SEX AT THE ANATOMICAL LEVEL

1. SEX AT THE ANATOMICAL LEVEL • Important for understanding behaviour. • Only clearly male and female types presented but there are variations. • Within clear male and female types also great variability. • Self-examination, self-knowledge important.

2. Sex Breasts Nipples Penis Testes Erection Sperm Semen Vulva Clitoris Vagina Intercourse Ejaculation Orgasm Fellatio Cunnilingus Masturbation Respect and Decency SEX AT THE ANATOMICAL LEVEL

3. SEX AT THE ANATOMICAL LEVEL • TRUE OR FALSE? • A name for the external female genitals is derived from Latin meaning “something to be ashamed of”. • Women, but not men, have a sex organ whose only known function is sexual pleasure. • It can be determined if a woman is a virgin by examining her hymen.

4. SEX AT THE ANATOMICAL LEVEL • TRUE OR FALSE (CONT’D) • Women with large breasts produce more milk than women with small breasts. • Many men who are paralyzed below the waist can attain erection and ejaculate. • Men can have orgasm without ejaculating.

5. SEX AT THE ANATOMICAL LEVEL • TRUE OR FALSE (CONT’D) • Men with large penises give women more sexual pleasure than men with small penises. • Women’s genitals are naturally foul smelling. • Male and female circumcision are almost identical. • Only middle-aged people need to practice breast or testicular self-examination. • There is a positive correlation between number of sexual partners a woman has and cervical cancer incidence.

7. SEX AT THE ANATOMICAL LEVEL FEMALE EXTERNAL ANATOMY • Mons veneris or mons pubis • Perineum: pelvic floor – Kegel muscles • Vulva: • clitoris, hood • labia majora (large, outer lips) • labia minora (small, inner lips) • urethral meatus (for urine) • vaginal opening: introitus • hymen (not proof of virginity)

12. SEX AT THE ANATOMICAL LEVEL • Clitoridectomy: surgical removal of the clitoris (affects orgasmic capacity). Last one performed in U.S. in 1964, to cure masturbation. • Infibulation: surgical removal of clitoris and labia, closing of the introitus. • Usually no anesthetic, poor hygiene, sepsis: pain, infections, painful intercourse, difficult birth, high rate of stillbirths, life-threatening.

13. SEX AT THE ANATOMICAL LEVEL • Pelvic Floor: • PC or pubococcygeus muscle: contracts during orgasm. Iliococcygeus muscle. • Kegel exercises: contract PC muscle voluntarily. A stronger PC muscle leads to better orgasms.

14. SEX AT THE ANATOMICAL LEVEL FEMALE INTERNAL ANATOMY • Vagina, a.k.a. birth canal • Graefenberg spot (G spot) • Cervix • Uterus, lined by endometrium (endometriosis) • Fallopian tubes, fimbria • Ovaries: produce ova (ovum: egg), follicle produce estrogen, progesterone.

18. SEX AT THE ANATOMICAL LEVEL FEMALE INTERNAL ANATOMY (CONT’D) • Hysterectomy: surgical removal of uterus. • Oophorectomy: surgical removal of ovaries • Too many done in N. America. • Surgical complications (short and long term) but also cervix and uterus important for sexual enjoyment, arousal and orgasm. • Without uterus, abdominal organs prolapse, may protrude into vagina. • Recurring infections, pain, discomfort.

19. SEX AT THE ANATOMICAL LEVEL DISEASES OF FEMALE ORGANS • Cervical cancer: STD – 33% in NL – condom • Uterine cancer: rare, mostly benign tumours • Fallopian tubes: mostly blockages due to scar tissue, due to STDs, infertility • PID: pelvic inflammatory disease: can affect internal reproductive organs, different pathogens, most often STDs, infertility

20. SEX AT THE ANATOMICAL LEVEL • Breasts • Mammary gland: lobules, ducts and sinuses • Fat tissue • Areola, nipple • Breast cancer: self-examination – lifestyle, genes • Augmentations: health problems, compromises breastfeeding. • Reduction: for comfort, can also compromise breastfeeding.

25. SEX AT THE ANATOMICAL LEVEL MALE EXTERNAL ANATOMY • Penis or phallus: • glans • prepuce (foreskin) (smegma) • coronal ridge • frenulum • urethral opening • Scrotum (contains testicles)

29. SEX AT THE ANATOMICAL LEVEL MALE EXTERNAL ANATOMY (Cont’d) • Circumcision: ritual (religious) or medical; controversial. • Pros: better genital health (partners too). • Cons: newborns feel pain (anesthetic), surgical accidents. • No evidence of decreased sensitivity.

30. SEX AT THE ANATOMICAL LEVEL • Penis • Externally: varying shapes and lengths. • Effect on sex: psychological. • But since you asked … • Average flaccid (non-erect) size: • 2.8 to 4.3 inches • Average erect size: • 4.9 to 6.9 inches • smaller penises increase in size during erection more than larger ones • e.g. 3 in.  6 in. (3 in. increase) 4 in.  6.5 in. (2.5 in. increase) • many women prefer average or under average penises and are somewhat apprehensive about large penises

31. SEX AT THE ANATOMICAL LEVEL • Scrotum: • varied colour, size and texture. Usually asymmetrical. • Can ascend or descend (involuntary muscle control: dartos and cremaster muscle) depending on temperature (internal and external) and state of arousal

32. SEX AT THE ANATOMICAL LEVEL • Male Internal Structures: • Testes (testicles). • Seminiferous tubules (make and store sperm). • Interstitial cells in testes: make testosterone. • Epididymis: store sperm till maturity. • Vas Deferens: carry sperm to urethra. • Seminal Vesicles: make seminal fluid. • Prostate: makes white fluid, alkaline. • Cowper’s glands: more alkaline fluid.

35. SEX AT THE ANATOMICAL LEVEL IMPORTANCE OF TEMPERATURE FOR SPERM PRODUCTION • Testes descend prenatally from pelvis to scrotum. Need to be about 2°C (6°F) cooler than body temperature for optimal sperm production • Undescended testes: cryptorchidia, leads to infertility – can be corrected surgically.

36. SEX AT THE ANATOMICAL LEVEL IMPORTANCE OF TEMPERATURE FOR SPERM PRODUCTION • Sperm count can decrease (infertility?) if: • long hot baths • prolonged fever • long distance truck drivers, any long sitting • steel workers close to furnaces • jockey shorts, tight jeans

37. SEX AT THE ANATOMICAL LEVEL IMPORTANCE OF TEMPERATURE FOR SPERM PRODUCTION (Cont’d) • Other causes of low sperm count: • severe stress • high altitudes • radiation • some types of chemical pollution

38. SEX AT THE ANATOMICAL LEVEL • Semen: • Or ejaculate: spermatozoa plus fluids from glands • About 3-5 cc average with 40-100 million sperm • Low sperm count: under 20 million some say 10 million • Count varies from study to study • Quality of sperm very important

39. SEX AT THE ANATOMICAL LEVEL • Issues associated with male genitals: • circumcision is associated with lower incidence of HIV and of penile cancer. • prostate cancer: common in older men, usually slow progress, should have checks after 45 or earlier if symptoms. • fracture of the penis: rare, but can happen, usually during sex when fully erect if body weight suddenly put on penis

40. SEX AT THE ANATOMICAL LEVEL • Testicular cancer: • Age range: 15-35 • Could be unrelated to lifestyle or family history or general health status, but higher incidence if • family history • cryptorchidia (undescended testicles) • Self examination during shower • Possible signs: • lumps • pain in scrotum • feeling of heaviness in lower abdomen or scrotum • dull ache in lower abdomen or groin • Very treatable, 98% success rate when discovered early

42. SEX AT THE ANATOMICAL LEVEL • Issues associated with male genitals: (Cont’d) • cancer of the penis: rare can be fatal if not treated early. Risk factors are • over 50 • history of multiple sex partners • history of STDs • poor genital hygiene • smoking

43. SEX AT THE ANATOMICAL LEVEL • Issues associated with male genitals: (Cont’d) • priapism: prolonged erection due to constant vibration (e.g. snowmobile), some pathological conditions, use of drugs like Cialis. Painful. Priapo (Greek) or Priapus (Latin: God of Fertility

44. SEX AT THE ANATOMICAL LEVEL • Some men get penile and/or testicular surgical augmentation. No long term studies yet, but reports of dissatisfied patients. • Cosmetic surgery is also being used extensively to alter female genitalia. • In the past, some women needed genital cosmetic surgery for medical reasons (e.g. a botched episiotomy, an accident) but rarely done. • More recently, women from certain immigrant groups requested re-hymenization (reconstruction of the hymen) due to strict rules about virginity before marriage. Even some Western women requested it upon finding out, some as a wedding anniversary gift for their husbands!

45. SEX AT THE ANATOMICAL LEVEL • The greatest influence has been the popularization of pornography on the Internet – seeing “perfect” vulvas. Tenfold increase in recent years. • Available modifications (referred to as “designer vaginas”): • Labioplasty: reduction of the labia minora • Plumping up labia with shots of the woman’s own fat tissue • Collagen shots to increase the size of the G-spot (for extra sexual pleasure) • Reduction of the clitoral hood • Tightening of the vagina and of the whole perineal area

46. SEX AT THE ANATOMICAL LEVEL • Dr. Lenore Tiefer calls this “culture disease of self-consciousness”. • There can be post-surgical complications, long and short-term and disfigurement from poor surgical techniques. Laser can be used instead of a scalpel, but there are risks with this method as well.