Asexuality
of various measures of mental health
o is a sexual orientation that describes
individuals who do not experience sexual
attraction.
o Asexuality is not the same as celibacy, which
is the abstention from sexual activity. Some
asexuals do have sex, and most celibates are
not asexual, or considered as such.
o Asexuals may experience romantic attraction, or
the desire for, fantasy of, or propensity
towards romantic love, often directed at people
of genders falling within an affectional
orientation.
o Many asexuals also identify as straight, gay,
or bi, using the terms in a strictly
affectional sense, or alternatively
o Some asexuals identify as "aromantic." A
relationship between an asexual and a sexual
person does not necessarily involve sexual
activity.
o Patterns of Sexual Activities:
Heterosexuality
o refers to sexual behavior with, or attraction
to, people of the opposite sex, or to a
heterosexual orientation.
o As a sexual orientation, heterosexuality refers
to "an enduring pattern of or disposition to
experience sexual, affectional, or romantic
attractions primarily to "persons of the
opposite sex";
o The term is usually applied to human beings,
but it is also observed in all mammals.
o The physical action of heterosexual
fertilization is the only means of sexual
reproductive capability among humans without
the use of assisted reproductive technology..
o In other cultures a heterosexual man may engage
in homosexual intercourse provided that he
keeps the role traditionally assigned to his sex
during intercourse and his gender during the
surrounding relationship.
o Most sexual orientation specialists follow the
general conclusion that minority of humans are
exclusively heterosexual or homosexual, and
that the majority are bisexual.
o Homosexual
o "sexual desire or behavior directed toward a
person or persons of one's own sex.“
o there is no genetic determinism in regards to
homosexuality (homosexuals are "not born that
way") and that there is abundant documentation
that individuals are able to leave
homosexuality and become heterosexuals
o Many studies demonstrate a sadly
disproportionate extent of sexual abuse in the
childhoods of homosexual men, suggesting at the
least that both homosexual unhappiness and
homosexuality itself derive from common causes.
o In research with 942 nonclinical adult
participants, gay men and lesbian women
reported a significantly higher rate of
childhood molestation than did heterosexual men
and women. Forty-six percent of the homosexual
men in contrast to 7% of the heterosexual men
reported homosexual molestation. Twenty-two
percent of lesbian women in contrast to 1% of
heterosexual women reported homosexual
molestation.
o homosexual population has significantly higher
rates of many diseases and the homosexual
population also has significantly lower rates
o one factor that makes engaging in homosexual
acts a bad choice for individuals is the
significantly higher rates of domestic violence
in homosexual couples. In addition, according
to experts homosexual murders are relatively or
quite common and often homosexual murders are
very brutal. Also, the homosexual population
has a greater propensity to engage in illegal
drug use.
o A new study by a group of University of Chicago
researchers reveals a high level of promiscuity
and unhealthy behavior among that city's
homosexual male population. According to the
researchers, 42.9 percent of homosexual men in
Chicago's Shoreland area have had more than 60
sexual partners, while an additional 18.4
percent have had between 31 and 60 partners.
All total, 61.3 percent of the area's
homosexual men have had more than 30 partners,
and 87.8 percent have had more than 15, the
research found.
o As a result, 55.1 percent of homosexual males
in Shoreland -- known as Chicago's "gay center"
-- have at least one sexually transmitted
disease
Homosexuality and Mental Health
o In respect to homosexuality and mental health,
studies have long indicated that homosexuals
have a substantially greater risk of suffering
from psychiatric problems (suicide, depression,
bulimia, antisocial personality disorder, and
substance abuse).
o autosexuality
o refers to sexual orientation and sexual behavior
of attraction or romance that one holds
exclusively, and expresses, towards oneself.
Concurrently, autoeroticism is sexual
stimulation of one's self.
o Autoerotic interests include autogynephilia,
apotemnophilia, autoerotic asphyxia.
o autogynephilia
o refer to "a man's paraphilic tendency to be
sexually aroused by the thought or image of
himself as a woman."It has been theorized to
motivate cross-dressing as a sexual fetish
o Apotemnophilia
o is the erotic interest in being or looking like
an amputee. It should not be confused with
acrotomophilia, which is the erotic interest in
people who are amputees.
o When experienced very strongly, some people
with apotemnophilia come to feel discontented
with their bodies and want to actually remove
an otherwise healthy limb, a condition called
Body Integrity Identity Disorder
o Autoerotic asphyxia
o refers to intentionally cutting off oxygen to
the brain for sexual arousal. Colloquially, a
person engaging in the activity is sometimes
called a gasper. The erotic interest in
asphyxiation is classified as a paraphilia
Nocturnal orgasm
o Orgasm during sleep
o It was discovered that spontaneous orgasm
during sleep was in most cases a result of
sexual dreams, especially when speaking of
males. These dreams often have a "taste of
forbidden", where a sleeping person often has
sexual intercourse in situations that seem
unacceptable during conscious state.
o For example, people have sex dreams when they
engage in group sex or sex with their
 relatives. The occurrence of such dreams is
explained by the fact that in unconscious state
during sleep our conscious control weakens
giving way to our deep sexual urges.
o fast facts:
o Many women achieve orgasm much faster during
sleep than during a conscious state.
o It is not surprising that men and women have
orgasms during sleep as sexual arousal does not
sleep. Men can have up to six erections during
an eight-hour sleep and women's genitals get
lubricated almost with the same frequency.
o There is no evidence to prove that nocturnal
orgasm is peculiar to particular age group. men
report the most nocturnal orgasms during their
teenage and early 20's. Women have wet dreams
more frequently during their 40s. Interesting
enough, for women number of nocturnal orgasms
increased if they had more "conscious" orgasms.
o Around 90% of men and less than 40% of women
said they had orgasm during sleep.
o Some people will have nocturnal orgasms during
their lifetime while others start experiencing
them at particular age.
o Though all the findings regarding nocturnal
orgasms show that men experience orgasm during
sleep more frequently, this difference can be
more due to the difficulty monitoring female
orgasm during the sleep.
o Anatomical differences may predispose men to
have more orgasms as any unconscious movements
can easier stimulate male genitals then female
one's as they are not so exposed to stimulation.
o Men are more aware of their nocturnal orgasms
as they ejaculate during sleep while women
cannot say exactly if they experienced orgasm
or not.
Sexual Relationships:
Premarital sexual relationships
o is sexual intercourse engaged in by a person or
persons who are not yet married.
o It is generally used in reference to young
people who are presumed who are not yet of
marriagable age, or who are and will one day be
married, but who are engaging sexual practices
priored to their being sanctioned within a
marriage.
o Postmarital sexual relationships
o is sexual intercourse engaged in by a person or
persons who are married.
o Extramarital sexual relationships
o occurs when a married person engages in sexual
activity with someone other than their marriage
partner.
o Extramarital sex is also sometimes referred to
as adultery, philandary, or infidelity, but
those terms for many people carry a moral or
religious association, while the term
"extramarital sex" is intended to be morally or
judgmentally neutral.
o Extramarital sex attempts to look at the social
phenomena of sexual relations outside of an
existing marriage relationship, at its
incidence, causes, and consequences, in an
objective and non-judgmental manner.
Sexual Stimulation:
Physiologic physical stimulation
o Physical sexual stimulation usually consists of
the touching of parts of the human body,
especially erogenous zones.
o Masturbation is considered a type of sexual
stimulation.
o Physiological reactions are usually triggered
through sensitive nerves in these body parts,
which cause the release of pleasure-causing
chemicals that act as mental rewards to pursue
such stimulation.
o Arousal is usually the term used to describe
such a physiological reaction. Physical sexual
stimulation may also involve the touching of
other people's body parts and may trigger
similar physiological reactions.
o psychologic stimulation
o Mental sexual stimulation consists of any
visual images, imagination, reading material,
or auditory stimulation that causes sexual
stimulation and leads to arousal.
o The degree of sexual stimulation derived from
any such activities depends upon the person and
the circumstance. Pornography is considered to
be the most prominent example of mental
stimulation, and watching pornographic material
can lead to arousal in most people.
o The input of mental sexual stimulation varies
by gender. women show more interest in sexual
acts and men focus on faces.
o
Patterns of Sexual response:
ORGASM
o Rhythmic muscular contractions
o of the genitals (sex organs)
o combined with waves of intense pleasurable
sensations
o in males, results in the ejaculation of semen.
o The peak of sexual excitement, characterized by
strong feelings of pleasure and by a series of
involuntary contractions
o ERECTION
o Sexual intercourse may be preceded by foreplay
which leads to sexual arousal of the partners
o resulting in erection of the penis and natural
lubrication of the vagina.
o Sexual intercourse or COITUS is the human form
of copulation.
o To engage in sexual intercourse:
o the erect penis is inserted into the vagina and
one or both of the partners move back and forth
to repeatedly remove and reinsert the penis
usually without ever fully removing it.
o In this way, they stimulate themselves and each
other usually until orgasm and ejaculation are
achieved.
o
EJACULATION
an abrupt emphatic exclamation expressing
emotion
o the discharge of semen in males
Sexual Response Cycle:
o Excitement Phase
o Plateau Phase
o Orgasmic Phase
o Resolution Phase
Reproductive organ disorders
Endometriosis
o In endometriosis, the endometrium, which
normally lines your uterus, grows in other
places as well. Most often, this growth is on
your fallopian tubes, ovaries or the tissue
lining your pelvis.
o When endometrial tissue is located elsewhere in
your body, it continues to act as it normally
would during a menstrual cycle
o It thickens, breaks down and bleeds each month.
Because there's nowhere for the blood from this
displaced tissue to exit your body, it becomes
trapped, and surrounding tissue can become
irritated
o Trapped blood may lead to cysts, scar tissue
and adhesions — abnormal tissue that binds
organs together.
o This process can cause pelvic pain, especially
during your period. Endometriosis also can
cause fertility problems.
o S&S
o Painful periods (dysmenorrhea). Pelvic pain and
cramping may begin before and extend several
days into your period and may include lower
back and abdominal pain..
o Pelvic pain at other times. You may experience
pelvic pain during ovulation, a sharp pain deep
in the pelvis during intercourse, or pain
during bowel movements or urination.
o Excessive bleeding. You may experience
occasional heavy periods (menorrhagia) or
bleeding between periods (menometrorrhagia).
o Infertility. Endometriosis is first diagnosed
in some women who are seeking treatment for
infertility.
o Causes
o One theory holds that menstrual blood
containing endometrial cells flows back through
the fallopian tubes, takes root and grows.
o Another hypothesis proposes that the
bloodstream carries endometrial cells to other
sites in the body.
o Still another theory speculates that a
predisposition toward endometriosis may be
carried in the genes of certain families. A
faulty immune response also may contribute to
the development of endometriosis.
o Lifestyle and home remedies
o Warm baths and a heating pad can help relax
pelvic muscles, reducing cramping and pain.
o surgery
Uterine prolapse
o means your uterus has descended from its
position in the pelvis farther down into your
vagina.
o Uterine prolapse occurs when pelvic floor
muscles and ligaments stretch and weaken,
providing inadequate support for the uterus.
The uterus then descends into the vaginal
canal.
o Uterine prolapse often affects postmenopausal
women who've had one or more vaginal
deliveries.
o Damage sustained by supportive tissues during
pregnancy and childbirth
o S&S
o Sensation of heaviness or pulling in your
pelvis
o Tissue protruding from your vagina
o Urinary difficulties, such as urine leakage or
urge incontinence
o Trouble having a bowel movement
o Low back pain
o Feeling as if you're sitting on a small ball or
as if something is falling out of your vagina
o Symptoms that are less bothersome in the
morning and worsen as the day goes on
o treatment
o Lifestyle changes
o Vaginal pessary.
o Surgery to repair uterine prolapse.
Uterine fibroids
o are noncancerous growths of the uterus that
often appear during your childbearing years.
o Also called fibromyomas, leiomyomas or myomas,
uterine fibroids aren't associated with an
increased risk of uterine cancer and almost
never develop into cancer.
o In general, uterine fibroids cause no problems
and seldom require treatment.
o Medical therapy and surgical procedures can
shrink or remove fibroids if you have
discomfort or troublesome symptoms.
o Rarely, fibroids can require emergency
treatment if they cause sudden, sharp pelvic
pain.
o
o
S&S
Heavy menstrual bleeding
o Prolonged menstrual periods or bleeding between
periods
o Pelvic pressure or pain
o Urinary incontinence or frequent urination
o Constipation
o Backache or leg pains
o treatment
o Medication
o Surgery
o hysterectomy
o myomectomy
o Uterine artery embolization
rectocele
o occurs when the fascia — a wall of fibrous
tissue separating the rectum from the vagina —
becomes weakened, allowing the front wall of
the rectum to bulge into the vagina.
o Childbirth and other processes that put
pressure on the fascia can lead to a rectocele.
Generally, rectoceles occur after menopause,
when estrogen — which helps keep your pelvic
tissues strong — decreases.
o S&S
o A small, mild rectocele may cause no signs or
symptoms. Otherwise, you may notice:
o A soft bulge of tissue in your vagina that may
or may not protrude through the vaginal opening
o Difficulty having a bowel movement
o The need to press your fingers on the bulge in
your vagina to help push stool out during a
bowel movement
o Sensation of rectal pressure or fullness
o A feeling that the rectum has not completely
emptied after a bowel movement
o Difficulty controlling the passage of stool
o Causes
o Pregnancy and delivery are the most common
causes of rectoceles. This is because the
muscles, ligaments and fascia that hold and
support your vagina become stretched and
weakened during pregnancy, labor and delivery.
As a result, the more pregnancies you have, the
 greater chance you have of developing a
rectocele.
o Treatment
o Pessary.
o Surgery
o Self-care measures you can take:
o Perform Kegel exercises.
o Avoid constipation by eating high-fiber foods
and drinking plenty of fluids.
o Avoid heavy lifting.
o Try to control coughing.
o Lose weight if you're overweight or obese.
cystocele
o occurs when the wall between a woman's bladder
and vagina weakens and stretches, allowing the
bladder to bulge into the vagina. A cystocele
may also be called a prolapsed bladder.
o A cystocele may occur from excessive straining,
such as during childbirth, chronic constipation
or heavy lifting. It may also occur after
menopause, when estrogen decreases. Therefore,
older women and those who've given birth to
several children are more likely to develop a
cystocele.
o Symptoms
o A feeling of fullness or pressure in your
pelvis and vagina — especially when standing
for long periods of time.
o Increased discomfort when you strain, cough,
bear down or lift.
o A bulge of tissue that, in severe cases,
protrudes through your vaginal opening. The
resulting soft bulge may feel walnut- or even
grapefruit-sized, and often goes away when you
lie down.
o A feeling that you haven't completely emptied
your bladder after urinating.
o Loss of urinary control with coughing, laughing
or sneezing (stress incontinence). In severe
cases, you may not be able to control urination
at all.
o Recurrent bladder infections.
o Pain or urinary leakage during sexual
intercourse.
o When other organs join the bladder in moving
into the space in the front part of the vagina,
the condition is called an anterior prolapse.
o treatment
o Pessary
o Estrogen therapy
o Kegel’s excercise
Enterocele
o Childbirth and aging may weaken the muscles and
ligaments (pelvic floor) that support your
bladder, uterus, colon and small intestine. The
weakening may cause one or more of these organs
to drop (prolapse). One resulting condition is
an enterocele.
o An enterocele occurs when your small intestine
(small bowel) drops into the lower pelvic
cavity and protrudes into your vagina, creating
a bulge. An enterocele is a vaginal hernia.
o S&S
o A pulling sensation in your pelvis that eases
when you lie down
o A feeling of pelvic fullness, pressure or pain
o Low back pain that eases when you lie down
o A soft bulge of tissue in your vagina
o Vaginal discharge and bleeding
o Vaginal discomfort and painful intercourse
(dyspareunia)
o treatment
o Pessary
o Estrogen therapy
o kegels
o Surgery
Double uterus
o In a female fetus, the uterus starts out as two
small tubes. As the fetus develops, the tubes
normally join to create one larger, hollow
organ — the uterus.
o Sometimes, however, the tubes don't join
completely. Instead, each one develops into a
separate cavity. This condition is called
double uterus (uterus didelphys).
o S&S
o Possible signs and symptoms may include:
o Unusual pain before or during a menstrual
period
o Abnormal bleeding during a period, such as
blood flow despite the use of a tampon
o treatment
o If you have a double uterus but you don't have
signs or symptoms, treatment is rarely needed.
Surgery to unite a double uterus is rarely done
— although surgery may help you sustain a
pregnancy.
o If you're pregnant and have a double uterus,
your risk of pregnancy complications may be
higher due to the smaller size of your uteri.
Uterine unicornis
o When one of the mullerian ducts fails to form,
a single horn (banana-shaped) uterus develops
from the healthy mullerian duct.
o This single horn uterus may stand alone.
However, in 65% of women with a unicornuate
uterus, the remaining mullerian duct may form
an incomplete (rudimentary) horn.
o There may no cavity in this rudimentary horn or
it may have a small space within it, but no
opening which communicates with the unicornuate
uterus and vagina.
o In the latter case, a girl may have monthly
pain during adolescence because there is no
outlet for the menses from this rudimentary
horn. This pain would lead to identification of
this problem.
o Uterine Deviation
o Anteversion
o Retroversion
o Anteflexion
o retroflexion
Pelvic inflammatory disease (PID)
o is an infection of the female reproductive
organs.
o It usually occurs when sexually transmitted
bacteria spread from your vagina to your uterus
and upper genital tract.
o Many women who develop pelvic inflammatory
disease either experience no signs or symptoms
or don't seek treatment. Pelvic inflammatory
disease may be detected only later when you
have trouble getting pregnant or if you develop
chronic pelvic pain.
o Pelvic inflammatory disease is important to
avoid because it can result in infertility or
complications during pregnancy. Prompt
treatment of a sexually transmitted disease can
help prevent PID.
o S&S
o Pain in your lower abdomen and pelvis
o Heavy vaginal discharge with an unpleasant odor
o Irregular menstrual bleeding
o Pain during intercourse
o Low back pain
o Fever, fatigue, diarrhea or vomiting
o Painful or difficult urination
o treatment
o Prevent STD
o Antibiotic
o surgery
BPH
o The prostate gland is the male organ that
produces semen, the milky-colored fluid that
nourishes and transports sperm during
ejaculation. It sits beneath your bladder and
surrounds your urethra — the tube that drains
urine from your bladder.
o When it becomes enlarged, the prostate can put
pressure on your urethra and cause difficulty
urinating.
o Most men have a period of prostate growth in
their mid- to late 40s. At this time, cells in
the central portion reproduce more rapidly,
resulting in prostate gland enlargement.
o As tissues in the area enlarge, they often
compress the urethra and partially block urine
flow. Benign prostatic hyperplasia (BPH) is the
medical term for prostate gland enlargement
o S&S
o Weak urine stream
o Difficulty starting urination
o Stopping and starting while urinating
o Dribbling at the end of urination
o Straining while urinating
o Frequent need to urinate
o Increased frequency of urination at night
(nocturia)
o Urgent need to urinate
o Not being able to completely empty the bladder
o Blood in the urine (hematuria)
o Urinary tract infection
o treatment
o TURP
o Drug therapy
o Limit beverages in the evening. Don't drink
anything for an hour or two before bedtime to
help you avoid wake-up trips to the bathroom at
night.
o Limit caffeine or alcohol. These can increase
urine production, irritate your bladder and
worsen your symptoms.
o Limit diuretics. If you take water pills
(diuretics), talk to your doctor. Maybe a lower
dose, a milder diuretic or a change in the time
you take your medication will help. Don't stop
taking diuretics without first talking to your
doctor.
o Limit decongestants or antihistamines. These
drugs tighten the band of muscles around your
urethra that control urine flow, which makes it
harder to urinate.
o Go when you feel the urge. Try to urinate when
you first feel the urge. Waiting too long to
urinate may overstretch the bladder muscle and
cause damage.
o Schedule bathroom visits. Try to urinate at
regular times to "retrain" the bladder. This
can be done every four to six hours during the
day and can be especially useful if you have
severe frequency and urgency.
o active. Inactivity causes you to retain urine.
Even a small amount of exercise can help reduce
urinary problems caused by BPH.
o keep warm. Colder temperatures can cause urine
retention and increase your urgency to urinate.
o Testicular torsion
o occurs when a testicle rotates on the spermatic
cord, which provides blood flow to the
testicle.
o This rotation cuts off the flow of blood and
causes sudden, often severe pain and swelling.
o Testicular torsion is most common in males
under 25, but it can occur at any age,
including in newborns and infants.
o Testicular torsion requires emergency
treatment. If it's treated within a few hours,
the testicle can usually be saved. But waiting
longer can cause permanent damage and may
affect the ability to father children.
o When blood flow has been cut off for more than
12 hours, a testicle may become so badly
damaged it has to be removed.
o S&S
o Sudden or severe pain in one testicle
o Swelling of the scrotum (a loose bag of skin
under your penis that contains your testicles)
o Nausea and vomiting
o Abdominal pain
o Fever
o Other signs of testicular torsion can include:
o A testicle positioned higher than normal or at
an odd angle
o Sudden testicle pain that went away without
treatment — this can occur when a testicle
twists and then untwists on its own
(intermittent torsion and detorsion)
o treatment
o surgery
Orchitis
o If you're an adult male, you may have heard
that getting mumps may affect your fertility.
The reason is viral orchitis, an inflammation
of one or both testicles, most commonly
associated with the virus that causes mumps.
About one-third of males who contract mumps
develop orchitis.
o Other causes of orchitis usually are bacterial,
including sexually transmitted diseases (STDs).
The best way to prevent orchitis is to prevent
mumps and to avoid behaviors that may result in
STDs.
Cryptorchidism
o Undescended testicle (cryptorchidism) is a
testicle that hasn't moved into its proper
position in the bag of skin hanging behind the
penis (scrotum) prior to the birth of a baby
boy.
o For most boys born with one or two undescended
testicles, the problem corrects itself within
the first few months of life.
o If your infant has an undescended testicle that
doesn't correct itself, surgery can usually be
used to relocate it into the scrotum.
hydrocele
o A hydrocele testis is the accumulation of
fluids around a testicle,

o is due to fluid secreted from a remnant piece

of peritoneum wrapped around the testis, called
the tunica vaginalis. It can be the result of
cancer, trauma (such as a hernia), or orchitis,
and can also occur in infants undergoing
peritoneal dialysis.

o It may be treated surgically.

o Hydroceles are usually not painful (neither
are testicular tumors) and a common way of
diagnosing them is by attempting to shine a
strong light through the enlarged testicle.
o A hydrocele will usually pass light, where a
tumor will not, but the diagnosis should be
made by a physician.

o spermatocele
o phimosis
o is a condition where, in men, the male
foreskin cannot be fully retracted from the
head of the penis

o hypospadias