Female Sexual
Anatomy and
Physiology
Chapter 3
Learning Objectives
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External Sex Organs
Internal Sex Organs
The Breasts
The Menstrual Cycle
Menstrual Problems
External Sex Organs
Pudendum
External female genitals
Derived from a Latin work that
means “something to be ashamed
of”
This sets the tone for
negative views of the
female genitalia
External Sex Organs
Vulva
External female structures that includes the mons veneris, the
labia majora and labia minora, the clitoris, and the vaginal
opening
Latin for “wrapper” or “covering
External Sex Organs
Labia
Majora
Large folds of skin that run downward from the mons along the
sides of the vulva
Shields inner genitalia
Labia
Minora
Hairless, light colored membranes located between the labia
majora
External Sex Organs
Clitoris
Female sex organ consisting of a shaft and glans
Shaft
Body of clitoris, approximately 1 inch long
Copora cavernosa, spongy tissue that becomes
engorged from sexual stimulation
Glans
Extremely sensitive tip of clitoris
Prepuce is the fold of skin covering the glans
External Sex Organs
Clitoris
Female sex organ consisting of a shaft and glans
Develops from the same embryonic tissue as the penis
Shaft
Body of clitoris, approximately 1 inch long
Copora cavernosa, spongy tissue that becomes
engorged from sexual stimulation
Glans
Extremely sensitive tip of clitoris
Prepuce is the fold of skin covering the
glans
Clitoridectomy
Surgical removal of the clitoral hood
• Ritualized genital mutilation considered a “rite of
passage” to womanhood in some cultures
• The removal is to ensure the girl’s chastity
• Outlawed in the US
• Creates physical and emotional scars
CRITICAL THINKING
Do you believe that disapproval of
clitoridectomy by Americans and other
Westerners shows cultural insensitivity?
Why or why not?
External Sex Organs
The Vestibule
The
Urethral
Opening
“Entranceway” within the labia minora that contains
the openings to the vagina and urethra
The opening through which urine passes form the
bladder out of the body
Its proximity to external sex organs
can pose hygienic problems for
sexually active women
Cystitis is an inflammation
of the urinary bladder
External Sex Organs
Vaginal
Opening
Introitus
Larger than urethral opening
Lies below urethral opening
Hymen
Fold of tissue across vaginal
opening
May remain intact until
intercourse
Its presence is often
considered a sign of virginity
External Sex Organs
The
Perineum
Skin and tissue that lie between vaginal opening
and anus
Contains many nerve endings and is very sensitive
Episiotomy is a surgical incision that may be made
here during childbirth to protect the vagina from
tearing
External Sex Organs
External Sex Organs
Underlying
Structures
Sphincters
Ring-shaped muscles that
surround body openings
Crura
Attach clitoris to pubic
bone
Vestibular bulbs
Cavernous structures
extending downward
along sides of introitus
Bartholin’s glands
Secrete fluid just prior to
orgasm
External Sex Organs
Underlying Structures
Internal Sex Organs
The Vagina
Tubular female
sex organ that
contains the
penis during
sexual
intercourse and
through which
a baby is born
Extends 3-5
inches back
and upward
from vaginal
opening
Has three
layers
Few nerve
endings
Inner lining (vaginal
mucosa)
Middle layer (muscular)
Outer (deeper) layer
(connects vagina to other
pelvic structures
Vaginitis
Ways to
prevent
vaginal
inflation
Wash vulva
and anus
Be certain your
partner’s genitals are
clean
Wear cotton
underwear
Avoid
pants tight
in crotch
Keep track of your
health
Avoid
sugar and
refined
carbs
Use only water soluble
lubricants
Internal Sex Organs
The Cervix
Lower end
of the uterus
Or
Opening in the
middle of the cervix
Pap Test
About the width of a straw
Allows passage of menstrual
blood and sperm
Expands to permit passage of
baby (10 cm)
Sample of cervical cells that
screens for cervical cancer and
other abnormalities
Internal Sex Organs
The Uterus (womb)
Hollow, muscular, pear-shaped organ in which a
fertilized ovum implants and develops until birth
Fundus –
uppermost part
Body – central
part
Cervix – lower
part
Internal Sex Organs
The Uterus (womb)
Three Layers
Endometrium –
innermost layer
Endometriosis – growth
of endometrial tissue
outside the uterus
Myometrium –
muscular second
layer
Perimetrium –
external cover
Internal Sex Organs
The Fallopian Tubes
Tubes that
extend from the
upper uterus
toward the
ovaries
Help nourish
and conduct ova
to uterus
Cilia (hair-like
projections) help
move ova through
tube
Ectopic pregnancy
Fertilized ovum
implants outside the
uterus, usually in the
fallopian tube
Risk increases with
age, pelvic
inflammatory disease,
tubal surgery, or the
use of intrauterine
devices (IUDs)
Internal Sex Organs
The Ovaries
Two almond-shaped organs that
produce ova and female sex hormones
Estrogen
Progesterone
Female sex hormones that
promote the development of
female sex characteristics and
regulate the menstrual cycle
Steroid hormone that
stimulates development of the
endometrium and regulates
menstruation
Follicle
Capsule within an
ovary that contains an
ovum
Ovarian Cancer
Fifth leading cancer killer of women between ages of 40 & 70
• More common in European American women than African American
• Over 22K diagnosed, over 15K die
Risk factors include
• Age
• Obesity
• Family history
• Use of certain hormones and fertility drugs
Early detection is essential
• When detected early, 89-99% survival rate
Internal Sex Organs
Internal Sex Organs
Hysterectomy
Surgical removal of the uterus
Complete hysterectomy Surgical removal of ovaries, fallopian tubes,
cervix, and uterus
Partial hysterectomy
Surgical removal of the uterus only
May be performed when women develop cancer of the uterus, ovaries,
or cervix and can relieve symptoms associated with various
gynecological disorders
Many gynecologists believe that hysterectomies are recommended too
often
Pelvic Examination
Recommended once a year
starting in late teens
External examination of genitalia
Internal
exam
Speculum – instrument that holds vaginal walls open
Pap smear
Internal palpations to examine position, size, and
possible growths on internal organs
Female Pelvic
Examination
The Breasts
Secondary sex
characteristics
Traits that distinguish women from men
Are not directly involved in reproduction
Mammary
glands
Milk-secreting glands
Areola – dark ring on the breast that encircles the nipple
Sensitive to stimulation
Breast Cancer
In the US
•Annually 230,000 women diagnosed, 39,500 die
•An estimated 410 men die each year
Risk factors include
•Family history, genetics
•High breast density
•Long-term use of HRT
•High body fat
•Physical inactivity
Early detection is essential
•Self exam, mammography
•If not spread beyond breast, 5 year survival rate is about 93%
Critical Thinking
The American Cancer Society
no longer recommends that
women need to conduct breast
self examinations as a means of
detecting breast cancer early.
Do you believe that this is a
good idea for women to do
self-exams anyhow? Why or
why not?
Breast Cancer Detection and Treatment
Mammogram
A type of X-ray that detects cancerous lumps in the breast
Lumps in the
breast
Cysts are sac-like structures filled with fluid or diseased material
Benign tumors do little or no harm and are called fibroadenomas
Malignant lumps are lethal, causing or likely to cause death
Lumpectomy
The surgical removal of a lump from the breast
Mastectomy
The surgical removal of the entire breast
The Menstrual Cycle
Menstruation
Cyclical bleeding that stems from the shedding of the uterine
lining (endometrium)
Regulated by estrogen and progesterone
Averages about 28 days but variations are common
Can be influenced by psychological factors
Regulation of the Menstrual Cycle
Hypothalamus
Brain structure that regulates body
temperature, motivation, emotion, and
hormone production
Pituitary hormones
Releases gonadotropin
that stimulate the
releasing hormone (Gn-RH)
gonads
which stimulates the
pituitary to release
gonadotropins
Regulation of the Menstrual Cycle
Pituitary
gland
Gland that secretes growth hormone, prolactin
(stimulates milk production), oxytocin (stimulates
uterine contractions in labor and the ejection of
milk during nursing), and gonadotropins
(stimulate the ovaries)
Gonadotropins
Follicle-simulating hormone (FSH)
(stimulates development of
follicles in the ovaries)
Luteinizing hormone (LH) (helps
regulate the menstrual cycle by
triggering ovulation)
Phases of the Menstrual
Cycle
Proliferative
Estrogen increases
Eggs ripen
Ovulatory
Ovulation occurs
Secretory or
Luteal
Uterus prepares for implantation
Menstrual
Shedding of uterine lining
The Menstrual Cycle
• First phase
• Endometrium
proliferates
• Follicles develop and
prepare for ovulation
Proliferative
Phase
The Menstrual Cycle
•Second phase
•Follicle ruptures
and releases a
mature ovum
Ovulatory
Phase
The Menstrual Cycle
• Third phase
• Large amounts of
progesterone and
estrogen
• Hormones signal
secretion of nutrients to
sustain implanted ovum
Secretory or
Luteal Phase
The Menstrual Cycle
• Fourth phase
• Ovum not fertilized,
hormone levels decline and
endometrium is removed
• Low estrogen results in
release of FSH, cycle starts
again
Menstrual
Phase
The Menstrual Cycle
Sex during menstruation
• No evidence that it is harmful
• Orgasmic contractions may alleviate
cramping
• Women can be sexually aroused at any
time during cycle
• Research indicates this peaks at ovulation
The Menstrual Cycle
Menopause
“Change of life”
Menstruation ceases
Perimenopause
Start of menopause
Climacteric
Long-term process of decline in the reproductive
capacity of the ovaries
The Menstrual Cycle
Symptoms resulting from
estrogen loss
Night sweats
Headaches
Decreased
vaginal
lubrication
Osteoporosis
Hormone Replacement Therapy
Synthetic replacement of
estrogen and/or
progesterone
Reduces symptoms of
menopause
Mixed research findings
• May increase risk of cancer,
stroke, blood clots
• May reduce/increase risk of
heart disease
• Fewer women on HRT now
There are other methods
to relieve symptoms
Menstrual Problems
Amenorrhe
a
• Absence of
menstruatio
n
• Is a
symptom of
anorexia
nervosa
Primary
Secondary
• Lack of
menstruatio
n in a
woman who
has never
menstruated
• Lack of
menstruatio
n in a
woman who
has
previously
menstruated
Menstrual Problems
Premenstrual Syndrome
Physical and psychological
symptoms that may afflict women
during the four to six day interval
that precedes menstruation
Menstrual Problems
Premenstrual Dysphoric Disorder (PMDD)
A diagnosis used by the American
Psychiatric Association to describe cases of
PMS that are characterized by severe
changes in mood and impaired functioning
at work or school or in social relationships
Menstrual Problems
PMDD
Symptoms
Feeling sad, hopeless, or worthless
Tension, anxiety, edginess
Frequent crying, significant mood changes
Irritability and anger causing interpersonal conflict
Decreased interest in activities and relationships
Difficulty concentrating
Fatigue, lethargy, lack of energy
Notable changes in appetite
Feeling overwhelmed or out of control
