LC 2.22 Flashcards
what is the physiology of the female sexual response?
- desire
- arousal
- plateau
- orgasm
- resolution
- why is there a cyclical response?
it is cyclical because if a woman had good sexual experience then it will make her want to have sex
what happens in the first stage of arousal?
- stimulation of the parasympathetic fibres of the ANS
- genitals innervated from the neurons in S2-S4 segments of spinal cord
- activation of ANS controls afflux of blood to genitalia, secretion of glands and contraction of smooth muscle
what happens to the genital during arousal?
- clitoris swells and elongates
- stimulation of teh bartholin glands and vaginal epithelium secretes mucus
- the inner 1/3 of the vagina start to distend and elongates
- elevation of uterus pulls cervix away from vagina - increasing in length of vagina
- walls of vagina and labia minora becomes engorged
- labia majora flatten out and pull apart exposing vulva
what happens to the peripheral during arousal?
- respiratory changes
- rise in BP
- pupillary dilation
- blood flow to the breast increases
- nipples become erect
what happens to the neurotransmitters and hormones during desire?
- dopamine, oestrogen, testosterone, progesterone, oxytocin will stimulate
- prolactin, serotonin will inhibit
what happens to the neurotransmitters and hormones during arousal?
- dopamine, noradrenaline, oxytocin will stimulate
- prolactin, serotonin will inhibit
what happens to the genital during plateau?
- outer 1/3 start to swell and orgasm platform will be formed
- this make the opening smaller therefore more pressure on the penis which help the man to get orgasm
- clitoris will retract under the foreskin
- clitoris is able to take more stimulation
- uterus has quick and weak contractions
what happens to the peripheral during plateau?
- further rise in pulse and BP
- increase muscular tension
- the areolar becomes increase in size and makes it looks like the nipple less erect
what happens to the genital during stage 3 (orgasm)
- release of oxytocin
- spasm of muscles surrounding teh lower 1/3 of vagina
- spasm begin 2-4 seconds after woman begins to experience orgasm and repeat at 0.8 second intervals
- number of contractions and intensity varies
what happens to the peripheral during stage 3 (orgasm)
- nipples intensly erect and hard
- sex flush peaks
- heart rate, Bp and breathing reach peak
what happens to the neurotransmitters and hormones during stage 3 (orgasm)
- oxytocin and noradrenaline will stimulate
- serotonin will inhibit
what happens during resolution?
- reversal of arousal takes longer if no orgasm
- reversal of pelvic congestions can take hours
- some women do not have refractory phase
wht causes loss of libido?
- major life events
- illness
- endocrine or neurological disorders
- pain during intercourse
- menopause
- fear of pregnancy
- stress or chronic anxiety
- medications
what kind of drugs impair libido?
- anti-androgens
- anti-oestrogen
- anti-depressants
- alcohol and illegal drug use
- sedatives
- narcotics
causes of orgasmic disorders
- may be psychlogical
- medications
- chronic disease
what types of sexual pain disorders?
- superficial and deep
- superficial - entrace of vagina
- deep - occurs deep penile penetration for 80% of women
causes of superficial pain?
- infection
- narrowing of the introitus
- menopause
- vulvodynia
- functional changes
causes of deep pain?
- associated with pelvic pathology
- acute or chronic PID(pelvic inflammatory disease)
- retroverted uterus or prolapsed ovaries
- endometriosis
- neoplastic disease
- foreign bodies
what is vaginismus?
- spasm of pelvic floow muscles and adductor muscles of the thigh
- prevents or results in pain on attempted penile penetration
causes of vaginismus?
primary - result of fear of penetration
secondary - result of an experience of pain with intercourse after infection, sexual assault, difficult delivery or surgery
what are the treatments for vaginismus?
- involves progressive muscle relaxation and vaginal dilation
- resort to surgery - not recommended
medical conditions that affect female sexual response
- psychological factors
- stress
- medications
- vascular damage
- physical symptoms
- depression
- nerve damage
