REPRODUCTION

By: Richard A. Cheng, R.N.

Anatomy & Physiology
I.Normal Sexual Differentiation

is the process of development of the differences

between males and females from an undifferentiated
zygote (fertilized egg). As male and female individuals
develop from zygotes into fetuses, into infants, children,
adolescents, and eventually into adults, sex and gender
differences at many levels develop: genes, chromosomes,
gonads, hormones, anatomy, psyche, and social behaviors

Human sexual differentiation is a complicated

process. In a simple manner, one can describe
four major steps which constitute normal sexual
differentiation. These four steps are:

 Fertilization and determination of genetic sex

 Formation of organs common to both sexes
 Gonadal differentiation
 Differentiation of the internal ducts and external genitalia

Step 1. Fertilization and determination of genetic sex

 The first step of sex differentiation takes place at fertilization. An egg from the
mother, which contains 23 chromosomes (including an X chromosome), is combined
with a sperm from the father, which also contains 23 chromosomes (including either an X
or Y chromosome). Therefore, the fertilized egg has either a 46,XX (genetic female) or
46,XY (genetic male) karyotype.
Step 2. Formation of organs common to both sexes
The fertilized egg multiplies to form a large number
of cells, all of which are similar to each other. However,
at specific times during the growth of an embryo, the
cells differentiate to form the various organs of the
body. Included in this development is the
differentiation of the sex organs. At that stage, both
46,XX and 46,XY fetuses have similar sex organs,
specifically:
 the gonadal ridges
 the internal ducts
 the external genitalia
gonadal ridges
 The gonadal ridges can be easily recognized by 4-5 weeks of gestation. At that
time, they already include the undifferentiated germ cells which will later develop into
either eggs or sperm.
 The formation of gonadal ridges similar in both sexes is a prerequisite step to the
development of differentiated gonads.
 If any one of these genes is non-functional, then there is no formation of a
gonadal ridge and therefore no formation of either testes or ovaries.

 Definition of terms:

 Gonad- a male or female reproductive organs that produces the gametes.

 Gamete- a mature sex cell. Ovum or spermatozoa.
 Mullerian duct- in the female, it develops into a fallopian tube,and part of the
vagina.
 Wolffian duct- persists in male as the epididymis andvas deferens.

internal ducts

 . By 6-7 weeks of fetal life, fetuses of both sexes have two sets of internal ducts,
the Mullerian (female) ducts and the Wolffian (male) ducts.
external genitalia
 . The external genitalia at 6-7 weeks gestation appear female and include a genital
tubercle, the genital folds, urethral folds and a urogenital opening.
Step 3: Gonadal Differentiation

The important event in gonadal differentiation is the commitment of the gonadal ridge to
become either an ovary or a testis.

 a. In males, the gonadal ridge develops into testes as a result of a product from a
gene located on the Y chromosome. This product has been termed the "testis determining
factor" or "sex determining region of the Y chromosome" (SRY).
 b. In females, the absence of SRY, due to the absence of a Y chromosome,
permits the expression of other genes which will trigger the gonadal ridge to develop into
ovaries.
Step 4: Differentiation of the Internal Ducts and External Genitalia

The next step in sex differentiation depends upon the

formation of two important hormones:
 the secretion of Mullerian Inhibiting Substance (MIS)
 and the secretion of androgens.

 If testes are developing normally, then Sertoli cells of the developing testes
produce MIS which inhibits the growth of the female Mullerian ducts (the uterus and
fallopian tubes) which are present in all fetuses early in development.

 the Leydig cells of the testes start secreting androgens.

 Androgens are hormones that produce growth effects on the male Wolffian ducts
 the ovaries do not produce androgens. As a result, the Wolffian ducts fail to grow
and consequently disappear in fetuses with ovarian development.

 the ovaries do not produce MIS at the appropriate time, and as a consequence, the
Mullerian (female) ducts can develop.

Summary of Normal Sex Differentiation

 genetic sex is determined

 testes develop in XY fetus, ovaries develop in XX fetus
 XY fetus produces MIS and androgens and XX fetus does not
 XY fetus develops Wolffian ducts and XX fetus develops Mullerian ducts
 XY fetus masculinizes the female genitalia to make it male and the XX fetus
retains female genitalia

II. Female reproductive system

the human female has a reproductive system located
entirely in the pelvis The external part of the female
reproductive organs is called the vulva, which means
covering. Located between the legs, the vulva covers
the opening to the vagina and other reproductive
Organs located inside the body.

 The fleshy area located just above the top of the vaginal opening is called the
mons pubis.

 Two pairs of skin flaps called the labia surround the vaginal opening.

 The clitoris a small sensory organ, is located toward the front of the vulva where
the folds of the labia join.

 Between the labia are openings to the urethra

 Once girls become sexually mature, the outer labia and the mons pubis are
covered by pubic hair. A female's internal reproductive organs are the vagina, uterus,
fallopian tubes, and ovaries.

 The vagina is a muscular, hollow tube that extends from the vaginal opening to
the uterus.
 The vagina is about 3 to 5 inches long in a grown woman. Because it has
muscular walls it can expand and contract.

 This ability to become wider or narrower allows the vagina to accommodate

something as slim as a tampon and as wide as a baby.

 The vagina's muscular walls are lined with mucous membranes, which keep it
protected and moist.

The vagina has several functions:

 for sexual intercourse
 as the pathway that a baby takes out of a woman's body during childbirth
 as the route for the menstrual blood (the period) to leave the body from the uterus.

 A thin sheet of tissue with one or more holes in it called the hymen partially
covers the opening of the vagina.

 Hymens are often different from person to person.

 Most women find their hymens have stretched or torn after their first sexual
experience, and the hymen may bleed a little (this usually causes little, if any, pain).

 Some women who have had sex don't have much of a change in their hymens,
though.

 The vagina connects with the uterus or womb, at the cervix

 The cervix has strong, thick walls. The opening of the cervix is very small (no
wider than a straw), which is why a tampon can never get lost inside a girl's body.

 During childbirth, the cervix can expand to allow a baby to pass.

 The uterus is shaped like an upside-down pear, with a thick lining and muscular
walls - in fact, the uterus contains some of the strongest muscles in the female body.
These muscles are able to expand and contract to accommodate a growing fetus and then
help push the baby out during labor.

 the fallopian tubes connect the uterus to the ovaries.

 The ovaries are two oval-shaped organs that lie to the upper right and left of the
uterus.

 They produce, store, and release eggs into the fallopian tubes in the process called
ovulation. Each ovary measures about 1 1/2 to 2 inches (4 to 5 centimeters) in a grown
woman.

 There are two fallopian tubes, each attached to a side of the uterus. The fallopian
tubes are about 4 inches (10 centimeters) long and about as wide as a piece of spaghetti.

 Within each tube is a tiny passageway no wider than a sewing needle.

 At the other end of each fallopian tube is a fringed area that looks like a funnel.
This fringed area wraps around the ovary but doesn't completely attach to it.

 When an egg pops out of an ovary, it enters the fallopian tube.

 Once the egg is in the fallopian tube, tiny hairs in the tube's lining help push it
down the narrow passageway toward the uterus.
 The ovaries are also part of the endocrine system because they produce female
sex hormones such as estrogen and progesterone
Menstrual Cycles:
What Really Happens in those 28 Days?!

 Menstruation (a period) is a major stage of puberty in girls; it's one of the many
physical signs that a girl is turning into a woman. And like a lot of the other changes
associated with puberty, menstruation can be confusing.
Puberty and Periods

 When girls begin to go through puberty (usually starting between the ages of 8
and 13), their bodies and minds change in many ways.

 he hormones in their bodies stimulate new physical development, such as growth

and breast development. About 2 to 2½ years after a girl's breasts begin to develop, she
usually gets her first menstrual period.

 About 6 months or so before getting her first period, a girl might notice an
increased amount of clear vaginal discharge.

 This discharge is common. There's no need for a girl to worry about discharge
unless it has a strong odor or causes itchiness.

 The start of periods is known as menarche

 Menarche doesn't happen until all the parts of a girl's reproductive system have
matured and are working together

 As a girl matures and enters puberty, the pituitary gland releases hormones that
stimulate the ovaries to produce other hormones called estrogen and progesterone.

 These hormones have many effects on a girl's body, including physical

maturation, growth, and emotions.

 when a baby girl is born, she has all the eggs her body will ever use, and many
more, perhaps as many as 450,000.

 They are stored in her ovaries, each inside its own sac called a follicle.

 As she matures into puberty, her body begins producing various hormones that
cause the eggs to mature.

The hypothalamus is a gland in the brain responsible for regulating the body's thirst,
hunger, sleep patterns, libido and endocrine functions.

 It releases the chemical messenger Follicle Stimulating Hormone Releasing

Factor (FSH-RF) to tell the pituitary, another gland in the brain, to do its job.
 The pituitary then secretes Follicle Stimulating Hormone (FSH) and a little
Leutenizing Hormone (LH) into the bloodstream which cause the follicles to begin to
mature.

 The maturing follicles then release another hormone, estrogen.

 As the follicles ripen over a period of about seven days, they secrete more and
more estrogen into the bloodstream.

 Estrogen causes the lining of the uterus to thicken. It causes the cervical mucous
to change.

 When the estrogen level reaches a certain point it causes the hypothalmus to
release Leutenizing Hormone Releasing Factor (LH-RF) causing the pituitary to
release a large amount of Leutenizing Hormone (LH). This surge of LH triggers the one
most mature follicle to burst open and release an egg.

 This is called ovulation. [Many birth control pills work by blocking this LH surge,
thus inhibiting the release of an egg.]

Ovulation
 As ovulation approaches, the blood supply to the ovary increases and the
ligaments contract, pulling the ovary closer to the Fallopian tube, allowing the egg, once
released, to find its way into the tube.

 Just before ovulation, a woman's cervix secretes an abundance of clear "fertile

mucous" which is characteristically stretchy.

 Fertile mucous helps facilitate the sperm's movement toward the egg.

 Some women use daily mucous monitoring to determine when they are most
likely to become pregnant.

 Mid cycle, some women also experience cramping or other sensations. Basal
body temperature rises right after ovulation and stays higher by about .4 degrees F until a
few days before the next period.

 Inside the Fallopian tube, the egg is carried along by tiny, hairlike projections,
called "cilia" toward the uterus.

 Fertilization occurs if sperm are present as the live egg reaches the uterus. [A
tubal pregnancy (ectopic pregnancy) is the rare situation where the egg is fertilized inside
the tube.

 It is a dangerous life-threatening situation. If an fertilized egg begins to develop

into an embryo inside the tube it will rupture the tube causing internal bleeding.

 Surgery is required if the tube ruptures. If the pregnancy is discovered before the
tube ruptures, medication (Methotrexate) can be used to stop the development of the
embryo.]

Uterine Changes

 Between midcycle and menstruation, the follicle from which the egg burst
becomes the corpus luteum (yellow body).

 As it heals, it produces the hormones estrogen and, in larger amounts,

progesterone which is necessary for the maintenance of a pregnancy.$

 In the later stages of healing, if the uterus is not pregnant, the follicle turns white
and is called the corpus albicans.

 Estrogen and progesterone are sometimes called "female" hormones, but both
men and women have them, just in different concentrations.
 Progesterone causes the surface of the uterine lining, the endometrium, to become
covered with mucous, secreted from glands within the lining itself.

 spiral arteries of the lining close off, stopping blood flow to the surface of the
lining.

 The blood pools into "venous lakes" which, once full, burst and, with the
endometrial lining, form the menstrual flow.

Fertility Awareness
relies upon the following assumptions:
 An egg (ovum) can live inside a woman’s body for 12-24 hours. However, in
calculating the fertile time we use 48 hours in case more than one egg is released.
 Sperm can live in a woman’s body up to 5 days after intercourse, though more
often 2 days. Pregnancy is most likely if intercourse occurs anywhere from 3 days before
ovulation until 2-3 days after ovulation.
 Since the exact time of ovulation cannot be predicted, we add 2 to 3 days to the
beginning and end.
 A woman’s fertile time (“unsafe days” if she wants to prevent pregnancy) is thus
about one-third of her cycle.

 Understanding your menstrual cycle is important if you want to chart your fertility
patterns, predict ovulation, and increase your chances of becoming pregnant.
 A woman's fertile period during her menstrual cycle, on average, lasts about
seven days:
 seven days before ovulation (the release of the
egg)
 the day of ovulation
 and the day after ovulation.

 After this, chances of conception decrease quickly, as the egg has a short life-span
of about 24 hours.

 The menstrual cycle is divided into two parts:

 pre-ovulation
 post-ovulation.

Pre-Ovulation

 "Day 1" of the menstrual cycle is the day bleeding begins. Bleeding - or
"menstrual flow" - last about three to five days.
 By the seventh day of the cycle, eggs in the ovaries begin to ripen due to various
hormonal changes.
 Between the seventh and the eleventh days, the lining of the uterus begins to
thicken and it is possible to observe changes in the presence and consistency of cervical
fluids.
 After the eleventh day, luteinizing hormone cause the egg that is most ripe to be
released from the ovary and begin its travel down the fallopian tubes to the uterus. For
women with a 28-day cycle, ovulation (the release of the egg) should take place on about
the 14th Day - or the very middle - of the menstrual cycle.

Post-Ovulation
 The period after ovulation is called the luteal phase, and it is marked by a slight,
but clearly measurable, increase in body temperature.
 Following ovulation, the egg travels the fallopian tube toward the uterus.
 If the egg is fertilized by a sperm (conception), then " implantation" should take
place in the uterus (if implantation takes place outside the womb, this is an ectopic
pregnancy.
 Ectopic pregnancy can occur in several places - but the most common is in the
fallopian tube). Pregnancy begins if "implantation" occurs. If the egg is not fertilized, it
will "expire" in about 24 hours. Without fertilization, levels of certain hormones will
decrease , causing the lining of the uterus to break down and shed - otherwise known as
menstruation, or a woman's "period"..

How Long and How Much?

 The amount of time that a girl has her period also can vary. Some girls have
periods that last just 2 or 3 days. Other girls may have periods that last 7 days or longer.
 how much blood comes out of the vagina can vary widely from girl to girl,.

 Some girls may be concerned that they're losing too much blood. It can be a shock
to see all that blood, but it's unlikely that a girl will lose too much, unless she has a
medical condition like von Willebrand disease. Though it may look like a lot, the average
amount of blood is only about 2 tablespoons (30 milliliters) for an entire period. Most
teens will change pads 3 to 6 times a day, with more frequent changes when their period
is heaviest, usually at the start of the period.

Especially when menstrual periods are new, you may be worried about your blood flow
or whether your period is normal in other ways. Talk to a doctor or nurse if:
 your period lasts longer than a week
 you have to change your pad very often (soaking more than one pad every 1–2
hours)
 you go longer than 3 months between periods
 you have bleeding in between periods
 you have an unusual amount of pain before or during your period
 your periods were regular then became irregular
Signs & symptoms
Premenstrual Syndrome or PMS

 refers to the collection of symptoms or sensations women experience as a result of

high hormone levels before, and sometimes during, their periods.
 These feelings are usually relieved with the onset of bleeding.

 One type of PMS is characterized by anxiety, irritability and mood swings.

 Most likely, this type relates to the balance between estrogen and progesterone.
 If estrogen predominates, anxiety occurs.
 If there's more progesterone, depression may
be a complaint.

 Sugar craving, fatigue and headaches signify a different type of PMS.

 In addition to sugar, women may crave chocolate,
white bread, white rice, pastries, and noodles. These food cravings may be caused by
the increased responsiveness to insulin related to increased hormone levels before
menstruation.
 In this circumstance, women may experience symptoms of low blood sugar;
their brains are signaling a need for fuel.
 A consistent diet that includes complex carbohydrates will provide a steady
flow of energy to the brain and counter the ups and downs of blood sugar variations.
Cramps and Other Sensations
 Women can experience a variety of sensations before, during or after their
menses.
 Common complaints include backache, pain in the inner thighs, bloating, nausea,
diarrhea, constipation, headaches, breast tenderness, irritability, and other mood changes.
 Women also experience positive sensations such as relief, release, euphoria, new
beginning, invigoration, connection with nature, creative energy, exhilaration, increased
sex drive and more intense orgasms

 Uterine cramping is one of the most common uncomfortable sensations women

may have during menstruation.

 There are two kinds of cramping.

 Spasmodic cramping is probably caused by prostaglandins, chemicals that
affect muscle tension. Some prostaglandins cause relaxation, and some cause
constriction. A diet high in linoleic and liblenic acids, found in vegetables and fish,
increases the prostaglandins for aiding muscle relaxation.

 Congestive cramping causes the body to retain fluids and salt. To counter
congestive cramping, avoid wheat and dairy products, alcohol, caffeine, and refined
sugar.
Natural options to alleviate cramping:

 Increase exercise. This will improve blood and oxygen circulation throughout the
body, including the pelvis.
 Try not using tampons. Many women find tampons increase cramping. Don't
select an IUD (intrauterine device) as your birth control method.
 Avoid red meat, refined sugars, milk, and fatty foods.
 Eat lots of fresh vegetables, whole grains (especially if you experience
constipation or indigestion), nuts, seeds and fruit.
 Avoid caffeine. It constricts blood vessels and increases tension.
 Meditate, get a massage.
 Have an orgasm (alone or with a partner).
 Drink ginger root tea (especially if you experience fatigue).

 Put cayenne pepper on food. It is a vasodilator and improves circulation.

 Breathe deeply, relax, notice where you hold tension in your body and let it go.
 Ovarian Kung Fu alleviates or even eliminates menstrual cramps and PMS, it also
ensures smooth transition through menopause
 Take time for yourself!
 The hormones in our bodies are especially sensitive to diet and nutrition. PMS
and menstrual cramping are not diseases, but rather, symptoms of poor nutrition.

Menstrual Problems
 A variety of menstrual problems can affect girls. Some of the more common
conditions are:

a.)Amenorrhea (the Absence of Periods)

 Girls who haven't started their periods by the time they're 16 years old or 3
years after they've shown the first signs of puberty have primary amenorrhea, which is
usually caused by a genetic abnormality, a hormone imbalance, or a structural problem.
 Hormones are also often responsible for secondary amenorrhea, which is when
a girl who had normal periods suddenly stops menstruating for more than 6 months or
three of her usual cycles.

 Since pregnancy is the most common cause of secondary amenorrhea, it should

always be ruled out when a girl skips periods. In addition to hormone imbalances, other
things that can cause both primary and secondary amenorrhea include:

 stress
 significant weight loss or gain
 anorexia (amenorrhea can be a sign that a girl is
losing too much weight and may have anorexia)
 stopping birth control pills
 thyroid conditions
 ovarian cysts
 other conditions that can affect hormone levels
 excessive exercising

Lifestyle and home remedies

 Make changes in your diet and exercise activity to achieve a healthy weight.
 Strive for a healthy balance in work, recreation and rest.
 Assess areas of stress and conflict in your life..
 Be aware of changes in your menstrual cycle and check with your doctor if you
have concerns. Keep a record of when your periods occur. Note the date your period
starts, how long it lasts and any troublesome symptoms you might experience.
 Talk to your mother, sister or other close female relatives.
 Amenorrhea may cause anxiety, but by working with your doctor, you can
determine the cause and find ways to regulate your cycle.

B.)Menorrhagia (Extremely Heavy, Prolonged Periods)

o signs of menorrhagia (excessively heavy or long periods) can include soaking

through at least one sanitary napkin (pad) an hour for several hours in a row or periods
that last longer than 7 days.

 Girls with menorrhagia sometimes stay home from school or social functions
because they're worried they won't be able to control the bleeding in public.

 The most frequent cause of menorrhagia is an imbalance between the levels of

estrogen and progesterone in the body, which allows the endometrium (the lining of the
uterus) to keep building up.
 When the endometrium is finally shed during menstruation, the resulting bleeding
is particularly heavy. heavy menstrual bleeding can be caused by problems such as:
 fibroids (benign growths) or polyps in the uterus
 thyroid conditions
 clotting disorders
 inflammation or infection in the vagina or cervix

Lifestyle and home remedies

 Get your rest. Your doctor may recommend rest if bleeding is excessive and
disruptive to your normal schedule or lifestyle.
 Keep a record. Record the number of pads and tampons you use so that your
doctor can determine the amount of bleeding. Change tampons regularly, at least every
four to six hours.
 Avoid aspirin. Because aspirin interferes with blood clotting, avoid it. Ibuprofen
(Advil, Motrin, others) often is more effective than aspirin in relieving menstrual
discomforts.

Drug therapy for menorrhagia may include:

 Iron supplements. If the condition is accompanied by anemia, your doctor may
recommend that you take iron supplements regularly.
 Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen
(Advil, Motrin, others) help reduce menstrual blood loss. NSAIDs have the added benefit
of relieving painful menstrual cramps (dysmenorrhea).
 Oral contraceptives. Aside from providing effective birth control, oral
contraceptives can help regulate ovulation and reduce episodes of excessive or prolonged
menstrual bleeding.
 Progesterone. The hormone progesterone can help correct hormonal imbalance
and reduce menorrhagia.

Dysmenorrhea (Painful Periods)

2 types:

 Primary dysmenorrhea is very common in teens and is not caused by a disease

or other condition. Instead, the culprit is prostaglandin, the same chemical behind cramps.
Large amounts of prostaglandin can lead to nausea, vomiting, headaches, backaches,
diarrhea, and severe cramps. Fortunately, these symptoms usually last for only a day or
two.

 Secondary dysmenorrhea is pain caused by some physical condition like polyps

or fibroids in the uterus, endometriosis, pelvic inflammatory disease (PID), or
adenomyosis (uterine tissue growing into the muscular wall of the uterus).

Lifestyle and home remedies

 Once the pain begins, soaking in a hot bath or using a heating pad on your
abdomen may ease your cramps. Exercise regularly. Exercise results in an increased
release of endorphins, your body's natural painkillers.
 Get adequate rest. Your body may be less vulnerable to pain when you're well
rested.

 Treatments and drugs

 For secondary dysmenorrhea, you'll need treatment for the underlying cause.
Depending on that cause, treatment could include antibiotics to treat infection or surgery
to remove fibroids or polyps or to treat endometriosis.
 You may be able to reduce your discomfort from dysmenorrhea by using an over-
the-counter nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen
(Advil, Motrin, others) or naproxen
 For severe cramping, your doctor might recommend low-dose oral contraceptives
to prevent ovulation, which may reduce the production of prostaglandins and therefore
the severity of your cramps.
III. Male reproductive system
Unlike the female, whose sex organs are located entirely within the pelvis, the male
has reproductive organs, or genitals that are both inside and outside the pelvis. The male
genitals include:

 the testicles
 the duct system, which is made up
of the epididymis and the vas
deferens
 the accessory glands, which include
the seminal vesicles and prostate
gland
 the penis

 the two testicles or testes, produce and store millions of tiny sperm cells.
 The testicles are oval-shaped and grow to be about 2 inches (5 centimeters) in
length and 1 inch (3 centimeters) in diameter.
 The testicles are also part of the endocrine system because they produce
hormones, including testosterone
 Testosterone is a major part of puberty in guys, and as a guy makes his way
through puberty, his testicles produce more and more of it. a
 Testosterone is the hormone that causes guys to develop deeper voices, bigger
muscles, and body and facial hair, and it also stimulates the production of sperm.

 Alongside the testicles are the epididymis and the vas deferens which make up
the duct system of the male reproductive organs.
 The vas deferens is a muscular tube that passes upward alongside the testicles and
transports the sperm-containing fluid called semen
 The epididymis is a set of coiled tubes (one for each testicle) that connects to the
vas deferens.

 The epididymis and the testicles hang in a pouch-like structure outside the pelvis
called the scrotum.
 This bag of skin helps to regulate the temperature of testicles, which need to be
kept cooler than body temperature to produce sperm.
 The scrotum changes size to maintain the right temperature. When the body is
cold, the scrotum shrinks and becomes tighter to hold in body heat.
 When it's warm, the scrotum becomes larger and more floppy to get rid of extra
heat. This happens without a guy ever having to think about it. The brain and the nervous
system give the scrotum the cue to change size.

 The accessory glands, including the seminal vesicles and the prostate gland,
provide fluids that lubricate the duct system and nourish the sperm.

 The seminal vesicles are sac-like structures attached to the vas deferens to the
side of the bladder.

 The prostate gland, which produces some of the parts of semen, surrounds the
ejaculatory ducts at the base of the urethra just below the bladder.

 The urethra is the channel that carries the semen to the outside of the body
through the penis.

 The urethra is also part of the urinary system because it is also the channel
through which urine passes as it leaves the bladder and exits the body.

The penis is actually made up of two parts:

 the shaft and the glans

 the shaft is the main part of the penis
 the glans is the tip (sometimes called the head).
 At the end of the glans is a small slit or opening, which is where semen and urine
exit the body through the urethra.
 The inside of the penis is made of a spongy tissue that can expand and contract.

 All boys are born with a foreskin, a fold of skin at the end of the penis covering
the glans.

 Some boys have a circumcision which means that a doctor or clergy member
cuts away the foreskin. Circumcision is usually performed during a baby boy's first few
days of life.

 Although circumcision is not medically necessary

 parents who choose to have their children circumcised often do so based on

religious beliefs, concerns about hygiene, or cultural or social reasons.

 Boys who have circumcised penises and those who don't are no different:
 All penises work and feel the same, regardless of whether the foreskin has been
removed.

 Once a guy has reached puberty, he will produce millions of sperm cells every
day.

 Each sperm is extremely small: only 1/600 of an inch (0.05 millimeters long).
Sperm develop in the testicles within a system of tiny tubes called the seminiferous
tubules

 At birth, these tubules contain simple round cells, but during puberty, testosterone
and other hormones cause these cells to transform into sperm cells.

 The cells divide and change until they have a head and short tail, like tadpoles.

 The head contains genetic material (genes). The sperm use their tails to push
themselves into the epididymis, where they complete their development. It takes sperm
about 4 to 6 weeks to travel through the epididymis

 The sperm then move to the vas deferens, or sperm duct.

 The seminal vesicles and prostate gland produce a whitish fluid called seminal
fluid, which mixes with sperm to form semen when a male is sexually stimulated.

 The penis, which usually hangs limp, becomes hard when a male is sexually
excited.

 Tissues in the penis fill with blood and it becomes stiff and erect (an erection).
The rigidity of the erect penis makes it easier to insert into the female's vagina during
sexual intercourse.

 When the erect penis is stimulated, muscles around the reproductive organs
contract and force the semen through the duct system and urethra.
 Semen is pushed out of the male's body through his urethra — this process is
called ejaculation (pronounced: ih-jak-yuh-lay-shun). Each time a guy ejaculates, it can
contain up to 500 million sperm.

 When the male ejaculates during intercourse, semen is deposited into the female's
vagina. From the vagina the sperm make their way up through the cervix and move
through the uterus with help from uterine contractions. If a mature egg is in one of the
female's fallopian tubes, a single sperm may penetrate it, and fertilization, or
conception, occurs.