leads to the vaginal canal. The opening to the urethra (where urine is secreted in people with vulvas) appears as a small opening toward the top. 4.2.1 Urethra The urethra resides between the vaginal opening and the clitoris, and its main function is to excrete urine from the bladder. It is a separate opening in the vulva exclusively for urine. This separation contrasts with the male penis, which uses the same opening for urine and seminal discharge. The urethral opening connects to the urethra and bladder. urethra Located between the vaginal opening and the clitoris, its main function is to excrete urine from the bladder. Cystitis, also known as a urinary tract infection (UTI), can occur when bacteria like E. coli invade the urethra and bladder, causing frequent, painful urination. It is often caused by irritation of the urinary meatus due to prolonged or frequent intercourse (Honeymoon Cystitis) and also by the use of spermicides, which can alter the vaginal flora and allow bacteria to proliferate. Anal intercourse followed by vaginal intercourse can also cause UTIs. cystitis a urinary tract infection (UTI) urinary tract infection (UTI) occurs when E. coli bacteria invade the urethra and bladder, causing frequent, painful urination Loading... This spotlight story discusses one person’s experience of Interstitial Cystitis. Her story focuses on diagnosing and managing this health issue in relation to sex. The Mayo Clinic provides an overview of the condition here. This story illustrates one (though there are many) condition that can cause pain during sex. Human Sexuality Female Anatomy- Interstitial Cystitis SoundCloud privacy policy Privacy policy Audio Spotlight series: Audio courtesy of the contributor, used with permission Loading... 4.2.2 Hymen In newborn girls, the vaginal introitus is usually covered with a membranous fold of skin called a hymen. As shown in Figure 4.6, like vulvas, hymens come in a variety of shapes and sizes, but almost all have at least one opening that allows for the exit of menstrual blood after the onset of menses. In rare cases, a person may have an imperforate hymen (see bottom row, right-hand column in Figure 4.6), which completely covers the opening of the vagina and will have to be surgically opened at puberty. The hymen usually stretches or even tears the first time a person with a vulva has intercourse, which can sometimes lead to pain and even bleeding. The notion that the state of a hymen reveals a person's virginity status is incorrect, however, because, in many, hymens naturally tear during adolescence from physical activity and some are fairly open to begin with. hymen a membranous fold of skin that partially covers the vaginal introitus imperforate hymen a hymen that completely covers the hymen and thus needs to be removed Figure 4.6 Various types of Hymens Long Text Description Watch Video 4.4 to learn more about common misconceptions about the hymen. Video 4.4 The Truth about Hymens Loading... 4.2.3 Perineum The perineum is the relatively flat area that resides between the vagina and anus and can be erotically sensitive for many people with vulvas. Unfortunately, the perineum can also enable the transport of bacteria from the anus to the vagina, which is why it is recommended that people with vulvas always wipe front to back. perineum the relatively flat area that resides between the vagina and anus and can be erotically sensitive for many people with vulvas 4.2.4 Bartholin's Gland Located on either side of the vaginal introitus are the openings to two glands called the Bartholin's gland illustrated in Figure 4.7. The Bartholin's glands are anatomically homologous to the bulbourethral glands in males and are responsible for secreting minute amounts of alkaline fluid into the vagina immediately prior to orgasm. This fluid is not the basis for vaginal lubrication, however, and its exact function is not known. Bartholin's gland responsible for secreting minute amounts of alkaline fluid into the vagina immediately prior to orgasm Figure 4.7 The Bartholin's Glans Long Text Description 4.2.5 Pubococcygeus (PC) Residing beneath the vulva and connected to the deeper, internal portions of the clitoris are the pelvic floor muscles, which provide a sling that supports the pelvic organs. The pubococcygeus (PC) muscle is an especially important pelvic floor muscle that steadily contracts during sex and helps to stiﬀen the walls of the vagina during sexual arousal. During orgasm, the pubococcygeus muscle rhythmically contracts, producing feelings of intense pleasure. It is also believed that these contractions help to keep semen in the vagina, thereby increasing the chances of a pregnancy occurring. In addition, the pubococcygeus plays an important role in preventing urine from escaping. For all of these reasons, it is important for people with vulvas to perform exercises, called Kegel exercises, to strengthen the pubococcygeus muscle, particularly after childbirth when it is naturally stretched out and weakened. Kegel exercises essentially involve repeatedly engaging the same muscle that is used to stop the flow of urine and can be done inconspicuously anytime and anywhere. In addition to helping prevent incontinence after childbirth, Kegel exercises increase the intensity and pleasure of orgasm. Video 4.5 features physical therapist Michelle Kenway, who explains what a Kegel exercise is and how to perform one. pubococcygeus (PC) pelvic floor muscle that steadily contracts during sex and helps to stiﬀen the walls of the vagina Kegel exercises exercises that strengthen the pubococcygeus muscle Video 4.5 Kegel Exercises Question 4.7 Review Mark as: None Important Confusing None Which of the following is a result of strengthening the pubococcygeus muscle? Select an answer and submit. For keyboard navigation, use the up/down arrow keys to select an answer. a increased risk of ovarian cancer b decreased bladder control c protection from uterine cancer d prevention of incontinence and better orgasms Show Submitted Answer This is your recorded answer from classroom or homework Show Correct Answer Check My Answer Please enter an answer to submit. 4.3 The Vaginal Canal L.O. 4.3 Understand the structure, location, and function of the vaginal canal. The main function of the vaginal canal is to provide a birth canal for a fetus and to help transport sperm up through the uterus into the oviducts to create a pregnancy. It is largely insensitive to stimulation, as it has few nerve endings. It is highly elastic, causing it to lengthen greatly during sexual arousal. In its unaroused state, the vagina is relaxed and collapsed and extends two to four inches up and toward the back of a person with a vulva's body. Penetration of the vagina by a penis is referred to formally as penis in vagina (PIV) sex. vaginal canal the vagina - birth canal penis in vagina (PIV) sex penetration of the vagina by a penis 4.3.1 The Layers of the Vagina The vagina has three layers. The innermost layer contains a thin cellular lining called mucosa, which is responsible for producing lubrication during sexual arousal. The mucosa is surrounded by an intermediate muscular layer, which tightens in order to wrap more tightly around the penis during coitus. The outermost layer is more tough and elastic. All three layers of the vagina swell with blood during sexual arousal, producing a state called vasocongestion. The portion of the vagina that is closest to the outside of the body has significantly more nerves and blood vessels than the more inner portion, making it the most sexually erotic part of the vagina. Importantly, the vagina contains millions of "good" bacteria that help maintain its slightly acidic environment. This helps to prevent the growth of harmful bacteria (Ma et al., 2012). During a person with a vulva's most fertile time in their cycle, the vagina becomes less acidic so as to not damage sperm as they travel through it. mucosa cells that line the innermost layer of the vagina vasocongestion when the vagina swells with blood during sexual arousal The vagina is naturally self-cleaning and does so via an odourless discharge that changes in colour and texture depending on where the person is in their cycle. Douching, which involves the rinsing of the vagina with various liquids, is therefore completely unnecessary and potentially harmful (Cottrell, 2003). By changing the pH level of the vagina, douching can allow the naturally occurring microbes in the vagina to overgrow, particularly the fungus Candida albicans. This fungus leads to a yeast infection known as candidiasis, which causes inflammation of the vaginal walls, itching, and sometimes a thick, whitish discharge. Candidiasis is diagnosed by microscopic examination of the discharge and is treated with antifungal medications. Though unpleasant, candidiasis is not particularly harmful from a health perspective, although repeated cases can suggest a compromised immune system. Other factors that can throw oﬀ the pH level of the vagina and cause candidiasis include stress, hormone changes related to pregnancy or birth control pills, diabetes, and antibiotics. Candida albicans the particular fungus that leads to a yeast infection, which is medically called candidiasis candidiasis the formal name for a yeast infection Loading... 4.3.2 The G-Spot The Grafenberg spot (G-spot) was discovered by sexologist Ernst Grafenberg in the 1950s. It is located about two inches inside the vagina on the front wall (toward the abdomen) and can feel slightly more crinkled or rough than the surrounding area. Its stimulation can be very sexually arousing and many find that it leads to more powerful orgasms than those brought on by clitoral stimulation. Grafenberg spot (G-spot) located about two inches inside the vagina on the front wall (toward the abdomen) and can feel slightly more crinkled or rough than the surrounding area Some experts question if the G-spot actually exists (Kiefer, 2020). Many that doubt its existence cite rigorous academic research addressing the question of whether it exists as a distinct anatomical structure (Kilchevsky, 2012). These researchers fear that stressing the existence of this "magical spot" will only frustrate vulva owners who search for it in vain hoping to find an easier path to orgasm. Other studies using ultrasound have claimed to have found strong supporting evidence for the G-spot, and argue it is absolutely a discrete anatomical structure (Buisson et al., 2010; Meston & Buss, 2009). Other studies have used vibrators to stimulate the G-spot to prove its existence as well as that of female ejaculation (Addeigo et al., 1981). There are even doctors who oﬀer G- spot enhancement injections or "G- shot parties," although these treatments lack data to support their eﬃcacy (Mosbergen, 2012; Childs, 2018). Assuming the G-spot does exist, at least in some people with vulvas, there is another debate surrounding whether G-spot orgasms diﬀer from those brought on by clitoral stimulation. Many people with vulvas report that G-spot orgasms diﬀer in their intensity, and we will explore this further in future chapters. Most of the evidence suggests, however, that there is nothing distinctly diﬀerent about an orgasm triggered via the clitoris versus the G-spot as both connect to the same underlying nerves and musculature. Video 4.6 provides an overview of the G-Spot and the controversy surrounding its existence. Video 4.6 The G-Spot In Figure 4.8, notice that the G-Spot is on the front wall of the vagina, about two to three inches in, and in close proximity to the clitoris. Directly behind the G-spot, between the front wall of the vagina and the urethra are important glands known as the paraurethral glands (also known as the Skene's gland), which is anatomically comparable to the prostate gland in men. Both the clitoris and G-Spot connect to the same nerves and, when stimulated, lead to orgasm. When a person with a vulva has an orgasm via stimulation of the G-spot, the paraurethral glands sometimes release a fluid that is secreted from the glands into the urethra. This fluid, combined with some urine, are then pushed out of the urethral opening during orgasm in what is known as female ejaculation. The force and volume released during female ejaculation vary widely from person to person. paraurethral glands When a person with a vulva has an orgasm via stimulation of the G-spot, the paraurethral glands sometimes release a fluid that is secreted from the glands into the urethra. Skene's gland the paraurethral glands female ejaculation when a fluid is released from the Skene's gland and pushed through the urethra during orgasm. Figure 4.8 The Paraurethral Glands and the G-spot Long Text Description 4.4 The Anus L.O. 4.4 Identify the anus and its characteristics. The anus is located behind the vagina (Figure 4.9). It is made up of internal and external sphincter muscles that control excretion. It is important to note that for sexual purposes, the inner sphincter is not under voluntary control. Therefore, penetrating the anus of any sex requires most people to go slowly. The inner sphincter needs time to open and relax during anal intercourse. The exterior sphincter is voluntary, but many people require practice to relax this muscle during intercourse which can be achieved by bearing down. anus made up of internal and external sphincter muscles that control excretion sphincter muscles muscles in the anus that control excretion Figure 4.9 Female Anus (Left) and Male Anus (Right) Beyond the anus, further into the body lies the rectum, which in people with vulvas is located posterior to the vagina. Like the vagina, the rectum is lined with mucosa, although unlike the vagina this inner cellular lining does not produce any lubrication, making the area susceptible to tearing. Like the vagina, the outer portion of the anus has more nerves and blood vessels than the inner portion, making it more sexually erotic. Although the rectum serves to transport fecal matter out of the body, fecal matter is stored in the colon, not in the rectum. Many people, regardless of their sexual orientation, find the anus to be a highly erotic area. rectum located deeper into the body behind the anus 4.5 The Uterus L.O. 4.5 Describe the uterus and discuss the symptoms and causes of cervical and endometrial cancers, as well as other non-cancerous conditions. Above the vagina, leading further into the reproductive tract, is the uterus. In a non-pregnant female, the uterus is about the size and shape of an upside-down pear. It is capable of expanding to approximately 60 times that size during pregnancy. Video 4.7 provides a 3D overview of the internal reproductive anatomy for a person with a vulva. uterus above the vagina, leading further into the reproductive tract, where pregnancy occurs Video 4.7 A 3D Overview of the Internal Reproductive Anatomy for a Person with a Vulva 4.5.1 The Layers of the Uterus The uterus is suspended by a broad ligament in the abdominal cavity in a horizontal position, slanted slightly forward. A tipped uterus is one which slants instead toward the spine, usually as a result of genetics. In severe cases, a tipped uterus can make sex and childbirth more diﬃcult, requiring that the uterus be repositioned via surgery. tipped uterus a uterus which slants instead toward the spine, usually as a result of genetics Like the vagina, the uterus is composed of three layers. As shown in Figure 4.10, the innermost layer is the endometrium, the middle layer is the myometrium, and the outer layer is the perimetrium. The endometrium serves to help transport sperm up toward the site of fertilization and also serves as a source of nourishment for an implanted embryo. For this reason, the inner lining of the endometrium changes during the menstrual cycle. During the first part of the menstrual cycle, this lining tends to change from being thin and slippery to becoming thicker and richer. A portion of this lining is then shed during menstruation, exiting the body through the cervix and vagina. The middle layer of the uterus consists of a powerful muscular wall called the myometrium, which contracts during labor, orgasm, menstruation, and occasionally ovulation. The perimetrium provides the last, outer covering of the uterus and separates it from the pelvic cavity. endometrium the innermost layer of the uterus menstruation the period during the menstrual cycle when the endometrium lining is expelled from the body myometrium the middle layer of the uterus perimetrium the outer layer of the uterus Figure 4.10 The Three Layers of the Uterus: Endometrium, Myometrium, and Perimetrium 4.5.2 The Cervix and Cervical Os The uterus connects downward with the vagina via the cervix (Figure 4.10). To feel the cervix, a person with a vulva can insert one or two fingers deeply into her vagina. During the fertile times of her menstrual cycle, the cervix will feel soft and gently parted, almost like a pair of lips. During all other times of her cycle, it feels more firm and closed, like the tip of a nose. cervix where the uterus and vagina connect The cervical os (Figure 4.10) refers to the portion of the cervix that connects the vagina with the cervical canal, which runs through the centre of the cervix into the uterus. The cervical os contains numerous mucous glands, which excrete diﬀerent types of mucus depending on where a person with a vulva is in their menstrual cycle. This mucus is slightly acidic, which serves to preserve the sterile uterine environment. Immediately prior to ovulation, the cervical os excretes muscin ("fertile mucus") which is alkaline, clear, copious, and stretchy, like raw egg white. The muscin facilitates the rapid transport of sperm into the uterus and oviducts, and it can allow pregnancy to occur even when sperm is deposited near (but not actually in) the vagina. cervical os the portion of the cervix that connects the vagina with the cervical canal, which runs through the center of the cervix into the uterus muscin ("fertile mucus") alkaline, clear, copious, and stretchy, like raw egg white that facilitates the rapid transport of sperm into the uterus and oviducts to facilitate pregnancy Question 4.9 Review Mark as: None Important Confusing None Match the layer of the uterus with its correct description. Drag and drop options on the right-hand side and submit. For keyboard navigation...SHOW MORE Press space or enter to grab innermost part of the uterus that grows increasingly thick in preparation for possible pregnancy Endometrium innermost part of the uterus that grows increasingly thick in preparation for possible pregnancy Press space or enter to grab powerful muscle that contracts during labor and orgasm Myometrium powerful muscle that contracts during labor and orgasm Press space or enter to grab outermost part of the uterus Perimetrium outermost part of the uterus Your answer Submitted: Show Submitted Answer This is your recorded answer from classroom or homework Show Correct Answer Check My Answer Please enter a new answer to submit. 4.5.3 Cervical Cancer The Canadian Cancer Society (2022) estimates that in 2022, about 1450 people will be diagnosed with cervical cancer, and approximately 380 people will die from it. Almost all cervical cancers are caused by the human papillomavirus (HPV) which is a sexually transmitted infection (STI). Factors including smoking, as well as the presence of other STIs including chlamydia, gonorrhea, syphilis, and HIV/AIDS, increase the risk of contracting an HPV infection and thereby also increase the risk of cervical cancer. Fortunately, there is a vaccine that protects against HPV and cervical cancer called Gardasil, which we will discuss in more detail in Chapter 18: Sexually Transmitted Infections. human papillomavirus (HPV) a sexually transmitted infection (STI) Gardasil a vaccine that completely protects against HPV Rates of cervical cancer have declined in the last 20 years due to advances with the Pap test. During a Pap test, a small, usually plastic, spatula-like instrument is inserted through the vagina up to the cervix. There, cells are gently scraped oﬀ the surface. These cells are then placed on a slide and examined by a technician for the presence for pre-cancerous lesions. Except in cases of very early detection, treatment for cervical cancer usually involves removal of the entire uterus, as well as the cervix. Chemotherapy and/or radiation are usually prescribed as additional treatments. 4.5.4 Non-Cancerous Conditions of the Uterus The uterus can also be aﬀected by fibroids, which are tumours of smooth muscle that tend to grow on the endometrium, in the myometrium, or near the outer surface of the uterus. Between 20% to 80% of people with vulvas develop fibroids at some point in their lives; however, according to the Mayo Clinic (2019), they almost never develop into cancer. Symptoms usually include pain and bleeding in the area. Often fibroids are only discovered during a routine pelvic exam. Removal of the fibroids in those cases is usually recommended, and in extreme cases, a full hysterectomy may be recommended. fibroids tumors of smooth muscle that tend to grow on the endometrium, in the myometrium, or near the outer surface of the uterus Another somewhat common condition of the uterus is endometriosis. This is when endometrial tissue grows in abnormal places, such as in the oviducts, the ovaries, or other surfaces within the pelvic cavity. As this endometrial tissue grows it becomes stuck and causes pain, bleeding, and irritation to surrounding tissue. Endometriosis is relatively common, aﬀecting 6% to 10% of women of reproductive age, 50% to 60% of women and teenage girls with pelvic pain, and up to 50% of women with infertility (Giudice, 2010). If the condition progresses untreated, symptoms can become worse, so it is extremely beneficial to obtain a diagnosis sooner rather than later. There is currently no cure to endometriosis. Laparoscopy is the most commonly used procedure for diagnosing and treating mild to moderate endometriosis. Birth control is often recommended to manage the symptoms (Healthwise Staﬀ, 2020). A lack of adequate knowledge and information surrounding endometriosis means that many women struggle with the symptoms and are unaware of their condition until they experience fertility issues later in life (Nnoaham et al., 2019). endometriosis the growing of endometrial tissue in abnormal places, such as in the oviducts, the ovaries, or other surfaces within the pelvic cavity Question 4.10 Review Mark as: None Important Confusing None Match the medical condition with its correct description. Drag and drop options on the right-hand side and submit. For keyboard navigation...SHOW MORE Press space or enter to grab inner lining of the uterus begins growing in other parts of reproductive tract including the oviducts Endometritis inner lining of the uterus begins growing in other parts of reproductive tract including the oviducts Press space or enter to grab a uterus that is slanted toward the spine Tipped uterus a uterus that is slanted toward the spine Press space or enter to grab caused by the Human Papillomavirus Virus Cervical cancer caused by the Human Papillomavirus Virus Press space or enter to grab non-cancerous tumors that grow on the surface or middle layer of the uterus Fibroid non-cancerous tumors that grow on the surface or middle layer of the uterus Your answer Submitted: Show Submitted Answer This is your recorded answer from classroom or homework Show Correct Answer Check My Answer Please enter a new answer to submit. 4.6 The Oviducts L.O. 4.6 Understand the location, structure, and function of the oviducts. At the very top of the uterus, forming a pathway between the uterus and ovaries, are two symmetrical branches called the oviducts, or fallopian tubes. As seen in Figure 4.11, each oviduct is about four inches long and connects to one ovary. Oviducts are lined with cells called cilia, which are tiny, hairlike structures that function to push the ovum (egg) along as it makes its way toward the uterus. Although these cilia push in the opposite direction from that in which sperm try to travel, they usually do not oﬀer a serious impediment to sperm. oviducts two symmetrical branches forming a pathway between the uterus and ovaries cilia tiny, hairlike structures that function to push the ovum (egg) along as it makes its way toward the uterus Figure 4.11 The Oviducts and Ovaries As the oviducts approach the ovaries, each widens into a flared opening with fingerlike extensions, known as fimbria. Although the fimbria brush against the ovaries, they are not attached to them. The fimbria are lined with cilia that gently sweep the ovum into the oviducts, where fertilization usually occurs. fimbria fingerlike extensions at the end of the oviducts In a normal pregnancy, the fertilized ovum will travel down the oviducts into the uterus before implanting in the endometrial lining. Occasionally, however, especially when an infection is present, the embryo may get stuck and implant in the lining of the oviduct, causing an ectopic pregnancy. Since the oviducts are not designed to support a developing embryo, sharp pain and bleeding usually result, and termination of the pregnancy will be required to prevent rupturing and serious damage to the person with the uterus. Ectopic pregnancy occurs usually in the oviducts (fallopian tubes) but sometimes also in other problematic areas, such as in the top of the uterus. If left untreated, it can cause the oviducts to rupture, which poses a serious threat to a female's health. Notice the structure and location of the uterus, oviducts, and ovaries in this diagram as well, and how the fimbria brush against but are not connected to the ovaries. Figure 4.12 shows the location of an ectopic versus normal pregnancy. ectopic pregnancy when an embryo gets stuck and implants in the lining of an oviduct Figure 4.12 Normal versus Ectopic Pregnancy Long Text Description Video 4.8 is an artistic representation of an ovum moving through the oviducts. Notice the oviducts are lined with cilia that help to sweep the ovum along. Video 4.8 An Ovum Moving through the Oviducts 4.7 The Ovaries L.O. 4.7 Describe the location, structure, and function of the ovaries and the causes and symptoms of ovarian cancer. As depicted earlier in Figure 4.11, the ovaries are two round structures each measuring about 1.5 inches in diameter. Ovaries and men's testicles are about the same size and shape, and both are considered gonads since they produce ova or sperm as well as sex hormones. These sex hormones include estrogens, androgens, and progestins and are secreted in a complex sequence which guides the stages of the menstrual cycle. Each ovary contains a number of follicles, and inside each follicle is an ovum, or egg cell, surrounded by fluids and supporting cells. Each individual ovum bears an X chromosome, unlike sperm, which have either an X or Y chromosome. ovaries two round structures each measuring about 1.5 inches in diameter During the menstrual cycle, a group of follicles will all start to develop, or ripen. Finally, one (usually) follicle ripens fully and releases its ovum into the oviducts in a process called ovulation. After discharging its ova, the remaining follicle then becomes a corpus luteum and assumes sex steroid production. The remaining follicles (that didn't fully ripen) then disintegrate and are reabsorbed by the body. ovulation when a follicle ripens fully and releases its ovum into the oviducts corpus luteum what the remaining follicle becomes after discharging its ova Unlike sperm, which are constantly regenerated, girls are born with their lifetime supply of ova. Most people with vulvas are born with about one million ova in each ovary. This supply slowly declines as a person with a vulva ages. During her reproductive life, a person with a vulva usually releases one ova per cycle, from either ovary, meaning that the vast majority of the eggs in the ovaries never make it to the point of ovulation. Ovaries do not trade oﬀ turns ovulating in perfect order each month - it is a random process where, on average, each ovary ovulates 50% of the cycles. Video 4.9 presents an overview of the ovaries and their function. Video 4.9 The Ovaries and Their Function Question 4.11 Review Mark as: None Important Confusing None Which of the following is NOT a sex hormone produced by the ovaries? Select an answer and submit. For keyboard navigation, use the up/down arrow keys to select an answer. a estrogen b androgens c progestins d oxytocin Show Submitted Answer This is your recorded answer from classroom or homework Show Correct Answer Check My Answer Please enter an answer to submit. 4.8 Summary L.O. 4.1 The external genitals are called the vulva and include the labia majora and minora, the mons, and the clitoris. All contain numerous nerve endings with the most concentrated region of nerve endings being on the clitoris. The clitoris has both internal and external structures and its sole function is sexual pleasure. Sometimes people with vulvas undergo medically unnecessary surgeries, called labiaplasty, to make their inner labia shorter. L.O. 4.2 The vaginal introitus is the entrance to the vagina. The vaginal opening is the connecting point between the interior and exterior genitalia. This opening, which is covered by the labia and sometimes the hymen, leads to the vaginal canal. The opening to the urethra (where urine is secreted in people with vulvas) appears as a small opening toward the top. L.O. 4.3 The main function of the vaginal canal is to provide a birth canal for a fetus and to help transport sperm up through the uterus into the oviducts to create a pregnancy. The vagina is the birth canal and has three layers. It connects to the cervix, which is the opening to the uterus. About three inches into the vagina on the upper frontal wall is the G-spot, although whether the G- spot exists as a distinct anatomical feature is a subject of debate. L.O. 4.4 The anus is located behind the vagina and is made up of internal and external sphincter muscles that control excretion. Many people, regardless of their sexual orientation, find the anus to be a highly erotic area. L.O. 4.5 Above the vagina, leading further into the reproductive tract, is the uterus, which is also composed of three layers. The uterus connects downward with the vagina via the cervix. Treatment for cervical cancer frequently involves the removal of the entire uterus. Some non-cancerous conditions of the uterus include fibroids and endometriosis. L.O. 4.6 At the very top of the uterus, forming a pathway between the uterus and ovaries, are two symmetrical branches called the oviducts, or fallopian tubes. Each oviduct is about four inches long and connects to one ovary. Oviducts are lined with cells called cilia, tiny hairlike structures that function to push the ovum (egg) along as it makes its way toward the uterus. L.O. 4.7 The ovaries are two round structures that produce ova and sex hormones, including estrogens, androgens, and progestins that are secreted in a complex sequence which guides the stages of the menstrual cycle. Loading... 4.9 Glossary anus: made up of internal and external sphincter muscles that control excretion Bartholin's gland: responsible for secreting minute amounts of alkaline fluid into the vagina immediately prior to orgasm Candida albicans: the particular fungus that leads to a yeast infection, which is medically called candidiasis candidiasis: the formal name for a yeast infection cervical os: the portion of the cervix that connects the vagina with the cervical canal, which runs through the center of the cervix into the uterus cervix: where the uterus and vagina connect cilia: tiny, hairlike structures that function to push the ovum (egg) along as it makes its way toward the uterus cliteracy: social movement, developed by conceptual artist Sophia Wallace, aiming to educate people about the clitoris clitoral hood: located on top of the clitoris clitoris: Located at the top of the vulva where the inner labia meet, the clitoris contains thousands of nerve endings. Its only function is for sexual pleasure. corpora cavernosu: erectile tissue within the shaft of the clitoris corpus luteum: what the remaining follicle becomes after discharging its ova corpus spongiosum: the erectile tissue inside the glans crura: the internal part of the clitoris which is a wishbone like structure cystitis: a urinary tract infection (UTI) ectopic pregnancy: when an embryo gets stuck and implants in the lining of an oviduct endometriosis: the growing of endometrial tissue in abnormal places, such as in the oviducts, the ovaries, or other surfaces within the pelvic cavity endometrium: the innermost layer of the uterus external female genitalia: the anatomical structures related to the genitals on the outside of the body female ejaculation: when a fluid is released from the Skene's gland and pushed through the urethra during orgasm fibroids: tumors of smooth muscle that tend to grow on the endometrium, in the myometrium, or near the outer surface of the uterus fimbria: fingerlike extensions at the end of the oviducts Gardasil: a vaccine that protects against HPV glans: the most sensitive external part of the clitoris, which becomes engorged during sexual arousal Grafenberg spot (G-spot): located about two inches inside the vagina on the front wall (toward the abdomen) and can feel slightly more crinkled or rough than the surrounding area human papillomavirus (HPV): a sexually transmitted infection (STI) hymen: a membranous fold of skin that partially covers the vaginal introitus imperforate hymen: a hymen that completely covers the hymen and thus needs to be removed Kegel exercises: exercises that strengthen the pubococcygeus muscle labia majora (outer labia): two pairs of skin that fold down and around the vulva on the outside labia minora (inner labia): two pairs of skin that fold down and around the vulva on the inside labiaplasty: a cosmetic surgery that shortens the length of the inner labia menstruation: the period during the menstrual cycle when the endometrium lining is expelled from the body mons pubis: the area on top of the vulva covered in pubic hair (unless it has been removed) which contains a thin layer of fat to oﬀer cushioning during sex mucosa: cells that line the innermost layer of the vagina muscin ("fertile mucus"): alkaline, clear, copious, and stretchy, like raw egg white that facilitates the rapid transport of sperm into the uterus and oviducts to facilitate pregnancy myometrium: the middle layer of the uterus ovaries: two round structures each measuring about 1.5 inches in diameter oviducts: two symmetrical branches forming a pathway between the uterus and ovaries ovulation: when a follicle ripens fully and releases its ovum into the oviducts paraurethral glands: When a person with a vulva has an orgasm via stimulation of the G-spot, the paraurethral glands sometimes release a fluid that is secreted from the glands into the urethra. penis in vagina (PIV) sex: penetration of the vagina by a penis perimetrium: the outer layer of the uterus perineum: the relatively flat area that resides between the vagina and anus and can be erotically sensitive for many people with vulvas pubococcygeus (PC): pelvic floor muscle that steadily contracts during sex and helps to stiﬀen the walls of the vagina rectum: located deeper into the body behind the anus Skene's gland: the paraurethral glands sphincter muscles: muscles in the anus that control excretion tipped uterus: a uterus which slants instead toward the spine, usually as a result of genetics urethra: Located between the vaginal opening and the clitoris, its main function is to excrete urine from the bladder. urethral opening: the opening for where urine exits the body urinary tract infection (UTI): occurs when E. coli bacteria invade the urethra and bladder, causing frequent, painful urination uterus: above the vagina, leading further into the reproductive tract, where pregnancy occurs vaginal canal: the vagina - birth canal vaginal introitus: the entrance to the vagina - also known as the vaginal introitus vasocongestion: when the vagina swells with blood during sexual arousal vestibular bulbs: curved masses residing beneath the crura vulva: the anatomical structures related to the genitals on the outside of the body

Document Details

Tags

Related

Summary

Full Transcript

Upgrade to continue