Wk 2A- Human Sexuality

Sexuality

• Is a multidimensional phenomenon that includes feelings, attitudes, and actions.

• It encompasses and gives direction to a person’s physical, emotional,social, and intellectual responsesthroughout life.

Concept of Human Sexuality

1. Biologic Gender

   • a person’s chromosomal sex male (XY) or female (XX)

2. Gender Identity

   • the inner sense a person has of being male or female

3. Gender Role

   • is the male or female behavior a person exhibits

Types of Sexual Orientation

• Sexual Gratification

  • is experienced in several ways and what is considered normal varies greatly among cultures, although general components of accepted sexual activity are that it is an activity of adults and privacy, consent, and lack of force.

1. Heterosexual

   • is a person who finds sexual fulfilment with a member of the opposite gender.

2. Homosexual

   • is a person who finds sexual fulfilment with a member of his or her own sex.

   • Many homosexual men prefer the use the term “gay” and “lesbian” to a homosexual woman

   • More recent terms are “men who have sex with men” (abbreviated as “MWM”) and “women who have sex with women” (WWW).

3. Bisexuality

   • is a person who achieves sexualsatisfaction from both homosexual and heterosexual relationships.

4. Transsexual/Transgender

   • is an individual who, although of one biologic gender, feels as if he or she is of the opposite gender

   • Such people may have sex change operationsso that they appear cosmetically as the gender they feel that they are.

Types of Sexual Expression

1. Sexual Abstinence (Celibacy)

   • is separation from sexual activity

2. Masturbation

   • is self-stimulation for erotic pleasure, and it can also be a mutually enjoyable activity forsexual partners

   • Children 2-6 y/o – discover masturbation as an enjoyable activity as they explore their bodies

   • School- age children and adolescent – continue to use masturbation for enjoyment to relieve tension

3. Erotic Stimulation

   • is the use of visual materials for sexual arousal.

   • Magazines, photographs, DVD’s

4. Fetishism

   • sexual arousal resulting from the use of certain objects or situations for stimulation.

5. Transvestite

   • is an individual who dresses in the clothes of the opposite sex.

   • can be heterosexual, homosexual, or bisexual, married

6. Voyeurism

   • is obtaining sexual arousal by looking at another person’s body.

7. Sadomasochism

   • involves inflicting pain or receiving pain to achieve sexual satisfaction

   • Masochism – receiving pain to achieve sexual satisfaction

8. Exhibitionism

   • is revealing one’s genitals in public

9. Obscene Phone Calling

   • telephone call where a person derives sexual pleasure by using sexual or foul language to someone

10. Beastiality

    • is sexual relations with animals

    • Zoophilia - attraction between human and non-human animals

11. Pedophiles

    • are individuals who are interested in sexual encounters with children

Human Sexual Response

• feelings and attitudes aboutsex vary widely,the sexual experience is unique to each individual, butsexual physiology has common features.

Stages of Human Sexual Response

1. Excitement

   • occurs with physical and psychological stimulation that leads to arterial dilation and venous constriction in the genital area.

   • e. g sound, emotion, sight or thought

   Women: vasocongestion causes

   1. Clitoris increase in size.

   2. Mucoid fluid appear on vaginal wall as lubrication.

   3. Vagina widens in diameter, increases in length.

   4. Nipples become erect.

   Men:

   1. Penile erection occurs

   2. Scrotal thickening and elevation of the testes.

   3. Both sexes – HR, RR and BP increases.

2. Plateau

   • intensification of excitement, reached just before orgasm.

   Women:

   1. Clitorisis drawn forward and retracts under the clitoral prepuce.

   2. Increased nipple elevation

   Men:

   1. Distention of the penis

   2. Heart rate increases to 100-175 bpm

   3. Respiratory rate 40 breaths/min

3. Orgasm

   • experienced asintense pleasure affecting the whole body (Pleasurable physical sensation)

   • A vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion.

   Women:

   1. The average number of contraction for a woman is 8-15 contractions at interval of 1 every 0.8 seconds

   Men:

   1. Muscle contraction of seminal vessels and prostate projectsemen into the urethra.

   2. Followed by 3-7 Propulsive ejaculatory contractions occurring atthe same time interval asthe woman which force semen from the penis

4. Resolution

   • is a 30 - minute period during which the external and internal genital organ returns to an unaroused state

   • Male – refractory period occurs during which further orgasm is impossible

   • Female – it is possible for women to have additional orgasm immediately after the first

Disorders of Sexual Functioning

1. Inhibit Sexual Desire

   • lessened interest in sexual relationsis normal in some circumstances.

   Causes:

   1. Death of a family member, divorce

   2. Stressful job change

   3. Side effects of medicines

   4. Chronic diseases(peptic Ulcers, pulmonary disordersthat causesfrequent pain or discomfort)

   5. Perimenopause - decrease in sexual desire

   Treatment:

   • administration of androgen (testosterone) to women can improve interest in sexual activity

   • Estrogen therapy

2. Failure to Achieve Orgasm

   Causes:

   1. Poorsexual technique

   2. Concentrating too hard on achievement

   3. Negative attitudestoward sexual relationships

   Treatment:

   • Instruction and counselling aboutsexual feelings and needs.

   • Female Viagra ( “Pink” Viagra)

     • Men - enhances sexual arousal by increasing the blood flow to the penis

     • Female - increasing the blood flow to the female genitals and thereby producing better arousal, sensation and lubrication in the genital area

3. Erectile Dysfunction (Impotence)

   • is the inability of a man to produce or maintain an erection long enough for penetration or partnersatisfaction

   • It affects as many as 40% of men – 40 years old

   • 65% of men by age 65 years old

   Causes:

   1. Physical (Aging, atherosclerosis, diabetes)

   2. Side effects of certain drugs (Antidepressants)

   Treatment

   • Drugs prescribed for Erectile dysfunction:

     Sildenafil (Viagra)

     Tadalafil (Cialis)

     Vardenafil (Levitra)

   • Vacuumerection devices orsurgical implants

   • Testosterone injections, intracavernosal injections of prostaglandin

   • Herbal products - Fennel extractsfor women which improve sexual libido

4. Premature Ejaculation

   • Testosterone injections, intracavernosal injections of prostaglandin d. Herbal products

   • Fennel extractsfor women which improve sexual libido

   Causes: Psychological

   1. Masturbating to orgasm (Orgasm is achieved quickly because of lack of time)

   2. Doubt about masculinity and fear of impregnating a partner

   Treatment

   • Sexual counselling for both partnersto reduce stress

   • Serotonergic antidepressants
     Mirtazapine – may be helpful for alleviating the problem

5. Persistent Sexual Arousal Syndrome

   • occursin women and is excessive and unrelenting sexual arousal in the absence of desire

   Causes:

   • Triggered by medications

   • Psychological factors

   • Herbal remedies(ginkgo biloba) – have arousal effects

   • Overactive bladder

6. Vaginismus

   • is involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted that prohibits penile penetration

   Causes:

   • Unknown

   • occur in women who have been raped

   • result of early learning patterns in which sexual relations were viewed as bad or sinful

   Management:

   • Sexual or psychological counselling to reduce this response

7. Dyspareunia

   • pain during coitus

   Causes

   1. Endometriosis (abnormal placement of endometrial tissue)

   2. Vestibulitis – inflammation of the vestibule)

   3. Vaginal infection

   4. Hormonal changes ( Menopause and cause vaginal drying

   Treatment:

   • Encouraging open communication between sexual partners can be instruments in resolving the problem