Female Sexual
Anatomy
Boys have a Penis…
And girls have…?
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What questions do you have about male
or female anatomy? (write down & hand
in)
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An important difference between the clitoris
and the penis is that the clitoris
A. Cannot undergo erection
B. Has no functions other than sexual pleasure
C. Has no cover that is equivalent to the
foreskin of the penis
D. Has relatively few nerve endings compared
to the penis
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Women
A. After experiencing the refractory period can
once again achieve orgasm.
B. Experience multiple orgasms regularly.
C. Are physiologically able to be orgasmic
immediately after orgasm.
D. Must achieve orgasm to fell emotionally
satisfied and fulfilled.
Female Sex Organs
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All embryos appear as female at first
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Genetic and hormonal signals trigger the
development of male organs in those embryos
with XY chromosomes that will become male
Female Sex Organs in Utero
Female Sex Organs
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In spite of all that is known about female sex
organs, some anatomical questions remain
unknown or disputed
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Range in clitoral size
Existence and function of the G-spot
Placement of nerves in the pelvic cavity
Female Sex Organs
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Sex organs serve a reproductive function
Also serve other functions:
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Bringing pleasure to self
Giving pleasure to others
May serve to attract potential sexual partners
Sharing of genital sexuality can play a bonding role
in relationships
External Structures
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External female genitals:
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mons pubis
clitoris
labia majora
labia minora
These genitals are collectively known as the vulva
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Often referred to as “vagina,” yet the vagina is an internal
structure
External Structures
Mons Pubis
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Latin for “pubic mound:”
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The pad of fatty tissue that covers the area of the
pubic bone about 6” below navel.
Pubic hair grows on mons pubis beginning in
puberty
In many women, this area is sensitive to
stimulation
Also called mons veneris
Clitoris
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The Clitoris is the center of sexual arousal in
the female
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Contains a high concentration of nerve endings
Exquisitely sensitive to stimulation
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glans clitoris: the shaft of the clitoris
Clitoral hood: covers glans when clitoris not engorged
Structurally analogous to penis, though sole
function of the clitoris is sexual arousal, primarily
via indirect stimulation
Clitoris
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Clitoris also has an internal structure
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Two 3.5” long branches called crura
crura contain two corpora cavernosa: hollow chambers that
fill with blood and swell during arousal
The clitoris when stimulated
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Enlarges initially, then retracts beneath hood just before
and during orgasm
Follows same pattern with repeated orgasms, though
swelling is less pronounced
Labia Majora and Minora
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Labia Majora – “outer lips”
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Two folds of spongy flesh extending from the
mons pubis to the perineum and enclosing the
labia minora, clitoris, urethral opening, and vaginal
entrance
Outer: covered with pubic hair; pigmented
 Inner: hairless; oil glands
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Engorge with blood if excited
Labia Majora and Minora
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Labia Minora
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Small folds within the labia majora that meet
above the clitoris to form the clitoral hood
No hair, many oil glands; darken if sexually
aroused
They vary in appearance from woman to woman
They are sensitive to the touch and swell during
sexual arousal
They enclose the “vestibule:” the vaginal opening
External genitals during sexual
arousal
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Clitoris becomes erect
Labia minora widen
Vestibule (vaginal opening) becomes visible
Bartholin’s glans (located in the vestibule)
secrete small amount of moisture
Internal Structures
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Vagina: from Latin word for sheath
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 Structures
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Two reproductive functions of vagina
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Introitus: the lower third of the vagina
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Encompasses penis during coitus (vaginal intercourse)
Birth canal
The majority of the vagina’s nerve endings are there
Hymen: named for Roman god of marriage
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a thin membrane that partially covers introitus prior to
first intercourse or other insertion
Internal Structures
Internal Structures
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Grafenberg Spot (G-spot)
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An erotically sensitive area on front wall of the vagina midway between pubic bone and cervix
Existence somewhat controversial
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
Internal Structures
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Uterus: a hollow, thick-walled (1-inch) muscular
organ between bladder & rectum
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Accommodates developing fetus during pregnancy
Only 3” by 3” in women who have not given birth
Inner lining of uterine walls known as endometrium
Contractions to expel menses and fetus
Cervix: the tapered end of the uterus, extends and
opens into the vagina
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Secretes mucous to help or impede sperm, depending on
the monthly cycle; menstrual fluid travels through
Os – opening leading into the uterus
Internal Structures
Internal Structures
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Ovaries: gonads that produce gametes
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Produce egg cells (oocytes; ova) for reproduction
(250,000 ova each)
Two ovaries; size and shape of large almonds
Ovaries release oocytes in a process called ovulation
Fallopian tubes:
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Also known as uterine tubes of oviducts
One tube extends toward each ovary
They fan over the ovaries, and carry oocytes into the
uterus during ovulation
Figure 5.3 The female internal reproductive system (side view).
Figure 5.4 The female internal reproductive system (front view).
Other Structures
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Urethra: tube through which urine passes
Urethral opening
Perineum: area between genitals and anus
Pelvic floor
Other Structures
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Anus: opening of rectum
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Contains two sphincters (circular muscles that
open and close like valves)
Some women and men find that the tissue of the
anus is erotically sensitive
The lining of the rectum is fragile
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if engaging in anal sex play care must be taken not to
rupture the delicate tissues
Other Structures
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Breasts: both women and men have them
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Reproductive function of female breasts is to nourish
offspring through lactation
Composed of fatty tissue and 15-25 lobes that radiate
around a central nipple
Areola: the ring of darkened skin around nipple
Nipples get erect in response to touch, cold, or sexual
arousal
Many (not all) women find breast stimulation
pleasurable.
Other Structures: Breasts
Other Sex Organs
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Skin, lips, ears, back of knee, armpit, base
of neck, brain
Any area can be arousing depending on the
type of stimulation and the perceptions of
the recipient
Female Puberty
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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 (Cont.)
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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
Female Sexual Physiology:
Reproductive Hormones
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Hormones: chemical substances that serve
as messengers
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Gonadotropins act directly on gonads
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Estrogens: affect maturation of reproductive organs,
menstruation, and pregnancy
Progesterone: helps maintain the uterine lining
Female Sexual Physiology:
Reproductive Hormones
Hormone
Where Found
Functions
Estrogen
ovaries, adrenal glands,
placenta during pregnancy
Promotes maturation of
reproductive organs,
development during puberty,
regulates menstrual cycle,
pregnancy
Progesterone
ovaries, adrenal glands
Promotes breast development,
maintains uterine lining,
regulates menstrual cycle,
sustains pregnancy
Gonadotropin-releasing
hormone (GnRH)
hypothalamus
Promotes maturation of
gonads, regulates menstrual
cycle
Follicle-stimulating
hormone (FSH)
pituitary
Regulates ovarian function and
maturation of ovarian follicles
Female Sexual Physiology:
Reproductive Hormones
Hormone
Where Found
Functions
Luteinizing hormone (LH) pituitary
Assists in production of
estrogen and progesterone,
regulates maturation of
ovarian follicles, triggers
ovulation
Human chorionic
gonadotropin (HCG)
embryo and placenta
Helps sustain pregnancy
Testosterone
adrenal glands and ovaries
Helps stimulate sexual
interest
Oxytocin
hypothalamus
stimulates uterine
contractions in childbirth
Prolactin
pituitary
stimulates milk production
Prostaglandins
all body cells
mediate hormone response,
stimulate muscle contractions
Menstruation
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Uterine lining is shed if no pregnancy;
tissue and blood exit the introitus
Figure 5.7 The ovarian and menstrual cycles.
The Ovarian Cycle
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3 Phases:
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Follicular phase: Days 1-10
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Ovulatory phase: Days 11-14
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Hormones signal 10 to 20 follicles to grow on ovaries;
Estrogen matures one oocyte
Oocyte undergoes cell division; Follicle wall thins and
ruptures; oocyte enters abdominal cavity near fimbrae
of fallopian tube
Luteal phase: Days 14-28
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Estrogen levels drop; egg travels through fallopian tube
towards uterus
The Ovarian Cycle
The Ovarian Cycle: Follicular
Phase
The Ovarian Cycle: Ovulatory
Phase
The Ovarian Cycle: Luteal
Phase
Figure 5.8 The cycle of female hormones.
Menstruation
The Menstrual Cycle
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3 Phases:
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Menstrual phase (about 3-5 days)
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Proliferative phase (about 9 days)
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Endometrium is shed
Endometrial tissue, mucous, other secretions, and 2-5 oz. Blood is
expelled through vagina
Endometrium thickens, clear thin mucus secreted
Ends with ovulation
Secretory phase (14 days)
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endometrium prepares for arrival of fertilized ovum
If no fertilization, ends with shedding of endometrium
Menstrual Effects
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Emotional, physical, or behavioral changes
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The vast majority of women notice in the week prior to
menstruation
More severe symptoms are associated with Pre- Menstrual
Syndrome (PMS)
Dysmenorrhea
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pelvic cramping and pain during menstruation
Caused by prostaglandins, a type of hormone
Variations in Menstruation
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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
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Menorrhagia – excessive menses; oral
contraceptives can help control
Variations in Menstruation (Cont.)
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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 (Cont.)
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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 (Cont.)
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Risk factors for PMS and PMDD: history of
depression, sexual abuse, PTSD, smoking,
ethnicity
Menstrual Manipulation and
Suppression
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Women can experience up to 450 periods
Ways to stem growth of the endometrium:
 Continuous birth control pills
 Progesterone intrauterine devices
 Injections
Can relieve many physical symptoms related to
menstruation
Some see menses as indicating health
No medical basis to avoid sex during a period
Menopause
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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 (Cont.)
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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 (Cont.)
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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 Sexual Response
Models
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Masters & Johnson 4 Phase Model:
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excitement
plateau
orgasm
resolution
Female Sexual Response
Models
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Kaplan’s Tri-Phasic Model
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Desire
Excitement
Orgasm
Female Sexual Response
Models
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Loulan’s Sexual Response Model:
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Incorporates biological & affective dimensions
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Willingness
Desire
Excitement
Engorgement
Orgasm
Pleasure
Desire: Mind or Matter?
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Desire is the psychological component of
sexual arousal.
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A complex interaction between
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Thoughts and feelings
Sensory organs
Neural responses
Hormonal reactions
Occurs throughout many parts of the body
Women’s Sexual Excitement
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Sweating: moistening of vaginal walls
Tenting: inner 2/3 of vagina expands
Labia may enlarge or flatten & separate
Clitoris swells
Breathing and heart rate increase
Nipples become erect, breasts may enlarge
Uterus elevates
Women’s Sexual Excitement
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As excitement increases
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Clitoris retracts beneath clitoral hood
Vaginal opening decreases by about 1/3
Outer third of vagina becomes more congested,
forming the orgasmic platform.
Continued stimulation brings orgasm:
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Rhythmic contractions of the vagina, uterus, and
pelvic muscles accompanied by pleasurable
sensation.
Female Reproductive and Sexual
Health
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Gynecological Health Concerns
Cancer of the Female Reproductive Organs
Female Reproductive and Sexual
Health (Cont.)
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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
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Gynecological Health Concerns
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Most prevalent:
Endometriosis
 Toxic Shock Syndrome
 Uterine Fibroids
 Vulvodynia
 Vaginal Infections
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Endometriosis
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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
Toxic Shock Syndrome
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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
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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
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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
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Non-sexually transmitted infections can occur
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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 of the Female
Reproductive Organs
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Breast
Uterine
Cervical
Endometrial
Ovarian
Breast Cancer
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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 selfexaminations, gynecological checkups,
mammography
Breast Cancer
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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
Cervical Cancer
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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
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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
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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 (Cont.)
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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