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SEMINAR
HUMAN SEXUALITY
&
SEXUAL HEALTH

Submitted by, Submitted to,

Mrs Gayathri R Mr Aneesh
1st Year MSc Nursing Assistant Professor
Upasana College Of Upasana College Of
Nursing Kollam Nursing Kollam

Submitted on:
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The sexual response cycle is a model that describes the physiological responses
that occur during sexual activity. This model was created by William
Masters and Virginia Johnson. According to Masters and Johnson, the human sexual
response cycle consists of four phases; excitement, plateau, orgasm, and
resolution, also called the EPOR model. During the excitement phase of the EPOR
model, one attains the intrinsic motivation to have sex. The plateau phase is the
precursor to orgasm, which may be mostly biological for men and mostly
psychological for women. Orgasm is the release of tension, and the resolution period
is the unaroused state before the cycle begins again.
The male sexual response cycle starts in the excitement phase; two centres in the
spine are responsible for erections. Vasoconstriction in the penis begins, the heart
rate increases, the scrotum thickens, the spermatic cord shortens, and the testicles
become engorged with blood. In the plateau phase, the penis increases in diameter,
the testicles become more engorged, and the Cowper's glands secrete pre-seminal
fluid. The orgasm phase, during which rhythmic contractions occur every 0.8
seconds, consists of two phases; the emission phase, in which contractions of the
vas deferens, prostate, and seminal vesicles encourage ejaculation, which is the
second phase of orgasm. Ejaculation is called the expulsion phase; it cannot be
reached without an orgasm. In the resolution phase, the male is now in an
unaroused state consisting of a refectory (rest) period before the cycle can begin.
This rest period may increase with age.
The female sexual response begins with the excitement phase, which can last from
several minutes to several hours. Characteristics of this phase include increased
heart and respiratory rate, and an elevation of blood pressure. Flushed skin or
blotches of redness may occur on the chest and back; breasts increase slightly in
size and nipples may become hardened and erect. The onset
of vasocongestion results in swelling of the clitoris, labia minora, and vagina. The
muscle that surrounds the vaginal opening tightens and the uterus elevates and
grows in size. The vaginal walls begin to produce a lubricating liquid. The second
phase, called the plateau phase, is characterized primarily by the intensification of
the changes begun during the excitement phase. The plateau phase extends to the
brink of orgasm, which initiates the resolution stage; the reversal of the changes
begun during the excitement phase. During the orgasm stage the heart rate, blood
pressure, muscle tension, and breathing rates peak. The pelvic muscle near the
vagina, the anal sphincter, and the uterus contract. Muscle contractions in the
vaginal area create a high level of pleasure, though all orgasms are centered in the
clitoris.

EVOLUTION OF NEUROBIOLOGICAL FACTORS IN SEXUALITY

From rodent to human, the corticalization of the brain induces several changes in the
control of sexual behaviour, including lordosis behaviour. These changes induce a
"difference between the stereotyped sexual behaviours in non-human mammals and
the astounding variety of human sexual behaviours".
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Evolution of the main neurobiological factors that control the sexual behaviour of
mammals
Sexual reflexes, such as the motor reflex of lordosis, become secondary. In
particular, lordosis behaviour, which is a motor reflex complex and essential to carry
out copulation in non-primate mammals (rodents, canines, bovid ...), is apparently no
longer functional in women. Sexual stimuli on women do not trigger any more neither
immobilization nor the reflex position of lordosis. On the level of olfactory systems,
the vomeronasal organ is altered in hominids and 90% of the
pheromone receptor genes become pseudo genes in humans. Concerning hormonal
control, sexual activities are gradually dissociated from hormonal cycles. Humans
can have sex anytime during the year and hormonal cycles. On the contrary, the
importance of rewards / reinforcements and cognition became major. Especially in
humans, the extensive development of the neocortex allows the emergence
of culture, which has a major influence on behaviour. For all these reasons, the
dynamics of sexual behaviour was modified.
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Multifactorial dynamics of human sexuality

In human beings, sexuality is multifactorial, with several factors that interact (genes,
hormones, conditioning, sexual preferences, emotions, cognitive processes, cultural
context). The relative importance of each of these factors is dependent both on
individual physiological characteristics, personal experience and aspects of the
sociocultural environment.

SEXUAL DYSFUNCTION
Sexual dysfunction can be a result of a physical or psychological problem.

 Physical causes. Many physical and/or medical conditions can cause problems

with sexual function. These conditions include diabetes, heart disease,
neurological diseases, hormonal imbalances, menopause plus such chronic
diseases as kidney disease or liver failure, and alcoholism or drug abuse. In
addition, the side effects of certain medications, including
some antidepressant drugs, can affect sexual desire and function.
 Psychological causes. These include work-related stress and anxiety, concern
about sexual performance, marital or relationship problems, depression, feelings
of guilt, or the effects of a past sexual trauma.
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Both men and women are affected by sexual dysfunction. Sexual problems occur in
adults of all ages. Among those commonly affected are older adults, and they may be
related to a decline in health associated with aging.
MALE DYSFUNCTION

It is any physical or psychological problem that prevents partners from getting

sexual satisfaction. Male sexual dysfunction is a common health problem affecting
men of all ages, but is more common with increasing age. Treatment can often help
men suffering from sexual dysfunction.

The main types of male sexual dysfunction are:

 Erectile dysfunction (difficulty getting/keeping an erection)

 Premature ejaculation (reaching orgasm too quickly)
 Delayed or inhibited ejaculation (reaching orgasm too slowly or not at all)
 Low libido (reduced interest in sex).

Physical causes of overall sexual dysfunction may be:

 Low testosterone levels

 Prescription drugs (antidepressants, high blood pressure medicine)
 Blood vessel disorders such as atherosclerosis (hardening of the arteries) and
high blood pressure
 Stroke or nerve damage from diabetes or surgery
 Smoking
 Alcoholism and drug abuse

Psychological causes might include:

 Concern about sexual performance

 Marital or relationship problems
 Depression, feelings of guilt
 Effects of past sexual trauma
 Work-related stress and anxiety

The most common problems men face with sexual dysfunction are troubles with
ejaculation, getting and keeping an erection, and reduced sexual desire.

Ejaculation disorders

Problems with ejaculation are:

 Premature ejaculation (PE) — ejaculation that occurs before or too soon after
penetration
 Inhibited or delayed ejaculation — ejaculation does not happen or takes a
very long time
 Retrograde ejaculation — at orgasm, the ejaculate is forced back into the
bladder rather than through the end of the penis
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The exact cause of premature ejaculation (PE) is not known. While in many cases
PE is due to performance anxiety during sex, other factors may be:

 Stress
 Temporary depression
 History of sexual repression
 Low self-confidence
 Lack of communication or unresolved conflict with partner

Studies suggest that the breakdown of serotonin (a natural chemical that affects
mood) may play a role in PE. Certain drugs, including some antidepressants, may
affect ejaculation, as can nerve damage to the back or spinal cord.

Physical causes for inhibited or delayed ejaculation may include chronic (long-

term) health problems, medication side effects, alcohol abuse, or surgeries. The
problem can also be caused by psychological factors such as depression, anxiety,
stress, or relationship problems.

Retrograde ejaculation is most common in males with diabetes who suffer from
diabetic nerve damage. Problems with the nerves in the bladder and the bladder
neck force the ejaculate to flow backward. In other men, retrograde ejaculation may
be a side effect of some medications, or happen after an operation on the bladder
neck or prostate.

Erectile dysfunction (ED)

Erectile dysfunction (ED) is the inability to get and keep an erection for sexual
intercourse. ED is quite common, with studies showing that about one half of
American men over age 40 are affected. Causes of ED include:

 Diseases affecting blood flow such as hardening of the arteries

 Nerve disorders
 Stress, relationship conflicts, depression, and performance anxiety
 Injury to the penis
 Chronic illness such as diabetes and high blood pressure
 Unhealthy habits like smoking, drinking too much alcohol, overeating, and
lack of exercise

Low libido (reduced sexual desire)

Low libido means your desire or interest in sex has decreased. The condition is often
linked with low levels of the male hormone testosterone. Testosterone maintains sex
drive, sperm production, muscle, hair, and bone. Low testosterone can affect your
body and mood.

Reduced sexual desire may also be caused by depression, anxiety, or relationship

difficulties. Diabetes, high blood pressure, and certain medications like
antidepressants may also contribute to a low libido.
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FEMALE DYSFUNCTION