NCM 107 8/15/19

Care of
Mother, Child,
& Adolescent Antepartum/Pregnancy

NCM 107
2

Male Reproductive System “

3 4

Male External Structures

• The Scrotum

“ • The Testes
• The Penis

5 Male Internal & External Reproductive Organs 6

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NCM 107
The Scrotum
• The scrotum is a rugated, skin-covered, muscular
pouch suspended from the perineum.
• Its functions are to support the testes and to help
regulate the temperature of sperm.
• In very cold weather, the scrotal muscle contracts
to bring the testes closer to the body;
• In very hot weather, or in the presence of fever,
the muscle relaxes, allowing the testes to fall away
from the body.
• In this way, the temperature of the testes can
remain as even as possible to promote the
production and viability of sperm.
7 8
Penis
• The penis is composed of three cylindrical masses of
erectile tissue in the penis shaft: two termed the corpus
cavernosa, and a third termed the corpus spongiosum.
• The urethra passes through these layers of erectile
tissue, making the penis serve as the outlet for both the
urinary and the reproductive tracts in men.
• With sexual excitement, nitric oxide is released from the
endothelium of blood vessels. This results in dilation of
blood vessels and an increase in blood flow to the
arteries of the penis (engorgement).
9 10
Male Internal Structures
• The epididymis
• The vas deferens
• The seminal vesicles
• The ejaculatory ducts
• The prostate gland
• The urethra
• The bulbourethral glands
11
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Testes
• The testes are two ovoid glands, 2 to 3 cm wide, that lie
in the scrotum.
• Each testis is encased by a protective white fibrous
capsule and is composed of several lobules, with each
lobule containing interstitial cells (Leydig’s cells) and a
seminiferous tubule.
• Seminiferous tubules produce spermatozoa.
• Leydig’s cells are responsible for the production of
testosterone.
• In most males, one testis is slightly larger than the other
and is suspended slightly lower in the scrotum than the
other (usually the left one).
Penis
• The ischiocavernosus muscle at the base of the penis
then contracts, trapping both venous and arterial blood
in the three sections of erectile tissue and leading to
distention and erection of the penis.
• The penile artery, a branch of the pudendal artery,
provides the blood supply for the penis.
• Penile erection is stimulated by parasympathetic nerve
innervation.
• At the distal end of the organ is a bulging, sensitive ridge
of tissue, the glans.
• A retractable casing of skin, the prepuce, protects the
nerve-sensitive glans at birth.
The epididymis
• The seminiferous tubule of each testis leads to a
tightly coiled tube, the epididymis, which is
responsible for conducting sperm from the
tubule to the vas deferens, the next step in the
passage to the outside.
• Each epididymis is tightly coiled, its length is
extremely deceptive: it is actually over 20 ft long.
• Some sperm are stored in the epididymis, and a
portion of the alkaline fluid that will surround
sperm at maturity (semen, or seminal fluid that
contains a basic sugar and mucin, a form of
protein) is produced by the cells lining the
epididymis.
12
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NCM 107
The epididymis
• Sperm are immobile and incapable of fertilization
as they pass or are stored at the epididymis level.
• It takes at least 12 to 20 days for them to travel
the length of the epididymis and a total of 64
days for them to reach maturity.
• This is one reason that aspermia (absence of
sperm) and oligospermia (<20 million sperm/mL)
are problems that do not appear to respond
immediately to therapy but rather only after 2
months.
13
Seminal Vesicles
• The seminal vesicles are two convoluted
pouches that lie along the lower portion
of the posterior surface of the bladder
and empty into the urethra by way of
the ejaculatory ducts.
• These glands secrete a viscous alkaline
liquid that has a high sugar, protein, and
prostaglandin content.
• Sperm become increasingly motile with
this added fluid, because it surrounds
them with nutrients and a more
favorable pH.
15
Prostate Gland
• The prostate is a chestnut-sized gland
that lies just below the bladder.
• The urethra passes through the center
of it, like the hole in a doughnut.
• The prostate gland secretes a thin,
alkaline fluid.
• When added to the secretion from the
seminal vesicles and the accompanying
sperm from the epididymis, this alkaline
fluid further protects sperm from being
immobilized by the naturally low pH
level of the urethra.
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Vas Deferens (Ductus Deferens)
• The vas deferens is an additional hollow tube
surrounded by arteries and veins and protected
by a thick fibrous coating.
• It carries sperm from the epididymis through the
inguinal canal into the abdominal cavity, where it
ends at the seminal vesicles and the ejaculatory
ducts.
• Sperm mature as they pass through the vas
deferens. They are still not mobile at this point,
however, probably because of the fairly acidic
medium of the semen produced at this level.
• The blood vessels and vas deferens together are
referred to as the spermatic cord.
14
Ejaculatory Ducts
• The two ejaculatory ducts pass through
the prostate gland and join the seminal
vesicles to the urethra.
16
Prostate Gland
• In middle life, many men develop benign
hypertrophy of the prostate.
• This swelling interferes with both
fertility and urination.
• A benign condition, it can be relieved by
medical therapy or surgery but needs to
be differentiated from prostate cancer.
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NCM 107 8/15/19

Bulbourethral Glands Urethra

• Two bulbourethral or Cowper’s glands • The urethra is a hollow tube leading

lie beside the prostate gland and empty
via short ducts into the urethra.
• Like the prostate gland and seminal
vesicles, they secrete an alkaline fluid
that helps counteract the acid secretion
of the urethra and ensure the safe
passage of spermatozoa.
• Semen, therefore, is derived from the
prostate gland (60%), the seminal
vesicles (30%), the epididymis (5%), and
the bulbourethral glands (5%).
19
from the base of the bladder, which,
after passing through the prostate
gland, continues to the outside through
the shaft and glans of the penis.
• It is approximately 8 inches (18 to 20
cm) long.
• Like other urinary tract structures, it is
lined with mucous membrane.
20

Female Reproductive System

“

21 22 Female External Reproductive Organs

Female External Structures

• Mons Veneris

“
• Labia Minora
• Labia Majora
• Other External Organs
• Vulvar Blood Supply
• Vulvar Nerve Supply

23 Female External Reproductive Organs 24

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NCM 107
Mons Veneris
• The mons veneris is a pad of adipose
tissue located over the symphysis pubis,
the pubic bone joint.
• It is covered by a triangle of coarse, curly
hairs.
• The purpose of the mons veneris is to
protect the junction of the pubic bone
from trauma.
25
Labia Majora
• The labia majora are two folds of
adipose tissue covered by loose
connective tissue and epithelium that
are positioned lateral to the labia
minora.
• Covered by pubic hair, the labia majora
serve as protection for the external
genitalia and the distal urethra and
vagina.
• They are fused anteriorly but separated
posteriorly.
27
Clitoris
• The clitoris is a small (approximately 1 to 2
cm), rounded organ of erectile tissue at the
forward junction of the labia minora.
• It is covered by a fold of skin, the prepuce.
• The clitoris is sensitive to touch and
temperature and is the center of sexual
arousal and orgasm in a woman.
• Arterial blood supply for the clitoris is
plentiful.
• When the ischiocavernosus muscle
surrounding it contracts with sexual arousal,
the venous outflow for the clitoris is blocked,
leading to clitoral erection.
29
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Labia Minora
• Just posterior to the mons veneris
spread two hairless folds of connective
tissue, the labia minora.
• Before menarche, these folds are fairly
small; by childbearing age, they are firm
and full; after menopause, they atrophy
and again become much smaller.
• Normally the folds of the labia minora
are pink; the internal surface is covered
with mucous membrane, and the
external surface with skin.
26
Vestibule
• The vestibule is the flattened, smooth
surface inside the labia.
• The openings to the bladder (the
urethra) and the uterus (the vagina)
both arise from the vestibule.
28
Skene’s Glands
• Two Skene’s glands (paraurethral
glands) are located just lateral to the
urinary meatus, one on each side.
• Their ducts open into the urethra.
30
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NCM 107
Bartholin’s Glands
• Bartholin’s glands (vulvovaginal glands)
are located just lateral to the vaginal
opening on both sides.
• Their ducts open into the distal vagina.
• Secretions from both of these glands
help to lubricate the external genitalia
during coitus.
• The alkaline pH of their secretions helps
to improve sperm survival in the vagina.
31
Perineal Muscle
• Posterior to the fourchette is the
perineal muscle or the perineal body.
• Because this is a muscular area, it is
easily stretched during childbirth to
allow for enlargement of the vagina and
passage of the fetal head.
• Many exercises suggested for pregnancy
(such as Kegel’s, squatting, and tailor-
sitting) are aimed at making the perineal
muscle more flexible to allow easier
expansion during birth without tearing
of this tissue.
33
Vulvar Blood Supply
• The blood supply of the external genitalia is
mainly from the pudendal artery and a
portion of the inferior rectus artery.
• Venous return is through the pudendal vein.
• Pressure on this vein by the fetal head can
cause extensive back-pressure and
development of varicosities (distended
veins) in the labia majora.
• Because of the rich blood supply, trauma to
the area, such as occurs from pressure
during childbirth, can cause large
hematomas.
35
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Fourchette
• The fourchette is the ridge of tissue
formed by the posterior joining of the
two labia minora and the labia majora.
• This is the structure that is sometimes
cut (episiotomy) during childbirth to
enlarge the vaginal opening.
32
Hymen
• The hymen is a tough but elastic
semicircle of tissue that covers the
opening to the vagina in childhood.
• It is often torn during the time of first
sexual intercourse.
• However, because of the use of
tampons and active sports participation,
many girls who have not had sexual
relations do not have intact hymens at
the time of their first pelvic
examination.
34
Vulvar Nerve Supply
• The anterior portion of the vulva derives
its nerve supply from the ilioinguinal and
genitofemoral nerves (L1 level).
• The posterior portions of the vulva and
vagina are supplied by the pudendal
nerve (S3 level).
• Such a rich nerve supply makes the area
extremely sensitive to touch, pressure,
pain, and temperature.
• Normal stretching of the perineum with
childbirth causes temporary loss of
sensation in the area.
36
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NCM 107 8/15/19

“ “

37 Female Internal Reproductive Organs 38 Female Internal Reproductive Organs

“ “

39 Female Internal Reproductive Organs 40 Female Internal Reproductive Organs

Female Internal Structures Ovaries

• Ovaries • The ovaries are approximately 4 cm long by

• Fallopian tubes 2 cm in diameter and approximately 1.5 cm
thick, or the size and shape of almonds.
• Uterus
• They are grayish white and appear pitted, or
• Vagina with minute indentations on the surface.
• An unruptured, glistening, clear, fluid-filled
graafian follicle (an ovum about to be
discharged) or a miniature yellow corpus
luteum (the structure left behind after the
ovum has been discharged) often can be
observed on the surface of an ovary.

41 42

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NCM 107
Ovaries
• Ovaries are located close to and on both
sides of the uterus in the lower abdomen.
• The function of the two ovaries (the female
gonads) is to produce, mature, and
discharge ova (the egg cells).
• In the process, the ovaries produce estrogen
and progesterone and initiate and regulate
menstrual cycles.
• The ovaries are held suspended and in close
contact with the ends of the fallopian tubes
by three strong supporting ligaments
attached to the uterus or the pelvic wall.
43
Ovaries
Division of Reproductive Cells (Gametes)
• At birth, each ovary contains approximately
2 million immature ova (oocytes), which
were formed during the first 5 months of
intrauterine life.
• Although these cells have the unique ability
to produce a new individual, they basically
contain the usual components of cells: a cell
membrane, an area of clear cytoplasm, and
a nucleus containing chromosomes.
45
Ovaries
Maturation of Oocytes
• Each oocyte lies in the ovary surrounded by
a protective sac, or thin layer of cells, called
a primordial follicle.
• Between 5 and 7 million ova form in utero.
• The majority never develop beyond the
primitive state and actually atrophy, so that
by birth only 2 million are present.
• By age 7 years, only approximately 500,000
are present in each ovary; by 22 years, there
are approximately 300,000; and by
menopause, none are left (all have either
47 matured or atrophied).
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Ovaries
Three principal divisions:
1. Protective layer of surface epithelium
2. Cortex, where the immature (primordial)
oocytes mature into ova and large amounts of
estrogen and progesterone are produced
3. Central medulla, which contains the nerves,
blood vessels, lymphatic tissue, and some
smooth muscle tissue
44
Ovaries
• The oocytes, like sperm, differ from all other
body cells in the number of chromosomes they
contain in the nucleus.
• The nucleus of all other human body cells
contains 46 chromosomes, consisting of 22 pairs
of autosomes (paired matching chromosomes)
and 1 pair of sex chromosomes (two X sex
chromosomes in the female, an X and a Y sex
chromosome pair in the male).
• Reproductive cells (both ova and spermatozoa)
have only half the usual number of
chromosomes, so that, when they combine
(fertilization), the new individual formed from
them will have the normal number of 46
46 chromosomes.
Fallopian Tubes
• The fallopian tubes arise from each
upper corner of the uterine body and
extend outward and backward until
each opens at its distal end, next to an
ovary.
• Fallopian tubes are approximately 10 cm
long in a mature woman.
• Their function is to convey the ovum
from the ovaries to the uterus and to
provide a place for fertilization of the
ovum by sperm.
48
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NCM 107
Fallopian Tubes
Four parts
• the interstitial portion, is that part of the tube that lies
within the uterine wall. This portion is only about 1 cm
in length; the lumen of the tube is only 1 mm in
diameter at this point.
• The isthmus is the next distal portion. It is
approximately 2 cm in length and like the interstitial
tube, is extremely narrow.
• The ampulla is the third and also the longest portion of
the tube. It is approximately 5 cm in length. It is in this
portion that fertilization of an ovum usually occurs.
• The infundibular portion is the most distal segment of
the tube. It is approximately 2 cm long and is funnel
shaped. The rim of the funnel is covered by fimbria
(small hairs) that help to guide the ovum into the
fallopian tube.
49
Uterus
Functions of the uterus
• To receive the ovum from the fallopian tube;
• Provide a place for implantation and
nourishment;
• Furnish protection to a growing fetus; and,
• At maturity of the fetus, expel it from a
woman’s body.
51
Uterus
• The body of the uterus is the uppermost
part and forms the bulk of the organ.
• The lining of the cavity is continuous with
that of the fallopian tubes, which enter at its
upper aspects (the cornua).
• During pregnancy, the body of the uterus is
the portion of the structure that expands to
contain the growing fetus.
• The portion of the uterus between the
points of attachment of the fallopian tubes
is termed the fundus.
53
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Uterus
• The uterus is a hollow, muscular, pear-
shaped organ located in the lower pelvis,
posterior to the bladder and anterior to the
rectum.
• During childhood, it is approximately the
size of an olive.
• An adolescent is closer to 17 years old
before the uterus reaches its adult size.
• With maturity, a uterus is approximately 5
to 7 cm long, 5 cm wide, and, in its widest
upper part, 2.5 cm deep and weighs
approximately 60 grams.
50
Uterus
• After a pregnancy, the uterus never returns
to its nonpregnant size but remains
approximately 9 cm long, 6 cm wide, 3 cm
thick, and 80 g in weight.
• Anatomically, the uterus consists of three
divisions: the body or corpus, the isthmus,
and the cervix.
52
Uterus
• The fundus is also the portion that can be
palpated abdominally
• to determine the amount of uterine
growth occurring during pregnancy,
• to measure the force of uterine
contractions during labor, and
• to assess that the uterus is returning
to its nonpregnant state after
childbirth.
54
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NCM 107 8/15/19

Uterus Uterus

• The isthmus of the uterus is a short segment • The cervix is the lowest portion of the
between the body and the cervix. uterus.
• In the nonpregnant uterus, it is only 1 to 2 • It represents approximately one third of the
mm in length. During pregnancy, this portion total uterus size and is approximately 2 to 5
also enlarges greatly to aid in cm long.
accommodating the growing fetus. • Approximately half of it lies above the
• It is the portion of the uterus that is most vagina and half extends into the vagina.
commonly cut when a fetus is born by a • Its central cavity is termed the cervical canal.
cesarean birth.
• The opening of the canal at the junction of
the cervix and isthmus is the internal
cervical os; the distal opening to the vagina
55 56
is the external cervical os.

Uterus Uterus

Uterine and Cervical Coats or layers of tissue: The endometrium layer of the uterus is the
• The endometrium - an inner one of mucous one that is important for menstrual
membrane, function.

• The myometrium - a middle one of muscle • It is formed by two layers of cells: the
fibers, basal layer and the glandular layer.

• The perimetrium - an outer one of • It grows and becomes so thick and

connective tissue responsive each month under the
influence of estrogen and progesterone
that it is capable of supporting a
pregnancy.
• If pregnancy does not occur, this is the
layer that is shed as the menstrual flow.
57 58

Uterus Uterus
The myometrium, or muscle layer of the uterus The perimetrium, or the outermost layer of the
• Composed of three interwoven layers of smooth uterus, serves the purpose of adding strength
muscle, the fibers of which are arranged in and support to the structure.
longitudinal, transverse, and oblique directions.
• The myometrium serves the important function
of constricting the tubal junctions and preventing
regurgitation of menstrual blood into the tubes.
• It also holds the internal cervical os closed during
pregnancy to prevent a preterm birth.
• When the uterus contracts at the end of
pregnancy to expel the fetus, equal pressure is
exerted at all points throughout the cavity
because of its unique arrangement of muscle
59 fibers. 60

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NCM 107
Uterine Deviations
• Anteversion, a condition in which the
entire uterus is tipped far forward
• Retroversion, a condition in which the
entire uterus is tipped backward
• Anteflexion, a condition in which the
body of the uterus is bent sharply
forward at the junction with the cervix
• Retroflexion, a condition in which the
body is bent sharply back just above the
cervix
61
Uterine Deviations
• Anteversion, a condition in which the
entire uterus is tipped far forward
• Retroversion, a condition in which the
entire uterus is tipped backward
• Anteflexion, a condition in which the
body of the uterus is bent sharply
forward at the junction with the cervix
• Retroflexion, a condition in which the
body is bent sharply back just above the
cervix
63
Uterine Flexion And Version
65 (A) Anteversion. (B) Anteflexion. (C) Retroversion. (D) Retroflexion.
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Uterine Deviations
• Anteversion, a condition in which the
entire uterus is tipped far forward
• Retroversion, a condition in which the
entire uterus is tipped backward
• Anteflexion, a condition in which the
body of the uterus is bent sharply
forward at the junction with the cervix
• Retroflexion, a condition in which the
body is bent sharply back just above the
cervix
62
Uterine Deviations
• Anteversion, a condition in which the
entire uterus is tipped far forward
• Retroversion, a condition in which the
entire uterus is tipped backward
• Anteflexion, a condition in which the
body of the uterus is bent sharply
forward at the junction with the cervix
• Retroflexion, a condition in which the
body is bent sharply back just above the
cervix
64
Vagina
• The vagina is a hollow, musculo-
membranous canal located posterior to the
bladder and anterior to the rectum.
• It extends from the cervix of the uterus to
the external vulva.
• Its function is to act as the organ of
intercourse and to convey sperm to the
cervix so that sperm can meet with the
ovum in the fallopian tube.
• With childbirth, it expands to serve as the
birth canal.
66
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NCM 107 8/15/19

Menstruation
• A menstrual cycle (a female reproductive cycle) is
episodic uterine bleeding in response to cyclic
hormonal changes.
• The purpose of a menstrual cycle is to bring an
ovum to maturity and renew a uterine tissue bed
Physiology of Menstrual Cycle that will be responsible for the ova’s growth should
it be fertilized.
• It is the process that allows for conception and
implantation of a new life.
• Menarche may occur as early as 9 years of age

67 68

Menstruation Characteristics of Normal Menstrual Cycles

• The length of menstrual cycles differs from woman

“
to woman, but the average length is 28 days (from
the beginning of one menstrual flow to the
beginning of the next).
• It is not unusual for cycles to be as short as 23 days
or as long as 35 days.
• The length of the average menstrual flow (termed
menses) is 4 to 6 days, although women may have
periods as short as 2 days or as long as 9 days.

69 70

Four Body Structures involved in Menstruation

a. Hypothalamus
b. Pituitary Gland
c. Ovaries
d. Uterus
The interaction of pituitary-
uterine-ovarian functions in
a menstrual cycle.

71 72

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NCM 107
Phases of menstrual cycle
1. Proliferative - immediately after a menstrual
flow (which occurs during the first 4 or 5 days of
a cycle), the endometrium, or lining of the
uterus, is very thin, approximately one cell layer
in depth.
2. Secretory - after ovulation, the formation of
progesterone in the corpus luteum (under the
direction of LH) causes the glands of the uterine
endometrium to become corkscrew or twisted in
appearance and dilated with quantities of
glycogen (an elementary sugar) and mucin (a
protein).
73
Cervix
• The mucus of the uterine cervix, as well as the uterine
body, changes each month during the menstrual cycle.
• During the first half of the cycle, when hormone
secretion from the ovary is low, cervical mucus is thick
and scant. Sperm survival in this type of mucus is poor.
• At the time of ovulation, when the estrogen level is high,
cervical mucus becomes thin and copious. Sperm
penetration and survival at the time of ovulation in this
thin mucus are excellent.
• As progesterone becomes the major influencing
hormone during the second half of the cycle, cervical
mucus again becomes thick and sperm survival is again
poor.
75
Fern Test
• When high levels of estrogen are present in the
body, as they are just before ovulation, the
cervical mucus forms fernlike patterns caused by
the crystallization of sodium chloride on mucus
fibers when it is placed on a glass slide and
allowed to dry.
• This pattern is known as arborization or ferning.
• When progesterone is the dominant hormone, as
it is just after ovulation, when the luteal phase of
the menstrual cycle is beginning, a fern pattern is
no longer discernible.
77
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Phases of menstrual cycle
3. Ischemic - If fertilization does not occur, the corpus
luteum in the ovary begins to regress after 8 to 10
days. As it regresses, the production of progesterone
and estrogen decreases. With the withdrawal of
progesterone stimulation, the endometrium of the
uterus begins to degenerate (at approximately day 24
or day 25 of the cycle). The capillaries rupture, with
minute hemorrhages, and the endometrium sloughs
off.
4. Menses - Menses, or the menstrual flow, is composed
of: Blood from the ruptured capillaries; Mucin from
the glands; Fragments of endometrial tissue; The
microscopic, atrophied, and unfertilized ovum
74
Cervix
• Women can analyze cervical mucus changes to help plan
coitus to coincide with ovulation if they want to increase
their chance of becoming pregnant or plan to avoid
coitus at the time of ovulation to prevent pregnancy.
• Fern Test
• Spinnbarkeit Test
76
Fern Test
• Cervical mucus can be examined at mid-cycle to
detect whether ferning, which suggests a high
estrogen surge, is present.
• Women who do not ovulate continue to show the
fern pattern throughout the menstrual cycle (i.e.,
progesterone levels never become dominant), or
they never demonstrate it because their estrogen
levels never rise.
78
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NCM 107 8/15/19

(A) A ferning pattern of cervical
mucus occurs with high
estrogen levels.
(B) Incomplete ferning during
secretory phase of cycle
79
Spinnbarkeit Test
• At the height of estrogen secretion, cervical mucus not only
becomes thin and watery but also can be stretched into long
strands.
• This stretchability is in contrast to its thick, viscous state when
progesterone is the dominant hormone.
• Performing this test, known as spinnbarkeit, at the midpoint of a
menstrual cycle is another way to demonstrate that high levels
of estrogen are being produced and, by implication, that
ovulation is about to occur.
• A woman can do this herself by stretching a mucus sample
between thumb and finger, or it can be tested in an examining
room by smearing a cervical mucus specimen on a slide and
stretching the mucus between the slide and coverslip.
80

The Sexual Response Cycle

• Excitement
• Plateau
• Orgasm
• Resolution

Spinnbarkeit is the property of cervical mucus to stretch

a distance before breaking

81 82

Excitement Plateau
• Excitement occurs with physical and psychological stimulation
(sight, sound, emotion, or thought) that causes • The plateau stage is reached just before orgasm.
parasympathetic nerve stimulation. • In the woman, the clitoris is drawn forward and retracts
• This leads to arterial dilation and venous constriction in the under the clitoral prepuce, the lower part of the vagina
genital area. becomes extremely congested (formation of the
• In women, this vasocongestion causes the clitoris to increase orgasmic platform), and there is increased breast nipple
in size and mucoid fluid to appear on vaginal walls for elevation.
lubrication.
• In men, vasocongestion leads to distention of the penis.
• The vagina widens in diameter and increases in length.
• Heart rate increases to 100 to 175 beats/min and
• Breast nipples become erect.
respiratory rate to about 40 breaths/min.
• In men, penile erection occurs as well as scrotal thickening and
elevation of the testes.
• In both sexes, there is an increase in heart and respiratory rate
83 and blood pressure. 84

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Orgasm Resolution
• Orgasm occurs when stimulation proceeds through the plateau stage
to a point at which a vigorous contraction of muscles in the pelvic
area expels or dissipates blood and fluid from the area of congestion. • The resolution is a 30-minute period during which the
• The average number of contractions for the woman is 8 to 15
external and internal genital organs return to an
contractions at intervals of 1 every 0.8 seconds.
unaroused state.
• In men, muscle contractions surrounding the seminal vessels and • For the male, a refractory period occurs during which
prostate project semen into the proximal urethra. further orgasm is impossible.
• These contractions are followed immediately by three to seven • Women do not go through this refractory period, so it is
propulsive ejaculatory contractions, occurring at the same time possible for women who are interested and properly
interval as in the woman, which force semen from the penis.
stimulated to have additional orgasms immediately after
• As the shortest stage in the sexual response cycle, orgasm is usually
the first.
experienced as intense pleasure affecting the whole body, not just
the pelvic area.
• It is also a highly personal experience: Descriptions of orgasms vary
greatly from person to person.
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