The purpose of this chapter is to provide information about the functionality of parts of the reproductive organs.

What are the female sexual organs?

The female sexual organs are divided into external -and internal organs.

External organs

The external organs are the clitoris, the inner lips, the mons pubis, the vaginal opening and the outer lips. Together they are called the vulva. Its appearance differs from one woman to another.

• The clitoris is a sensitive organ that is important in sexual response. It exists from the tip (glans), two copora cavernosa, a knob of tissue and two crura. They develop before birth and the gender organs of one gender are homologous. The clitoris of the female is homologous to the male’s penis because they exist from the same embryonic tissue. The clitoris is also erectile and fills with blood as the penis does. The clitoris is unique because it has no reproductive function.

• The mons pubis is the rounded and fatty part of tissue covered in pubic hairs.

• The labia is the part along both sides of the opening of the vagina and also covered with pubic hairs. The Bartholin glands lie inside the inner lips and do not have a significant function. The perineum is the area between the anus and the vagina. The introitus is the opening of the vagina itself. Urine does not pass through the clitoris itself, but through the urethra, which is a separate opening.

• The hymen is a thin membrane that partly covers the opening of the vagina. It has some openings for menstrual fluid. It can be opened or stretched when the penis moves into the vagina. The hymen may be taken as a sign of virginity as it typically breaks when first having intercourse. However, a women without a hymen can still be a virgin, some girls are just born without.

Internal organs

The internal organs consist of the vestibular bulbs, the skene’s glands, the vagina, a pair of fallopian tubes and a pair of ovaries.

• The vagina is the organ in which the penis is inserted during sex. It is also referred to as the birth canal or introitus. The cervix at the lower part of the uterus is connected to the top. The walls of the vagina have three layers. The inner part of the vagina is sensitive to erotic stimulation. Around the vagina there is the pubococcygeus muscle, which is stretched during childbirth.

• The vestibular bulbs are two small organs that lie on either side of the vaginal wall.

• The skene’s gland or female prostate lies between the wall of the vagina and the urethra. This organ is the G-spot responsible for female ejaculation.

• The uterus or womb has the cervix which opens into the vagina. The major function is the development of a foetus.

• The fallopian tubes are the pathway by which the sperm reaches the egg.

• The ovaries lie on either side of the uterus and produce the eggs. They also produce estrogen and progesterone. They contain follicles, capsules that surround an egg.

The Breasts

Although they are not sex organs, they have a reproductive and erotic significance. They consist of fifteen to twenty clusters of mammary glands, all with a separate opening to the nipple. They are covered with a fibrous and fatty tissue. The nipple has a lot of nerves and is therefore sensitive to stimulation. The darker area around the nipple is called areola. The symbolical and psychological meaning of the breasts is enormous.

What are the male sexual organs?

The most notable parts of the sexual organs of the male are the scrotum, scrotal sac and the penis.

External organs

• The penis has an important function in reproduction, urination and sexual pleasure. The end or tip is called the glans. The opening at the end is called the meatus or urethral opening. Trough this opening pass urine and semen. The main part is called shaft and the raised ridge is called corona. The corona and the rest of the glans are most sensitive to stimulation. Inside the penis there are the corpora cavernosa and the corpus spongiosum. During the erection these tissues are swollen because they are filled with blood, making the penis stiff. The skin of the penis is usually not covered in hair.

• The foreskin is an additional layer of skin that covers the glans. In some adults this is absent if they are circumcised. Two small glands under the foreskin produce smegma. If the foreskin is not washed properly the smegma hopes up and can start to smell.

• Circumcision is the removal of foreskin. It can be done for religious or cultural reasons and symbolises the covenant between the Jewish people and god. In Polynesia they use supercision, where they just make a small incision in the foreskin leaving the rest intact. In some tribes they do subincision, which is an incision in the lower side of the penis to the urethra. Urine is then coming from the base of the penis instead of the top.

Internal organs

• The testes or gonads are important in reproduction. They produce sperm and sex hormones, such as testosterone. In the internal structure, the seminiferous tubules are responsible for storing sperm and the interstitial cells produce testosterone. The cresmasteric reflex is the movement of the scrotum. When it is cold the scrotum moves closer to the body and when it is hot it moves further away to remain a constant temperature that is slightly lower than the body temperature.

• The male germ cells go through several stages of maturation: the spermatogonium, spermatocyte with spermatid as final stage. The sperm passes out of the testes into a single tube, the epididymis. While ejaculating, the sperm moves through vas deferens to the ejaculatory duct, which opens in the urethra. The sperm is then ejaculated out of the penis. The seminal vesticles are two structures that look like a sac and lie above the prostate. They produce about sixty percent of the seminal fluid or ejaculate. The other forty percent is created by the prostate.

• The prostate is situated below the bladder. It exists from glandular tissue and muscle. The prostate is small at birth and grows during puberty. It shrinks at old age. Sometimes it grows big enough to infer with urination, a surgical or medicinal procedure is then needed.

• Cowper’s glands or bulbourethral glands are just below the prostate. They empty into the urethra. The function is to neutralize the acidic urethra which allows safe passage of the sperm.

What kind of cancer exists in sex organs?

There are several kinds of cancer people can have in their sex organs. There is breast cancer, cancer of the cervix, endometrium -and ovaries, cancer of the prostate and cancer of the testes.

Breast cancer

This is the most common form of cancer in women. About five to ten percent is genetic. Other risk factors are long-term use of menopausal hormone therapy (MHT) and obesity. Self-exams of breasts can help to detect changes in an early stage. There are three kinds of breast lumps: cysts, fibroadenomas and malignant tumours. About eighty percent of lumps in breasts are not malignant. The technique used for early detection of breast cancer is mammography, also MRI scans can be used, but only recommended for high-risk cases. There are several forms of treatment including lumpectomy and radical mastectomy.

1. Lumpectomy is a surgical treatment where only the lump and surrounding tissue are removed.

2. Radical mastectomy is a surgical treatment where the entire breast is removed.

Both techniques have psychological consequences. The emotional response is often depression and anxiety. Relationship tensions can increase. However, most women show posttraumatic growth when they learn to live with their new body. Cognitive behavioural therapy can be useful in treatment of emotional responses to breast cancer.

Cancer of the cervix, endometrium and ovaries

About ninety-five percent of this type of cancer is caused by the HPV virus. Early heterosexual intercourse and multiple are known risk-factors. HPV interferes with the tumour suppressor genes. A pap test can detect this type of cancer early and helps to decrease the death rate. Diagnosis is difficult due to the varying symptoms. The symptoms such as vomiting and cramping can be related to many less serious conditions. Treatment, when detected early is cryotherapy that uses extreme cold to destroy the abnormal cells. For women with advanced cervical cancer, hysterectomy is used. This is the removal of the uterus. The vagina is left intact, so intercourse is quite possible.

Cancer of the prostate

Most cases of prostate cancer are not lethal. Most tumors are small and not widespread. The prostate cancer gene is called HPC1, but only accounts for three percent of the cases. Symptoms are frequent urination (especially at night), difficulties in urinating and prostate enlargement. The tumour presses onto the urethra causing these symptoms. In the beginning the disease may give a men frequent erections and increase in sex drive which results in problems with sexual functioning as the disease progresses. Rectal examination is the simple and best way for preliminary diagnosis. Treatment involves surgical removal of the prostate. Surgery can result in erection problems. The risk for prostate cancer increases with the number of sex partners.

Cancer of the testes

This is not a common form of cancer. It tends to happen to young men between the age of twenty-nine and thirty-five. The first sign is change in consistency of the testes or a painless lump. Many men do not discover the tumour. When the lump is early detected the survival rate is almost a hundred percent. When the tumour develops this is only seventy percent. Final diagnosis involves surgical removal of the testes. The other testicle can remain so hormone production and functioning can continue normally.