HUMAN SEXUALITY TOPIC 1: INTRODUCTION Major Terms used in Human Sexuality. Human sexuality can be defined as the ways in which we experience and express ourselves as sexual beings. activities involving our sexual organs (for purposes of reproduction or pleasure). It also relates to erotic feelings, experiences or desires such as sexual fantasies, urges or sexual attraction. Gender: this is one’s personal, social, and legal status as male or female. Gender identity: this is one’s personal experience of being male or female. Gender roles: these are complex clusters of ways in which males and females are expected to behave within a given culture. expression of erotic or affectionate feelings. Sexual behaviour includes masturbation, coitus, kissing, hugging, manual manipulation of genitals and oral-genital manipulation. understanding, interpersonal sexual skills, scientific knowledge, and consideration of the cultural context of sexuality. Foreplay: this is the mutual sexual stimulation that precedes sexual intercourse. The Study of Human Sexuality how our sexual behaviour and attitudes are shaped by perception, learning, thought, motivation and emotion, and personality. Socio-cultural theorists consider the socio-cultural contexts of sexual behaviour. Anthropologists focus on cross-cultural similarities and differences in sexual behaviour. (Rathus, Nevid, Rathus, 1997). Thinking Critically about Human Sexuality 1. Be skeptical 2. Examine definitions of terms 3. Examine the assumptions or premises of arguments 4. Be cautious in drawing conclusions from evidence 5. Consider alternative interpretations of research evidence 6. Consider the kinds of evidence upon which conclusions are based 7. Do not oversimplify 8. Do not over-generalize Perspectives on Human Sexuality It is important to view the field/study of human sexuality from different perspectives. For purposes of this course, we will use the following: 1. The Historical Perspective History places our sexual behaviour in the context of time. History also shows little evidence of universal sexual trends

2. The Biological Perspective genetic, hormonal, vascular and neural. They are used to explain human sexual behaviour. Issues of sexual stimulation can be assessed using the biological perspective.

3. The Cross-Species Perspective of other animal species. Studies in this area have revealed behaviour similar to that of humans although caution is advised not to generalize findings across species.

4. The Cross-Cultural Perspective affect sexual behaviour and people’s sense of morality. Cross-cultural research shows that some cultures are more sexually permissive than others although all cultures place some limits on sexual freedom.

5. The psychological perspective psychological factors of perception, learning, motivation, emotion and personality, amongst others that affect gender and sexual behaviour in the individual.

6. The sociocultural perspective in sexuality among the groups within a society as defined by factors such as race, social class, age, educational level, etc

TOPIC 2: SEX RESEARCH test assumptions in a scientific way. To find out of assumptions are true or false and to document what underlying relationships, if any, are revealed. private area in our lives that few of us are ready and willing to discuss with others. Sexual matters are also clouded by myth, exaggeration, secrecy and value judgments. Goals of Sexology sexology include understanding, explaining, predicting and controlling or influencing events in the field of human sexuality. in control of behaviour has some value. Research has been used to develop initiatives that have led to the reduction in HIV infection rates and the increase in the use of contraceptives. have been criticized for e.g. helping couples choose the biological sex of children. Sex therapists have also been criticized for work done among deviant sex offenders. Definitions in Sexology Variables: Quantities or qualities that vary or may not vary in a study Demographic: Concerning the vital statistics of human populations e.g. Density, race, age etc. Population: A complete group of organisms or events Sample: Part of a population Generalize: To go from the particular to the general should take an empirical approach. This means that discussions are derived from or based on observation and experimentation. The scientific method has a number of elements involved in gathering evidence and testing assumptions through research. These are: 1. Formulating a research question 2. Framing the research question in the form of a hypothesis 3. Testing the hypothesis 4. Drawing conclusions A hypothesis is a precise prediction about behaviour that is tested through research.

Research Methods in sexology

Methods of Observation a) The Case-Study Method biographies of individuals or groups of people that focus on discovering the interplay of various factors in individuals’ backgrounds. b) The Survey Method information about behaviour through interviews or questionnaires administered to large samples of people. c) The Naturalistic-Observation Method This involves directly observing the behaviour of people or animals where it happens d) The Ethnographic-Observation Method This focuses on providing data concerning sexual behaviours and customs that occur widely across cultures. e) The Participant-Observation Method This involves investigators learning about people’s behaviour by interacting with them. f) The Laboratory-Observation Method This involves having people engage in the behaviour under study in the laboratory setting.

The Correlational Method of Research the strength and direction of the relationship between variables. They do not show/reveal cause and effect.

The Experimental Method of Research the variables of interest and observing their effects. This therefore allows one to draw conclusions about cause and effect. A summary of research methods

Method Brief Description Advantages Disadvantages subject or a small group of subjects, each of whom is studied individually and in depth Flexibility in data-gathering procedures. In-depth explorations of behaviours, thoughts, and feelings. Limited generalizability of findings. Accuracy of data limited by fallibility of human memory Not suitable for many kinds of research questions from relatively large groups of people by means of questionnaires and interviews Relatively cheap & quick method of obtaining large amounts of data Can obtain data from more people than is practical to study in the laboratory or through case studies Problems of: Nonresponse Demographic bias Inaccurate information observe & record responses of particular subjects Virtually eliminates the possibility of data falsification Subjects’ behaviour can be influenced by presence of observer(s) or the artificial nature of the environment where observations are made. of conditions, or variables, and observes the effect of this manipulation on subjects’ behaviour. Provides a controlled environment for managing relevant variables. relationships between variables Artificiality of laboratory settings can adversely influence or bias subjects’ responses. Problems of Sex Survey Research sample for their studies. Many people would rather not participate in sex studies. Some of the most common problems incurred in sex research are: a) Nonresponse participate in a research study. Often, only a minority of the selected subjects voluntarily participate in studies b) Self-selection or Volunteer bias more sexually experienced and hold more positive attitudes toward sexuality and sex research than do non-volunteers (Boynton, 2003; Plaud et al., 1999). Research also indicates that women are less likely than men to volunteer for sex research (Boynton, 2003; Plaud et al., 1999). c) Inaccuracy of responses Ochs & Binik, 1999). People may have forgotten facts that they then report or may exaggerate so as to increase their ‘social desirability’. People can also feel pressure to deny or minimize their experiences regarding behaviours for which strong taboos exist, such as incest, homosexuality and masturbation. d) Demographic bias which certain segments of society are disproportionately represented in a study population. University students tend to be overrepresented in such studies. Ethics in Research a) Confidentiality: Sex researchers must keep the identities and responses of participants confidential at all times. in sex research must be provided enough/adequate information about the purposes, procedures, risks and benefits of the studies in order to make informed decisions. necessary to deceive participants in order to effectively carry out a study. This is particularly in regard to purposes and procedures. d) Debriefing: When people are deceived in research, they are debriefed afterward to minimize the risk of harm. conducted only when the expected benefits outweigh the anticipated risks to participants. It therefore behooves the experimenter to minimize expected risks. Evaluating Research TOPIC 3: FEMALE SEXUAL ANATOMY AND PHYSIOLOGY an important aspect of a woman’s sexual well-being and her sexual intelligence. This lecture will focus on a detailed description of all female genital structures, external and internal. A) EXTERNAL STRUCTURES

The Vulva majora, labia minora, clitoris and urinary and vaginal openings. It is sometimes mistakenly referred to as the vagina which is an internal structure with only the opening, a part of the vulva. The appearance of the vulva differs from person to person. It has been likened to different forms found in nature such as flowers. The Mons Veneris tissues between the pubic bone and the skin. Touch and pressure on the mons can be sexually pleasurable because of the presence of numerous nerve endings. hair in mons area also prevents uncomfortable friction and provides cushioning during intercourse. Removing pubic hair by way of trimming, shaving, waxing etc. has however now become common. The Labia Majora They begin next to the thigh and extend inward, surrounding the labia minora and the urethral and vaginal openings. Next to the thigh the outer lips are covered with pubic hair; their inner parts, next to the labia minora are hairless.

The Labia Minora prepuce is the foreskin or fold of skin over the clitoris. The labia minora contain sweat and oil glands, extensive blood vessels, and nerve endings. They vary in size, shape, length and colour. labiaplasty is increasingly being done to alter labia minora. Piercing and wearing jewelry on vulva tissues is another way some alter the appearance of their genitals. The most common sites for female genital piercings are the clitoral hood or body and the labia minora or majora. hypersensitivity and decreased sexual function (Committee on Gynecological Practice, 2007). Risks from piercings include contracting HIV, Hepatitis B, and bacterial infections. Local and systemic infections, abscess formation, allergic reactions, torn flesh and problematic scarring can also result from labial piercings.

The Clitoris comprises the external shaft and glans and the internal crura (roots) that project inward from each side of the clitoral shaft. The glans is the head of the clitoris, which is richly endowed with nerve endings, while the shaft the length of the clitoris between the glans and the body. the highly concentrated nerve endings in the clitoris, the erroneous belief has persisted that vaginal rather than clitoral stimulation is or should be exclusively responsible for female sexual arousal and orgasm. Some women experience more intense arousal from vaginal stimulation than from clitoral stimulation, especially after they are aroused and the vaginal tissues are fully The Vestibule This is the area of the vulva inside the labia minora. It is rich in blood vessels and nerve endings, and its tissues are sensitive to touch. The Urethral Opening The urethra is the short tube through which urine passes from the bladder. The Introitus and the Hymen usually large enough to insert tampons. In rare cases, an imperforate hymen, tissue that completely seals the vaginal opening, causes menstrual flow to collect inside the vagina. When this is discovered, the hymen needs to be opened with an incision. woman to become pregnant even with an intact hymen and without penile penetration. With semen placed on the labia minora, sperm can swim into the vagina. discomfort or bleeding to occur. In some cases it may even remain intact after intercourse. If a woman manually stretched her hymen before initial intercourse, she may be able to minimize the discomfort that sometimes occurs. The Perineum and anus of the female and the scrotum and anus of the male. It is endowed with nerve endings and is sensitive to touch. Underlying Structures The Vestibular Bulbs arousal causing the vagina to lengthen and the vulva area to swell. Compression of these tissues by the penis during intercourse causes internal sensations that some women find pleasurable (Ellison, 2000). Bartholin’s glands These are two small glands, one on each side of the vaginal opening, that secrete a few drops of fluid during sexual arousal. B) INTERNAL STRUCTURES Internal female sexual anatomy consists of the vagina, cervix, uterus, and ovaries

The Vagina upward toward the small of the back, to the cervix and uterus. It extends about 3 to 5 inches into the pelvis when un aroused. The vagina contains three layers of tissue: mucous, muscle and fibrous tissue. can be felt by a woman when she inserts a finger in her vagina. During sexual arousal, a lubricating substance exudes through the mucosa. Muscle: this is mainly concentrated around the vaginal opening. The muscles contract rhythmically at orgasm. Fibrous tissue: this layer aids in vaginal contraction and expansion and acts as connective tissue to other structures in the pelvic cavity. The Grafenberg Spot vagina, about 1 centimeter from the skin’s surface and one third to one half the distance from the vaginal opening to the back of the vagina. It consists of a system of glands (Skene’s glands) and ducts that surround the urethra. This area is believed to be the female counterpart to the male prostate gland, developed from the same embryonic tissue. experience sexual arousal, orgasm, and an ejaculation of fluid when stimulated there (Darling et al., 1990), although many women do not have such an area of increased sensation Arousal and Vaginal Lubrication the vaginal mucosa within 10 to 30 seconds after effective physical or psychological stimulation begins. Vaginal lubrication serves two functions: chemical balance. Vaginal pH level changes from 4.5 to 6.0-6.5 with sexual arousal (Meston, 2000). Sperm travel faster and survive longer in an alkaline environment than in an acidic one. touching. During oral-genital sex, some women’s partners enjoy the erotic scent and taste of the vaginal lubrication. During intercourse, vaginal lubrication makes the walls of the vagina slippery, which facilitates entry of the penis into the vagina. Vaginal Secretions and Chemical Balance of the Vagina secretions vary in appearance according to hormone level changes during the menstrual cycle. The taste of vaginal secretions can also vary with the time of a woman’s cycle and her level of arousal. healthy mucosa. The chemical balance is normally pH 4.5. There are some factors that can alter the pH balance of the vagina. These include: found that douching increases the risk of pelvic inflammatory disease, endometriosis, transmission of HIV, ectopic pregnancy and decreased fertility. These sprays can cause irritation, allergic reactions, burns, infections, dermatitis of thighs amongst other problems. The Cervix the vagina. It contains mucus- secreting glands. Sperm pass through the vagina into the uterus through the os; the opening in the center of the cervix. The Uterus suspended in the pelvic cavity by ligaments. In different women its position can vary from anteflexed (tipped forward to the abdomen) to retroflexed (tipped back toward the spine). Women with retroflexed uteri are more likely to experience menstrual discomfort. The walls of the uterus consist of three layers: a) Perimetrium: This is a thin membrane that covers the outside of the uterus muscle layer made of longitudinal and circular muscle fibers that interweave to enable the uterus to stretch during pregnancy as well as contract during labour and orgasm lining of the uterus that is rich in blood vessels. It nourishes the zygote. It is also a source of hormone production. The Fallopian Tubes egg leaves the ovary, it is drawn into the tube by the fimbriae. Once the egg is inside the fallopian tube, the movements of tiny hair-like cilia and contractions of the tube walls move it along at a rate of approximately 1 inch every 24 hours. fallopian tube. This implantation can rupture and cause uncontrolled bleeding. The most common symptoms of ectopic pregnancy are abdominal pain and spotting that occur 6 to 8 weeks after the last menstrual period. The Ovaries They are located at the ends of the fallopian tubes, one on each side of the uterus and are connected to the pelvic wall and the uterus by ligaments. The ovaries are endocrine glands that produce different classes of sex hormones: a) Estrogens: these hormones influence the development of female physical sex characteristics and help regulate the menstrual cycle. these help regulate the menstrual cycle and promote maturity of the uterine lining in preparation for pregnancy. Ovulation: this is the release of a mature ovum from the ovary. Menstruation This is the sloughing off of the built-up uterine lining that takes place if conception has not occurred. Attitudes about menstruation attitudes among different communities about menstruation. Sexual Activity and the Menstrual Cycle: Discuss Menarche and occurs during a time of other changes in body size and development. Researchers attribute the decrease in age of first menses to the increase in the number os girls who are overweight. Fat cells produce a hormone, leptin, which supports reproductive functions and is likely the primary cause of earlier menstruation. Menstrual Physiology to woman and time to time. One study found that women who menstruated every 30-31 days had higher rates of pregnancy than did women with shorter or longer cycles (Small et al., 2006). Longer intervals between periods can be a sign of an underlying medical problem that causes hormone imbalances. Menstrual Synchrony occur among women who live in close proximity. The function of the uniform cycles is unknown, but the sense of smell is believed to be the trigger. Premenstrual Syndrome sugar and salt. Psychological symptoms include irritability, tensions, depression, mood swings and a feeling of a lack of emotional control. A small percentage of women have symptoms severe enough for a diagnosis of Premenstrual Dysphoric Disorder (PMDD), with symptoms significantly affecting their normal functioning (Steiner et al., 2006). Dysmenorrhea primary dysmenorrhea usually appear with the onset of menstruation at adolescence. The symptoms include abdominal aching and or cramping. Some women report to experiencing nausea, vomiting, diarrhea, headache, dizziness, fatigue, irritability or nervousness. dysmenorrhea, are thought to be cause by; presence of an intrauterine device (IUD), pelvic inflammatory disease, benign uterine tumors, obstruction of the cervical opening and endometriosis. Endometriosis is a condition in which uterine tissue grows on various parts of the abdominal cavity. Amenorrhea This is defined as the absence of menstruation. Two types of amenorrhea exist: failure to begin to menstruate at puberty. It can because of; problems with the reproductive organs, hormonal imbalances, poor health of an imperforate hymen. involves the disruption of an established menstrual cycle, with the absence of menstruation for 3 months or more. pregnancy and breast-feeding, is common in women who have just began menstruating and in women approaching menopause. amenorrhea have decreased estrogen levels and are at increased risk for developing certain health problems. These health problems include decreased bone mineral density which can result in increased bone fractures and atrophy of the genital tissues. Self-Help for Menstrual Problems: Discuss Toxic Shock Syndrome include fever, sore throat, nausea, vomiting, diarrhea, dizziness and low blood pressure (Hanrahan, 1994). TSS is caused by toxins produced by the bacterium Staphylococcus aureus. TSS can cause death because it progresses rapidly. Some suggestions to help prevent TSS include: a) Use sanitary napkins instead of tampons. b) For users of tampons, use regular instead of super-absorbent tampons. c) Change tampons three to four times during the day. d) Use napkins for some time during each 24 hours of menstrual flow. Menopause menstruation. It occurs as a result of certain physiological changes and takes place at a mean age of 51 but can occur in the 30s or as late as the 60s (G. Andrews, 2006). the ovaries begin to slow the production of estrogen. This period before complete cessation of menstruation is called perimenopause. This period can last up to 10 years. Up to 90% of women experience a change in menstrual patterns and sexual response during perimenopause. smoke tobacco, began their periods by age 11, had shorter cycles, had fewer pregnancies, and had less time of oral contraceptive use than women who experience menopause later (Palmer et al., 2003). uncomfortable or painful (Ettinger et al., 2008). Women may have difficulty achieving sexual arousal (Dennerstain, 2007). Sleep disturbance can increase during menopause and can easily result in fatigue, irritability, short-term memory loss, and difficulty concentrating during the day (Kantrowitz, 2006a; Maki et al., 2008). Menopausal symptoms can also include dizziness, difficulty Hormone Therapy Hormones typically used are estrogen, progesterone and testosterone. Hormone therapy is used to alleviate problems that can arise from the decrease in natural hormone production that occurs during the female climacteric. Estrogen and progesterone are made from synthetic chemicals or can be derived from plants, some of which are bio-identical to human estrogen. Testosterone is made from synthetic chemicals. Bio-identical Hormones These hormones have the same molecular structure as hormones produced by the human body. Women should keep themselves abreast with new research results and discuss the available evidence and their individual health history and lifestyle with a health-care specializing in menopause and hormone therapy.