Circumcision

Circumcision is the surgical removal of the foreskin, the tissue covering the head of the penis. It is an ancient practice that has its origin in religious rites. Today, many parents have their sons circumcised for religious or other reasons.

When Is Circumcision Done?

Circumcision is usually performed on the first or second day after birth. (Among the Jewish population, circumcision is performed on the eighth day.) The procedure becomes more complicated and riskier in older babies, children, and men.

How Is Circumcision Done?

During a circumcision, the foreskin is freed from the head of the penis (glans), and the excess foreskin is clipped off. If done in the newborn period, the procedure takes about five to ten minutes. Adult circumcision takes about one hour. The circumcision generally heals in five to seven days.

Is Circumcision Necessary?

The use of circumcision for medical or health reasons is an issue that continues to be debated. Currently, the American Academy of Pediatrics does not recommend routine circumcision for newborn males stating the evidence was not significant enough to prove the operation's benefit. The procedure may be recommended in older boys and men to treat phimosis (the inability to retract the foreskin) or to treat an infection of the penis.

Parents should talk with their doctor about the benefits and risks of the procedure before making a decision regarding circumcision of a male child. Other factors, such as your culture, religion, and personal preference, will also impact your decision.

What Are the Benefits of Circumcision?

There is some evidence that circumcision has health benefits, including:

• A decreased risk of urinary tract infections.
• A reduced risk of sexually transmitted diseases in men.
• Protection against penile cancer and a reduced risk of cervical cancer in female sex partners.
• Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin).
• Prevention of phimosis (the inability to retract the foreskin) and paraphimosis (the inability to return the foreskin to its original location).

Circumcision also makes it easier to keep the end of the penis clean.

Note: Some studies show that good hygiene can help prevent certain problems with the penis, including infections and swelling, even if the penis is not circumcised. In addition, using a condom during sex will help prevent STDs and other infections.

What Are the Risks of Circumcision?

Like any surgical procedure, there are risks associated with circumcision. However, this risk is low. Problems associated with circumcision include:

• Pain
• Risk of bleeding and infection at the site of the circumcision
• Irritation of the glans
• Increased risk of meatitis (inflammation of the opening of the penis)
• Risk of injury to the penis

Preventing Testicular Cancer

Cells in the body normally divide (reproduce) only when new cells are needed. Sometimes cells will divide for no reason and without order, creating a mass of tissue called a tumor. Tumors can be benign (not cancer) or malignant (cancer). Testicular cancer is a malignant tumor in a testicle. The testicles are oval-shaped sex glands in a sac of skin called the scrotum. The scrotum is located behind the penis.

This type of cancer, although relatively rare, mostly affects men between the ages of 15 and 40.

But this cancer can affect males of any age including infants and the elderly.

How Can I Protect Myself From Testicular Cancer?

You can protect yourself from testicular cancer by doing a monthly testicular self-exam. Testicular self-exam is a way that men can examine themselves to look for signs of cancer of the testicles. To do a self-exam, follow these steps.

1. Do the exam after a warm shower or bath. The warmth relaxes the skin of the scrotum, making it easier to feel for anything unusual.
2. Use both hands to examine each testicle. Place your index and middle fingers underneath the testicle and your thumbs on top. Roll the testicle between your thumbs and fingers. (It's normal for testicles to be different in size.)
3. As you feel the testicle, you may notice a cord-like structure on top and in back of the testicle. This structure is called the epididymis. It stores and transports sperm. Do not confuse it with a lump.
4. Feel for any lumps. Lumps can be pea-size or larger and are often painless. If you notice a lump, contact your doctor. Also check for any change in size, shape or consistency of the testes.
5. You should also get a physical exam once a year.

After a while, you will know how your testicles feel and will be more alert to any changes.

What Are the Symptoms of Testicular Cancer?

Symptoms of testicular cancer include:

• A lump in either testicle.
• An enlarged (swollen) testicle.
• A dull ache in the lower abdomen or groin.
• A sudden gathering of fluid in the scrotum.
• Feeling of heaviness in the scrotum.

What Should I Do If I Have Symptoms of Testicular Cancer?

If you have symptoms of testicular cancer, don't panic. Many times, changes in the testicles are not cancer. But, you should contact your doctor to find the cause of your symptoms.

What Should I Expect When I Go to the Doctor?

During your visit, you will be asked to talk about your symptoms and any illnesses you have had in the past. The doctor will feel the scrotum for lumps. Samples of blood and urine may be taken for testing. An ultrasound examination of the scrotum and its contents may be performed. (Ultrasound is a painless test that creates images by using high-frequency sound waves that are transmitted through body tissues.) You also may be given a chest X-ray or computed tomography (CT) scan.

When cancer is present, the testicle must be removed. Removing the testicle should not lead to problems with having children or sex. The remaining testicle will continue making sperm and the male hormone testosterone. To re-establish a normal appearance, a man may be able to have a testicular prosthesis surgically implanted in the scrotum which looks and feels like a normal testicle.

Can Testicular Cancer Be Cured?

Most cases of testicular cancer can be cured, even if the cancer has spread.

What Is a Pap Smear?

A Pap smear is a way to look at a sample of cells taken from a woman's cervix. The test is used to look for changes in the cells of the cervix that show cervical cancer or conditions that may develop into cancer.

All women who are or who have been sexually active, or who have reached age 21, should have an annual Pap smear. It is your best tool to detect pre-cancerous conditions and hidden, small tumors that may lead to cervical cancer. If detected early, cervical cancer can be cured.

How Is a Pap Smear Performed?

The Pap smear is done during a pelvic exam. A doctor uses a device called a speculum to widen the opening of the vagina so that the cervix can be examined. A plastic spatula and small brush are used to collect cells from the cervix. After the cells are taken, they are placed into a solution. The solution is sent to a lab for testing.

Is the Pap Smear Painful?

A Pap smear is not painful, but the pelvic exam may be a little uncomfortable.

When Will I Know the Results of the Pap Smear?

It may take several weeks to get the test results. If you haven't heard from your doctor's office after 3 weeks, give them a call to see if your results have come back.

What Do the Results of a Pap Smear Mean?

A normal Pap smear means the cells from the cervix look normal. An abnormal Pap smear means the cells do not look normal. Sometimes repeat Pap smears are needed. Different tests also may need to be done, such as a colposcopy (the use of a special microscope to examine the cervix and vagina). Pap smears can occasionally show signs of infection but cannot be relied on to screen for sexually transmitted diseases. Other tests are necessary to determine the presence of an STD.There are several things you can do to help make the Pap smear as accurate as possible. These include avoidance of sex, douching and vaginal creams for 48 hours before the test.

 

What Happens If the Results Are Abnormal?

An abnormal Pap smear does not necessarily mean that cancer cells were found during the examination. There are many causes for abnormal Pap smear results. Your doctor will evaluate the results to determine if further testing is necessary.

Why Would I Need to Repeat the Pap Smear?

A repeat Pap smear may be necessary if you had an infection at the time of the test or if there were not enough cells collected during the test. Since decreased levels of the female hormone estrogen also can influence Pap smear results, menopausal women may need to take estrogen before they repeat the test.

If the results of the repeat Pap smear are still abnormal, your doctor may recommend that you have a colposcopy to further evaluate the problem.

What Is a Colposcopy?

Colposcopy is an examination of the cervix and the walls of the vagina. During the examination, a speculum is inserted into the vagina (as done in a Pap smear). Your doctor looks through a magnifying instrument called a colposcope to detect cervical problems that cannot be seen by the eye alone. During the colposcopy, the colposcope remains outside the vagina. Biopsies (tissue samples) of the abnormal cervical area may be taken.

Colposcopy is not always necessary immediately after an abnormal Pap smear. Be sure to ask your doctor about other options.

How Often Should I Get a Pap Smear?

You should get a Pap smear once a year if you are having or have had sex or if you have reached the age of 21. Some women who have a higher risk of cancer may need a Pap smear more often. Women who have had normal Pap smears for several years in a row, and have had only one sex partner may need the test less often.

Women with certain risk factors, such as being HIV positive (carrying the virus that causes AIDS), a weakened immune system due to chemotherapy, organ transplant, chronic steroid use, or have a history of diethylstilbestrol (DES) exposure before birth, should continue to be screened more frequently.

What Symptoms Should I Watch for Between Pap Smears?

Pre-cancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap smear are usually required.

When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching. Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms are not sure signs of cancer. But be sure to see your doctor if any of these symptoms develop.

Do I Need to Get Pap Smears If I Have Had a Hysterectomy?

Pap smears may be discontinued total hysterectomy (removal of the uterus and cervix), unless the surgery was performed for cervical pre-invasive or invasive cancer or other uterine cancers. Women who have had a partial hysterectomy with the cervix remaining should continue to have routine Pap smears. Check with your doctor to determine if you still need Pap smears. Even women who no longer require Pap smears should see their doctor annually for pelvic exams.

Sexual Health:The Pelvic Examination

A pelvic exam is a way for doctors to look for signs of illness in organs in a woman's body. The word "pelvic" refers to the pelvis. The exam is used to look at a woman's:

• Vulva (external genital organs)
• Uterus (the womb)
• Cervix (opening from the vagina to the uterus)
• Fallopian tubes (tubes that carry eggs to the womb)
• Ovaries (organs that produce eggs)
• Bladder (the sac that holds urine)
• Rectum (the chamber that connects the colon to the anus)

When Are Pelvic Exams Done?

Pelvic exams are performed:

• During a yearly physical exam.
• When a woman is pregnant.
• When a doctor is checking for an infection (such as chlamydia, vaginosis, trichomoniasis and others).
• When a woman is having pain in her pelvic area or low back.

Do I Need to Do Anything to Prepare for the Exam?

You do not have to do anything special to get ready for the exam. When you arrive at the office, your doctor may ask if you need to use the bathroom. This question is asked so that you can stay comfortable during the exam. Sometimes, a urine sample is requested.

What Can I Expect During the Exam?

You can expect to feel a little discomfort, but you should not feel pain. The exam itself takes about 10 minutes. If you have any questions during the exam, be sure to ask your doctor.

How Is the Exam Performed?

During a typical pelvic exam, your doctor or nurse will:

1. Ask you to take off your clothes in private (You will be given a gown or other covering.)
2. Talk to you about any health concerns
3. Ask you to lie on your back and relax
4. Press down on areas of the lower stomach to feel the organs from the outside
5. Help you get in position for the speculum exam (You may be asked to slide down to the end of the table.)
6. Ask you to bend your knees and to place your feet in holders called stirrups
7. Perform the speculum exam. During the exam, a device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen.
8. Perform a Pap smear. Your doctor will use a plastic spatula and small brush to take a sample of cells from the cervix (A sample of fluid also may be taken from the vagina to test for infection.)
9. Remove the speculum.
10. Perform a bimanual exam. Your doctor will place two fingers inside the vagina and uses the other hand to gently press down on the area he or she is feeling. Your doctor is noting if the organs have changed in size or shape.
11. Sometimes a rectal exam is performed. Your doctor inserts a gloved finger into the rectum to detect any tumors or other abnormalities.
12. Talk to you about the exam (You may be asked to return to get test results.)

What Tests Are Taken During the Pelvic Exam?

A sample of cells may be taken as part of regular test called a Pap smear, or Pap test, to screen for cervical cancer or cells that look like they might lead to cancer. The sample is placed in a solution and sent to a lab where it is examined. Tests also may be taken to screen for sexually transmitted diseases.

How Often Should I Get a Pelvic Exam?

According to the American Cancer Society it's a good idea for women to begin having yearly pelvic exams within three years of becoming sexually active or at the age of 21, whichever comes first. The exam should also include a yearly Pap smear. Some women who have a higher risk of cancer may need to have a Pap smear more often. Women who have had normal Pap smear results for several years and have only one sex partner may need a Pap smear less often. Talk to your doctor to see what is right for you.

Sexual Health:Frequently Asked Questions About Sexual Health

Print out these questions and answers to discuss with your doctor.

1. Does a Man Go Through Menopause?

Yes, but to a different extent as women. Menopause is a term used to describe the end of a woman's fertility. Female menopause is characterized by changes in hormone production. The testes, unlike the ovaries, do not lose the ability to make hormones. A healthy male may be able to make sperm well into his 80's or longer.

On the other hand, subtle changes in the function of the testes may occur as early as 45-50 years of age, and more dramatically after the age of 70. Since men do not go through a distinct period of menopause, some doctors refer to this as androgen (testosterone) deficiency in the aging male (ADAM). Men typically experience a decline in the production of testosterone due to aging but it can also be related to some diseases such as diabetes.

Whether waning function of the testicles contributes to such symptoms as fatigue, weakness, depression, decreased sexual desire or impotence often remains uncertain.

There are treatments for these symptoms. If testosterone levels are low, replacing that hormone may help relieve symptoms, such as the loss of interest in sex, depression, and fatigue. However, replacing male hormones can worsen prostate cancer and high cholesterol levels. Talk to your doctor to see if hormone treatment is right for you.

2. How Often Should I Get a Pelvic Exam and Pap Smear?

According to the American Cancer Society, it's a good idea for women to begin having yearly pelvic exams within 3 years of becoming sexually active, but no later then 21, whichever comes first. The exam should also include a yearly Pap smear. Some women who have a higher risk of cancer may need to have a Pap smear more often. Women who have had normal Pap smear results for several years and have only one sex partner may need a Pap smear less often. Talk to your doctor to see what is right for you.

 

3. I Am Considering Having My Newborn Boy Circumcised. What Are the Benefits? Are There Any Risks?

The use of circumcision for medical or health reasons is an issue that continues to be debated. Currently, the American Academy of Pediatrics does not recommend routine circumcision for newborn males. But, there is some evidence that circumcision has health benefits, including:

• A decreased risk of urinary tract infections
• A reduced risk of sexually transmitted diseases in men
• Protection against penile cancer and a reduced risk of cervical cancer in female sex partners
• Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin).
• Prevention of phimosis (the inability to retract the foreskin) and paraphimosis (the inability to return the foreskin to its original location)

Circumcision may also make it easier to keep the end of the penis clean. Although, some studies show that good hygiene can help prevent certain problems with the penis, including infections and swelling, even if the penis is not circumcised. In addition, using a condom during sex will help prevent STDs and other infections.

As with most medical procedures, there are risks associated with circumcision. These include:

• Pain
• Risk of bleeding and infection at the site of the circumcision
• Irritation of the glans
• Increased risk of meatitis (inflammation of the opening of the penis)
• Risk of injury to the penis

4. Is Vaginal Discharge Normal?

A woman's vagina normally produces a discharge that usually is described as clear or slightly cloudy, non-irritating and odor-free. During the normal menstrual cycle, the amount and consistency of discharge can vary. At one time of the month there may be a small amount of a very thin or watery discharge; and at another time, a more extensive thicker discharge may appear. All of these descriptions could be considered normal.

A vaginal discharge that has an odor or that is irritating usually is considered an abnormal discharge. The irritation might be itching or burning, or both. The itching may be present at any time of the day, but it often is most bothersome at night. These symptoms often are made worse by sexual intercourse. It is important to see your doctor if there has been a change in the amount, color, or smell of the discharge.

5. Is Hormone Treatment for Menopause Bad for Me?

There has been much debate by the scientific community regarding the safety of hormone treatment. In general, hormone treatment is believed to maintain healthy bones after menopause, in addition to relieving menopausal symptoms. But, like all treatments, there may be some harmful side effects, including an increased risk for endometrial (uterine) cancer and breast cancer.

6. Can I Get Pregnant If I am Breastfeeding?

Yes. Even though breastfeeding may suppress or delay menstruation, you can still get pregnant. Ovulation will occur before you start having menstrual periods again, so follow your doctor's recommendation on the appropriate method of birth control to use.

7. Can a Hysterectomy Cause Sexual Problems?

Some women may experience changes in sexual function after a hysterectomy (surgical removal of the uterus). These changes may include a loss of desire, and decreased vaginal lubrication and genital sensation. These problems may be associated with the hormonal changes that occur with the loss of the uterus. Furthermore, nerves and blood vessels critical to sexual function can be damaged during the hysterectomy procedure.

8. Can a Person with Syphilis Spread the Disease?

Yes. Syphilis is a sexually transmitted disease. A person with syphilis can spread the infection during the first two stages of the disease. If you come in contact with an open sore (first stage) or skin rash (second stage), you can pick up the bacteria that cause the infection. If the bacteria enter your body through an opening such as the penis, anus, vagina, mouth or broken skin, you can get syphilis.

If a person has had syphilis for more than two years, it's unlikely that he or she can spread the disease. Don't take a chance. Use a lubricated condom during sex.

9. How Do People Get HIV?

A person gets HIV when an infected person's body fluids (blood, semen, fluids from the vagina or breast milk) enter his or her bloodstream. The virus can enter the blood through linings in the mouth, anus or sex organs (the penis and vagina), or through broken skin.

Both men and women can spread HIV. A person with HIV can feel okay and still give the virus to others. Pregnant women with HIV also can give the virus to their babies.

Common ways people get HIV:

• Sharing a needle to take drugs.
• Having unprotected sex with an infected person.

You cannot get HIV from:

• Touching or hugging someone who has HIV/AIDS.
• Public bathrooms or swimming pools.
• Sharing cups, utensils, or telephones with someone who has HIV/AIDS.
• Bug bites.

10. Is It OK to Use Vaseline As a Lubricant with a Latex Condom?

No. Use only water-based lubricants, such as K-Y Jelly, with condoms. Oil-based lubricants, like Vaseline, will weaken the condom and cause it to break.

11. I Forgot to Take My Birth Control Pills. What Should I Do?

If you forget to take a pill, take it as soon as you remember. If you don't remember until the next day, go ahead and take 2 pills that day. If you forget to take your pills for 2 days, take 2 pills the day you remember and 2 pills the next day. You will then be back on schedule. If you miss more than 2 pills, call your health care provider for instructions. Those instructions may be to take one pill daily until Sunday and then start a new pack or to discard the rest of the pill pack and start over with a new pack that same day.

Any time you forget to take a pill, you must use another form of birth control until you finish the pill pack. When you forget to take a pill, you increase the chance of releasing an egg from your ovary. However, if you forget to take any of the last 7 out of the 28 day pills you will not raise your chance of pregnancy since these pills contain only inactive ingredients. If you miss your period and have forgotten to take one or more pills, get a pregnancy test. If you miss 2 periods even though you have taken all your pills on schedule, you should get a pregnancy test.

12. Can I Get Pregnant If My Partner Pulls Out?

Pulling out before the man ejaculates, known as withdrawal, is not a foolproof method for contraception. Some ejaculate (fluid that contains sperm) may be released before the man actually begins to climax. In addition, some men may not have the willpower or be able to withdraw in time.

Your Guide to Masturbation

Masturbation is the self-stimulation of the genitals to achieve sexual arousal and pleasure, usually to the point of orgasm (sexual climax). It is commonly done by touching, stroking or massaging the penis or clitoris until an orgasm is achieved. Some women also use stimulation of the vagina to masturbate or use "sex toys," such as a vibrator.

Who Masturbates?

Just about everybody. Masturbation is a very common behavior, even among people who have sexual relations with a partner. In one national study, 95% of males and 89% of females reported that they have masturbated. Masturbation is the first sexual act experienced by most males and females. In young children, masturbation is a normal part of the growing child's exploration of his or her body. Most people continue to masturbate in adulthood, and many do so throughout their lives.

Why Do People Masturbate?

In addition to feeling good, masturbation is a good way of relieving the sexual tension that can build up over time, especially for people without partners or whose partners are not willing or available for sex. Masturbation also is a safe sexual alternative for people who wish to avoid pregnancy and the dangers of sexually transmitted diseases. It also is necessary when a man must give a semen sample for infertility testing or for sperm donation. When sexual dysfunction is present in an adult, masturbation may be prescribed by a sex therapist to allow a person to experience an orgasm (often in women) or to delay its arrival (often in men).

Is Masturbation Normal?

While it once was regarded as a perversion and a sign of a mental problem, masturbation now is regarded as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable and safe. It is a good way to experience sexual pleasure and can be done throughout life.

Masturbation is only considered a problem when it inhibits sexual activity with a partner, is done in public, or causes significant distress to the person. It may cause distress if it is done compulsively and/or interferes with daily life and activities.

Is Masturbation Harmful?

In general, the medical community considers masturbation to be a natural and harmless expression of sexuality for both men and women. It does not cause any physical injury or harm to the body, and can be performed in moderation throughout a person's lifetime as a part of normal sexual behavior. Some cultures and religions oppose the use of masturbation or even label it as sinful. This can lead to guilt or shame about the behavior.

Some experts suggest that masturbation can actually improve sexual health and relationships. By exploring your own body through masturbation, you can determine what is erotically pleasing to you and can share this with your partner. Some partners use mutual masturbation to discover techniques for a more satisfying sexual relationship and to add to their mutual intimacy.

Sexual Health:Your Guide to the Sexual Response Cycle

The sexual response cycle refers to the sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities, including intercourse and masturbation. Knowing how your body responds during each phase of the cycle can enhance your relationship and help you pinpoint the cause of any sexual problems.

What Are the Phases of the Sexual Response Cycle?

The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. Both men and women experience these phases, although the timing usually is different. For example, it is unlikely that both partners will reach orgasm at the same time. In addition, the intensity of the response and the time spent in each phase varies from person to person. Understanding these differences may help partners better understand one another's bodies and responses, and enhance the sexual experience.

Phase 1: Excitement

General characteristics of this phase, which can last from a few minutes to several hours, include the following:

• Muscle tension increases.
• Heart rate quickens and breathing is accelerated.
• Skin may become flushed (blotches of redness appear on the chest and back).
• Nipples become hardened or erect.
• Blood flow to the genitals increases, resulting in swelling of the woman's clitoris and labia minora (inner lips), and erection of the man's penis.
• Vaginal lubrication begins.
• The woman's breasts become fuller and the vaginal walls begin to swell.
• The man's testicles swell, his scrotum tightens, and he begins secreting a lubricating liquid.

Phase 2: Plateau

General characteristics of this phase, which extends to the brink of orgasm, include the following:

• The changes begun in phase 1 are intensified.
• The vagina continues to swell from increased blood flow, and the vaginal walls turn a dark purple.
• The woman's clitoris becomes highly sensitive (may even be painful to touch) and retracts under the clitoral hood to avoid direct stimulation from the penis.
• The man's testicles are withdrawn up into the scrotum.
• Breathing, heart rate, and blood pressure continue to increase.
• Muscle spasms may begin in the feet, face, and hands.
• Muscle tension increases.

Phase 3: Orgasm

This phase is the climax of the sexual response cycle. It is the shortest of the phases and generally lasts only a few seconds. General characteristics of this phase include the following:

• Involuntary muscle contractions begin.
• Blood pressure, heart rate, and breathing are at their highest rates, with a rapid intake of oxygen.
• Muscles in the feet spasm.
• There is a sudden, forceful release of sexual tension.
• In women, the muscles of the vagina contract. The uterus also undergoes rhythmic contractions.
• In men, rhythmic contractions of the muscles at the base of the penis result in the ejaculation of semen.
• A rash, or "sex flush" may appear over the entire body.

Phase 4: Resolution

During this phase, the body slowly returns to its normal level of functioning, and swelled and erect body parts return to their previous size and color. This phase is marked by a general sense of well-being, enhanced intimacy and, often, fatigue. Some women are capable of a rapid return to the orgasm phase with further sexual stimulation and may experience multiple orgasms. Men need recovery time after orgasm, called a refractory period, during which they cannot reach orgasm again. The duration of the refractory period varies among men and usually lengthens with advancing age.

Sexual Health:Your Guide to the Male Reproductive System

The purpose of the organs of the male reproductive system is to perform the following functions:

• To produce, maintain and transport sperm (the male reproductive cells) and protective fluid (semen)
• To discharge sperm within the female reproductive tract during sex
• To produce and secrete male sex hormones responsible for maintaining the male reproductive system

Unlike the female reproductive system, most of the male reproductive system is located outside of the body. These external structures include the penis, scrotum, and testicles.

• Penis: This is the male organ used in sexual intercourse. It has 3 parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans, which is the cone-shaped part at the end of the penis. The glans, also called the head of the penis, is covered with a loose layer of skin called foreskin. (This skin is sometimes removed in a procedure called circumcision.) The opening of the urethra, the tube that transports semen and urine, is at the tip of the penis. The penis also contains a number of sensitive nerve endings.

  The body of the penis is cylindrical in shape and consists of 3 circular shaped chambers. These chambers are made up of special, sponge-like tissue. This tissue contains thousands of large spaces that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.

  Semen, which contains sperm (reproductive cells), is expelled (ejaculated) through the end of the penis when the man reaches sexual climax (orgasm). When the penis is erect, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.

• Scrotum: This is the loose pouch-like sac of skin that hangs behind the penis. It contains the testicles (also called testes), as well as many nerves and blood vessels. The scrotum acts as a "climate control system" for the testes. For normal sperm development, the testes must be at a temperature slightly cooler than body temperature. Special muscles in the wall of the scrotum allow it to contract and relax, moving the testicles closer to the body for warmth or farther away from the body to cool the temperature.

• Testicles (testes): These are oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for generating sperm. Within the testes are coiled masses of tubes called seminiferous tubules. These tubes are responsible for producing sperm cells.

The internal organs of the male reproductive system, also called accessory organs, include the following:

• Epididymis: The epididymis is a long, coiled tube that rests on the backside of each testicle. It transports and stores sperm cells that are produced in the testes. It also is the job of the epididymis to bring the sperm to maturity, since the sperm that emerge from the testes are immature and incapable of fertilization. During sexual arousal, contractions force the sperm into the vas deferens.

• Vas deferens: The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens transports mature sperm to the urethra, the tube that carries urine or sperm to outside of the body, in preparation for ejaculation.

• Ejaculatory ducts: These are formed by the fusion of the vas deferens and the seminal vesicles (see below). The ejaculatory ducts empty into the urethra.

• Urethra: The urethra is the tube that carries urine from the bladder to outside of the body. In males, it has the additional function of ejaculating semen when the man reaches orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.

• Seminal vesicles: The seminal vesicles are sac-like pouches that attach to the vas deferens near the base of the bladder. The seminal vesicles produce a sugar-rich fluid (fructose) that provides sperm with a source of energy to help them move. The fluid of the seminal vesicles makes up most of the volume of a man's ejaculatory fluid, or ejaculate.

• Prostate gland: The prostate gland is a walnut-sized structure that is located below the urinary bladder in front of the rectum. The prostate gland contributes additional fluid to the ejaculate. Prostate fluids also help to nourish the sperm. The urethra, which carries the ejaculate to be expelled during orgasm, runs through the center of the prostate gland.

• Bulbourethral glands: Also called Cowper's glands, these are pea-sized structures located on the sides of the urethra just below the prostate gland. These glands produce a clear, slippery fluid that empties directly into the urethra. This fluid serves to lubricate the urethra and to neutralize any acidity that may be present due to residual drops of urine in the urethra.

How Does the Male Reproductive System Function?

The entire male reproductive system is dependent on hormones, which are chemicals that regulate the activity of many different types of cells or organs. The primary hormones involved in the male reproductive system are follicle-stimulating hormone, luteinizing hormone, and testosterone.

Follicle-stimulating hormone is necessary for sperm production (spermatogenesis) and luteinizing hormone stimulates the production of testosterone, which is also needed to make sperm. Testosterone is responsible for the development of male characteristics, including muscle mass and strength, fat distribution, bone mass, facial hair growth, voice change and sex drive.

Sexual Health:Your Guide to the Female Reproductive System

The female reproductive system is designed to carry out several functions. It produces the female egg cells necessary for reproduction (called the ova or oocytes). The system is designed to then transport the ova to the site of fertilization where conception - the fertilization of an egg by a sperm - normally occurs in the fallopian tubes.

After conception, the uterus offers a safe and favorable environment for a baby to develop before it is time for it to make its way into the outside world. If fertilization does not take place, the system is designed to menstruate (the monthly shedding of the uterine lining). In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.

What Parts Make-up the Female Anatomy?

The female reproductive anatomy includes internal and external structures.

The function of the external female reproductive structures (the genitals) is twofold: To enable sperm to enter the body and to protect the internal genital organs from infectious organisms. The main external structures of the female reproductive system include:

• Labia majora: The labia majora enclose and protect the other external reproductive organs. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males. The labia majora contain sweat and oil-secreting glands. After puberty, the labia majora are covered with hair.
• Labia minora: Literally translated as "small lips," the labia minora can be very small or up to 2 inches wide. They lie just inside the labia majora, and surround the openings to the vagina (the canal that joins the lower part of the uterus to the outside of the body) and urethra (the tube that carries urine from the bladder to the outside of the body).
• Bartholin's glands: These glands are located beside the vaginal opening and produce a fluid (mucus) secretion.
• Clitoris: The two labia minora meet at the clitoris, a small, sensitive protrusion that is comparable to the penis in males. The clitoris is covered by a fold of skin, called the prepuce, which is similar to the foreskin at the end of the penis. Like the penis, the clitoris is very sensitive to stimulation and can become erect.

The internal reproductive organs in the female include:

• Vagina: The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal.
• Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus. The uterus is divided into two parts: the cervix, which is the lower part that opens into the vagina, and the main body of the uterus, called the corpus. The corpus can easily expand to hold a developing baby. A channel through the cervix allows sperm to enter and menstrual blood to exit.
• Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the uterus. The ovaries produce eggs and hormones.
• Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.

What Happens During the Menstrual Cycle?

Females of reproductive age experience cycles of hormonal activity that repeat at about one-month intervals.(Menstru means "monthly"; hence the term menstrual cycle.) With every cycle, a woman's body prepares for a potential pregnancy, whether or not that is the woman's intention. The term menstruation refers to the periodic shedding of the uterine lining.

The average menstrual cycle takes about 28 days and occurs in phases: the follicular phase, the ovulatory phase (ovulation), and the luteal phase.

There are four major hormones (chemicals that stimulate or regulate the activity of cells or organs) involved in the menstrual cycle: follicle-stimulating hormone, luteinizing hormone, estrogen and progesterone.

Follicular Phase

This phase starts on the first day of your period. During the follicular phase of the menstrual cycle, the following events occur:

• Two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH) are released from the brain and travel in the blood to the ovaries.
• The hormones stimulate the growth of about 15-20 eggs in the ovaries each in its own "shell," called a follicle.
• These hormones (FSH and LH) also trigger an increase in the production of the female hormone estrogen.
• As estrogen levels rise, like a switch, it turns off the production of follicle-stimulating hormone. This careful balance of hormones allows the body to limit the number of follicles that complete maturation, or growth.
• As the follicular phase progresses, one follicle in one ovary becomes dominant and continues to mature. This dominant follicle suppresses all of the other follicles in the group. As a result, they stop growing and die. The dominant follicle continues to produce estrogen.

Ovulatory Phase

The ovulatory phase, or ovulation, starts about 14 days after the follicular phase started. The ovulatory phase is the midpoint of the menstrual cycle, with the next menstrual period starting about 2 weeks later. During this phase, the following events occur:

• The rise in estrogen from the dominant follicle triggers a surge in the amount of luteinizing hormone that is produced by the brain.
• This causes the dominant follicle to release its egg from the ovary.
• As the egg is released (a process called ovulation) it is captured by finger-like projections on the end of the fallopian tubes (fimbriae). The fimbriae sweep the egg into the tube.
• Also during this phase, there is an increase in the amount and thickness of mucous produced by the cervix (lower part of the uterus.) If a woman were to have intercourse during this time, the thick mucus captures the man's sperm, nourishes it, and helps it to move towards the egg for fertilization.

Luteal Phase

The luteal phase begins right after ovulation and involves the following processes:

• Once it releases its egg, the empty follicle develops into a new structure called the corpus luteum.
• The corpus luteum secretes the hormone progesterone. Progesterone prepares the uterus for a fertilized egg to implant.
• If intercourse has taken place and a man's sperm has fertilized the egg (a process called conception), the fertilized egg (embryo) will travel through the fallopian tube to implant in the uterus. The woman is now considered pregnant.
• If the egg is not fertilized, it passes through the uterus. Not needed to support a pregnancy, the lining of the uterus breaks down and sheds, and the next menstrual period begins.

How Many Eggs Does a Woman Have?

During fetal life, there are about 6 million to 7 million eggs in the female ovaries. From this time, no new eggs are produced.

The vast majority of the eggs within the ovaries steadily die, until they are depleted at menopause. At birth, there are approximately 1 million eggs; and by the time of puberty, only about 300,000 remain. Of these, 300 to 400 will be ovulated during a woman's reproductive lifetime. The eggs continue to degenerate during pregnancy, with the use of birth control pills, and in the presence or absence of regular menstrual cycles.