Physiology of Female and Male Sexuality

Physiology of Female and
Male Sexuality
Dr. Martha Tara Lee, D.H.S.
16 May 2016
Symposium: Sex and the Spine: All You Ever Wanted to Know about Sex and the Spine but were
Afraid to Ask

Dr. Martha Tara Lee
Clinical Sexologist
• Doctorate in Human Sexuality
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Certificate in Sex Therapy
• Certitificate in Practical
Counselling
• Cert in Life Coaching

Agenda
• Sex Characteristics
• Male Reproductive
System
• Female Reproductive
System
• Sexual Response Cycle
• Gender Differences in
Desire and Erotic Stimuli

Where It All Begins: Sex
Characteristics
• There are two types of sex characteristics:
– Primary sex characteristics are the
reproductive organs.
– Secondary sex characteristics are the body
attributes of each sex.
• Sexual dimorphism refers to the extent to which
the secondary characteristics are evident between
women and men.

Secondary Sex Characteristics:
Human Species
• Human sexual dimorphism falls
somewhere in the middle range
of all animal species
• Women have the following
– Pendulous breasts for lactation
– Wide pelvis for childbirth
• Men have the following
– Facial hair
– Greater grip strength
– Larger hearts and lungs
– Narrow pelvis

Male Reproductive System
External Organs
1) Penis
2) Scrotum
Internal Organs
1) Testes
2) Epididymis
3) Vas Deferens
4) Ejaculatory Duct
5) Seminal Vesicle
6) Prostate Glands
7) Cowper’s Gland

External Organs
1.) Penis - male organ of copulation and urination
• Parts:
A) Shaft/ body
B) Glans penis – enlarged end; most sensitive
C) Prepuce/ foreskin – fold of retractable skin
covering the glans and is
removed during circumcision
- if it can not be retracted:
phimosis
D) Urethral meatus – slit like opening located
at the tip of the penis; passageway
for both semen and urine

External Organs
2.) Scrotum – saclike structure containing the
testes
– Darker coloration than the rest of the
body
– Covered with sparse hair and wrinkled
– Environmental temperature affects the
scrotum: too hot---the dartos muscle
relaxes and the testes hangs or descend
away from the body
– Too cold ----- the testes contracts and pull
closer to the body
– Spermatogenesis is affected by extremes
of temperature
– Testosterone production is not affected

Internal Organs
1.) Testes – oval shaped glandular organ
lying within the abdominal cavity in
early fetal life and descend in the
scrotum after 28 weeks gestation
• Undescended testes /cryptorchidism
• Functions:
1. Hormone production – testosterone
that stimulates spermatogenesis
and responsible for the secondary
males characteristics
2. Spematogenesis – production and
maturation of sperm cells; begins in
puberty and continue until old age

Internal Organs
Parts of the testes:
1) seminiferous tubules – long
coiled tubes where
spermatogenesis takes place
2) Leydig/interstitial cells –
produce testosterone
3) Sertoli cells – supporting cells
which play a role in sperm
transport

Internal Organs
2) Epididymis - long coiled tube
approximately 20 feet long;
where sperm travels for 12- 20
days
• Takes 64 days for the sperm
cells to mature; rationale why
therapy for azoospermia and
oligospermia becomes effective
only after 2 months
• Epididymitis – inflammation of
the epididymis

Internal Organs
3) Vas Deferens - passageway
of the sperm cells from the
epididymis; contractile power
of this area propels the
spermatozoa to the urethra
during ejaculation
• Cut during vasectomy
4) Ejaculatory Duct -
passageway for the semen

5) Seminal Vesicle - a pouch like
organ lying behind the
bladder and in front of the
rectum
6) Prostate Gland - walnut shaped
body lying below the
bladder
- Surrounds the urethra and
the 2 ejaculatory ducts
Internal Organs

5) Seminal Vesicle - A pouch like organ
lying behind the bladder and in front of
the rectum
6) Prostate Gland - Walnut shaped body
lying below the bladder
- Surrounds the urethra and the 2
ejaculatory ducts
7) Cowper’s Gland - Located behind the
prostate gland
- Secretes an alkaline secretions that
helps to neutralize the acidic nature of
the urethra and provides lubrication
during intercourse
- Bulbourethral Glands
Internal Organs

Semen
Seminal Fluid
–An organic fluid that may contain
spermatozoa
–It contains fructose and other elements of
seminal fluids that promote survival of the
spermatozoa and provide a medium
through which spermatozoa can move or
swim

Semen
A mixture of secretions from:
1. Ejaculatory ducts
2. Seminal Vesicles
3. Prostate glands
4. Cowpers Gland
Semen Color:
Translucent with white,
grey or yellowish tint; if
reddish: hematospermia

Semen
Semen Quality: measured
by its ability to
accomplished fertilization
Normal volume :
– 2-5ml/ejaculation
– 100 million sperm cells/ml
A sperm count of below 20
million is associated with
infertility and sterility

Sperm Motility Grading
4: Progressive motility
3: Non linear motility;
moves forward but
in crooked motion
2: More on tails
1: Immotile

Female Reproductive System
External Reproductive Organs
1) Mons Veneris/ Mons Pubis
2) Labia Majora
3) Labia Minora
4) Clitoris
5) Vestibule
6) Vaginal Opening
7) Urethral Opening
8) Hymen
9) Skene’s Glands
10) Bartholin’s Glands
11) Fourchette
Internal Reproductive
Organs
1) Vagina
2) Uterus
3) Fallopian Tubes/Oviducts
4) Ovaries

Female Reproductive System
Vulva
• Structures that form the
entire female external
reproductive genitalia
• From the latin word
meaning for covering

Features of the vulva
The clitoris and labial folds are labelled.

Mons Pubis
• Pad of adipose tissue located over the
symphysis pubis (pubic bone joint)
Function: protect the junction of pubic bone from
trauma
- Richly supplied with sebaceous glands
- Childhood: hairless and smooth
- Puberty: covered by a triangular coarse of
curly hairs (escutheon)
- Pattern of hair growth: Female: Triangular;
Male: Diamond-shaped
- Growth of pubic hair is stimulated by
Testosterone while the pattern of hair growth is
governed by estrogen

Labia Majora
• Two thick folds of adipose tissues
originating from the mons pubis and
terminating in the perineum
• It unites anteriorly to form the anterior
commissure and posteriorly to form the
posterior commissure
• -Its outer surface is thick and covered by
hair; inner surface is smooth and moist
• - Main function: provide covering and
protection to the external organs located
under it
• -Nulliparous women: in close apposition to
each other; but tends to gape wider after
birth

Labia Minora
• Two thin folds of connective tissue that
joins anteriorly to form the prepuce and
posteriorly to form the fourchette
• It is most highly vascular, sensitive and
richly supplied with sebaceous glands
• Nulliparous women: covers the vaginal
introitus, vestibule and urethra
• Obliterated during vagina

Clitoris
• Highly sensitive and erectile tissue
situated under the prepuce of the labia
minora
• Known as the “seat of woman’s sexual
arousal and orgasm” being the most
sensitive part of the female external
genitalia
• Covered by a fold of skin called
prepuce; Sensitive to both touch and
temperature

Vestibule
Triangular space between the
Labia minora where the six (6) openings
are located:
1) Urethral Opening
2) Vaginal Opening
3) Opening of Bartholin’s Glands
4) Opening of Skene’s Glands

Vaginal Opening
• The external opening of the vagina
located just below the urethral meatus
• Grafenberg or G spot is a very sensitive
area located at the inner anterior
surface of the vagina

Urethral Opening
• External opening of the female urethra
located in the midline of the vestibule
just below the clitoris
• Shortness of the female urethra makes
women more susceptible to UTI than
men

Hymen
• Thin but tough and elastic semicircular
membrane that covers the opening of the
vagina; often torn during the first sexual
contact
• Women may be born without a hymen; can
be torn by active sports and tampon insertion
• Imperforate Hymen – a hymen that
completely covers the vaginal opening
preventing coitus and passage of menstrual
discharge
• Hymenotomy/ Hymenectomy – is the surgical
incision of an imperforate hymen

Skene’s Glands
• Paraurethral glands; minor
vestibular glands
• A pair of glands situated on
each side of the urethral
meatus
• Its secretion help to lubricate
the external genitalia during
coitus

Bartholin’s Glands
• Vulvovaginal glands; major
vestibular glands; paravaginal
glands
• Situated on each inner side of the
vagina
• Lubricates the external vulva
during coitus with an alkaline
secretions that enhances sperm
survival

Fourchette
• The ridge of tissue
formed by the posterior
joining of the two labia
minora and majora;
sometimes cut during
episiotmomy
• Episiotomy –
perineotomy; surgically
planned incision on the
perineum and the
posterior vaginal wall
during the second stage
of labor

Vagina
• A tubular musculomembranous
structure about 8-12 cm long
that extends from the vulva to
the uterus
• Functions:
• a) Excretory canal of the
uterus through which
uterine secretions and
menstrual flow escape
• b) Female organ of
copulation
• c) Forms part of the birth
canal
Internal Reproductive Organs

Vagina
• Rugae – transverse folds of
skin in the vaginal wall -
absent in childhood
- appear at puberty
- disappear at
menopause
• Function: Allow the vaginal
canal to stretch and enlarge
during deliver

Uterus
• a hollow muscular canal resembling an
inverted pear that is situated in the true
pelvis
Functions:
a) Organ of reproduction (main) –
serves for reception, implantation,
retention and nutrition of the fetus
b) Organ of menstruation
c) Uterine contraction for the expulsion
of the fetus during delivery and to seal
torn blood vessels after placental deliver

Uterus
• Intrinsic motility – capable of
contraction even if the nerves that
supply them is being cut
• Parts of the uterus
• 1) Fundus
• 2) Cornua
• 3) Corpus
• 4) Isthmus
• 5) Cervix

Layers of the Uterus

Fallopian Tubes
• pair of tube like structures originating from the
cornua of the uterus with distal ends located
near the ovaries
• Parts:
1) INTERSTITIAL/INTRAMURAL
2) ISTHMUS – narrowest portion; site for
tubal ligation
3) AMPULLA – middle, widest part; site for
fertilization
4) INFUNDIBULUM – has fimbrae (funnel
shaped opening at the distal end)

Different Stages of Follicles

Layers of the Ovary

Anatomy of the human female breast
Major features of the female breast are illustrated

Sexual Response Cycle
Phase 1: Excitement
• General characteristics of the excitement phase, which can last from a few
minutes to several hours, include the following:
– Muscle tension increases.
– Heart rate quickens and breathing is accelerated.
– Skin may become flushed (blotches of redness appear on the chest
and back
– Nipples become hardened or erect.
– Blood flow to the genitals increases, resulting in swelling of the
woman's clitoris and labia minora (inner lips), and erection of the man's
penis.
– Vaginal lubrication begins.
– The woman's breasts become fuller and the vaginal walls begin to
swell.
– The man's testicles swell, his scrotum tightens, and he begins
secreting a lubricating liquid
Source:
http://www.medicinenet.com/sexual_response_cycle_phases_of_sexual_response/page2.htm

Phase 2: Plateau
• General characteristics of the plateau phase, which extends to the
brink of orgasm, include the following:
– The changes begun in phase 1 are intensified.
– The vagina continues to swell from increased blood flow,
and the vaginal walls turn a dark purple.
– The woman's clitoris becomes highly sensitive (may even
be painful to touch) and retracts under the clitoral hood to
avoid direct stimulation from the penis.
– The man's testicles are withdrawn up into the scrotum.
– Breathing, heart rate, and blood pressure continue to
increase.
– Muscle spasms may begin in the feet, face, and hands.
– Muscle tension increases.
Source:
http://www.medicinenet.com/sexual_response_cycle_phases_of_sexual_response/page2.htm

Phase 3: Orgasm
• Peaking of sexual pleasure
• Release of sexual tension
• Rhythmic contraction of the perineal muscles and the pelvic
reproductive organs.
• A subjective sense of ejaculatory inevitability triggers men's
orgasms. The forceful emission of semen. 4 to 5 rhythmic
spasms of the prostate, seminal vesicles, vas, and urethra.
• In women, orgasm is characterized by 3 to 15 involuntary
contractions of the lower third of the vagina and by strong
sustained contractions of the uterus, flowing from the fundus
downward to the cervix.

Phase 4: Resolution
• Resolution consists of the disgorgement of blood from the
genitalia (detumescence). Body back to its resting state.
• If orgasm occurs: resolution is rapid, a subjective sense of
well-being, general and muscular relaxation.
• If orgasm does not occur : resolution may take from 2 to
6 hours and may be associated with irritability and
discomfort.
• After orgasm, men have a refractory period (several
minutes to many hours) when they cannot be stimulated to
further orgasm. Women do not have a refractory period and
are capable of multiple and successive orgasms.

1. Hypogastric nerve - transmits from the uterus and the cervix in women
and from the prostate in men
2. Pelvic nerve - transmits from the vagina and cervix in women and from the
rectum in both sexes
3. Pudendal nerve - transmits from the clitoris in women and from the
scrotum and penis in men
4. Vagus nerve - transmits from the cervix, uterus and vagina. Does not pass
through the spinal cord (making it possible for some women to achieve
orgasm even though they have had complete spinal cord injuries)
Orgasms after SCI
The Journal of Sexual Medicine (July 2011) Barry Komisaruk,
Rutgers University
“… consider that the vagus nerve connects all of these functions, throat, chest,
cervix and uterus, and that when they are utilized to the fullest extent of the nerve,
and all of its endings, the nerve becomes so activated that it produces out of body
pleasure that is more than the sum of its parts.” - Suzie Heumann
http://www.huffingtonpost.com/suzie-heumann/what-do-singing-throats-
a_b_268642.html

Orgasmic Possibilities
“Orgasmic sensations are reported to be produced also by
stimulation of other body components. Men and women with
spinal cord injury commonly describe a region of skin
hypersensitivity near the level of the injury. When this skin is
stimulated inadvertently (e.g. by clothing brushing it) it feels
aversive. However, if the skin region is stimulated in the ‘right’
way by the ‘right’ person, it can produce orgasmic feelings….
…orgasms elicited by stimulation also of lips, hand, knee and
anus occurring during dreaming sleep, of phantom limbs, from
electrical or chemical stimulation of the septum, amygdala or
thalamus of the brain and of the spinal cord”
https://thepsychologist.bps.org.uk/volume-21/edition-2/orgasm

• “Thinking Off” by Barbara
Carrellas
https://www.youtube.com/watc
h?v=qeMMRAwBXE8
• Energy Orgasm by Martha Tara
Lee
https://www.youtube.com/watc
h?v=8fRYnyRED8Q
Thinking Off

Six Points for Sex
1. Preparation
2. Position
3. Duration
4. Concentration
5. Relaxation
6. Frequency

Gender Differences in Desire
and Erotic Stimuli
• Sexual impulses and desire
exist both in men and women
but males generally possess a
higher baseline level of desire
than do women
• Men respond sexually to visual
stimuli of nude or barely dressed
women.
• Women report responding
sexually to romantic stories with
a tender, demonstrative hero
whose passion for the heroine
impels him toward a lifetime
commitment to her .

Gender Differences in Desire
and Erotic Stimuli
• Woman's subjective sense of arousal is not always
congruent with her physiological state of arousal.
• Women’s sense of excitement may reflect a readiness
to be aroused rather than physiological lubrication.
Conversely, she may experience the physical signs of
arousal without being aware of them.
• This situation rarely occurs in men.

Trends
• Labioplasty: Reduction
• Vaginoplasty: Tightening/ Rejuvenation
• Vulvoplasty
• Hymenoplasty: Repair/ reconstruction
• Labia Dye

From the book "Sex for One: The Joy of Selfloving" by Betty Dodson.
Copyright 1987, 1983, 1974 By Betty Dodson.

Thank you!
Dr. Martha Tara Lee, D.H.S.
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email: drmarthalee@eroscoaching.com

Physiology of Female and Male Sexuality

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