Human sexuality plays a major role in everyone's life. Sexual characteristics are either primary, directly related to reproduction, or secondary, distinguishing one sex but not essential for reproduction. Sexual behavior is dependent on hormones produced in various glands. Learning theory also influences sexual behavior through environmental factors and observational learning. Sexual development occurs through distinct stages from prenatal to adulthood. Puberty brings secondary sex characteristics and ability to reproduce. Physiology of sex involves stages of excitement, plateau, orgasm, and resolution. Sexual dysfunctions can impact these stages.

1. OBSTETRICS &
GYNAECOLOGICALNURSING – I
Unit ii

2. Introduction
• Human sexuality plays a major role in everyone‟s life.
Regardless, whether we are young or old, man or woman,
it is an integral part of what we do and who we are.
• Human sexuality is a general term referring to various
sexually related aspects of human life, including physical
and psychological development, and behaviors, attitudes
and social customs associated with the individual‟s sense
of gender, relationships, sexual activity, mate selection,
and reproduction

3. Human sexual characteristics
Sexual characteristics are divided in to two types:
• Primary sexual characteristics are directly related to
reproduction and include the sex organs (genitalia).
• Secondary sexual characteristics are attributes other
than the sex organs that generally distinguish one sex
from the other but are not essential to reproduction, such
as the breasts characteristics of women and the facial hair
and deeper voices characteristics of men.

4. Biological perspective
• The sexual behavior is also dependent on the hormones.
Hormones may be viewed as one of the major “ driving
forces” of sexual behavior. Hormones are produced by the
gonads (i.e. testes and ovaries), the adrenal cortex, the
pituitary gland, and the hypothalamus. In addition, the
hormones of androgens, estrogens, and progestins all
exist in both male and females.

5. Learning perspective
• Learning theory focuses on environmental factors that
shape behavior. When applied to sexual behavior,
children exploring sexual behavior without parental
guidance will learn what feels good and tend to repeat it.
However, when sexual behavior feels pleasurable, but
parents connect it with feeling of guilt and shame, the
child is placed in conflict.
• Social learning theory also uses „learning by observation‟.
Observational learning or modeling refers to acquiring
knowledge and skills through observing others.
Observational learning may also take place when
exposed to certain films, books, or music.

6. Principles regarding information about
sexuality
• Each child’s process of maturation as a person is
different. Each child is a unique and unrepeatable person
must receive individualized formation. Since parents
know, understand and love each of their children in their
uniqueness, they are in the best position to decide what
the appropriate time is for providing a variety of
information, according to their children‟s physical and
spiritual growth.

7. • Parent who are alone will have to act with great
sensitivity when speaking with a child of the opposite
sex. The communication works out better when the parent
who communicates the biological, emotional, moral and
spiritual information is of the same sex as the child or
young person. Being aware of the role, emotions and
problems of their own sex, mothers have a special bond
with their daughters and fathers with their sons.

8. • Timely information regarding sexuality must be
provided in the broadest context. Constant help is also
required for the growth of children. Therefore, in talks
with children, suitable advice should always be given
regarding how to grow in the love and the meaning of
sexuality. Parents should always present positive models
and suitable ways of using their vital energies.

9. • Delay should not be done in providing information to the
children. Parents should provide this information with
great delicacy, but clearly and at the appropriate time.
Parents are well aware that their children must be treated
in a personalized way, according to the presonal
conditions of their physiological and psychological
development.

10. Stages of sexual Development
• There are two periods of marked sexual differentiation in
human life. The first occurs prenatally and the second
occurs at puberty.
• Although adult women and men may differ greatly in
genital appearance and secondary sexual characteristics,
they are almost identical during prenatal development.
From fertilization through about the first six weeks of
development, male and female embryos differ only in the
pair of sex chromosomes they have in each cell- two X
chromosomes (XX) in females and one X and one Y
chromosomes (XY) in male.

11. Prenatal sexual development
• About six weeks after conception, if a Y chromosome is
present in the embryo‟s cells, a gene on the chromosome
directs the undifferentiated gonads to become testes.
• If the Y chromosome is not present, the undifferentiated
gonads will become ovaries.
• If the gonads becomes testes, they begin to produce
androgens (male hormones, primarily testosterone) by
about eight weeks after conception

12. Childhood development
• Usually children touch or play with their genital organs at
this age. From the beginning itself, there is difference in
toys and play references. Children indulge in play games
such as „doctor‟ or „house‟ that include sexual
exploration. Such experiences are usually not labeled
sexual by the children
• Generally by the age of six or seven, children develop a
sense of privacy and are aware of social restrictions on
sexual expression.

13. Development of puberty
• Puberty typically begins in girls from 8 to 12 years of
age, whereas boys start about two years later. The
secondary sexual characteristics develop at this age,
followed by menstrual period in females. The hormones
primarily responsible for these changes in young girls are
the adrenal androgens, estrogens, progesterone, and
growth hormone.
• Growth hormone androgens, particularly testosterone, are
responsible for the pubertal changes in boys

14. Development in Adolescence
• Adolescence period is from about the age of 12 to the age
of 17 or older, and is marked by increased sexual
behavior. It is the socially defined period during which a
person adjust to the physical, emotional, and social
changes associated with the transition from childhood to
adulthood. In terms of personal development,
adolescence represents the period of self- projection and
therefore the discovery of one‟s vocation.

15. Development in Adulthood
• It is the period leading to engagement and the choice of
that preferred attachment which can lead to forming a
family. During this period, more permanent relationships,
in the form of marriage become prevalent. People in
marital relationship often engage in sexual activity. As
people age, they may experience physical changes,
illnesses, or emotional upheavals, such as the loss of
partner, that can lead to decline in sexual interest and
behavior

16. Physiology of sex
It is important to help people become
more familiar with their bodies and their
sexual responses and to assist in the
diagnosis and treatment of sexual
dysfunctions.
Master and Johnson described the
human sexual response cycle in four
stages: excitement, plateau, orgasm, and
resolution

17. Excitement
• It is the stage of sexual arousal in which there is vaso-
congestion.
• In men, the tissue in the penis become engorged with blood,
causing the penis to become larger and erect.
• The skin of the scrotum thickens, tension increases in the
scrotal sac, and the scrotum is pulled up closer to the body.
• In women, fluid seeps through the vaginal wall to produce
vaginal lubrication.
• The glans of the clitoris becomes larger and harder than usual.
• Nipples also become erect. The labia majora flattens and
spread apart somewhat and the labia minora swell and open. ,
pulse rate and blood pressure increase during the excitement
phase.

18. Plateau
• In this phase, vaso-congestion peaks. Breathing rate,
pulse rate, and blood pressure increase. The man‟s penis
become completely erect and the glans swells.
• Fluid secreted from the Cowper‟s gland (located near the
urethra, below the prostate) may appear at the tip of the
penis. This fluid, which nourishes the sperm, may contain
active sperm capable of impregnating a woman.

19. Orgasm
• It is also called as climax. It is an intense and usually
pleasurable sensation that occurs at the peak of sexual arousal.
Not all sexual arousal leads to orgasm.
• Orgasm consist of a series of rhythmic contractions in the
genital region and pelvic organs. Breathing rate, pulse rate,
and blood pressure increase dramatically during orgasm.
• General muscle contraction may lead to facial contortions and
contractions of muscles in the extremities, back, and buttocks.
These contractions can range in number and intensity. The
sensation is very intense – more intense than the tingling or
pleasure that accompany strong sexual arousal.

20. Resolution
• In this phase the processes of the excitement and plateau
stages reverse, and the bodies of both women and men
return to the unaroused step and there is reduction in
muscular tension.

21. Sexual Dysfunctions
• Erectile dysfunction (Impotence).
• Premature ejaculation.
• Female orgasmic dysfunction.
• Vaginismus.
• Inhibited male orgasm.
• Dyspareunia.
• Low sexual desire.
• Discrepant sexual desire.