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Understanding Human Sexuality 12th

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CHAPTER 5: SEX HORMONES,


SEXUAL DIFFERENTIATION, AND THE MENSTRUAL CYCLE

Lecture Outline

Are You Curious?


Questions are posed regarding the regulation of sex hormones, effects of environmental
chemicals, and what an “intersex” person is.

1) Sex hormones
Hormones are chemical substances manufactured by the endocrine glands. Those linked to
sexuality include testosterone, estrogen, and progesterone. The hypothalamus regulates the
pituitary gland, which in turn regulates other glands, such as the testes and ovaries, and their
production of hormones.
a) Sex hormone systems in males operate in a feedback loop referred to as the HPG
(hypothalamus-pituitary-gonad) axis.
i) The pituitary produces FSH, which controls sperm production, and LH, a hormone
that controls testosterone production.
ii) The hypothalamus secretes GnRH to regulate FSH and LH levels. Testosterone levels
in turn affect the hypothalamus and its release of GnRH.
b) In the sex hormone system of females, the ovaries produce estrogen and progesterone in a
negative feedback loop similar to that of the male.
i) Estrogen and progesterone levels fluctuate across the menstrual cycle and during
pregnancy and menopause.

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ii) Other hormones produced by the pituitary include prolactin, a substance that
stimulates milk production after birth, oxytocin, which is responsible for stimulating
contractions and affectionate bonding, and inhibin, which helps control the menstrual
cycle.
2) Prenatal sexual differentiation
a) At conception, individuals typically receive two sex chromosomes. One is an “X,” and
the other may be an “X” or a “Y.” In some cases, individuals have a sex chromosome
combination other than XX or XY.
b) Gonads begin to differentiate seven weeks following conception into either testes or
ovaries. By studying cases of atypical development, researchers located a gene
designated SRY on the Y chromosome that appears to direct male differentiation.
c) Upon differentiation of the gonads, the ovaries and testes begin to produce sex hormones
that influence further differentiation of internal and external genital structures.
d) In females, Wolffian ducts degenerate and Mullerian ducts form the fallopian tubes,
uterus, and upper part of the vagina. In males, an opposing process occurs, and the
Wollfian ducts remain to form the epididymis, vas deferens, and the ejaculatory duct.
e) Both testes and ovaries begin in the top of the abdominal cavity. Both structures drop to
the pelvic region by the 10th week, and the testes move even further into the scrotum via
the inguinal canal. Problems with testicular descent include cryptorchidism and inguinal
hernia.
f) Brain differences in the size of the amygdala and hypothalamus of males and females
have been observed on MRIs.
g) Atypical gender differentiation can result in inconsistency between an individual’s
genitals, chromosomal makeup, and gender identification. Approximately 2 percent of
births show such a contradiction, referred to as an intersex condition, or disorder of sex
development (DSD). Intersex: biologically a person’s gender is ambiguous.
i) One intersex condition is CAH, in which a genetic female with ovaries is exposed to
an overproduction of androgens.
ii) Another is AIS, a condition resulting when a genetic male has an insensitivity to
testosterone.
iii) In the Dominican Republic, 5-Alpha Reductase Syndrome results in genetic males
who appear female at birth and are raised as girls in childhood, but who develop a
penis at puberty and typically identify in adolescence and adulthood as male.
3) Sexual differentiation during puberty
A second stage of sexual differentiation occurs during puberty, a time when the gonads and
genitalia enlarge and mature and secondary sex characteristics develop. The benchmark event is
first ejaculation for males and menarche, or menstrual onset, for females. Adolescence is a
culturally defined period surrounding puberty that is protracted in modern U.S. culture.
a) Changes in females include the development of the breasts, deposits of fatty tissue in the
hips, and growth of pubic and axillary hair. The vaginal walls also thicken and the pelvic
bones grow and widen. The pubescent growth spurt for girls occurs between the ages of 9

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and 15. The trigger for puberty is unknown, but recent research suggests that the protein
leptin may play a role in onset for both females and males.
b) Changes in males are similar and include growth of the testes, scrotum, and penis. Pubic
hair begins to grow, and roughly two years later, axillary and facial hair appears.
Erections increase, sperm production begins, and nocturnal emissions become common
for many boys. The growth spurt begins later than in girls, occurring between the ages of
approximately 11 and 16. Boys are more likely than girls to be affected by acne.
c) Puberty also results in changes in behavior – increasing sensation-seeking behaviors,
such as sex.
4) The menstrual cycle
The biology of the menstrual cycle is regulated by fluctuating levels of sex hormones. Humans
differ from most animals in having a menstrual cycle rather than an estrous cycle. A significant
difference between the two is that females with estrous cycles engage in sexual behavior only
when in heat, while human females can and do engage in sexual behavior throughout the
menstrual cycle.
a) There are four phases in the menstrual cycle.
i) The first is the follicular phase. The pituitary secretes FSH, causing one follicle to
mature and begin secreting estrogen.
ii) During ovulation, the follicle ruptures and releases the mature egg. The increase in
estrogen secreted by the ovaries triggers the hypothalamus to decrease FSH and
increase LH production.
iii) In the luteal phase, the follicle transitions into the corpus luteum and produces
progesterone, which inhibits pituitary secretion of LH. As the corpus luteum
degenerates, estrogen and progesterone levels fall and the pituitary again secretes
FSH to begin the cycle again.
iv) The decrease in estrogen and progesterone triggers the menstrual phase
(menstruation).
v) The uterine lining thickens during the follicular phase in preparation for a fertilized
ovum. If pregnancy does not occur, the lining is shed.
vi) The average menstrual cycle lasts 28 days, with ovulation typically occurring midway
through the cycle.
vii) Mucous on the cervix is thick during most of the cycle, but thins and increases in
alkalinity during ovulation. The basal body temperature also changes across the cycle,
with an increase in temperature during the luteal phase.
b) Menstrual problems
i) Dysmenorrhea is the result of elevated levels of prostaglandins, which cause uterine
contractions.
ii) Endometriosis is an often painful condition caused by endometrial tissue growing in
places other than the uterus.
iii) Amenorrhea – absence of menstruation
a. Primary amenorrhea is defined as a female who has not menstruated by about 18
years of age.

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b. Secondary amenorrhea is a cessation of menstruation in a female who has had at
least one period. It may be caused by pregnancy, stress, diet, cysts, or other factors.

5) Psychological aspects of the menstrual cycle


a) Premenstrual syndrome describes a condition characterized by physical and
psychological symptoms such as breast pain, irritability, and depression. Studies provide
conflicting evidence concerning the validity of PMS. The DSM-IV has included PMDD
in the appendix, but its inclusion is quite controversial.
b) Mood fluctuations are often reported by women, but studies of female academic and
athletic functioning do not offer support for variation in performance.
c) Support for fluctuations in sex drive is inconsistent, but there is an increase in
testosterone levels at ovulation, and some women report higher sexual interest at this
time.
i) In a recent study, women tracked biological changes and their sexual fantasies as a
means to better understand and correlate the two.
d) Biological explanations of mood fluctuation center on hormonal changes as a cause.
e) Cultural explanations focus on the impact of taboos and negative attitudes about
menstruation on women’s emotional well-being.
6) Cycles in men are less observable than the noticeable signs of menstruation; however, male
hormone levels do fluctuate at various times and in various situations.
7) The chapter ends with the Critical THINKing Skill: Understanding how scientific research
can be applied to making policy decisions.

Lecture Extension

Discussion Questions

DQ1: Hormones. What are hormones and how do they function?

DQ2: Signaling masculinity. How does a developing fetus know to begin masculinizing? What
chromosome is critical? What genetic material in that chromosome initiates masculinization? Is
it possible for that material to be missing or defective? What happens in that case?

DQ3: Gender differences. The textbook states that “differences exist between human male and
female brains ... although these differences may develop after birth rather than prenatally.” What
can we conclude from this research? Does it matter if the differences develop prenatally or after
birth? How might differences that develop after birth be interpreted as biological, sociological, or
both?

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DQ4: Puberty and weight gain. How does puberty affect the body weight of young girls? What
is the typical pattern of weight gain at puberty? What is the typical response of a young girl in
this situation? What are the consequences of the societal emphasis on thinness for girls and the
normal pattern of weight gain with puberty? Does this affect boys at all? What sort of weight
gain patterns can they expect to go through? What other sort of changes might they experience
with discomfort?

DQ5: Dream orgasms. Nocturnal emissions (wet dreams) are often discussed in sex education
for boys. Do girls have orgasms in their sleep? Is there a word to describe this experience for
women? Why might such experiences for women have been overlooked? Think of at least one
biological and one sociological reason.

DQ6: What is gender? What visual clues do you use to determine whether a person is a male or
female? How do you know for sure that a person walking down the street is male or female? Is
there any marker that assures you that you can correctly guess the gender of another person? The
textbook describes eight variables of gender. Does one of these variables determine gender? Are
any of them sufficient?

DQ7: The sex drive. What is the relationship between a woman’s sex drive and her adrenal
gland? How do the thresholds for testosterone and effects on sex drive differ in women and men?

DQ8: The hormonal systems. What are the important structures in the hormonal systems of
men and women? What hormone(s) does each structure contribute? How do the hormones relate
to each other? Which structures and hormones do men and women have in common? For
example, both men and women have follicle-stimulating hormone. What does it do in men and
what does it do in women? How are these functions similar?
Note to the instructor: Make sure to include the hypothalamus, the pituitary gland, the ovaries,
the testes, progesterone, estrogen, androgens, testosterone, gonadotropin-releasing hormone,
follicle-stimulating hormone, and leutenizing hormone.

DQ9: Transsexualism as a biological condition. Transsexual surgery costs tens of thousands of


dollars. In some countries (like the Netherlands), health insurance will cover a sex change
(including psychotherapy, hormone therapy, and surgery). Other countries (like Thailand) offer
sex changes very cheaply. More and more Americans who desire a sex change but cannot afford
it are going to the Netherlands to gain residency and have it covered by insurance or to Thailand
for a cheap, but not necessarily as safe, operation. Should United States health insurance be
required to cover transsexual surgery? Is your opinion based on whether you think the problem is
biological or psychological? What would be the best way to handle this issue?

DQ10: Rethinking AIS. What is AIS? Read the poem at the beginning of the chapter. Is this
person with AIS devastated about her condition? How has she interpreted it? Are there things
about AIS that she values? What are they?

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DQ11: Endocrine disrupters. Box 5.1 discusses the topic of endocrine disrupters. List some
examples of this problems occurring in non-human species. Give several examples of suspected
endocrine disrupters. Are YOU at risk for endocrine disrupters? If you answered yes, give some
examples of how you might reduce your risks.

DQ12: Knife conformity. Babies often undergo surgery because their external sexual anatomy
does not perfectly match typical male or female genitalia. What does this practice tell us about
the world we live in? When we surgically alter a child’s genitals, are we altering the child to fit
in with nature or with society? Can this practice be characterized as interfering with nature to
force people to fit into unnatural categories?

DQ13: The myth of two genders. Are there some societies in which more than two genders are
recognized? What are those societies like? If three or more genders were recognized in America,
do you think there would be as much transsexualism?

DQ14: Sexual activity during menstruation. Research indicates that females’ rates of
masturbation increase during menstruation, but their interpersonal sexual activity decreases. Why
do you think people tend not to want to engage in intercourse during menstruation? Is there any
biological reason not to? Can you think of any social reason why many people are reluctant?

DQ15: Anticipating PMS. Your 10-year-old daughter tells you that she has heard about PMS
and wonders whether she will get it when she begins her periods. What would you tell her?

DQ16: Interpreting correlation. Researchers have conducted studies to determine the extent of
correlations between cycles in emotional state and sex hormone cycles in both men and women.
The studies have found cycles of diverse lengths in emotional states of both men and women, but
researchers have had a difficult time tying the cycles to sex hormones. Are sex hormones the
only thing that could cause such a cycle? What other events, biological or not, might influence a
person cyclically? Is it possible that a socialized expectation for cycling emotions might layer
onto a biological cycle? Give an example.

DQ17: Acting on cycles. The textbook describes a study in which men’s work schedules were
designed to correlate with their documented behavioral cycles, resulting in a lower accident rate
at work. Is this good evidence that men experience a monthly cycle? If it was, is it reasonable for
a workplace to schedule their workers based on such evidence? Would such a procedure be
acceptable for women? What are the possible drawbacks?

DQ18: The impact of the menstrual cycle. The textbook defines the difference between the
estrous cycle and the menstrual cycle. Presumably humans evolved from an estrous cycle to the
menstrual cycle we now have. What might humans be like if we still had an estrous cycle? What
sort of advantages might the menstrual cycle have brought for humans? For families?

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Classroom Activities

CA1: Personal reflections. Have students anonymously answer the questions in Personal
Reflections on Puberty (Handout 5A). Ask them to disclose their answers and discuss them with
the class.

CA2: Quiz. Pass out Sex Hormones and Differentiation (Handout 5B). Put students into groups
and have them answer the questions together. Discuss the correct answers (found on the third
page of the handout).

CA3: Guest speaker. One of the most powerful experiences in a classroom can be when the
students have the opportunity to listen and talk with a person who embodies the facts and issues
at hand. Contact a local (perhaps university-affiliated) intersex organization and arrange a
speaker or panel of speakers. Such organizations often have excellent programs designed to
provide just this kind of service.

CA4: Forced choice—intersexual baby. Have students work in groups to respond to the
following scenario: Congratulations, new parent! You have just given birth to a healthy baby.
You baby does, however, appear to be intersexed. What are some of both the immediate and
long-term issues you and your child must face? Will you choose to have surgery to “normalize”
the appearance of the child’s genitalia? If so, what are the possible repercussions of this choice?
If not, what challenges await your new family?

CA5: The eight variables of gender. Arrange your students into groups and ask them to discuss
the eight variables of gender, listed in the textbook. After they have discussed each variable,
assign each group one of the following: congenital adrenal hyperplasia, androgen insensitivity
syndrome, progestin-induced pseudohermaphrotism, and 5-Alpha reductase syndrome. Have
each group look up their syndrome and analyze it in terms of the eight variables of gender. At
which point did normal development because interrupted? What happened at each stage after the
initial interruption? What can we infer about an individual with the syndrome, based on what we
know about development?

CA6: Gates of departure. As a group, look over the Gates of Development (Handout 5C) and
Departures from Normal Sexual Development (Handout 5D). For each problem, at which gate is
the departure from normal sexual development made? How do you know? Is it sometimes
difficult to tell? (Also see Classroom Activity 7.)

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CA7: Determining gender. Brainstorm a list of how to tell what gender a person is. Split the list
up into clues that a person uses in his or her day-to-day life (e.g., clothes, hair, makeup, vague
body shape), clues that a person uses with an intimate other or child (such as whether the person
has a penis and scrotum, vulva, or breasts), and clues that can only be used with the help of
technology (such as hormone levels and genetic makeup). Which of these clues are most often
used to determine a person’s gender? Are any of the clues on the first list foolproof? The second
list? The third? How, then, does a person tell what gender another person is? By asking?
Note to the instructor: With a quick look at the Gates of Development (Handout 5C) and
Departures from Normal Sexual Development (Handout 5D), you should be able to show that
none of these methods is foolproof. (Also see Classroom Activity 6.)

CA8: Have students fill out Handout 5E about their experiences with PMS. Discuss the results in
class.

CA9: Quiz. Pass out Menstrual Cycle Details (Handout 5F). Ask students to fill it out,
individually or in groups. Discuss the answers (found on the second page of the handout) with
the class.

CA10: Talking about periods. Brainstorm a list of words and phrases that are often used to
refer to menstruation. What types of words are used? What sort of connotations do they carry?
What do they imply about women?

CA11: Menstruation. Have students make a list of things they have heard about menstruation.
Identify the myths versus facts.

CA12: Menstruation reality. Divide students into groups where some groups have only males,
some groups have only females, and some are mixed. Have them write out what women
experience during menstruation (from beginning to end) and how women use tampons. Have
them read their answers aloud and talk about what it was like to write it out. How accurate were
the men’s writing? For the mixed group, was it helpful to have women involved? How active
were the men in participating and what questions did they have?

CA13: Capitalizing on menstruation. Historical and cross-cultural examples are often used to
demonstrate a history of menstrual blood as impure. Do such beliefs still operate in
contemporary American society? Ask your students to bring in magazine advertisements or
transcribe television commercials for menstrual products. Analyze them together for messages
about the impurity of menstruation and women who are menstruating.

CA14: Gender difference in sex drive. It is a common belief that men have a higher sex drive
than women. Brainstorm a list of biological reasons and a list of sociological reasons why this
assumption may be true. Which of the reasons are supported by research?

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Internet Activities

IA1: Annual editions online. Visit http://www.dushkin.com to access the online version of
Annual Editions and read extra articles about the body and its responses.

IA2: Sex hormones. For a more in-depth look at sex hormones and reproduction, visit
http://www.ultranet.com/~jkimball/BiologyPages/S/SexHormones.html. This website also
includes information on related topics, such as anabolic steroids and environmental estrogens.

IA3: Intersex activism. Visit the website http://www.isna.org to read personal stories by
intersex individuals, get information on the frequency of intersex births, and read about intersex
activism.

IA4: AIS support groups. Visit a support group for androgen insensitivity syndrome (AIS) at
http://www.aissg.org/. What concerns do they voice on the site? What are the frequently asked
questions? What stories do people with these syndromes tell?

IA5: Oxytocin. Oxytocin is a fascinating hormone important for childbirth, orgasm, and
bonding. Visit http://www.oxytocin.org to read more about this “contentment” hormone (also see
your textbook).

IA6: The Museum of Menstruation. Visit the website http://www.mum.org/ to explore the
history of menstruation.

Outside Activities

OA1: Book review


Colapinto, J. As Nature Made Him: The Boy who was Raised as a Girl. New York: Harper
Collins, 2000.
Colapinto explores the story of a man whose penis was mutilated during a routine
circumcision. The doctors and parents decided to raise him as a girl under the direction of
noted sex researcher John Money. Later, as an adult, John/Joan tells his story.

Roberts, T. “Female trouble: The menstrual self-evaluation scale and women’s self-
objectification.” Psychology of Women Quarterly 28, no. 1 (2004), pp. 22-27.

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Roberts investigates the degree to which female subjects self-objectified and the impact
this had on attitudes toward menstruation.

Bullivant, S.; Sellergren, S.; Stern, K.; Spencer, N.; Jacob, S.; Mennella, J.; and McClintock, M.
“Women’s sexual experience during the menstrual cycle: Identification of the sexual phase by
noninvasive measurement of luteinizing hormone.” Journal of Sex Research 41, no. 1 (2004), pp.
82-94.
Bullivant et al. explore the effect of increased levels of luteinizing hormone on sexual
motivation in women, noting that women are more likely to initiate sex with a partner at
this time.

OA2: Journal reviews


Alderson, J.; Madill, A.; and Balen, A. “Fear of devaluation: Understanding the experience of
intersexed women with androgen insensitivity syndrome.” British Journal of Health Psychology
9, no. 1 (2004), pp. 81-101.

Herman-Giddens, M.; Kaplowitz, P.; and Wasserman, R. “Navigating the recent articles on girls’
puberty in pediatrics: What do we know and where do we go from here?” Pediatrics 113, no. 4
(2004), pp. 911-918.
The authors investigate the misconceptions about puberty in females and variation that is
seen across different groups.

Visootsak, J.; Aylstock, M.; and Graham, J. “Klinefelter’s syndrome and its variants: An update
and review for the primary care physician.” Clinical Pediatrics 40, no. 12 (2001), pp. 639-652.

OA3: In-depth intersex. Assign your students a short research paper on one of the interruptions
in sexual development discussed in the textbook. In their paper, ask them to synthesize the
material in the textbook with their own research on both the biology and physiology of the
syndrome and the sociological and psychological concerns, including stigmatization and surgical
treatment.

OA4: Remembering puberty. This exercise is designed to encourage students to think


analytically and critically about their experience of puberty. Beginning with the questions in
Personal Reflections (Handout 5A), ask them to write an autobiography of their experience of
puberty, focusing on their education about puberty, the most memorable events, their feelings
and beliefs about what they were going through, and the reactions of others around them. This
can be assigned as a semester-long paper or it can be completed in a brief format and used as
material for group discussion.

OA5: Interviews. Assign your students the task of interviewing one or more adults about their
experience with hormonal changes. This assignment will include designing an open-ended
interview instrument, administering the interview, and writing up or presenting their conclusions.

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OA6: Understanding the menstrual cycle. The menstrual cycle is a complex and difficult
process to understand. To help students grasp it, ask them to do group projects in which they use
the information from the textbook to creatively build, draw, or chart the menstrual cycle,
including the workings of the brain, the ovaries, the endometrium, and the cervix. Ask them to
also address fertility and the negative feedback loop.

OA7: Field trip. Direct your students to go to a grocery or drug store and take notes on the
variety of products marketed to women for their menstrual cycle. Ask them to write a paper
answering the following questions: How many brands are there? How many products and
variations on each product does each brand offer? How does each brand differentiate its products
from each other? How do brands distinguish themselves from other brands? What benefits do
they claim come with using their products? What risks do they imply come from not using them?

OA8: Menstruation cross-culturally. Ask your students to find research documenting the
approach to understanding menstruation, PMS, menopause, or the climacteric in countries other
than the United States. In a short paper, ask them to compare their knowledge about the U.S.
understanding with what they learned.

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Handout 5A: Personal Reflections on Puberty

Please write an answer to each question. Do not write your name on the survey.

Did you look forward to puberty with positive or negative expectation? What were you most
excited/worried about?

List your most memorable physical change of adolescence. Why was it memorable?

What do you remember about your first period/ejaculation? Did you know what it was? How
was it a positive or negative experience? Could it have been a better experience? How?

If you are a woman: What did you know about erection, ejaculation, or wet dreams? How did
you learn it? If you are a man: What did you know about menstruation? How did you learn it?

Remember back to when you were a teenager. How did you deal with pressures to fit in? What
are some things you did to be popular? How far would you have gone?

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Handout 5B: Sex Hormones and Differentiation

1. This is the general term for chemical substances manufactured by the endocrine glands and
secreted directly into the bloodstream.

2. Beard growth, maintenance of the genitals and their sperm-producing capability, and
stimulation of growth of bone and muscle are controlled by this hormone.

3. This hormone controls sperm production.

4. This hormone, secreted by the pituitary gland, regulates estrogen and ovulation.

5. The pituitary gland produces this hormone, which plays a role in stimulating secretion of
milk by the mammary glands.

6. This substance is produced by the Sertoli cells and regulates FSH levels.

7. A fertilized egg carrying these chromosomes will normally develop into a female.

8. This sex chromosome is the smaller of the two and carries less information.

9. In this syndrome, a genetic male has an extra X chromosome. As a result, the testes are
abnormal and no sperm are produced.

10. This sex chromosome can only be contributed by the male parent.

11. Guevodoces have these sex chromosomes.

12. The sex chromosomes direct the gonads to begin sexual differentiation during this week of
gestation.

13. The testes travel down this passageway around the seventh month after conception.

14. In this condition, one or both testes may have failed to descend by the time of birth.

15. In this condition, the passageway through which the testes pass before birth does not close
off completely, and part of the intestine may enter the scrotum.

16. This gene, identified in 1986 and located on the Y chromosome, directs the gonads to
differentiate into testes.

17. This is the term for testes and ovaries before the time of sexual differentiation.

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18. How many weeks after conception does the gonad develop into a testis in males and ovaries
in females?

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Handout 5B: Sex Hormones and Differentiation (cont’d)

19. These ducts develop into the fallopian tubes and the uterus.

20. These ducts develop into the epididymis and the ejaculatory duct.

21. The gender of the fetus is clear from the appearance of the external genitals by this period of
gestation.

22. This substance causes the Müllerian ducts to degenerate in males.

23. This portion of the brain differentiates prenatally based on the presence or absence of
testosterone and directs a cyclic or an acyclic production of sex hormones at puberty.

24. At 28 days of age, the male and female embryos are identical except for their chromosomes,
indicating that they are in this state.

25. These organs are both analogous and homologous to the testes.

26. The clitoris is homologous to this highly sensitive part of the penis.

27. The scrotum is homologous to this portion of the vulva.

28. The fallopian tubes have no homologous structure in the male because of the degeneration of
these ducts.

29. The seminal vesicles have no homologous structure in the female because of the
degeneration of these ducts.

30. The Skene’s glands and Bartholin’s glands are homologous to these glands in the male.

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Handout 5B: Answers

1. Hormones
2. Testosterone
3. Follicle-stimulating hormone
4. Luteinizing hormone
5. Prolactin
6. Inhibin
7. X chromosomes
8. The Y chromosome
9. Klinefelter’s syndrome
10. The Y chromosome
11. The X and Y chromosomes
12. The seventh week
13. The inguinal canal
14. Undescended testes or cryptorchidism
15. An inguinal hernia
16. Testis-determining factor
17. Gonads
18. In the male, at about 7 weeks; in the female, at around 10 or 11 weeks
19. The Müllerian ducts
20. The Wolffian ducts
21. Four months
22. Anti-Müllerian hormone (AMH)
23. The hypothalamus
24. The undifferentiated state
25. The ovaries
26. The glans
27. The outer lips
28. The Müllerian ducts
29. The Wolffian ducts
30. The prostate and the Cowper’s glands

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Handout 5C: Gates of Development

MALE PLAN FEMALE PLAN

Gate 1: Genetic Sex

XY or XX

Gate 2: Gonadal Sex

Testes or Ovaries

Gate 3: Hormonal Sex

Androgens or Estrogens

Gate 4: Internal Sexual Anatomy

Defeminization or Feminization
Masculinization or Nonmasculinization

Gate 5: External Sexual Anatomy

Masculinization or Feminization

Gate 6: Dimorphic Prenatal Encoding

Masculinization or Feminization

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Handout 5D: Departures from Normal Sexual Development

Turner’s Syndrome
XO
Identifies as female
Normal female anatomy
Underdeveloped ovaries
Sterile but capable of intercourse

Klinefelter’s Syndrome
XXY
Identifies as male
Normal male anatomy
Underdeveloped testes
Enlarged breasts
Sterile but capable of intercourse

Fetally Androgenized Females


XX
Unusual dose of testosterone
Born with enlarged clitoris
Gender identity dissatisfaction

Androgen Insensitivity Syndrome


XY
Lacks receptors for testosterone
Testes
Female external genitals
Identifies as female

Hermaphrodite
Both testicular and ovarian tissue

Pseudohermaphrodite
A mixture of male and female external and/or internal anatomy

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18
Handout 5E: Personal Reflections on PMS

Please write an answer to each question. Do not write your name on the survey.

As a kid, what do you remember hearing about PMS?

If you are female, did you expect to get PMS? How did it make you feel?

Did any female members of your family appear to have PMS? What were the symptoms?

Do you ever hear women blaming PMS for things like being in a bad mood?

Do you ever hear women being blamed or discredited because of PMS?

Do you think all women experience PMS in the same way? Do you think all women experience
PMS?

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19
Handout 5F: Menstrual Cycle Details

List as thoroughly as possible the various changes that occur in each phase of the menstrual
cycle.

Follicular Phase
In the ovaries:

In the uterus:

Ovulation
In the ovaries:

In the uterus:

Luteal Phase
In the ovaries:

In the uterus:

Menstruation
In the ovaries:

In the uterus:

Define dysmenorrhea.

What causes dysmenorrhea?

What is endometriosis?

How is endometriosis related to dysmenorrhea?

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What is amenorrhea?

Handout 5F: Answers

Follicular Phase
In the ovaries: An egg matures in preparation for ovulation. Estrogen is secreted.
In the uterus: The endometrium grows, thickens, and forms glands.

Ovulation
In the ovaries: An egg is released.
In the uterus: The endometrium waits.

Luteal Phase
In the ovaries: The follicle turns into a corpus luteum and releases progesterone.
In the uterus: The endometrium secretes nourishing substances.

Menstruation
In the ovaries: The ovary is releasing very small quantities of estrogen and progesterone.
In the uterus: The endometrium is sloughed off in the menstrual discharge.

Define dysmenorrhea.
Painful menstruation

What causes dysmenorrhea?


The current leading hypothesis involves prostaglandins.

What is endometriosis?
A condition in which the endometrium grows abnormally outside the uterus.

How is endometriosis related to dysmenorrhea?


Endometriosis causes pain.

What is amenorrhea?
The absence of menstruation.

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authorized for sale or distribution in any manner. This document may not be copied, scanned,
duplicated, forwarded, distributed, or posted on a website, in whole or part.

21

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