CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107

(WELL CLIENTS) 1st Semester

A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

Nursing Process Overview for

Reproduction & Sexuality E. Outcome Evaluation
1. The client or couple is knowledgeable about
A. Assessment reproductive system structure and function and
sexuality.
1. Before interacting with any client regarding sexuality
2. The client or couple reports establishment of optimal
and reproduction, the nurse must perform a self-
sexual functioning and a satisfying sexual
assessment, personal attitudes, and values will
relationship.
greatly influence the nursing care provided.
3. The client or couple reports reduced anxiety
2. A sexual history involves gathering information about
regarding reproductive and sexuality issues.
the client or couple, such as:
a. Past and current experiences with sexual activity
b. Sexual knowledge and how it was obtained.
c. Attitudes toward sexuality A. Concept of Unitive and Procreative Health
d. Current problems; if any
e. Number of sexual partners in the last 6 months
f. History of sexually transmitted diseases
GOD wills that the expression of human sexuality in
g. Knowledge and use of “safer” sex practices
sexual acts occur only within marriage.
h. Menstrual and obstetric history
The Unitive meaning is a specific type of physical
i. method of birth control used
union, the sexual union of a man and a woman in
j. Specific concerns related to sex and sexuality
natural intercourse. This type of sexual act is in
harmony with, and ordered toward, the other
B. Nursing Diagnoses
meanings: marital and procreative.
1. Knowledge deficit Procreative - producing new life or offspring; the
2. Sexual dysfunction reproductive potential of a species is its relative
3. Altered sexual function capacity to reproduce itself under optimal conditions;
4. Anxiety the reproductive or generative organs, reproductive,
generative; fruitful – productive or conducive to
C. Planning and Outcome Identification producing in abundance; “be fruitful and multiply”
having the power to procreate...
1. The client and her partner will be knowledgeable
about reproduction and sexuality.
2. The client and her partner will achieve optimal sexual
functioning, Distinction Between Procreation & Reproduction
3. The client’s and her partner’s anxiety will be
alleviated. Reproduction - action of making a copy of something,
or the production of offspring by sexual intimacy...
D. Implementation Procreation - roots sexuality and childbearing deeply
within with two relations: that of the man and woman,
1. Provide education regarding reproduction and
and that between the couple and GOD (2006).
sexuality.
a. Provide the client or couple with specific
information about the reproductive system’s
structure and function. Theories Related to Procreation
b. Suggest ways to alleviate reproductive system
discomforts and how to prevent reproductive Procreation is the creation of humans. There are two
disease. main theories:
c. Discuss risk and potential effects of sexual activity
Creation
2. Promote optimal sexual functioning.
a. Plan interventions to strengthen gender identity or
God created the world an all that's in it, including
role behavior.
humans, and they reproduce thorough sexual intercourse
b. Design care that demonstrates acceptance of all
lifestyle choices equally. Evolution
c. Provide information about alternate means of
sexual expression. Darwin's theory that humans evolved over the years
d. Discuss perceptions and expectations of sexual through natural occurrences and from the growth and
functioning. development of monkeys and other creatures.
e. Refer clients with complex problems to
professionals specializing in sexuality issues.
3. Provide support to relieve anxiety. Allow the client or
couple to discuss sexual feelings and concerns Procreation - creation of a new human person, by the
openly. act of sexual intercourse, by a man and a woman.
Creation - making of all things from nothing by an act of
God at some time in the past. God's action could have
taken a second, or 6 days, or a million years.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

B. Female & Male Reproductive System

Evolutionary theory - all things came about by the
repeated random actions of natural selection, whereby:
Life came into existence, and then
Structure and Function of the
Female Reproductive System
Primitive life evolved into more and more complex
organisms, and eventually producing mankind.

Note: Evolutionary theory requires the assumption of

billions of years for its processes

With the introduction of artificial birth control to the

marital act, the procreative dimension is purposefully
suppressed and ignored. The unitive dimension,
therefore, is separated from the procreative. Just as a
forced act of physical love by one's spouse upon the
other violates the unitive dimension of marital love,
the impairment of the capacity to transmit human life
violates the procreative dimension.
Moreover, we must also consider the possible side
effects of these pills to the health of the woman. In Female Reproductive System: External Structures
examining for various oral contraceptives, possible
health complications include, thrombosis,
Mons pubis
cerebrovascular disorders, birth defects and various
forms of cancer (breast, cervical, ovarian and mound of fatty tissue over the symphysis pubis that
uterine). cushions and protects the bone
Tragically, many doctors do not inform the woman of
these health risks when prescribing these drugs. Since Labia majora
each individual has an obligation for maintaining his
longitudinal folds of pigmented skin extending from the
or her own health, any drug which consistently
mons pubis to the perineum
changes the normal functioning of the body and
which carries these risks would be morally Labia minora
objectionable
soft longitudinal skin folds between the labia majora

Clitoris
Sex used to be spoken about only behind closed doors or Clitoris is erectile tissue located at the upper end of the
as the topic of suggestive remarks. Now it’s something labia minora. It is the primary site of sexual arousal
everyone must know everything about, including every
form of sexual depravity If there were no pleasure Urethral meatus (urethral orifice)
attached to sex, who would do it? small opening of the urethra; located between the clitoris
and the vaginal orifice for the purpose of urination
2 Purposes of Pleasure:
To strengthen the couple’s relationship Skene or paraurethral glands
To give them the ability to share with God in the
creation of another human being small mucus-secreting glands that open into the
posterior wall of the urinary meatus and lubricate the
Sexuality is all those things that go with being male or vagina
female--including physical and emotional differences.
Vestibule
They are all part of being human.
almond-shaped area between the labia minora
Sexual intercourse - involves genital and erotic activity. containing the vaginal introitus, hymen, and Bartholin
We are all sexual beings, but it isn’t necessary to become glands
involved in genital sex to be fully human
Vaginal introitus
Not everyone gets married, but everyone is a sexual
external opening of the vagina
human being to be loved and accepted for who they
are, and able themselves to give and receive love.
Hymen
UNITIVE purpose of our sexuality - Two becoming one
flesh membranous tissue ringing the vaginal introitus
PRO-CREATIVE purpose - Increase and multiply
Two becoming one flesh - part of the life-long
commitment that is marriage
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

Bartholin or vulvovaginal glands Fallopian tubes

mucus-secreting glands located on either side of the Extend from the upper outer angles of the uterus and end
vaginal orifice near the ovary. These tubes serve as the passageway for
the ovum to travel from the ovary to the uterus and
Perineal body for the sperm to travel from the uterus to the ovary.
composed of muscles and fascia that support pelvic Ovaries
structures
Female sex glands located on each side of the uterus.
Perineum The two functions of the ovaries are:
area of tissue between the anus and vagina; an 1. Ovulation (release of ovum)
episiotomy is performed here 2. Secretion of hormones (estrogen and progesterone)

Female Reproductive System: Internal Structures

Female Reproductive System: Pelvis
Vagina
female organ of copulation and also serves as the birth
Pelvis
canal; tubular musculomembranous organ that lies bony ring in the lower portion of the trunk. It consists of:
between the rectum and the urethra 3 parts
ilium
Uterus
ischium
hollow, muscular organ with 3 muscle layers pubis
perimetrium 4 bones
myometrium two innominate bones or hipbones
endometrium sacrum
coccyx
located between the bladder and rectum, and consists
of the fundus, body (corpus), and cervix. Uterine functions
Pelvic bones
include: held together by four joints (articulations) – symphysis
Menstruation is the sloughing away of spongy layers pubis, two sacroiliac, and sacrococcygeal. Fibrocartilage
of endometrium with bleeding from torn vessels. between these joints provides movability
Environment for pregnancy; the embryo and fetus
develop in the uterus after fertilization. Types of Pelves
Menstruation is the sloughing away of spongy layers
of endometrium with bleeding from torn vessels. Gynecoid - typical female pelvis with a rounded
Environment for pregnancy; the embryo and fetus inlet.
develop in the uterus after fertilization. Android - normal male pelvis with a heart-shaped
inlet.
Uterine ligaments
Anthropoid - “apelike” pelvis with an oval inlet.
Broad and round ligaments provide upper support for Platypelloid - flat, female-type pelvis with a
the uterus transverse oval inlet.
Cardinal, pubocervical, and uterosacral ligaments
are suspensory and provide middle support.
Pelvic muscular floor ligaments provide lower support.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

Menstrual Cycle & Hormones

Pelvimetry (the process of measuring the internal or
external pelvis) is performed with radiography or by
Menarche (onset of menstruation) typically occurs
internal examination.
between 10 and 13 years. The menstrual cycle is a
Internal pelvic inlet measurements measures the
monthly pattern of ovulation and menstruation.
diagonal conjugate, which is the lower margin of the
Ovulation - discharge of a mature ovum from the
symphysis pubis to the promontory of the sacrum; it is
ovary.
normally 11.5 cm or more.
Menstruation - periodic shedding of blood, mucous,
Internal midpelvic measurements measures the
and epithelial cells from the uterus; average blood
distance between ischial spines and prominence or
loss is 50 mL (1/4 cup)
bluntness of spines; it is normally 10.5 cm
Internal pelvic outlet measurement is an estimation of
The ovaries produce mature gametes and secrete the
the angle of the pubic arch (90 degrees), mobility of
following hormones.
coccyx, intertuberous diameter (11 cm), and posterior
Estrogen contributes to the characteristics of
sagittal diameter (7.5 cm)
femaleness (eg. female body build, breast growth).
Progesterone (hormone of pregnancy) quiets or
Note: Pelvic size and structural irregularities can alter
decreases the contractility of the uterus.
labor and birth.
Prostaglandin regulate the reproductive process by
stimulating the contractility of uterine and other
smooth muscles.
Female Reproductive System: Breasts (Internal)
The menstrual cycle occurs on 4 levels:
The female breasts (mammary glands) are specialized 1. central nervous system (CNS; hypothalamic-pituitary)
sebaceous glands that produce milk after childbirth 2. ovarian
(lactation). 3. endometrial (menstrual)
4. cervical
Glandular tissue (parenchyma)
CNS Response
composed of acini (milk-producing) cells that cluster in
groups of 15 to 20 to form the lobes of the breast The hypothalamus stimulates the anterior pituitary
gland by secreting gonadotropin-releasing hormone
Lactiferous ducts or sinuses (GnRH). The anterior pituitary secretes two
form passageways from the lobes to the nipple gonadotropins--follicle-stimulating hormone (FSH)
and luteinizing hormone (LH)
Adipose and fibrous tissues (stroma) FSH prompts the ovary to develop ovarian
follicles; the developing follicles secrete estrogen,
provide the lative size and consistency of the breast
which feels back to the anterior pituitary to
suppress FSH and trigger a surge of LH
LH acts with FSH to cause ovulation and enhance
Female Reproductive System: Breasts (External) corpus luteum formation

Nipple Ovarian Response

a raised pigmented area of the breast
An oocyte grows within the primordial follicle in 2
Areola phases: follicular and luteal.
Follicular phase (days 1 to 14) - follicle matures due
pigmented skin around the nipple to FSH
Luteal phase (days 15 to 22) - the corpus luteum
Montgomery tubercles
develops from a ruptured follicle
sebaceous glands of the areola

The breasts change in size and nodularity in response to

cyclic ovarian hormonal changes, including:
Estrogen stimulation, which produces tenderness
Progesterone (postovulation), which causes increased
tenderness and breast enlargement

Physical changes in breasts size and activity are at a

minimum 5 to 7 days after menstruation stops; this is the
best time to detect pathology changes through breast
self-examination.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Endometrial Response
In the menstrual phase (days 1 to 5) the estrogen level
is low and cervical mucus is scanty.
In the proliferative (follicular) phase (days 6 to 14),
the estrogen level is high, the endometrium and
myometrium thicken, and changes in cervical
mucous occurs. (Note: variations in the menstrual
cycle are due to variations in the number of days
in this phase.) On average, ovulation occurs on
day 14of a 28-day cycle.
In the secretory phase (days 14 to 26), after
release of the ovum, the estrogen level drops, the
progesterone level is high, increased uterine
vascularity occurs, and tissue glycogen levels
increase.
In the ischemic phase (days 27 to 28), estrogen
and progesterone level recede, arterial vessels
constrict, the endometrium prepares to shed, the
blood vessels rupture, and menstruation begins.
Cervix and Cervical Mucous Response
Before ovulation, estrogen levels rise, causing
cervical os dilation, abundant liquid mucus, high
spinnbarkeit, and excellent sperm penetration.
After ovulation, progesterone levels rise, resulting
in cervical os constriction, scant viscous mucus,
low spinnbarkeit, no ferning, and poor sperm
penetration.
During pregnancy, cervical circulation (blood
supply) increases and a protective mucus plug
forms.
Climacteric period and menopause
The climacteric is a transitional period during
which ovarian function and hormonal
production decline.
Menopause refers to a woman’s last
menstrual period; the average age of
menopause is 51.4 years. However, it is
important to note that women may ovulate
after menopause and thus can become
pregnant.
Menstrual Cycle & Hormones
Characteristics Description
Beginning (Menarche) Average age onset, 12.4 years; Average
range, 9-17 years
Interval between cycles Average 28 days, cycles of 23-35 days
not unusual
Duration of menstrual flow Average flow, 4-6 days, Ranges of 2-9
days not abnormal
Amount of menstrual flow Difficult to estimate, average 30-80 mL
per menstrual period, saturating a pad
or tampon in less than I hour as heavy
bleeding
Color of menstrual flow Dark red, a combination of blood, mucus
and endometrial cells
Odor Similar to marigolds
Neri, H.A.G. | BSN 2E
Determination of Ovulation
Mittelschmerz
Spinnbarkeit test
Basal Body Temperature
Ferning
Glycogen content of vagina and the cervical cells
Note: To compute for the exact date of ovulation, count
back 14 days from the first day of menstruation.
Mittelschmerz
pain or discomfort in the lower abdomen experienced by
some women midway in the intermenstrual interval. It
occurs at or around the time of an egg is released from
the ovaries (ovulation)
Spinnbarkeit
Ability of cervical mucus to stretch into long strands
at the height of estrogen secretion. When
progesterone is the dominant hormone cervical
mucus is thick, viscous state.
First half of the cycle - cervical mucus is thick and
scant
At the time of ovulation, when the estrogen level is
high- cervical mucus become thin and copious
During the second half of the cycle, the cervical
mucus again becomes thick and sperm survival is
poor.
Ferning
an interesting property of cervical mucus just before
ovulation when estrogen levels are high is the ability
to form fernlike patterns on a microscope slide when
allowed to dry. When progesterone is the dominant
hormone, just after ovulation, this fern pattern is no
longer discernible.
Fern Test - mucus can be examined at mid cycle to
detect ferning
Cervical mucous forms “fernlike“ patterns when it
smeared and dried on a glass slide. The pattern are
due to crystallization of sodium chloride on mucus
fibers.
If increased progesterone fern pattern is no longer
discernible.
INCOMPLETE FERNING DURING SECRETORY PHASE
OF CYCLE
A FERNING PATTERN OF CERVICAL MUCUS OCCURS
WITH HIGH ESTROGEN LEVELS
Basal Body Temperature
the lowest temperature reached by the body during
one’s waking hours
usually occurs immediately upon wakening in the
morning
The basal temp. drops before the day of ovulation
and rises on the day after ovulation
The temperature remains at this level until
approximately day 24 of the menstrual cycle when the
level of the progesterone drops.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Endometrial Response
In the menstrual phase (days 1 to 5) the estrogen level
is low and cervical mucus is scanty.
In the proliferative (follicular) phase (days 6 to 14),
the estrogen level is high, the endometrium and
myometrium thicken, and changes in cervical
mucous occurs. (Note: variations in the menstrual
cycle are due to variations in the number of days
in this phase.) On average, ovulation occurs on
day 14of a 28-day cycle.
In the secretory phase (days 14 to 26), after
release of the ovum, the estrogen level drops, the
progesterone level is high, increased uterine
vascularity occurs, and tissue glycogen levels
increase.
In the ischemic phase (days 27 to 28), estrogen
and progesterone level recede, arterial vessels
constrict, the endometrium prepares to shed, the
blood vessels rupture, and menstruation begins.
Cervix and Cervical Mucous Response
Before ovulation, estrogen levels rise, causing
cervical os dilation, abundant liquid mucus, high
spinnbarkeit, and excellent sperm penetration.
After ovulation, progesterone levels rise, resulting
in cervical os constriction, scant viscous mucus,
low spinnbarkeit, no ferning, and poor sperm
penetration.
During pregnancy, cervical circulation (blood
supply) increases and a protective mucus plug
forms.
Climacteric period and menopause
The climacteric is a transitional period during
which ovarian function and hormonal
production decline.
Menopause refers to a woman’s last
menstrual period; the average age of
menopause is 51.4 years. However, it is
important to note that women may ovulate
after menopause and thus can become
pregnant.
Menstrual Cycle & Hormones
Characteristics Description
Beginning (Menarche) Average age onset, 12.4 years; Average
range, 9-17 years
Interval between cycles Average 28 days, cycles of 23-35 days
not unusual
Duration of menstrual flow Average flow, 4-6 days, Ranges of 2-9
days not abnormal
Amount of menstrual flow Difficult to estimate, average 30-80 mL
per menstrual period, saturating a pad
or tampon in less than I hour as heavy
bleeding
Color of menstrual flow Dark red, a combination of blood, mucus
and endometrial cells
Odor Similar to marigolds
Neri, H.A.G. | BSN 2E
Determination of Ovulation
Mittelschmerz
Spinnbarkeit test
Basal Body Temperature
Ferning
Glycogen content of vagina and the cervical cells
Note: To compute for the exact date of ovulation, count
back 14 days from the first day of menstruation.
Mittelschmerz
pain or discomfort in the lower abdomen experienced by
some women midway in the intermenstrual interval. It
occurs at or around the time of an egg is released from
the ovaries (ovulation)
Spinnbarkeit
Ability of cervical mucus to stretch into long strands
at the height of estrogen secretion. When
progesterone is the dominant hormone cervical
mucus is thick, viscous state.
First half of the cycle - cervical mucus is thick and
scant
At the time of ovulation, when the estrogen level is
high- cervical mucus become thin and copious
During the second half of the cycle, the cervical
mucus again becomes thick and sperm survival is
poor.
Ferning
an interesting property of cervical mucus just before
ovulation when estrogen levels are high is the ability
to form fernlike patterns on a microscope slide when
allowed to dry. When progesterone is the dominant
hormone, just after ovulation, this fern pattern is no
longer discernible.
Fern Test - mucus can be examined at mid cycle to
detect ferning
Cervical mucous forms “fernlike“ patterns when it
smeared and dried on a glass slide. The pattern are
due to crystallization of sodium chloride on mucus
fibers.
If increased progesterone fern pattern is no longer
discernible.
INCOMPLETE FERNING DURING SECRETORY PHASE
OF CYCLE
A FERNING PATTERN OF CERVICAL MUCUS OCCURS
WITH HIGH ESTROGEN LEVELS
Basal Body Temperature
the lowest temperature reached by the body during
one’s waking hours
usually occurs immediately upon wakening in the
morning
The basal temp. drops before the day of ovulation
and rises on the day after ovulation
The temperature remains at this level until
approximately day 24 of the menstrual cycle when the
level of the progesterone drops.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Structure and Function of the
Male Reproductive System
Male Reproductive System: External Structures
Penis
male organ of copulation; this cylindrical shaft consists
of the following:
two lateral columns of erectile tissue (corpora
cavernosa)
A column of erectile tissue on the underside of the
penis (corpus spongiosum) that encases the urethra
The glans penis, a cone-shaped expansion of the
corpus spongiosum that is highly sensitive to sexual
stimulus
The prepuce, or foreskin, a skin flap that covers the
glans penis in uncircumcised men
Scrotum
pouch hanging below the penis that contains the testes.
Internally, the medial septum divides the scrotum into
two sacs, each of which contains a testicle
Male Reproductive System: External Structures
Testes
2 solid ovoid organs 4 to 5 cm long, divided into lobes
containing seminiferous tubules. The 2 functions of the
testes are production of testosterone and
spermatogenesis
Epididymis
tubular sac located next to each testis that is a reservoir
for sperm storage and maturation
Vas deferens
duct extending from the epididymis to the ejaculatory
duct, which provides a passageway for sperm.
Neri, H.A.G. | BSN 2E
Ejaculatory duct
canal formed by the union of the vas deferens and the
excretory duct of the seminal vesicle. It enters the
urethra at the prostrate gland
Urethra
passageway for urine and semen that extends from the
bladder to the urethral meatus
Male Reproductive System: Accessory Glands
Accessory glands - other structures in the male
reproductive system produce secretions that facilitate
transportation of spermatozoa along the urethra during
ejaculation and provide a temporary safe milieu for the
fragile sperm. The function of the accessory glands is
maintained by testosterone.
Seminal vesicles
located behind the bladder and in front of the rectum
deliver secretions to the urethra through the ejaculatory
ducts.
Prostate gland
surrounds the base of the urethra and the ejaculatory
duct, secretes a clear fluid with a slightly acid pH rich in
acid phosphatase, citric acid, zinc, and proteolytic
enzymes
Bulbourethral & Urethral glands (Cowper’s glands)
lie at the base of the prostate and on either side of the
membranous urethra. They produce a clear, alkaline
mucinous substance that lubricates the urethra and
coats its surface. The alkalinity assists in neutralizing
acidic female vaginal secretions, which otherwise would
be detrimental to sperm survival.
Male Reproductive System: Semen
thick, whitish fluid ejaculated by the man during
orgasm
It contains spermatozoa and fructose-rich nutrients.
During ejaculation, semen receives contributions of
fluid from the seminal vesicles and the prostate
gland.
Semen is alkaline (average pH, 7.5) and the average
amount of semen released during ejaculation is 2.5 to
3.5 ml.
Male Reproductive System: Male Breasts
Male mammary tissue remains dormant throughout
life, but the breasts are a site of sexual excitation and
arousal.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

Male Reproductive System: General Comparison of the Human

Neurohormonal Control Male and Female Reproductive System

At puberty, the hypothalamus stimulates the pituitary Primary sex organs - Gonads
gland to produce FSH and LH. Female - ovaries
FSH stimulates germ cells within the testes to Male - testes
manufacture sperm.
LH stimulates the production of testosterone in the Produce gametes which unite to form a new individual
testes. Although LH stimulates the Leydig cells to oocyte
produce testosterone from cholesterol, testosterone sperm
inhibits the secretion of LH by the anterior pituitary.
Gonads produce large amounts of sex hormones which
Testosterone one of several androgens (and the most affect maturation,, development, and changes in the
potent) produced in the testes, is responsible for the activity of the reproductive system organs
development of secondary sex characteristics at Female - Estrogen & progesterone
puberty. Male - Androgens (Testosterone)
Testosterone production occurs in the interstitial
Leydig cells in the seminiferous tubules. Leydig cells
are abundant in the newborn and pubescent boy,
and testosterone is abundant during these periods. C. Human Sexuality
Testosterone production slows after 40 years of age;
by 80 years of age, production is only about one-fifth
peak level. Human Sexual Response

Spermatogenesis (sperm production) occurs continually
after puberty, providing large numbers of sperm for
unlimited ejaculations during the mature life span.
Spermatozoa are released from the epithelial walls of
the seminiferous tubules. Meiosis occurs during the
process, and the number of chromosomesin each cell
is reduced by one-half (haploid number)
Spermatogenesis is a heat-sensitive process; the 2° to
3° F difference to proceed in the cooler environment.
The entire period of spermatogenesis, from germinal cell
to mature sperm, takes about 75 days.
The human sexual response cycle, or how the human
body responds to sexual arousal, is composed of 4
distinct phases:
A. Excitement
occurs with physical and psychological stimulation
(i.e. sight, sound, emotion, or thought) that causes
parasympathetic nerve stimulation.
This leads to arterial dilation and venous constriction
in the genital area.
The resulting increased blood supply leads to
vasocongestion and increasing muscular tension.

B. Plateau
Homologous Structures of the Human
Male and Female Reproductive System The plateau stage is reached just before orgasm.

C. Orgasm
Male Embryo Structure Female
Testis Gonad Ovary occurs when stimulation proceeds through the
Penis Genital Tubercle Clitoris
plateau stage to a point at which the body suddenly
Scrotum Genital Swellings Labia majora
Cowper’s gland
Bartholin’s gland dischargers accumulated sexual tension
Skin shaft of penis
Genital Folds Labia minora
(ventral)

D. Resolution
Foreskin of penis Clitoral hood
The period during which the external and internal
genital organs return to unaroused state.
Analogous Structures of the Human
Male and Female Reproductive System
Male Female
Hormone produced Testosterone Estrogen & Progesterone

Hormones Interstitial cells Corpus luteum & granulosa

produced by cells

epididymis, urethra, & vas uterus, fallopian tube, &

Duct system deferens - Wolffian duct vagina - Mullerian duct
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Human Sexual Response
Excitement Phase
In women, the following occur:
Vaginal lubrication increases.
The inner two thirds of the vagina begins to
lengthen and distend, the outer one third
undergoes slight thickening, and the body of the
uterus is pulled upward. The vaginal walls
become congested with blood and darken in
color, and the clitoris increases in diameter,
possibly with slightly increased tumescence of
the glans clitoris.
The labia minora become engorged with blood
and increase in size.
The labia majora flatten somewhat and retract
away from the middle of the vulva
The nipples become erect, and breast size
increases.
Flushing occurs in approximately 75% of women.
Overall muscle tension increases.
In men, the following occur:
Penile erection begins
Scrotal skin becomes congested and thick
Testes elevate into the scrotal sac
Some nipple erection may occur
Flushing may occur
Heart rate and blood pressure begin to increase
Generalized muscle tension increases, with a
tendency toward involuntary muscle
contractions.
Plateau Phase
In women, the following occur:
The walls of the outer one third of the vagina
become further engorged with blood, decreasing
the internal vaginal diameter.
The labia minora become further engorged with
blood and darken and swell.
The clitoris retracts and is covered by the clitoral
blood: the clitoral body decreases in size by
about 50%.
The nipple become further engorged.
Flushing may spread to the abdomen, thighs, and
back.
Muscle tension increases. Breathing becomes
deeper; heart rate and blood pressure increase
markedly as tension rises toward orgasm.
In men, the following occur:
The penis further enlarges, sometimes undergoing
color changes corresponding to reddening of the
female labia.
Preorgasmic emission may occur from Cowper’s
glands.
The testes continue to be elevated, enlarge, and
rotate (approximately 30 degrees)
Heart rate, blood pressure, and respiratory rate
continue to increase.
Muscle tension increases
Neri, H.A.G. | BSN 2E
Orgasmic Phase
In women, the following occur:
Strong muscular contractions occur in the outer
one third of the vagina, and the inner two thirds
expands.
The uterine muscles contract.
No observable changes occur in the labia majora,
labia minora, clitoris or breasts
Flushing reaches a peak of color intensity and
distribution.
Possibly strong muscular contractions, both
voluntary and involuntary, may occur in many
parts of the body, including the rectal sphincter
muscle.
Respiratory rate may reach a peak of two or
three times normal, heart rate may double, and
blood pressure may increase as much as one-
third above normal
In men, the following occur:
Rhythmic contractions expel semen from the
epididymis through the vas deferens; seminal
vesicles, prostate glands; urethra, and urethral
meatus.
Testes are at maximum elevation, size, and
rotation.
Flushing reaches its peak.
Heart and respiratory rates also peaks.
A general loss of voluntary control occurs.
A refractory period begins as the final
contractions of the urethral walls occur.
Resolution Phase
In women, the following occur:
Blood engorging the walls of the outer one-third
of the vagina disperses rapidly.
The inner two thirds of the vagina gradually
shrinks, and color returns to pre-excitement
shade.
The uterus descends, and the cervix dips into the
seminal pool.
The labia minora and majora return to
unstimulated thickness and close toward the
midline.
The clitoris protrudes from under the clitoral
hood, and eventually returns to pre-stimulated
size.
Flushing disappears.
Muscles relax quickly.
Heart rate and blood pressure return to normal.
In men, the following occur:
More than 50% of the erection is lost rapidly in the
first stage of resolution, with the penis gradually
returning to its unstimulated size during the
second stage.
The scrotum gradually loses its congested and
thick status.
The testes descend and return to normal size
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Resolution Phase (continued)
Nipple erection subsides.
Flushing disappears.
Heart rate, blood pressure, and respiratory rate
return to normal
General muscle relaxation occurs
Sexuality, Sexual Identity, and
Sexual Orientation and Expression
Sexuality
A person’s sexuality encompasses complex emotions,
attitudes, preferences, and behaviors related to
expression of the sexual self and eroticism.
Sexual relationships are a dynamic aspect of life and
are intertwined with biologic and psychosocial
components.
Nurses commonly are resource people for clients
seeking information related to human sexuality and
functioning during the reproductive years.
Responsible sexuality involves commitment to a
relationship, responsible reproductive health care,
and rational decisions about childbearing.
Gender Identity (sexual identity) & Gender Roles
Gender identity is a person’s sense of his or her own
masculinity or femininity. Gender identity is thought to
be established in part by how the individual was
treated by his or her parents as a child, by hormonal
influences in utero, and by psychosocial factors.
Gender roles are composed of behaviors, attributes,
and attitudes an individual conveys about being male
or female.
Born a sexual being, a child’s gender identity and
gender role behavior usually develop from, and
conform to, cultural norms and expectations.
Gender role is the male or female behavior a
person exhibits, which, again, may or may not be
the same as biologic gender or gender identity.
Biologic gender is the term used to denote a
person’s chromosomal sex: male (XY) or: female
(XX).
Biological gender - biological or assigned sex is about
biology, anatomy, and chromosomes.
Sexual Orientation & Expression
Sexual orientation - a person’s preference for
heterosexual, homosexual, or bisexual relationships.
Preference may vary during a person’s lifetime and is
probably shaped by a complex interaction of several
factors including prenatal hormone environment,
early parental interactions , social mores and values,
family dynamics and imitation of the most valued
parent.
Sexual expression - the activities that the individual
chooses to give and receive physical love and
gratification.
Neri, H.A.G. | BSN 2E
There are many ways to experience sexual
gratification such as coitus, masturbation,
celibacy, and fetishism
One’s culture determines acceptable forms of
sexual expression.
What is considered normal may vary greatly
among cultures.
Acceptable sexual activity includes the elements
of privacy, consent, and lack of force.
Adolescence is an especially confusing and
difficult time because adolescents need to feel
comfortable wit their own sexuality before they
can reach out to others.
Differences in Male & Female Sexual Response
Women have 3 identifiable sexual response patterns.
Rapid progression to plateau stage with some peaks
and valleys, and one intense orgasm, followed by
rapid resolution, resembles the male pattern
Steady progression to plateau stage, followed by an
intense orgasm and possibly subsequent orgasm,
causing prolonged pleasurable feelings without
definitive orgasm and possibly subsequent orgasms,
with slower resolution
Slower progression to plateau stage, followed by
minor surges toward orgasm, causing prolonged
pleasurable feelings without definitive orgasm
Men have 1 basic sexual response pattern.
excitement progresses steadily to plateau stage, with
one intense orgasm, followed by resolution.
In general, women experience orgasms in a wider range
of duration and intensity than do men.
Female orgasmic contractions last twice as long as the
man’s contractions; however, the strength of the
contractions is not as markedly concentrated in the first
few pulsations.
Controversies About the Female Orgasm
Unlike some animals, human females can have sex any
time of the month, and they do not have to orgasm to
ovulate or get pregnant.
Male-dominated scientific norms mean that much about
the female orgasm remains misunderstood, and many
harmful myths persist.
A female orgasm can be highly pleasurable and occur
during masturbation or sexual activity with one or more
partners. Scientists are unsure whether it has additional
benefits.
The benefits of the male orgasm are clear. Men must
ejaculate to deposit sperm in the vagina, possibly
leading to pregnancy. The male orgasm, therefore,
serves a clear evolutionary purpose.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

The purpose of the female orgasm is less clear.
Researchers have suggested numerous potential
benefits, but few have been rigorously tested, and no
theory has conclusive scientific support.
Not everything the body does has a clear purpose,
however. Scientists have not discovered the evolutionary
benefits of some traits that have persisted in humans.
A 2016 study Trusted Source argues that the female
orgasm may have no obvious evolutionary benefit and
that it may be a relic of a time when the hormones
associated with orgasm were necessary for a woman to
ovulate.
Since there was no evolutionary need to eliminate the
female orgasm, it persisted even when it was no longer
necessary for fertility.
Orgasm may serve important purposes, however. The
pleasure it can cause can encourage females to have
sex. This may also promote bonding with a sexual
partner, which does have significant evolutionary
benefits.
Women do not need to orgasm to get pregnant.
However, a limited body of evidence suggests that
orgasms may boost fertility.
One very small study Trusted Source, for example,
measured whether there was better sperm retention
after female orgasm. While the results confirmed this,
proving that the female body retains sperm better after
an orgasm will require larger studies with designs of
higher quality.
Influence of the Menstrual Cycle
on Sexual Response
Despite being a miraculous process of Nature that
prepares women to be mothers, the menstrual cycle has
suffered such regression for centuries that, in the middle
of this room, if we asked how to summarize it in a few
words, many would respond, "blood, sweat, and tears."
But not all is lost; Fortunately, more and more women are
rebelling against labels recognizing that, in addition to
bleeding, suffering pain and enduring several different
emotions, we sometimes feel great sexual desire. And
why does this happen? This article will explain the main
reasons that influence the generality of menstrual cycles.

What happens during an orgasm? Hormones and female sexual desire

During arousal, blood flow to the genitals increases,
causing them to become more sensitive.
As arousal increases, a person’s heart rate, blood
pressure, and breathing rate may also increase. As
orgasm approaches, the muscles may twitch or spasm.
Many women experience rhythmic muscle spasms in the
vagina during an orgasm.
Several researchers have proposed that sexual response
follows specific stages, though their theories about these
stages differ.
Hormones are substances secreted by specialized cells
that circulate through the blood to organs and tissues,
acting as "chemical messengers" in the body in
processes related to metabolism, growth and
development, and reproduction.
Female sex hormones, specifically, prepare our
reproductive system for the reception of sperm and the
implantation of the fertilized ovum, and affect our mood,
desire and sexual response, especially estrogens and
progesterone; although some studies also point to
androgen hormones such as testosterone.

Still, most theories include the following stages: Estrogens

excitement, during which arousal builds
are produced mainly by the ovaries and the placenta
plateau, during which arousal increases and levels off
during pregnancy.
orgasm, which causes intense feelings of pleasure
The most relevant are estrone and estradiol, the
resolution, during which arousal diminishes
former having the function of preparing ovulation and
Many females are able to have another orgasm after
the latter, regulating the menstrual cycle.
resolution, whereas males usually require a period of
Estrogens also influence our libido, as well as our
rest before having another orgasm.
emotional behavior, as they are linked to the
neurotransmitters "of happiness" that we will see
Health benefits
later, the sexual desire, optimism, feelings of well-
While the internet is filled with articles promising that
being and fulfillment being greater the greater their
orgasms improve skin, hair, and overall health, there is
presence. in the body.
little scientific evidence that orgasms offer any
specific health benefits.
Scientists have not identified any evolutionary
benefits of female orgasms or found that orgasms
improve health.
But orgasms are pleasurable, and pleasure can be its
own benefit. Pleasurable sex may improve a person’s
mood, relieve stress, boost immunity, and foster
better relationships.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Dopamine
also acts as a hormone and neurotransmitter
involved in functions such as movement, learning, milk
production, memory, sleep or attention, although it is
known above all because it provides pleasure and
relaxation.
To this is added that, as it is related to the brain's
reward system, the organism encourages us to repeat
those behaviors that have caused its liberation,
among which, of course, is sex; But, like oxytocin, you
don't have to have an orgasm during the menstrual
cycle for it to appear, its levels increase notably in
the... precisely, pre-ovulatory phase.
Hormones, neurotransmitters and the menstrual cycle
As we explained in this report about the different phases
of the menstrual cycle, during this, hormonal levels vary,
directly affecting our mood and our libido. And when is
the sexual desire strongest?
Although each woman is a world and her menstruation is
another, various studies have determined that sexual
desire begins to manifest itself at the time of
menstruation and increases until it reaches its highest
peak at approximately 14 or 15 days, just before
menstruation. ovulation. Why?
Because during the cycle, the levels of estrogens and
progesterone vary and, as we have seen, estrogens
increase sexual desire and elevate the mood (due to its
interaction with the neurotransmitters of happiness),
while progesterone reduces them.
Sex drive during menstruation
Many women feel especially lustful in the first phase of
their menstrual cycle for various reasons.
One of them is the increase in lubrication and
sensitivity, which increase the pleasure of all sexual
games; to which is added the analgesic power of
orgasm, which reduces menstrual pain.
Influence of Pregnancy on Sexual Response
Sexual Intercourse During Pregnancy
Pregnancy marks the beginning of a physiological
transition that has a profound effect on physical,
psychological and sexual aspects of a pregnant
female’s life. This transition is partly attributed to the
hormonal aberrations and partly to the biochemical
changes that occur in response to the influx of
different hormones in the blood.
Although a lot of women regard pregnancy as the
most memorable period of their life, but many find it a
difficult and overwhelming experience due to wide
array of physical emotional issues such as backache,
mood swings, ailing health, poor energy levels and
shift in the center of gravity due to expanding uterus.
Neri, H.A.G. | BSN 2E
The pregnancy can also have positive effects on the
sexual life; for example, many females report
increased sensitivity of certain parts of the body,
especially breast and vaginal region which can be
accounted to an increased blood supply to these
tissues. Additionally, sex during pregnancy is better in
quality because of an increase in the rate of vaginal
secretions that improves the chances of orgasms and
intense pleasure
On the other hand, few women may experience pain
or uterine contractions due to excessive sensitivity
that makes it uncomfortable to engage in the sexual
encounters. It is imperative to mention that changing
sexual positions or intensity of stimulation can help in
improving the sexual experience.
Mood Changes During Pregnancy and its Effect on
Sexual Life
Most women, especially those who are pregnant for
the first time feel overwhelmed by the physical and
mental changes of pregnancy. The first trimester is
usually the hardest in terms of libido due to extreme
nausea, morning sickness, weakness and mood
swings.
Most of the time, these feelings are worsen with
certain activities, smells and other changes in the
surrounding environment. However, during second
and third trimesters, most females experience
remarkable improvement in the libido and sexual
desires under the influence of hormones.
Most healthcare providers recommend sexual
intercourse during pregnancy due to following
potential benefits:
Lower risk of post-term delivery
Active pregnancy
Positive effects on the mood and psychological
health of mother
Improved quality of the relationship between
the partners
Sexual Life and a Safe Pregnancy
Many couples continue their sexual encounters during
pregnancy without any substantial difficulty; but
some females may experience displeasure or
discomfort. A lot of couples are also skeptical about
the safety of the fetus if the couple engages in the
act of intercourse during pregnancy.
There are just so many questions and queries in this
subject with no absolute right or wrong answers. But
here are a few tips to ensure safer pregnancy with
sexual intercourse.
Consult your physician or mid-wife to know the status
of your pregnancy and if activities like sex can have a
potential disastrous effect on the fetal development.
Call your doctor immediately, if you notice any
bleeding or discharge from your vagina or sudden
onset of painful, spasmodic uterine contractions that
does not resolve after 5-10 minutes of complete rest.
Do not engage in chance sexual encounters in order
to minimize your risk of contracting sexually
transmitted infections that may have a deleterious
effect on your pregnancy.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Some women may be asked to maintain complete
abstinence from the sexual intercourse. In all such
case, show care and love to your partner by kissing,
hugging and non-sexual activities.
Types of Sexual Orientation
The American Psychology Association defines sexual
orientation as "an enduring pattern of emotional,
romantic and/or sexual attractions to men, women or
both sexes." This implies interest in a person due to
different factors: biological, psychological, economic,
cultural, religious, and social (Pérez, 2014).
A person's identity in relation to the gender or genders to
which they are sexually attracted; the fact of being
heterosexual, homosexual, etc.
Sexual orientation is about who you’re attracted to and
want to have relationships with. Sexual orientations
include gay, lesbian, straight, bisexual, and asexual.
Heterosexual
an individual feels attraction on an emotional,
romantic or sexual level to people of the opposite sex.
For example, a man to a woman or a woman to a
man.
Homosexual
refers to those with a sexual preference for people of
the same sex.
This means a man that's attracted to another man, or
a woman that's attracted to another woman.
Bisexual
one feels emotional, romantic, sexual, or affective
attraction towards both sexes.
In other words, when men have feelings for both men
and women; or when a woman feels attracted to both
men and women.
Together, homosexual and bisexual individuals have
started a fight for the recognition of sexual diversity,
having launched the LGBTI+ movement (lesbian-gay-
bisexual-transgender-intersexual and more).
Neri, H.A.G. | BSN 2E
Asexual
lack of sexual, social, physical, or affective attraction
towards others
an asexual person doesn't feel attracted to any
subject, no matter what their sex. That's why many
consider this a 'lack' of sexual orientation. However,
many stand up for asexuals, saying that asexuality is
indeed a sexual orientation.
Pansexual
attracted to any sex or gender
This means that a pansexual person might feel
equally attracted on an emotional, romantic, sexual,
or affective level to people of any sexual orientation
or gender identity.
Pansexuality is different from bisexuality since the
latter stems from the gender binary, meaning, the
idea that there are only two possible genders: male
and female.
works to bring sexual diversity beyond the binary to
light, in a context where there can be more than two
genders and sexes, as well as a wide range of
possibilities for expressing them
Demisexual
a sexual preference where the individual needs to
establish an emotional bond with someone first
before they feel attraction.
This means a demisexual person might not feel sexual
or affective desire for someone until they get to know
them well and they can trust this person.
was once considered a variety of asexuality, but
today, it's recognized as a separate sexual
orientation since the possibility of feeling physical
and emotional attraction towards someone still exists,
but only after getting really close to this individual.
Anthrosexual
a non-defined sexual orientation, which means that
individuals that identify as anthrosexual make
connections with all different types of people
Some might consider this type of sexual preference a
sort of mix between bisexuality and pansexuality,
although they don't identify exclusively with either of
these.
Autosexuality
an individual feels sexually attracted to himself or
herself, which means that they have autoerotic
tendencies.
Graysexuality
sexual preference that represents the most
substantial part of the sexual desire continuum.
a sexual orientation located between the two poles of
desire: asexuality and sexuality.
A graysexual person isn't exclusively sexual or
asexual. Instead, they move from having sexual
feelings to being asexual during different phases of
their life.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Hyposexuality
practically the same as asexuality (a lack of sexual,
emotional, or affective attraction to anyone).
The difference is that, while asexuality defines
someone's sexual preferences as a norm,
hyposexuality is a consequence of external factors
like too much stress at work, or even the result of a
medical condition.
On the same note, in some contexts, it isn't defined as
a sexual orientation, but instead, a transitional phase
caused by external factors.
Lithsexuality
the person feels physical and emotional attraction
towards a person, regardless of whether this feeling
is corresponded.
Reciprocity in desire and sexual interest isn't a
determining factor for someone lithsexual to feel
attraction.
Sapiosexuality
'sapio' comes from Latin and means 'wise'
a fixed attraction towards people that they consider
intelligent.
Sapiosexual people feel attracted to others due to
their cognitive and emotional abilities, through which
they are able to make fundamental intellectual
connections.
Skoliosexuality
individuals feel attracted to transgender and
intersexual people, or other people with more open
gender identities.
This means that a skoliosexual person doesn't feel
attracted to cisgender individuals (people who
identify with the gender assigned to them at birth),
instead, they are drawn exclusively to people with
open sexual identities.
Queer
The word 'queer' originally meant "strange" or
"peculiar," and throughout history, it has been used
as a derogatory term to refer to people who aren't
straight or heterosexual.
This is a concept traditionally used to talk about
sexual minorities; in other words, those who break
heteronormative ideas (that don't fit the traditional
gender binary).
However, towards the end of the 20th century and the
beginning of the 21st, the LGBTI+ community began
the reappropriation of the word 'queer' to reclaim
sexual diversity and the right to experience their
sexual orientation freely.
And thus, the word queer refers to those with fluid
sexual orientations and gender identities. In this
sense, the concept is similar to skoliosexuality,
although it also encompasses almost all of the sexual
orientations we mentioned before (since they all
question heteronormativity).
Neri, H.A.G. | BSN 2E
Adolescence and sexuality
People often wonder at what age sexual orientation
and sexual identity are established. Is this set in stone
at a certain point in time? The answer is: no, not
necessarily. Traditionally, adolescence is a phase in
life where different expectations are set, and social
roles are established, and sexual orientation is also
often conceived around this time as well.
However, current evidence shows that this doesn't
necessarily happen during the teenage years and, if
it doesn't, then it doesn't necessarily occur within any
specific time frame. However, this doesn't make
adolescence any less significant when it comes to
psychological conflicts regarding sexuality, especially
since it opens up different environments with different
rules.
Offering different role models favors self-knowledge,
and therefore self-assuredness. Plus, it helps to
improve one's ability to coexist with others and to
take responsibility for decisions consciously.
Types of Sexual Expression
Because people are individuals, types of sexual
expression are individualized.
Celibacy
the state of abstaining from marriage and sexual
relations
(from Latin caelibatus) is the state of voluntarily being
unmarried, sexually abstinent, or both, usually for
religious reasons. It is often in association with the
role of a religious official or devotee. In its narrow
sense, the term celibacy is applied only to those for
whom the unmarried state is the result of a sacred
vow, act of renunciation, or religious conviction. In a
wider sense, it is commonly understood to only mean
abstinence from sexual activity.
Masturbation
stimulation of the genitals with the hand for sexual
pleasure
act or practice of self-stimulation of one's sexual
organs.
It is usually done with the goal of achieving sexual
climax, sexual gratification, or the release of sexual
tension.
Although masturbation exists among both males and
females, it is generally considered more common
among men than women (Leitenberg et al. 1993, 87-98).
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Erotic Stimulation
The use of visual materials such as magazines or
photographs for sexual arousal.
Although this is thought to be mostly a male
phenomenon, there is increasing interest in centerfold
photographs in magazines marketed primarily to
women.
Some parents of adolescents may need to be assured
that an interest in this type of material is
developmental and normal. Respect this type of
reading material when straightening patient’s room in
a health care facility.
Fetishism
a form of sexual behavior in which gratification is
strongly linked to a particular object or activity or a
part of the body other than the sexual organs
worship of an inanimate object for its supposed
magical powers or because it is considered to be
inhabited by a spirit
behavior in which someone has so much interest in an
object or activity that they spend an unreasonable
amount of time thinking about it or doing it
Leather, rubber, shoes and feet are frequently
perceived to have erotic qualities
Transvestism
the action or practice of dressing in clothes primarily
associated with the opposite sex
the practice of dressing in a manner traditionally
associated with the opposite sex.
In some cultures, transvestism is practiced for
religious, traditional, or ceremonial reasons. The term
is considered outdated in Western cultures, especially
when used to describe a transgender or gender-fluid
person.
Transvesite - an individual who dresses to take on the
role of the opposite sex.
Transvesites can be heterosexual, homosexual, or
bisexuals.
Voyuerism
practice of gaining sexual pleasure from watching
others when they are naked or engaged in sexual
activity
the sexual interest in or practice of watching other
people engaged in intimate behaviors, such as
undressing, sexual activity, or other actions usually
considered to be of a private nature.
The term comes from the French voir which means "to
see".
A male voyeur is commonly labelled as "Peeping Tom"
or a "Jags", a term which originates from the Lady
Godiva legend. However, that term is usually applied
to a male who observes somebody secretly and,
generally, not in a public space.
Neri, H.A.G. | BSN 2E
Sadomasochism
giving and receiving of pleasure from acts involving
the receipt or infliction of pain or humiliation
Practitioners of sadomasochism may seek sexual
pleasure from their acts.
terms sadist and masochist refer respectively to one
who enjoys giving and receiving pain, some
practitioners of sadomasochism may switch between
activity and passivity.
The abbreviation S&M is commonly used for
Sadomasochism (or Sadism & Masochism), although
the initialisms S-M, SM, or S/M are also used,
particularly by practitioners.
Sadomasochism is not considered a clinical
paraphilia unless such practices lead to clinically
significant distress or impairment for a diagnosis.
Similarly, sexual sadism within the context of mutual
consent, generally known under the heading BDSM, is
distinguished from non-consensual acts of sexual
violence or aggression.
Other Types of Sexual Expression
Exhibitionism
revealing one’s genital in public
Pedophiles
individuals who are interested in sexual encounters
with children.
Known pedophiles are registered sex offenders.
When they move into a new community, families are
notified of the move according to Megan’s law, a
national law designed to alert citizens to the
presence of a sex offender in a community.
Obscene Phone Calling
an unsolicited telephone call where a person uses
foul or sexual language to interact with someone who
may be known to them or who may be a complete
stranger
Making obscene telephone calls for sexual arousal or
other sexual pleasure is known as telephone
scatologia and is considered a form of exhibitionism.
Telephone Scatologia
usually classed as a paraphilia from a psychiatric
viewpoint
It is in the DSM-5 as an other specified paraphilic
disorder.
Related psychiatric terms (such as coprophonia) were
coined in Australia, the United States, and Germany;
most of the pertinent literature is North American.
From the viewpoint of the recipient of the calls,
obscene calls may be considered to be a form of
sexual harassment, stalking, or both.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025
REPRODUCTIVE & SEXUAL HEALTH
Bestiality
sexual intercourse between a person and an animal
There are few things stranger or more repulsive than
bestiality
When you say bestiality, you can hear the word beast,
which is a good clue to the meaning. People who are
into bestiality like having sex with animals.
It doesn't matter what animal is involved: if someone
if having sex with something alive that's not a person,
it's bestiality.
Bestiality is illegal and usually considered very wrong
and harmful to everyone involved.
Necrophilia
sexual intercourse with or attraction towards corpses
A person commits the offense of necrophilia when he
performs any sexual act with a dead human body
involving the sex organs of the one and the mouth,
anus, penis, or vagina of the other.
obsession with and usually erotic interest in or
stimulation by corpses
Sexual Harassment, Disorders of Sexual
leads to significant personal distress, involves
Functioning; Disorders of Sexual Arousal;
Orgasm Disorders; Pain Disorders
Sexual Harrassment
refers to unwelcome sexual advances, comments of a
sexual nature, requests for sexual favors, and
harassment or comments about an individual’s
gender, all of which create a hostile work environment
Most commonly, sexual harassment is perpetrated by
someone in a position of authority over the victim,
such as an employer, supervisor, or teacher.
Sexual harassment is illegal in the U.S., defined and
governed by the Equal Employment Opportunity
Commission (EEOC). Failure to prevent, or to stop, such
behavior, may expose the employer to serious civil
penalties. To explore this concept, consider the
following sexual harassment definition.
Uninvited and unwanted sexual behavior, whether
verbal or physical, especially by an individual in a
position of authority over the victim (such as an
employer, or a teacher).
The concept of sexual harassment is relatively new,
originating in the early 1970s, when the President and
Chancellor of MIT addressed a variety of gender
issues. Sexual harassment is a serious problem in the
U.S. that is addressed by the EEOC. Commonly, sexual
harassment is perpetrated by an individual in a
position of power or authority, whether by social,
political, or educational differences, difference in
age, or an employment relationship. Occasionally, an
individual looking to receive an advantage, such as a
promotion, may engage in sexual harassment,
attempting to induce or entice the victim to elevate
his or her position.
Neri, H.A.G. | BSN 2E
Common relationships in sexual harassment include:
Perpetrator - employer, supervisor, co-worker, client,
teacher or professor
Victim - male or female, person in an inferior role, may
be someone other than the person who is being
harassed, such as a witness to sexually harassing
behavior
Place - workplace, school, university, or other location
Gender - both perpetrators and victims may be of
either gender, and the perpetrator is not necessarily
someone of opposite gender
Disorders of sexual functioning
Sexual Desire Disorders
Healthy sexual activity can include a wide range of
desires and activities, which, when fantasized about
or experienced between consenting adults as part of
a fulfilling relationship, bring people pleasure, even if
others may prefer to live their sex lives in a different
way.
Some sexual behavior, however, indicates the
presence of sexual disorder, because the practice
harming others, or becomes compulsive.
Inhibited sexual desire (ISD)
a medical condition with only one symptom: low
sexual desire.
According to the DSM/ICD-10, ISD is more correctly
referred to as HSDD or hypoactive sexual desire
disorder. A person with HSDD seldom, if ever, engages
in sexual activities. They don’t initiate or respond to a
partner’s sexual overtures.
It’s important to distinguish HSDD from asexuality.
Asexuality is a type of sexual orientation defined as a
general lack of sexual attraction, while HSDD is a
condition focused on a lack of sexual desire.
HSDD is one of the more common problems couples
face today.
HSDD can be a primary or secondary condition. This is
an important distinction for treatment purposes. It’s a
primary condition if the person with HSDD has never
had sexual desire.
It’s a secondary condition if the person with HSDD
began a relationship with normal sexual desire but
later became disinterested.
HSDD can also be understood as a relationship issue,
which helps to guide medical or psychological
treatment.
Situational HSDD means that the person with HSDD
has sexual desire for others, but not for their partner.
General HSDD means the person with HSDD has no
sexual desire for anyone.
There’s no true normal range for sexual desire
because it naturally fluctuates throughout life.
CARE OF MOTHER, CHILD, ADOLESCENT NCM 2107
(WELL CLIENTS) 1st Semester
A.Y. 2022-2023
Lecture | Level 2 | CPU CON Batch 2025 Neri, H.A.G. | BSN 2E

REPRODUCTIVE & SEXUAL HEALTH

Nonsexual Diseases
Major life changes that can affect your sexual
Certain conditions can affect libido (sexual desire). The
desire include:
most common of these are:
pregnancy
high blood pressure
partner changes (marriage or divorce)
cancer
physical or psychological disability
coronary heart disease
menopause
sexually transmitted diseases (STDs)
work and life imbalance
neurological issues
diabetes
People seek help when HSDD puts stress on their arthritis
relationships. However, the problem isn’t always a
case of HSDD. One partner may have an overactive
sexual desire. This creates a ‘sexual mismatch,’ which
also puts undue strain on a relationship. When this Sexual Dysfunction
happens, it can:
erode affection Women who have had breast or vaginal surgery may
cause neglect of the nonsexual relationship experience sexual dysfunction, poor body image, and
cause the other partner to lose sexual interest inhibited sexual desire.
Erectile dysfunction (ED) - inability to achieve an
erection of the penis. This can cause HSDD in the
What Causes Inhibited Sexual Desire? person with the penis, who may feel a failure sexually.
HSDD is often an intimacy issue. Common Perceived failure in both men and women (failure to
relationship factors that can impact sexual desire orgasm, for example) can cause the individual
include: experiencing the dysfunction to have HSDD.
conflict
toxic communication
Erectile dysfunction isn’t necessarily due to aging.
controlling attitudes
It can be a sign of medical problems such as:
contempt or criticism
diabetes
defensiveness
heart disease
breach of trust (infidelity)
clogged blood vessels
lack of emotional connection
In many HSDD cases, medical conditions aren’t
spending too little time alone
as influential as each partner’s attitude about
sexual intimacy.
People who are most at risk of developing HSDD have
experienced trauma (incest, rape, or sexual abuse), or
were taught negative attitudes about sex by their
How Is Inhibited Sexual Desire Diagnosed?
family (or by their religion) while growing up.
blood tests to check for diabetes, high
cholesterol, thyroid problems, or low
There are many medical and psychological factors testosterone
that can also hamper sexual desire, including: pelvic exam to check for physical changes,
painful intercourse such as vaginal dryness, painful areas, or
erectile dysfunction (impotence) thinning of the vaginal walls
delayed ejaculation (inability to ejaculate blood pressure check
during intercourse) tests for heart disease
negative thinking patterns (anger, dependency, prostate gland examination
fear of intimacy, or feelings of rejection)
pregnancy and breastfeeding
mental health problems (depression, anxiety,
low self-esteem)
stress
use/overuse of alcohol and street drugs
chronic illness
pain and fatigue
side effects of medicines (especially
antidepressants and anti-seizure drugs)
hormonal changes
low testosterone (in both women and men)
menopause