The document discusses female sexuality and psychosexual dysfunction. It provides information on:
1. The sexual response cycle of women, which consists of 5 phases - desire, arousal, plateau, orgasm, and resolution.
2. Biological and psychosocial factors that influence female sexuality, such as hormones, brain regions, experiences, and relationships.
3. Common forms of female sexual dysfunction according to the 1999 consensus classification system, including disorders of desire, arousal, orgasm, and pain.
4. Factors that can cause sexual dysfunction, including medical issues, medications, psychological factors, and relationship issues.
Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
female sexual dysfunction
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Understand the history and pathophysiology of endometriosis
Understand the critical need for timely diagnosis and effective intervention
Understand the considerable effects and cost burdens of this chronic disease and employ best-practice techniques to mitigate them
female sexual dysfunction
For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
CHRONIC PELVIC PAIN can affect men, MORE common (60%) in women, lifelong vs. acquired, generalized vs. situational, psychological factors, physical Contact SlenderImage@gmail.com for Consulting & Speaking - P.Anderson 323-486-3770
Gynecologic diseases in childhood are common. This review is intended to enable careful and sound management of pediatric patients as the initial assessment is paramount to proper management.
Overview normal physiological development; skeletal growth, maturation of the reproductive tract, development secondary sexual characteristics, CNS maturation, personality and psychology of the female adolescent.
CHRONIC PELVIC PAIN can affect men, MORE common (60%) in women, lifelong vs. acquired, generalized vs. situational, psychological factors, physical Contact SlenderImage@gmail.com for Consulting & Speaking - P.Anderson 323-486-3770
Gynecologic diseases in childhood are common. This review is intended to enable careful and sound management of pediatric patients as the initial assessment is paramount to proper management.
Overview normal physiological development; skeletal growth, maturation of the reproductive tract, development secondary sexual characteristics, CNS maturation, personality and psychology of the female adolescent.
In this PPT i have discussed regarding sexuality and sexual health. The sub topics covered under sexuality and sexual health are as under:
1) Introduction
2) Definition of sexuality, human sexuality and sexual health
3) Importance of sexual health
4) Components of sexual health
5) Factor affecting sexual health
HUMAN SEXUALITY AND SEXUAL DYSFUNCTIONS (1).pptxIshneetKaur41
Human Sexuality - Normal sexuality, normal sexual response, sexual identity and orientation and sexual dysfunctions with treatment - female sexual arousal disorder, anorgasmia, ejaculatory dysfunction, male hypoactive sexual desire disorder
Similar to Femal sexuality and female sexual dysfunction koc univ. (20)
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Femal sexuality and female sexual dysfunction koc univ.
1. Female Sexuality and
Female Psychosexual Dysfunction
Dr Süleyman E. Akhan
Istanbul University School of Medicine
Department of Obstetrics and Gynecology
2. Sexuality is a multi-
dimensional concept with
ethical, psychological,
biological and cultural
dimensions.
Sexuality reflects human
character and the way in
which people interact.
3. Sexuality is the lifelong process of
acquiring information and
developing values about one’s
identity, relationships and intimacy.
It includes learning sexual
development, reproductive health,
interpersonal relationships, affection,
body image, and gender roles.
4. genotype
The main organ that affects male and female
sexual response is the BRAIN.
learning process
pre-and postnatal
hormonal environment
experience
6. The perception of sexuality is
different for each individual.
Is unique.
The main factors affecting this individuality is
how we spend our adolescence and form
our relationship with the opposite sex.
7. Activated Areas During “Sexual Arousal”
Medial insula
Anterior cingulate cortex
Hippocampus
Striatum
Nucleus accumbens
Hypothalamus
Concentration of dopamine is high in all these areas.
8. Inactivated Areas During “Sexual Arousal”
Amygdala
Frontal cortex
Prefrontal cortex
Temporal pole
Prefrontal cortex is responsible for control mechanism.
Amygdala acts like our emotional memory. Our fears, emotional
moments, events that cause our worry are all evaluated and
stored.
10. Sexual Response Cycle of the Woman
Sexual response cycle of woman consists of 5 phases:
1. Sexual desire phase: Can last for days. Fantasies, dreams about
the sexual object.
2. Arousal phase: Can last from 1-2 minutes to hours.
3. Plato phase: Between 30 seconds to 3 minutes.
4. Orgasm phase: 3-15 seconds
5. Relaxation phase: 10-15 minutes
In this cycle, there are two basic physiologic processes:
Vasocongestion
Neuromuscular tension– Myotonia
Vasocongestion takes place in lower and upper genital organs and
breasts, while myotonia takes place in the whole body.
11. Sexual Desire Phase
Motivation to be sexual
Subjectivity (Experience)
Adequate neuroendocrine function
Sexual orientation
Choice
Psychological status
Environmental factors
12. Arousal Phase
Can last from 1-2 minutes to hours. As a result of parasympathetic
stimulation.
Changes in organs that take place during arousal phase:
Nipples: Harden. Length can go up to 1cm. In addition, breast volume
increases due to congestion.
Clitoris: Length of clitoris increase with venous congestion.
Labium majus: Labium majus moves upward and opens outward with
erection.
Labium minus: Increase in size 2-3 times both in nullipara and
multipara. Finally, vagina goes out of vault, passes labium majus by
1cm and becomes visible. In nullipara, its color is bright pink, while its
color is dark red in multipara.
13. Vagina:
When there is an effective sexual stimulation, there is a light colored
vaginal secretion 10-20 seconds after the initiation of the stimulation.
The stimulation can by physical or psychological. Secretion is in
transuda form. When venous plexus that surrounds vagina fills up
with venous congestion and dilated, capillary permeability increases.
Then, droplets are formed in vagina and vaginal secretion is released.
Secretion has two purposes:
1. Providing vaginal lubrication
2. Neutralizing vaginal acidity.
Another important change is the increase of length up to 3 cm in
vagina.
14. Plato Phase
Lasts around 30 seconds to 30 minutes. In 75% of women, there will
be red spots, known as sexual flash, on the breasts and the skin. In
reality, these spots start in the late section of the arousal phase and
continue in the plate phase.
It is argued that the red areas are correlated to the intensity of the
sexual arousal.
Breasts are tense and increase in size.
Clitoris becomes erect and only mechanical stimulus can be enough to
reach orgasm.
Uterus re-locates in this phase. It is lengthened to the vagina.
Near the end of this phase, uterus starts to contract.
15. Orgasm Phase
Orgasm can be described as the conclusion of the
vasocongestion, release of the collected blood and following
stage of myotonia.
It is the shortest phase of all phases. It can only be reached
when there is maximum sexual tension.
Uncontrolled muscle contractions happen every 0.8 seconds.
3-15 contractions can happen. During this phase, uterus also
contracts.
16. Relaxation Phase
Last phase of the sexual response. It is the phase
with the most varying length.
If orgasm is reached, it can last up to 15 minutes. If
orgasm is not reached, it can last up to 1 day.
Clitoris can turn into normal shape in 10-15
seconds. It will take 15 minutes to turn back to
totally normal function. If orgasm is not reached,
this period can go up to 6 hours.
17. Sexual Response
Cycle of the Woman
1. Sexual desire phase: Can last for
days. Fantasies, dreams about the
sexual object.
2. Arousal phase: Can last from 1-2
minutes to hours.
3. Plato phase: Between 30 seconds to
3 minutes.
4. Orgaxm phase: 3-15 seconds.
5. Relaxationp phase: 10-15 minutes.
ParasimpaticSimpatic
18. Biopsychosocial Approch to
Female Sexual Function Cycle
Basson R. Obstet Gynecol 2001;98:350–353
Emotional and
physical
satisfaction
Arousal and
sexual desire
Sexual arousal
Emotional
intimacy
Sexual stimuli
+
+
motivates the sexually
neutral woman to
find/be responsive to
psychological and
biological factors
govern “arousal”
“Spontaneous”
sexual drive
“hunger”
19. Hormones that Influence Female Sexuailty
1. Estrogen
Sexual Identity: Secondary sexual characteristics
Functional Influence:
a. Sexual desire: indirect influence (direct
influence??)
b. Arousal: Vasocongestion, vasodilation,
lubrication
c. Orgasm: Matures the orgasmic platform.
Influence on the Relation: Builds up woman’s unique
scent (??)
20. 5. Androgens
Basic hormones that have central influence and triggers
sexual desire and central arousal.
Modulate peripheral arousal.
Influence secretion of NO.
Increase clitoral arousal.
Increase “life energy”. Induce self-esteem.
Influence pheromone (??).
21. Sexual Desire
Arousal,
Desire for arousal
Orgasm
Experience-
Satisfaction
Systemic Androgens
Systemic
Estrogens
Graziottin A. 2005
Basic Flow Diagram of
Female Sexual Oritentation
22. Oxytocin Vasopressin
Known as coupling and love hormones
Oxytocin and V1a type vasopressin receptors are located at
dopaminergic areas that are activated during romantic love.
Oxyitocin; anxiolytic. Named as the trust hormone. Increases in
the beginning of romantic love.
Vasopressin increases response to fear and stress. Induces man’s
claiming urge.
23. Oxytocin - Vasopressin
Field Rat
Monogamous
One partner lifelong
More oxytocin receptors at
prelimbic cortex, nucleus
accumbens and amigdaloid
complex
Mountain Rat
Polygamous
Randomized partner
selection
Less vasopression
receptors (V1a) at lateral
amigdala, ventral pallidum
Vazopressin reseptörleri
Vasopressin
V1a
receptor
Lim 2004
25. Dopamine
D1 receptors are important after coupling
Increase in number
Avoids new coupling
Beninger & Miller, 1998; Edwards & Self, 2006
Dopamine
antagonist
26. When we live so synthetically
in the modern world, can
sexuality and love be
manipulated with hormones?
Should we?
Shouldn’t we?
27. Female Sexual
Dysfunction
Organic
• Neurological problems
• Cardiovascular diseases
• Cancer, gynecological
cancers
• Urogynecologic pathologies
• Drugs
• Hormonal disorders
Psychological
• Depression/anxiety
History of sexual and/or
physical assault
• Stress
• Alcohol and/or drug
addictions.
Sociocultural Factors
• Inadequate education
• Conflict with religious,
personal, family values
Social taboos
Relationship Level
• Performance of the partner
• Loss of the partner
• Quality of the relation
• Loss of specialness
28. Reasons for Female Sexual Dysfunction
Female sexual dysfunction can be temporary, episodic or
continuous
Can resolve by itself or need treatment
Reasons are evaluated in 2 headings.
I- Psychosocial Factors
Mental inhibition, education that refused sexuality during
growing-up: pleasure regarded as a sin ethically.
Past psychosexual trauma.
Fears: unwanted pregnancy, somebody finding out about the
cohabitation, pain during coitus
Problems with the partner: Not desiring intimacy with the
partner, relations that are falling apart.
31. Radical Hysterectomy
Oophorectomy
Pelvic Radiotherapy
Chemotherapy
Vulvectomy
Damage to the innervation of the pelvic
floor musculature
Shortness of the vagina
Decreased lubrication
Dyspareunia
Decrease in desire???
Decreased lubrication
Dyspareunia
Fibrosis and stenosis
Tiredness
Nausea, vomiting
Depression
Anatomic anomalies
32. Female Sexual Dysfunction
1999 Consensus Classification System
(The Journal of Urology. Basson R. 2000)
Sexual Desire Disorders
Decreased Sexual Desire (hypoactive)
Sexual Aversion Disorder
Sexual Arousal Disorder
Orgasm Related Disorders
Sexual Pain Disorders
Dyspareunia
Vaginismus
Other sexual pain disorders
33. What should we do to identify the problem?
High sexual orientation
High motivation
Normal sexual desire and
motivation
High sexual orientation
Low motivation
Question the quality of the sexual intercourse
and the relation with the partner
Low sexual orientation
High motivation
Evalute the hormone profile
Primarily the androgens and
PRL
Low sexual orientation
Low motivation
Which one comes first?
Question depression, biochemical
environment and the quality of the
relationship Derogatis 2002
34. Female Sexual Dysfunction
1999 Consensus Classification System
(The Journal of Urology. Basson R. 2000)
Sexual Desire Disorders
Decreased Sexual Desire (hypoactive)
Sexual Aversion Disorder
Sexual Arousal Disorder
Orgasm Related Disorders
Sexual Pain Disorders
Dyspareunia
Vaginismus
Other sexual pain disorders
35. Female Sexual Dysfunction
1999 Consensus Classification System
(The Journal of Urology. Basson R. 2000)
Sexual Desire Disorders
Decreased Sexual Desire (hypoactive)
Sexual Aversion Disorder
Sexual Arousal Disorder
Orgasm Related Disorders
Sexual Pain Disorder
Dyspareunia
Vaginismus
Other sexual pain disorders
Subjective
Genital
36. The Factors Affecting Female Sexual Function and
the Relation with Different Contraception Methods
Süleyman Engin Akhan, Ümran Oskay, Ebru Alıcı, Funda Güngör, Samet
Topuz, Cem İyibozkurt, Önay Yalçın
Department of Obstetrics and Gynecology,
Istanbul University School of Medicine, Istanbul
37. Results
Totally 349 cases were taken into consideration.
They were 32,59±7.04 old on average and the number
of weekly intercourse were 2,36±1,34 on average.
6.6% (23/349) were single.
While 39.8% of women used coitus interruptus as a
contraception method,
21.5% used IUD,
16.3% preferred condom,
10% used oral contraceptive,
5.2% preferred tubal ligation
7.2% used none of the methods.
38. 24.6% of them were masturbating in different
frequencies, 5% were performing anal sex and
26.1% were performing oral sex.
36.7% were complaining of dyspareunia. Sexual
dysfunction was identified in 24.4% of the
partners.
39. It is interesting that women performing oral sex was an
independent factor which had a positive effect on
arousal (p=0.02; RR=0.54; [95%CI: 0.32-0.909]),
orgasm (p=0.0045; RR=0.48; [95%CI:0.29-0.8]) and
total score (p=0.016; RR=0.505; [95%CI:0.28-0.88]).
Woman performing oral sex, can be a sign of woman
being capable of sexuality (motivated sexually or
having a good sexual drive) and have a healthy
relationship with her partner on a sexual level. So, the
arousal and orgasm scores of women performing oral
sex are affected positively.
40. Number of sexual intercourse showed negative correlation with
age (-0.151; p=0.005) and the number of deliveries (-0.140;
p=0.009). As the number of deliveries increases, the number of
sexual intercourse decreases and the domains of desire, arousal
and satisfaction were influenced negatively.
Desire Arousa
l
Lubrication Orgasm Satisfaction Pain Total Score
Age
Pearson coeff.
p
- 0,91
0,0001
- 0,125
0,02
- 0,018
0,027
- 0,106
0,047
- 0,204
0,0001
- 0,94
0,078
- 0,138
0,01
Partus
Pearson coeff.
p
- 0,147
0,006
- 0,109
0,042
- 0,077
0,154
- 0,061
0,253
- 0,145
0,007
0,94
0,81
- 0,092
0,085
Education
Pearson coeff.
p
- 0,68
0,208
0,41
0,443
0,069
0,201
0,033
0,538
0,023
0,666
0,094
0,081
- 0,092
0,085
Number of coitus
/week
Pearson coeff.
p
0,181
0,001
0,189
0,0001
0,171
0,001
0,17
0,001
0,186
0,0001
0,012
0,828
0,203
0,0001
41. Factors that directly affect
female sexuality
Age
Physical and
Emotional Health Education
Quality of the relationship
with the partner
Sexual Performance
of the Partner
Hormonal Status