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This document contains chapters 1 to 3 CHAPTER 1 CULTURAL, HISTORICAL, AND RESEARCH PERSPECTIVES ON SEXUALITY TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 1: Cultural, Historical, and Research Perspectives On Sexuality CULTURE AND SEXUALITY Teaching Suggestions: 1(A), 2(A), 4(A), 5(A), 1(B), 1(C), 3(B),3(C), 4(B), 6(A), 8(A,B,C), 9(A,B) Learning Objectives: #1,2,3,4,5,6,7,8,9,10,11,12, 13,14,15 MILESTONES IN SEX RESEARCH: A BRIEF HISTORICAL SURVEY Teaching Suggestions: 3(A), 7(A), 7(B), 9(C,D) Learning Objectives: #16,21,22,23,24,25,26,27,28, 29, 31, 32,33 THE METHODS OF SEXOLOGICAL RESEARCH Teaching Suggestions: 1(D), 7(C), 7(D), 9(E) Learning Objectives: #34,35,36,37,38,39,40,41,42, 43,44,45 LEARNING OBJECTIVES After reading this chapter, students should be able to: Consider the ambivalent and conflicting messages about sex perpetuated in Western Cultures. Discuss the relationship between education and sexual decision-making. Describe the influence of homogeneous and heterogeneous cultures on sexuality. Describe the European cultural influence on North American sexuality. Discuss the impact of the sexual revolution.. Discuss factors leading to the counterculture movement and how it impacted the sexual revolution. Describe how and why the changing role of men and women impacted cultural perception of sexuality. Discuss how technological advances in birth control and medicine affected sexuality. Describe the shift in attitudes and politics toward sexual orientation and gender identity. Discuss the changing cultural perception of the relationship between romance and commitment in Western cultures. List the three categories of attitudes toward sexuality in the US today. Discuss the role of the internet and its affect on sexuality. Discuss global perspectives on sexuality. State four examples of how HIV and AIDS impacted human sexuality. Describe how the media affects sexuality. Describe how politics and family values are involved with the social dimensions of sexuality. Briefly describe the perception of Krafft-Ebing toward masturbation. Describe attitudes regarding same-gender sexual expression. Identify three positive and affirming concepts about human sexuality that have emerged within the last 30 years and the contributing factors of these concepts. Describe the historical perceptions regarding sex and romance. Describe and contrast the views regarding comprehensive sexuality education. Consider when sex research became a credible scientific course of study and define “sexology”. List three sex researchers from the 19th century that significantly impacted and shaped public concepts about human sexuality. Identify the sex research focus of the early and mid-20th century Describe the influence of Krafft-Ebing, Freud, and Ellis regarding early sex research. Describe the significance of Kinsey’s research and the questions it has raised. Describe the two major research efforts of Masters and Johnson. List the survey studies of the 1970s, 1980s, and 1990s and describe the flaws in early sex surveys. Summarize findings of the of the early 1990s sex research. Describe the process of selecting samples and list two types of bias in sex surveys. Describe a reason for gender discrepancies in sex surveys. List four methods of talking surveys. Describe both case studies and clinical research. Describe both case studies and clinical research. Distinguish between the concepts of ethnography and ethno-sexuality and identify at least one challenge to anthropologists conducting field studies. Describe how and when controlled experiments are used and what variables are. Describe the principles of informed consent, list and describe three additional challenges for researchers. CHAPTER OVERVIEW This chapter, used imaginatively and with care, can offer a solid base on which to build your course in human sexuality. Students traditionally are somewhat resistant toward historical foundations and the technicalities of research, but any effort to understand sexuality without these underpinnings would be incomplete. With respect to the material in this chapter, it will be crucial for you, the instructor, to create a learning climate that will stimulate interest, retrospection, and introspection. The chapter opens by calling attention to the current culture wars in the United States as reflected in attitudes and policies related to human sexuality. This should capture the interests of students at the outset. Activities for self-evaluation are introduced in Chapter 1. This is one of the most valuable parts of any sexuality course. Students can be encouraged to see how factual material connects with their own lives and decisions. We sexuality educators have a significant responsibility for helping students bring together the facts about sex with the very individualized sexual values and lifestyles they are developing, clarifying, and coming to understand in themselves. The evaluative devices in several chapters throughout the text and in this instructor’s manual can assist with that process. It is important to emphasize at the outset of the course that human sexuality is closely interrelated with social, cultural, and historical trends. Students generally tend to think in ethnocentric terms; most believe their own sex-related values to be the right ones. We cannot study human sexuality without understanding the basic teachings of biology, sociology, psychology, anthropology, medicine, law, and a variety of other fields. There has been debate over the magnitude of what has been called the “sexual revolution.” There have been ongoing shifts in social attitudes and values regarding sexuality. Although sexuality is more openly discussed now, much ambivalence about sex still exists. These are times in which conservative and liberal religious and political factions hold conflicting views of sexuality. The traditional view of the family unit as being that of a married couple with their own children is no longer the norm in the United States. The concept of family values is difficult to define. There is a continuing debate over the degree to which human sexual traits and orientations are determined by biological and evolutionary factors or by social factors. The variability of human traits is probably influenced by both nature and nurture. North American attitudes regarding sexuality seem to fall into three main categories: traditional or procreational, relational, and recreational. These attitudinal systems exist side by side in our society and greatly influence people’s sexual choices and behavior. Attitudes toward masturbation and nonmarital sex have become more accepted in recent years; there is greater openness about sexual orientations, alternative behaviors, and gender identities. Double standards regarding female and male sexual activity still exist. Almost all states now recommend or require sexuality education in their public schools. There is a continuing debate between groups that encourage comprehensive sexuality education and those that believe sexuality education should emphasize abstinence until marriage or postponement of sexual activity. Three significant pioneers in 19th century studies of human sexuality were Richard von Krafft-Ebing, Sigmund Freud, and Henry Havelock Ellis. Their work established fundamental perspectives on sexuality that persisted well into the 20th century. The early 20th century was heavily influenced by Victorian values about sex and romance. The Kinsey studies opened new vistas concerning the spectrum of sexual behavior, and Masters and Johnson pioneered work in understanding sexual physiology and the treatment of sexual dysfunctions. Much early research on sexual behavior did not represent accurate generalizations for the entire population because only population samples of convenience were used in the studies. The random sampling and interview techniques employed by the National Health and Social Life Survey have yielded the most statistically reliable results on sexual behaviors and attitudes in the United States. This survey has caused us to reassess many of our assumptions about the spectrum and frequency of sexual activity. A new national study on adolescent sexual behavior is in progress, along with research on HIV transmission, inclusion of the feminist perspective, and global contraception. These issues represent emerging themes of sex research in the new millennium. Scientific study of sex can involve various methods: population samples, surveys, case studies and clinical data, direct observation of behavior, ethnosexual field studies, and controlled experiments. Scientific research raises numerous ethical issues, and informed consent is considered essential to participation in any such research. Finally, before moving to the other chapters, it is a good idea to call attention to the organization of the book and how it reflects various aspects of human sexuality: the biological, psychological, sociocultural, behavioral, medical, problematic, and personal. The first five chapters offer historical, methodological, and biological underpinnings; with Chapters 2, 3, and 4 providing the basic anatomy and physiology crucial to further understanding. Chapter 5 establishes basic concepts about the differentiation of the sexes and the development of gender identity. This chapter also begins to bring the social and political dimensions of human sexuality into perspective. Chapter 6 and 7 provide an overview of sexual development and behavior at various stages in the life span. Chapter 8 reemphasizes the highly individualized sexual natures that we develop as human beings and examines attitudinal frameworks in greater detail, and Chapter 9 places sexuality firmly in the context of interpersonal communication and relationships. Chapter 10 discusses the reproductive processes, while Chapter 11 follows with information on deciding about parenthood and preventing pregnancy. Chapters 12–14 deal with sexual behaviors and can be especially interesting or possibly upsetting to students. Instructors should be sensitive to their students’ needs and should prepare them for the fact that there is a wide spectrum of human sexual orientations and activities. Chapter 15 rounds out the unit on behavior and contemporary society by examining the media, sexually explicit materials and their effects, and the legal/political aspects of sexual behaviors. Chapters 16–18 highlight the various forms of sexual problems that people face and discuss what they might do about them. Chapter 17 offers detailed coverage of HIV infection and AIDS, topics about which college students should be properly informed. Chapter 18 takes a thorough look at sexual dysfunctions; you can assume that some of your students have already had concerns about these problems in their own lives. This discussion might even be a good time to mention what counseling services are available to your students. TEACHING SUGGESTIONS 1. Small Group Activities Influences of Language on the Culture of the United States Objective: To help students understand the impact of slang terms on cultural attitudes and behavior. Method: Break students into groups of four or five. Give each group three large pieces of poster paper and a marker. Tell students to write using large print because after each exercise the student will tape the poster paper to a wall. The instructor calls out one term at a time, such as sexual intercourse, penis, or vagina. The students then write down as many slang terms as possible within a two-minute limit for that one term. Tape the poster paper to a wall. Complete all terms before moving on to discussion. After all of the pieces of paper have been taped to the walls, redirect the students’ attention to the first term (sexual intercourse). Explain to them that it is time to be serious and to examine the activity. Tell students to close their eyes, and without talking or laughing, listen to the words that you call out, such as fuck, knockin’ boots, grind, ram, making love, and fornicate. Ask them what images and thoughts came to mind. Explore how the use of these terms influences thoughts and perceptions on our own culture. This can lead to a variety of discussions on issues such as erotica, control, violence, and intimacy. The terms penis and vagina could lead to discussions of performance expectations, degradation, gender bias, and erotica. Upon completion: Students will be able to analyze how their own use of slang terms may influence their attitudes and behaviors. B) “Where did you get that message?” Objective: To assist students with personal consideration of their sexuality education from birth to present. And to discuss, early in the course, potentially controversial topics that will encourage and help establish a comfort level for discussion in the course. Method: Divide students into small groups of 3-5 members keeping in mind that a gender, age, and ethnicity mix will enhance this exercise. Distribute an index card to each group. A different sexuality subject is listed at the top of each index card. The subjects are: Boys Body Changes, Girls Body Changes, Intercourse, Conception and Pregnancy, Masturbation, and Homosexuality. Each index card has the following questions listed: How old were you when you first learned about this subject? Was it the right age? What were you told and who told you? Was this information accurate and would you have preferred someone else tell you about this subject? How did you feel about this information? What did you think about this information? What do you want children and adolescents to know today about this subject? Ask the groups to discuss keeping in mind they are to own their opinions and identify their values while respecting others. One person in the group should follow the discussion so they can report to the larger group. The “reporter” should not identify who said what in the small group…just simply summarize the discussion. After approximately 10 minutes of discussion has passed, reform into the larger group and ask each group to present what they discussed. As the Instructor, use this opportunity to introduce basic teaching points about each topic. You are essentially laying the philosophical groundwork for future discussion in your course. C) Ask groups of students to design brief lists of topics that they think should be offered in sexuality education classes to various age groups. Identify the difference in the concepts: age appropriate vs. developmentally appropriate. D) Take the class through an exercise that poses a research question about human sexuality. Divide into groups of four or five. Develop a hypothesis. Design the study. Select the sample population. Develop the statistical guidelines for drawing conclusions. Have each group share their research designs, implementation, and conclusions. 2. Large Group Activities Ask students who have spent time in another country or culture to discuss the differences in sexual attitudes and behavior. To enhance the interaction, encourage the other students to ask questions of those students who have spent time away. 3. Role-Plays Have two students act out the differing sexuality perspectives of Henry Havelock Ellis and Richard von Krafft-Ebing. Have students role-play the concepts of procreational, relational, and recreational sexual attitudes. Let the rest of the class guess which one is which. Lead a discussion on the pros and cons of each sexual attitude category. Let four to five students perform an improvisation on the classic double standard. Discussion could lead to issues on societal and gender expectations, variations about women’s and men’s sexual wants and needs, and acceptable and unacceptable behaviors. 4. Guest Speakers Invite an individual or couple from another culture to discuss relational and sexual issues from that culture, such as arranged relationships. The guest(s) might also discuss the pressures that contemporary Western values may be bringing to bear on these other traditions. Bring someone into the class who either works partially or completely nude or lives in a nudist camp to discuss issues regarding the body and nudity. 5. Case Study The case of Anil (in the main text) provides a particularly interesting cross-cultural topic. The instructor may explore: The pros and cons of arranged marriages. Concepts of love from other cultures. Family expectations involving arranged marriages. 6. Essays/Papers Have students write essays about their own families’ values relating to sexuality. To what degree are values similar among various members of their families? Explain how their values are different from those of their parents and siblings. What factors have had the most powerful effects on their families’ value system? What influences have peers and significant others made on their values. 7. Projects Student reports on selected historical figures in the field of human sexuality (Krafft-Ebing, Ellis, Kinsey, Masters and Johnson) can be stimulating. Ask students to investigate recent research studies on sexual behavior in more detail, focusing on the political struggles (sexuality education programs, AIDS treatment programs) behind some of the research and the social implications of the findings. The references cited in the text concerning the National Health and Social Life Survey can offer some rich insights in this regard. To examine the different approaches to sex research, students could read a variety of journal articles, and then classify the research method used. They need to understand that examining aspects of sexuality scientifically is a complicated process because controlling variables is so difficult. It would also be worth pointing out the unique features of ethnographic research, which often involves the interpretation of observations from the researcher’s particular cultural biases. If you ask students to try designing some mock research studies, they will come face to face with the difficulties and complexities inherent in all human sex research. They will also encounter some of the ethical problems of such research. Tearoom Trade: Impersonal Sex in Public Places (Humphreys, 1970) is one example of a fascinating and innovative sex research project accomplished with questionable ethics. Gather some materials about sexual behaviors in different cultures, and then ask students to develop guidelines for observing and interpreting those behaviors. Suggest to students that they pay particular attention to their own values and emotions that might obscure an objective view of the customs of other cultures. 8. Questionnaires Instructors may find the following questionnaires useful in helping students to explore their knowledge and values. Your Sexual History (in the main text) Sexual Attitudes in Your Life (in the main text) Your Sexual Myths and Misconceptions (on the following pages) 9. SexSource Video Bank – The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource A) Beautiful video clip- Ask students to write down a short description of what is physically beautiful or attractive. After receiving a few responses from the class, show the Beautiful video clip and ask why and how our ideas of beauty have developed. This demo can serve as a springboard for a discussion on culture and sexuality. Alfred Kinsey Research video clip - Ask students what their grandparents were taught about sex and what college courses were taught in their day. Then show the Alfred Kinsey Research video clip. This serves as an excellent discussion starter for the history of sexuality research. Evolutionary Psychology video clip – Ask students how much our biology drives our sexual desires and what we want in a relationship. Then show the Evolutionary Psychology video clip. This can be used to start a lively debate of current sexuality research and illustrate the difference in the Nature vs. Nurture argument in Human Sexuality. Female Sexual Response video clip - Ask students what “g-spot” means. How does a woman reach orgasm? Then show the Female Sexual Response video clip. This clip is excellent for illustrating how little students may know about sexuality, the historical study of human sexuality. Additionally, many students will find it both engaging and humorous. The Plethysmograph video clip – Ask students how often men have erections. Is it normal to have an erection in the morning? How do doctors test for erectile dysfunction (ED)? Then show The Plethysmograph video clip. This clip shows the applicability and use of a modern day version on an adult male penis. This is a graphic clip. It is useful for illustrating how little students may know about sexuality as well as the historical study of human sexuality. Your Sexual Myths and Misconceptions Because human beings have had so little accurate, objective information about sex, many myths and fallacies have arisen about human sexuality. In recent years, with an increase in sex research, many of the old myths have died away—only to be replaced by new ones. The following test may help you to explore the myths and inaccuracies about sex that you still hold. It also may help you to decide in which areas of human sexuality you could use further study. Remember: this test is not for grading; it is for you to evaluate yourself. Indicate whether each of the following statements relating to sexuality is true or false. Answers are found at the end of the questionnaire. Participation in sexual activity prior to athletic activity will lower an athlete’s performance level. T F Sexually fulfilled, mature adults do not masturbate. T F Alcohol enhances the body’s sexual responsiveness. T F Women may have sexual needs that are as strong as men’s. T F Both men and women have sex hormones of the opposite sex in their bodies. T F On psychological tests of creativity, girls on the average score better than boys. T F Romance can be important to men, just as it is to women. T F Women who use vibrators to produce orgasm are likely to become dependent on the vibrator. T F Men who get their sexual kicks from dressing up in women’s clothes are most likely gay. T F Viewing pornography probably has no effect on most people. T F The sex chromosome found in the male’s sperm determines whether a baby will be a boy or a girl. T F There is no risk of pregnancy when sexual intercourse takes place during the woman’s menstrual period. T F In no way does having a vasectomy physically affects a man’s sexual functioning. T F A woman who takes birth control pills increases the risks of dangerous side effects if she smokes. T F Generally, intercourse should be avoided during the last month or two of pregnancy. T F As people grow older, they are more apt to remain sexually active if they have tried for sexual moderation and abstinence in their younger years. T F Women must reach orgasm in order to become pregnant. T F Adults who become involved in sexual contacts with children are usually known by the child. T F If continuing impotence in a man does not respond to psychotherapy, it is often caused by some organic problem. T F People with a same-gender sexual orientation are more prone than heterosexuals to various personality disturbances. T F Most adults do not masturbate. T F As men grow older, their need for orgasm during sexual activity often decreases. T F HIV may be transmitted by an infected person who shows no symptoms of disease. T F Women are naturally more nurturing and gentle with children than are men. T F The larger the penis is in its non-erect state, the larger it will be when it is erect. T F If a man loses both of his testes, he also loses his sex drive and becomes impotent. T F Circumcision does not produce premature ejaculation in males. T F After menopause, a woman’s sex drive usually begins to decline. T F Gay men usually come from families with a dominating mother and a submissive father. T F Not all boys and men have nocturnal emissions (wet dreams). T F For many women, sexual intercourse without other stimulation is not the best form of activity for producing orgasm. T F Some women eject a fluid from their vaginas or urethras when they have orgasm. T F Women who continue to seek sexual contact with a variety of sexual partners are usually nymphomaniacs. T F Gonorrhea and syphilis are no longer common sexually transmitted diseases. T F Vaginismus—the tensing of the outer vaginal musculature, making vaginal entry painful or impossible—is usually caused by psychological rather than physical factors. T F Most women who are raped have placed themselves in compromising situations where rape is a likely outcome. T F HIV is rarely transmitted by heterosexual intercourse. T F Most physicians are well equipped to treat the routine sexual problems of their patients, such as impotence or lack of orgasm. T F Blacks generally have a stronger sex drive than whites. T F There are several documented cases of men and women becoming stuck together during sexual intercourse. T F If a woman lacks a hymen, it does not necessarily mean she has already experienced sexual intercourse. T F The sperm that produce male babies come from one testis, while the female-producing sperm come from the other testis. T F Sexual molesters of children are usually elderly males. T F A man who enjoys inserting a finger into his anus during masturbation is displaying homosexual tendencies. T F Even if people are paralyzed from the waist or neck down, they may still respond sexually with erection, lubrication, and/or orgasm. T F Women tend to experience multiple orgasms during a single sexual encounter more often than men. T F Most prostitutes are nymphomaniacs. T F Children under the age of eight can have romantic and sexual feelings. T F Certain drugs can cause a condition in which a male experiences orgasm without ejaculation of semen. T F During sexual arousal, the male’s testicles can increase in size up to 50 percent more than their unexcited size. T F 1. F 11. T 21. F 31. T 41. T 2. F 12. F 22. T 32. T 42. F 3. F 13. T 23. T 33. F 43. F 4. T 14. T 24. F 34. F 44. F 5. T 15. F 25. F 35. T 45. T 6. T 16. F 26. F 36. F 46. T 7. T 17. F 27. T 37. F 47. F 8. F 18. T 28. F 38. F 48. T 9. F 19. T 29. F 39. F 49. T 10.F 20. F 30. T 40. F 50. T GLOSSARY case study: an in-depth look at a particular individual and how he or she might be helped to solve a sexual or other problem. Case studies may offer new and useful ideas for counselors to use with other patients. clinical research: the study of the cause, treatment, or prevention of a disease or condition by testing large numbers of people. controlled experiment: research in which the investigator examines what is happening to one variable while all other variables are kept constant. cultural absolutism: the view that behaviors and values from one’s culture of origin should be disregarded once the individual is living in a new culture. The expectation is that immigrants must abide by new cultural standards. cultural relativism: the view that one’s culture determines what is normal and acceptable, and that judgments about those standards should consider their cultural origins. ethnography (eth-NOG-ruh-fee): the anthropological study of other cultures. ethnosexual: referring to data concerning the sexual beliefs and customs of other cultures. Eurocentric (yoor-uh-SEN-trik): a cultural attitudinal framework typical of people with Western European heritages. informed consent: the consent given by research subjects, indicating their willingness to participate in a study, after they are informed about the purpose of the study and how they will be asked to participate. random sample: a representative group of the larger population that is the focus of a scientific poll or study in which care is taken to select participants without a pattern that might sway research results. sample: a representative group of a population that is the focus of a scientific poll or study. sexology: the scientific study of human sexuality. sexologist: person who studies human sexuality from a scientific perspective. sexual revolution: the changes in thinking about sexuality and sexual behavior in society that occurred in the 1960s and 1970s. variable: an aspect of a scientific study that is subject to change. Chapter 2 FEMALE SEXUAL ANATOMY AND PHYSIOLOGY TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 2: Female Sexual Anatomy and Physiology The Vulva Teaching Suggestions: 1(A), 2(B-1), 2(B-2), 8(A) Learning Objectives: #1,2,3,4,5,6 The Vagina Teaching Suggestions: 1(A), 7(A) Learning Objectives: #7,8,9,10,11,12,13, The Uterus and Ovaries Teaching Suggestions: 6(A), 6(B), 7(A), 9(B) Learning Objectives: #14,15, 16,17,18,19,20,21, 22,23,24 Female Breasts Teaching Suggestions: 4(A), 5(A), 6(B), 8(A), 9(A) Learning Objectives: #25,26,27,28,29,30,31 the MenstRual cycle Teaching Suggestions: 2(A), 2(B-3), 2(B-4), 3(A) Learning Objectives: #32,33,34,35,36 Menopause Teaching Suggestions: 3(A), 5(B) Learning Objectives: #37, 38, 39 LEARNING OBJECTIVES After reading this chapter, students should be able to: List and describe the functions of the external female sex organs. List and describe the function of the clitoris, including the parts of the organ. Describe the potential result of, and treatment for, collection of smegma collecting around the clitoral prepuce. Describe the procedure for conducting female genital cutting. Describe the purposes of female genital cutting. Describe different cultural perceptions regarding female genital cutting. Describe the structures, functions, and potential concerns regarding the vagina and surrounding muscles. Describe concerns with the procedure of douching. List the four types of hymens, myths about the presence of a hymen, and cultural expectations surrounding the presence of a hymen. Describe the social and medical concerns regarding the hymen. Describe the procedure for female genital self-exam. List some common disorders of the female sex organs. Describe the causes of and treatments for disorders of the female sex organs. Explain the importance and function of a pap smear. List and describe the parts and functions of the uterus. Identify five sex-related factors associated with higher risk for cervical cancer. Consider the new Pap test screening guidelines from the American Cancer Society. Describe how a pelvic exam is conducted. List and describe the two procedures for examining suspicious cells of the cervix. List and describe the parts and functions of the ovaries. List and describe the parts and functions of the fallopian tubes. List and describe two stages of uterine cancer. List and describe three additional disorders associated with the uterus. Describe two anatomical abnormalities associated with the uterus. Describe the parts of the breast. Describe the process of lactation. Discuss three facts about breast cancer. Describe genetic concerns associated with the female breasts. Describe the process for undertaking breast self-examination. Describe the recommendations for mammograms. List and describe two procedures for addressing malignant breast tumors. Briefly describe perceptions of menarche and menopause. List the glands and hormones associated with the menstrual cycle. Describe the four-phase process of menstruation. Describe the difference between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Describe the hormonal and physiological body changes associated with menopause. Describe the benefits and risks of hormone replacement therapy. Describe the sexual implications of menarche and menopause, as well as the relationship to positive self-perception. CHAPTER OVERVIEW The first part of this chapter covers basic female sexual anatomy, with a view toward making the material interesting and accessible to students. Understanding anatomical details and relationships is fundamental to examining the mechanisms of sexual response as discussed in Chapter4. Focus on Health (FOH) questions are particularly evident in this chapter. Remember that the FOH questions are listed at the end of each chapter in the main text with appropriate page numbers where students may find the answer. For some students, this chapter will represent the first time female sexual anatomy has been discussed frankly and in detail. It is important to be sensitive to their naiveté, as well as the sense of relief and liberation that can result from dealing with this material. For every student, being well grounded in the biological basis of sexuality is important to the development of later concepts. The female sex organs have always been recognized for their procreative (reproductive) functions, but their potentials for pleasure and intimate communication have become increasingly recognized. The female vulva consists of the external sex organs known as the mons, the labia majora and minora, the clitoris, and the openings to the urethra and vagina. Some cultures, religions, or social customs require surgical procedures such as a clitoridectomy or infibulation to be performed as rites of passage. These forms of female genital mutilation (FGM) (or genital cutting) have created worldwide controversy. The vagina is a muscular-walled organ of sexual pleasure and reproduction that extends into the woman’s body. Its opening may be partially covered by tissue called a hymen. The hymen may be present in the opening of the vagina and may be one of several types. The hymen may cause sexual difficulties if it is imperforate (having no openings) or tough and fibrous. The uterus is the organ in which fetal development takes place. Its cervix extends into the posterior part of the vagina. The ovaries mature eggs (ova) and produce female hormones. The fallopian tubes transport ova down toward the uterus, and fertilization of an egg by a sperm can take place in these tubes. Papanicolaou (Pap) smears offer the possibility of early detection for cervical cancer or precancerous cells in the cervix called cervical intraepithelial neoplasia (CIN). Untreated cervical cancer may become invasive cervical cancer (ICC). The female breasts are strongly connected with sexuality in our culture, and women often worry about breast size. Milk glands in the breasts produce milk after a woman gives birth. Breast cancer is one of the more common types of malignancy. Regular breast self-examination is essential to the detection of potentially malignant lumps. Mammography is a form of X-ray that can detect breast cancer in very early stages. Between menarche and menopause, a woman’s fertility is regulated by the menstrual cycle. At roughly four-week intervals, an ovum ripens in one ovary as the result of increased levels of follicle-stimulating hormone (FSH). Estrogen thickens the uterine wall, producing a suitable location for fetal growth. The ovum breaks through the ovary wall at ovulation. If the ovum is not fertilized, extra blood and tissue are shed from the uterus in menstruation. Hormones from the pituitary, hypothalamus, and ovaries regulate the menstrual cycle. Premenstrual syndrome (PMS) consists of uncomfortable physical and emotional symptoms. Severe symptoms may be classified as premenstrual dysphoria disorder (PMDD). Menopause is the time of life when menstruation ceases. The perimenopausal years may have unpleasant symptoms as hormone production decreases. TEACHING SUGGESTIONS 1. Small Group Activities Female Sexual Anatomy Name Game Objective: To learn the location of parts and their functions. Method: Photocopy the transparencies of the vulva and the female internal sexual and reproductive organs (see outline at beginning of chapter for reference). Be sure to cover the names of the parts on the transparency as you copy. Handout photocopies to students in groups of three to four. Students will then label and write the definition or function of the body part without using the textbook. Allow 15 minutes to complete. This activity will test the students’ current knowledge or lack of it. Instructor then lectures on the information. Upon Completion: Students will have a better understanding of female sexual anatomy and physiology. 2. Large Group Activities Menstrual Cycle Quiz Game Objective: To test the knowledge of students on the menstrual cycle. Method: Put students into groups of four or five per group. Instructor reads one piece of information at a time about the phases of the menstrual cycle, such as FSH ripens one or more ova. Instructor may establish a group order to answering the question or to allow whoever raises their hand first to answer. Give one point to the group if the answer is correct and take away one point if the answer is wrong. Upon completion: Students should be able to discuss the correct sequence of the menstrual cycle. Discussion Topics 1. Female Sexual and Reproductive Anatomy Discuss at what age students began to name/identify and understand physiological function of female sexual and reproductive anatomy. What distinguishes “sexual” and “reproductive” anatomical parts? Identify different teaching approaches to this topic. Plumbing lesson vs. Wellness lesson vs. Pleasure lesson. Compare and contrast these approaches, the messages that they send, and which approach is best suited for a college audience. Discuss the Pleasure approach to teaching sexual anatomy. Are girls and women in the United States encouraged to understand how their genitals can bring pleasure? Is there high school academic preparation that identifies the G-spot or female ejaculation? 2. Female Genital Mutilation (FGM) vs. Genital Cutting Discuss the terms specifically noting implications for changing “mutilation” to “cutting”. Examine the cultural value of FGM. Discuss the Western societal viewpoint of this practice. Explore the intersection between an individual’s personal rights versus the cultural expectation. Compare Genital Cutting to the Western practice of male circumcision. 3. Menarche Encourage students to discuss their first menstruation experience. Explore their feelings of excitement, fear, and surprise. Ask who educated them on the subject (parents, siblings, peers) and when they were educated (before or after). Compare their experiences with those expressed in the boxed material on Celebrating Menarche across Cultures (in the main text). Examine why a lack of rituals involving menarche exists in North America. 4. Premenstrual Syndrome (PMS) vs. Menstrual Discomfort and Control (MDC) Discuss the terms specifically noting the implications in changing “PMS” to “MDC”. Have students explain the variety of symptoms they experience and what treatment options they have used. Discuss in what ways they would like their significant other to respond. Explore the variety of male perspectives on Menstrual Discomfort and Control. 3. Role-Play Let students act out the signs and symptoms of Menstrual Discomfort and Control and menopause. Set up the dramatic presentation before class. Let it be a surprise at the beginning of the class. Have the students perform at their desks or come up front. The instructor will ask what is wrong, and let the actors describe their symptoms. This should stimulate interest and discussion. 4. Case Study Brittany: Breast Size Matters to Her. Explore reasons how and why breasts have developed sexual meaning in our society. Why does our society believe that bigger is better, or does it? Examine the impact on women’s self-esteem. Discuss the risks associated with breast enlargement surgery. Pamela Anderson and Jenny McCarthy have both had their implants removed. What impact might these cases have on the issue? 5. Guest Speakers Invite a nurse or health educator to demonstrate the techniques of a Breast Self-Exam (BSE). Also, have the person discuss issues related to breast cancer and other breast problems. Invite a physician to discuss the benefits and risks of hormone replacement therapy. 6. Essays/Papers Students can identify the five sex-related factors associated with a higher risk for cervical cancer. In short answer format, students should consider their personal risks for each factor and write thoughts, feelings, and steps they are taking to reduce their risk. Male students can complete the assignment via sympathetic critical thinking. B) Have students write papers on breast, cervical, uterine, and ovarian cancer. This assignment will increase their knowledge and awareness of these potentially life-threatening diseases. 7. Media Several films/slides can graphically illustrate the range of individual differences in, for example, the shape or color of the vulva, breasts, and/or hymen Present if explicit graphic representations are appropriate to your educational setting. (If you’re not certain, check it out before showing such materials.) 8. Questionnaires The following self-evaluation at the end of the chapter in the main text may help students discover more about themselves as a sexual being. You and Your Body 9. SexSource Video Bank The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource Breasts video clip – Ask paired students: How big are the average woman’s breasts? What size is attractive? How do breasts change over a woman’s life? Does size affect sexual stimulation? Once students have been given some time to share their initial answers, show the Breasts video clip and continue discussion. Be aware that the clip is graphic and shows full frontal nudity. It is advisable to show the video clip Male Anatomy during the same class. (See Chapter 3 of the Instructor’s Manual). Additionally, this is an excellent activity for brining in issues on cultural attractiveness and societal norms. B) The Ovaries video clip – Ask paired students: What do the ovaries look like? What color are they? Where are they? How many eggs do they contain and when do they form? If time permits, ask two or more pairs of students to come draw the ovaries on the whiteboard or chalkboard. This activity can be both engaging and humorous for students, as many will have little knowledge of the ovaries. Afterward, show the Ovaries video clip and take this opportunity to cover the ovaries in detail. This is an excellent starter for the female anatomy. GLOSSARY acute urethral syndrome: infection or irritation of the urethra. areola (a-REE-a-la): darkened, circular area of skin surrounding the nipple of the breast. Bartholin’s glands (BAR-tha-lenz): small glands located in the opening through the minor lips that produce some secretion during sexual arousal. cervical intraepithelial neoplasia (CIN) (ep-uh-THEE-lee-al nee-oh-PLAY-zhee-uh): abnormal, precancerous cells sometimes identified in a Papanicolaou (Pap) smear. cervix (SERV-ix): lower “neck” of the uterus that extends into the back part of the vagina. cilia: microscopic, hairlike projections that help move the ovum through the fallopian tube. circumcision (SIR-kuhm-sizh-uhn): of clitoris—surgical procedure that cuts the prepuce, exposing the clitoral shaft. clitoridectomy (klit-er-i-DEK-tuh-mee): surgical removal of the clitoris; practiced routinely in some cultures. clitoris (KLIT-er-is): sexually sensitive organ found in the female vulva; it becomes engorged with blood during arousal. corpus luteum: cell cluster of the follicle that remains after the ovum is released, secreting hormones that help regulate the menstrual cycle. cystitis (si-STAHY-tis): a nonsexually transmitted infection of the urinary bladder. diethylstilbestrol (DES) (dahy-eth-uhl-stil-BES-trol): synthetic estrogen compound once given to mothers whose pregnancies were at high risk of miscarrying. dysmenorrhea (dis-men-uh-REE-uh): painful menstruation. E. coli: bacteria naturally living in the human colon, which often cause urinary tract infection. endometrial hyperplasia (hahy-per-PLAY-zhuh): excessive growth of the inner lining of the uterus (endometrium). endometriosis (en-doh-mee-tree-O-sis): growth of the endometrium out of the uterus into surrounding organs. endometrium: interior lining of the uterus, innermost of three layers. estrogen (ES-troh-jen): hormone produced abundantly by the ovaries; it plays an important role in the menstrual cycle. fallopian tubes: structures that are connected to the uterus and that lead the ovum from an ovary to the inner cavity of the uterus. fibroid tumors: non-malignant growths that commonly grow in uterine tissues, often interfering with uterine function. fibrous hymen: condition in which the hymen is composed of unnaturally thick, tough tissue. follicles: capsules of cells in which an ovum matures. follicle-stimulating hormone (FSH): pituitary hormone that stimulates the ovaries or testes. fundus: the broad top portion of the uterus. glans: sensitive head of the female clitoris, visible between the upper folds of the minor lips. gonadotropin-releasing hormone (GnRH) (go-nad-uh-TROH-pin): hormone from the hypothalamus that stimulates the release of FSH and LH by the pituitary. hormone replacement therapy (HRT): treatment of the physical changes of menopause by administering dosages of the hormones estrogen and progesterone. hot flash: a flushed, sweaty feeling in the skin caused by dilated blood vessels; often associated with menopause. hymen: membranous tissue that can cover part of the vaginal opening. hysterectomy: surgical removal of all or part of the uterus. imperforate hymen: lack of any openings in the hymen. infibulation (in-fib-yuh-LAY-shun): surgical procedure, performed in some cultures, which seals the opening of the vagina. interstitial cystitis (IC): a chronic bladder inflammation that can cause debilitating discomfort and interfere with sexual enjoyment. introitus (in-TROID-us): the outer opening of the vagina. invasive cancer of the cervix (ICC): advanced and dangerous malignancy requiring prompt treatment. isthmus: narrowed portion of the uterus just above the cervix. labia majora (LAY-bee-uh muh-JOR-uh): two outer folds of skin covering the minor lips, clitoris, urinary meatus, and vaginal opening. labia minora (LAY-bee-uh mih-NOR-uh): two inner folds of skin that join above the clitoris and extend along the sides of the vaginal and urethral openings. lactation: production of milk by the milk glands of the breasts. lumpectomy: surgical removal of a breast lump along with a small amount of surrounding tissue. luteinizing hormone (LH) (LOO-tee-uh-nahyz-ing): pituitary hormone that triggers ovulation in the ovaries and that stimulates sperm production in the testes. mammography: sensitive X-ray technique used to discover small breast tumors. mastectomy: surgical removal of all or part of a breast. menarche (muh-NAHR-kee): onset of menstruation at puberty. menopause (MEN-uh-pawz): time in midlife when menstruation ceases. menstrual cycle: the hormonal interactions that prepare a woman’s body for possible pregnancy at roughly monthly intervals. menstruation (men-stroo-AY-shun): phase of menstrual cycle in which the inner uterine lining breaks down and sloughs off; the tissue, along with some blood, flows out through the vagina; also called the “period”. mons: cushion of fatty tissue located over the female’s pubic bone. myometrium: middle, muscular layer of the uterine wall. oocytes (OH-a-sites): cells that mature to become ova. os: opening in the cervix that leads into the hollow interior of the uterus. osteoporosis (ah-stee-o-puh-ROH-sis): disease caused by loss of calcium from the bones in postmenopausal women, leading to brittle bones and stooped posture. ova: egg cells produced in the ovary. A single cell is called an ovum; in reproduction, it is fertilized by a sperm cell. ovaries: a pair of female gonads, located in the abdominal cavity, that mature ova and produce female hormones. ovulation: release of a mature ovum through the wall of an ovary. oxytocin (ok-si-TOH-suhn): pituitary hormone that plays a role in lactation and in uterine contractions. Papanicolaou (Pap) smear: medical test that examines a smear of cervical cells to detect any cellular abnormalities. perimenopause: the time of a woman’s life surrounding menopause, characterized by symptoms resulting from reduced estrogen levels. perimetrium: outer covering of the uterus. polycystic ovary syndrome (PCOS) (PAH-lee-SIS-tick): a disorder of the ovaries that can produce a variety of unpleasant physical symptoms often because of elevated testosterone levels. premenstrual dysphoric disorder (PMDD): severe emotional symptoms such as anxiety or depression around the time of menstruation. premenstrual syndrome (PMS): symptoms of physical discomfort, moodiness, and emotional tensions that occur in some women for a few days prior to menstruation. prepuce (PREE-peus): in the female, tissue of the upper vulva that covers the clitoral shaft. progesterone (pro-JES-tuh-rohn): ovarian hormone that causes the uterine lining to thicken. prolactin: pituitary hormone that stimulates the process of lactation. prolapse of the uterus: weakening of the supportive ligaments of the uterus, causing it to protrude into the vagina. prostaglandin: hormonelike chemical whose concentrations increase in a woman’s body just prior to menstruation. pubococcygeus (PC) muscle (pyub-o-kox-a-JEE-us): part of the supporting musculature of the vagina that is involved in orgasmic response and over which a woman can exert some control. shaft: in the female, the longer body of the clitoris, containing erectile tissue. smegma: thick, oily substance that may accumulate under the prepuce of the clitoris or penis. urinary meatus (mee-AY-tuhs): opening through which urine passes from the urethra to the outside of the body. uterus (YOO-ter-uhs): muscular organ of the female reproductive system; a fertilized egg implants itself within the uterus. vagina (vuh-JAHY-nuh): muscular canal in the female that is responsive to sexual arousal; it receives semen during heterosexual intercourse for reproduction. vaginal atresia (uh-TREE-zhuh): birth defect in which the vagina is absent or closed. vaginal atrophy: shrinking and deterioration of vaginal lining, usually the result of low estrogen levels during aging. vaginal fistulae (FIS-choo-luh or -lie): abnormal channels that can develop between the vagina and other internal organs. vaginismus (vaj-uh-NIZ-muhs): involuntary spasm of the outer vaginal musculature making penetration of the vagina difficult or impossible. varicose veins: overexpanded blood vessels; can occur in veins surrounding the vagina. vulva: external sex organs of the female, including the mons, major and minor lips, clitoris, and opening of the vagina. vulvar vestibulitis: one form of vulvodynia that often interferes with sexual penetration of the vagina. vulvodynia: a medical condition characterized by pain and burning in the vulva and outer vagina. Chapter 3 Male sexual Anatomy and Physiology TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 3: Male Sexual Anatomy and Physiology The Testes and Scrotum Teaching Suggestions: 1(A), 2(A), 2(B-1) Learning Objectives: #1,2,3,4,5,6,7(B) The Penis Teaching Suggestions: 1(A), 2(A), 2(B-1), 2(B-2), 3(A),7(A) Learning Objectives: #7,8,9,10,11,12,13,14,15,16, Internal Male Sex Organs Teaching Suggestions: 1(A), 2(A), 2(B-1), 4(B), 6(A) Learning Objectives: #17,18,19,20,21,22,23,24 MALE HORMONES AND THE MALE CLIMACTERIC Teaching Suggestions: 4(A), 5(A) Learning Objectives: #25,26,27,28 LEARNING OBJECTIVES After reading this chapter, students should be able to: Describe the structure and function of the lobes of the testes. Describe the structure and purpose of the scrotum. Describe the reasons for and the process of conducting a testicular exam. Describe the consequences of testicular cancer treatments. List and describe sex disorders of the testes. Describe the structure and functions of the penis. Describe the general process of erection in men. Describe the muscular and chemical process of erection. Describe the characteristics of an average penis. Describe how penis size can affect the physiological process in penis-vagina intercourse. What is the equalizing effect with regard to penis size and proportion? Describe two procedures and concerns about them regarding penis enlargement. Describe the pros and cons of male circumcision. List and describe disorders of the penis. Describe how vigorous stimulation can damage the penis. List and describe three congenital penile conditions. Describe the structure and functions of the internal male organs. List and describe two types of prostatitis. Describe the treatments for prostate enlargement. Describe the procedure for examining the prostate. List the hormones and cells associated with sperm production. Describe how sperm are expelled from the body. List and describe two ejaculatory problems. Describe the concerns regarding sperm count. Describe aging changes in the male body. Describe the phenomena of andropause. Describe the benefits and risks of testosterone replacement therapy. Describe ways in which men can cope with their midlife period. CHAPTER OVERVIEW In this chapter, the male sex organs are described, along with genital and testicular self-examination. The process of erection is discussed thoroughly, as well as issues involving the male climacteric. The male’s testes, located in the scrotum, produce male hormones and sperm. Sperm cells develop best at a temperature slightly lower than inner body temperature, mature in tubes called the epididymis, and travel upward through the vas deferens. Regular self-examination of the genitals and testes is an effective way to detect infections or growths that indicate the presence of testicular cancer. The penis has a sensitive, rounded head called the glands and a longer shaft. Three columns of spongy tissue compose the interior of the penile shaft and become filled with blood during erection. Sperm and urine move through the penis via the urethra. Penis size is quite variable among males and includes a wide range of “normal” sizes. Circumcision is a surgical procedure in which the penile foreskin, or prepuce, is removed. This procedure’s advisability has been the subject of controversy. Some diseases that can affect the penis are priapism (painful, undesired, continuous erection), Peyronie’s disease (calcificaton of erectile tissue), phimosis (too-tight foreskin), and cancer. The prostate gland and seminal vesicles of the male produce secretions that mix with sperm to produce the semen that is ejaculated through the penis. Cowper’s glands produce clear secretions that line the urethra during sexual arousal. Prostatitis, or prostate infection, can be either acute or chronic. A common problem in older men is prostate enlargement, which may be caused by benign prostatic hyperplasia or by malignant tumors. It must be corrected usually by surgery. The prostate-specific antigen (PSA) test has proved useful in detection of prostatic cancer. Sperm production is controlled by the secretion of the follicle-stimulating hormone (FSH). Interstitial-cell-stimulating hormone (ICSH) stimulates the testes to produce testosterone. Up to 30 billion sperm are produced by the testes each month. Some studies suggest that the sperm counts of human males may have been decreasing over the past few decades, although fertility has not yet been affected. Other researchers believe these changes to be geographically isolated or the result of different ways of analyzing sperm counts. Further study is needed to fully understand this phenomenon. Men experience a less-well-defined male climacteric (andropause) than women, involving mood changes that may be associated with reduced production of testosterone. Testosterone replacement therapy may improve sexual desire and other symptoms of male midlife but also carries health risks. TEACHING SUGGESTIONS 1. Small Group Activities Male Anatomy Name Game Objective: To learn the locations and functions of the male sex organs. Method: Photocopy the available transparencies of the external and internal male sex organs (see outline at beginning of chapter for details). Be sure to cover the names of the parts as you copy. Put students into groups of four or five and hand them the copies. Instruct them to label and write down the definition or functions of the organs without using the textbook. Allow 10 to 15 minutes to complete. Instructor then lectures on the material. Upon completion: Students will gain knowledge on the male sexual anatomy. 2. Large Group Activities Male Sexual Anatomy and Physiology Quiz Game Objective: To learn and recall information on male sex organs. Method: Develop questions on male sexual anatomy and physiology. Divide class into groups of four per group. Let students pick numbers out of a container to determine order of groups. Ask one question per group. If they answer correctly give1 point; if not, ask the same question to the next group. Award prize to the winning group (prize optional). Upon completion: Students will have a better understanding of the material. Discussion Topics 1. Male Sexual and Reproductive Anatomy Discuss at what age students began to name/identify and understand physiological function of male sexual and reproductive anatomy. What distinguishes “sexual” and “reproductive” anatomical parts? Identify different teaching approaches to this topic. Discuss Plumbing lesson vs. Wellness lesson vs. Pleasure lesson. Compare and contrast these approaches, the messages that they send, and which approach is best suited for a college audience. Discuss the Pleasure approach to teaching sexual anatomy. Are boys and men in the United States encouraged to understand how their genitals can bring pleasure? Is there high school academic preparation that identifies stimulation of the prostate as a most likely enhancement to orgasm? 2. Male Circumcision Explore religious reasons for circumcision. Discuss medical reasons for circumcision. Examine the movement against circumcision and discuss. Review the cultural influence of the father wanting the son to look like he does concerning the penis. What other considerations might be taken into account? 3. Case Study Jake: Concerns About the Male Body (in the main text) Review information on average penis size. Explore psychological reasons for male penis envy. How does penis size impact self-esteem? Examine concerns of a male with a larger than average penis size. 4. Guest Speakers Invite a male in his late 50s to 60s to discuss the sexual changes that have occurred over time. Invite a physician (urologist), nurse, or health educator to discuss prostate and testicular illnesses and to demonstrate the techniques of a testicular self-examination. 5. Essays/Papers Have students write a paper on the risks and benefits of testosterone replacement therapy. 6. Questionnaires Your Sexuality Education: Past, Present, and Future (in the main text) Encourage students to complete this evaluation in the text. It will help them to understand the impact of sexuality education as it relates to their lives. 7. SexSource Video Bank The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource Male Anatomy video clip – Ask paired students: What size is the average man’s penis? What size is attractive? Is a large or small penis preferable? Does size affect sexual stimulation? Once students have been given some time to share their initial answers, show the Male Anatomy video clip and continue discussion. While the Breasts video clip shows full nudity, this clip shows none. Ask students why it is more acceptable in our society to view breasts than the penis. What does this say about our sexual norms and attitudes? It is advisable to show the video clip Breasts during the same class. (See Chapter 2 of the Instructor’s Manual). Shown together the Breasts and Male Anatomy video clips are an excellent way to address issues of social perspectives in Chapter 5, as well as covering anatomy and physiology. B) The Testes video clip – Ask paired students: Why are the testes located outside of the body? How many sperm are made each day? What do sperm look like and how do they function? Afterward show the Testes video clip and take this opportunity to cover the testes and sperm in detail. This is an excellent starter for the male anatomy. GLOSSARY agenesis (absence) of the penis (ae-JEN-uh-sis): a congenital condition in which the penis is undersized and nonfunctional. anejaculation: lack of ejaculation at the time of orgasm. anorchism (a-NOR-kiz-um): rare birth defect in which both testes are lacking. benign prostatic hyperplasia (BPH): enlargement of the prostate gland that is not caused by malignancy. bulbourethral glands: another term for Cowper’s glands. circumcision (SUR-kuhm-sizh-uhn): in the male, surgical removal of the foreskin from the penis. corona: the ridge around the penile glans. Cowper’s glands: two small glands in the male that secrete an alkaline fluid into the urethra during sexual arousal. cryptorchidism (krip-TAWR-ki-diz-uhm): condition in which the testes have not descended into the scrotum prior to birth. cyclic GMP: a secretion within the spongy erectile tissues of the penis that facilitates erection. ejaculation: muscular expulsion of semen from the penis. epididymis (ep-i-DID-uh-mis): tubular structure on each testis in which sperm cells mature. epididymitis (ep-i-did-uh-MITE-is): inflammation of the epididymis of the testis. epispadias (ep-i-SPADE-ee-as): birth defect in which the urinary bladder empties through an abdominal opening and the urethra is malformed. erection: enlargement and stiffening of the penis as internal muscles relax and blood engorges the columns of spongy tissue. foreskin: fold of skin covering the penile glans; also called the prepuce. frenulum (FREN-yuh-luhm): thin, tightly drawn fold of skin on the underside of the penile glans; it is highly sensitive. glans: in the male, the sensitive head of the penis. hypospadias (hye-pa-SPADE-ee-as): birth defect caused by incomplete closure of the urethra during fetal development. interstitial cells (in-ter-STIH-shul): cells between the seminiferous tubules that secrete testosterone and other male hormones. interstitial-cell-stimulating hormone (ICSH): pituitary hormone that stimulates the testes to secrete testosterone; known as luteinizing hormone (LH) in females. monorchidism (muh-NAWR-ki-diz-uhm): presence of only one testis in the scrotum. orgasm: pleasurable sensations and series of contractions that release sexual tension, usually accompanied by ejaculation in men. penis: male sexual organ that can become erect when stimulated; it leads urine and sperm to the outside of the body. Peyronie’s disease (pay-ruh-NEEZ): development of fibrous tissue in spongy erectile columns within the penis. phimosis (fahy-MOH-ss): a condition in which the penile foreskin is too long and tight to retract easily. priapism (PRAHY-uh-piz-uhm): continual, undesired, and painful erection of the penis. prostate: gland located beneath the urinary bladder in the male; it produces some of the secretions in semen. prostatitis (pros-tuh-TAHY-tis): inflammation of the prostate gland. retrograde ejaculation: abnormal passage of semen into the urinary bladder at the time of ejaculation. scrotum (SKROH-tuhm): pouch of skin in which the testes are contained. semen (SEE-men): mixture of fluids and sperm cells that is ejaculated through the penis. seminal vesicle (SEM-uh-nl): gland at the end of each vas deferens that secretes a chemical that helps sperm to become motile. seminiferous tubules (sem-uh-NIF-er-hus): tightly coiled tubules in the testes in which sperm cells are formed. shaft: in the male, cylindrical base of penis that contains three columns of spongy tissue: two corpora cavernosa and a corpus spongiosum. sperm: reproductive cells produced in the testes; in fertilization, one sperm unites with an ovum. spermatocytes (sper-MAT-o-sites): cells lining the seminiferous tubules from which sperm cells are produced. testes (TES-teez): a pair of male gonads that produce sperm and male hormones. testicular failure: lack of sperm and/or hormone production by the testes. testosterone (tes-TAHS-tuh-rohn): major male hormone produced by the testes; it helps to produce male secondary sex characteristics. testosterone replacement therapy: administering testosterone injections to increase sexual interest or potency in older men; not considered safe for routine use. urethra (yoo-REE-thruh): tube that passes from the urinary bladder to the outside of the body. vas deferens: tube that leads sperm upward from each testis to the seminal vesicles. vasa efferentia: larger tubes within the testes, into which sperm move after being produced in the seminiferous tubules. Instructor Manual for Sexuality Today Gary Kelly 9780078035470

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