Concept of Sexuality

Year 1 , Semester II

Misbah Khan
Lecturer DINM,DUHS.
 Objectives
At the end of this unit learner will be able to
• Review the anatomy & physiology of male and female
reproductive system.
• Describe normal sexual patterns.
• Relate sexuality to all stages of life cycle.
• Identify factors that effect sexual functioning.
• Describe common risks and alteration in sexuality.
• Understand nursing process as it relate to sexual
functioning.
 Introduction

• Sexuality is an integral part of our entire being from the time

of birth. It includes physical, physiological, social, emotional,
cultural, spiritual and ethical dimensions of sex and gender.

• Sexuality influences thoughts, feelings, actions and

interactions, and it is a fundamental human right.
Anatomy of Male Reproductive
System
 Male External Genitalia
• Penis:Male copulatory organ
• Urethra: Tube for transport urine and semen
• Testes: Produce sperm secrete male hormone
• Scrotum: Skin covered pouch containing testes

Sexuality pattern 5
11/11/2019
 Male Internal Ganitalia
• Epididymis: Tightly coiled tube lying along top of each
testes. Store spermatozoa
• Vas deferens: Transport spermatozoa from testes to urethra
• Ejaculatory duct: Tube that pass through prostate to
urethra passage way for semen and fluid from seminal
vesicles
• Seminal Vesicles : glands that produce the fluids that will
turn into semen. The vesicles may also be called seminal
glands or vesicular glands
Sexuality pattern 6
11/11/2019
• Prostate glands :Secrete thin, milky, slightly alkaline
• fluid, rich in nutrients into the seminal fluid, these
secretion protect spermatozoa from acidic environment
• Cowper’s gland: Contribute alkaline fluid to semen
Anatomy of Female Reproductive
 Female External Genitalia
• External Female Structures
Collectively, the external female reproductive organs are called the
Vulva.
• Mons pubis :Fatty tissue above the pubic bone
• Labia Majora: Large, outer fatty folds of skin tissue
• Labia Minora :Inner folds of skin
• Clitoris: Small, highly sensitive organ
• Urethral orifice: Urine passage
• Vaginal vestibules :The cleft containing the vagina and urethral
opening
• Vulva :External visible area
• Vestibular glands: Bartholin’s gland one on each side near vaginal
opening secretes mucus and keep the vulva moist
Sexuality pattern 3
11/11/2019
Female Internal genitalia
• Vagina: Tubular organ connecting external genitalia with uterus

• Uterus: Hollow muscular organ, purpose to nature developing fetus

• Cervix: Small lower portion of the uterus that project into the vagina

• Cervical os: Small opening in vagina

• Ovaries :Containing the immature

• Fallopian tubes: Thin flexible muscular structure connecting the

ovaries with uterus. Passage way ovum to travel to uterus

Sexuality pattern 5
11/11/2019
 Sexual Health
The World Health Organization defines:

Sexual health as a state of physical, emotional, mental and social

well-being in relation to sexuality; it is not merely the absence of
disease, dysfunction or infirmity.
 Sexuality-reproductive Pattern
• Describes patterns of satisfaction or dissatisfaction
with sexuality; describes reproductive pattern.
Includes the individual’s perceived satisfaction or
reports of disturbances in his or her sexuality.

• Included also is the female’s reproductive stage

(premenopause or post menopause) and any
perceived problems.
 Normal sexuality pattern
• Sexuality is determined by
– Anatomy
– Physiology
– The culture in which a person lives
– Relationships with others
– Developmental experiences throughout the life cycle

• Normal sexual behavior brings pleasure to oneself and one's

partner, involves stimulation of the primary sex organs
including coitus.
 Gender
• A concept that refers to the differences between men’s and
women’s roles and responsibilities that are socially
constructed.
Sex
• Biological sex is our anatomy as female, male, or intersex.
• Biological constructed
• It includes our internal and external sex organs,
chromosomes, and hormones

• Female: XX (♀)
• Male: XY (♂)
 Sexual Orientation
• Heterosexuality – Sexual attraction to the opposite gender

• Homosexuality – Sexual attraction to the same gender

• “Gay” refers to a male homosexual
• “Lesbian” refers to a female homosexual

• Bisexuality – Sexual attraction toward both genders

Growth and Development of Sexuality
Growth and Development of Sexuality

• The development of sexuality begins with conception

and continues throughout the life span
Growth and Development of Sexuality
STAGE CHARACTERSTICS
INFANCY Given gender assignment of male or female.
Birth–18 months Differentiates self from others gradually.
Male infants have penile erections; females, vaginal
lubrication.
TODDLER Continues to develop gender identity. Able to identify own
1–3 years gender
SCHOOL AGE Has awareness of self and strong identification with parent
6–12 years of same gender.
Tends to have friends of the same gender.
desire for privacy.
Learns the role and concepts of own gender as part of the
total self-concept.
At about 8 or 9 years becomes concerned about specific sex
behaviors and often approaches parents with explicit
concerns about sexuality and reproduction
STAGE CHARACTERISTICS

ADOLESCENCE 12–18 Primary and secondary sex characteristics develop.

years Menarche usually takes place.
Develops relationships with interested partners.
Masturbation is common. May participate in sexual
activity
Are at risk for pregnancy and sexually transmitted
infections (STIs)
YOUNG ADULTHOOD Sexual activity is common.
18–40 years Establishes own lifestyle and values.
Many couples share financial obligations and household
tasks.
MIDDLE Men and women experience decreased hormone
ADULTHOOD production.
40–65 years The menopause occurs in women usually anywhere
between ages 40 and 55.
LATE ADULTHOOD Lack of sexual stimulation.
65 years and older Degeneration of organs.
 Freud's 5 Stages of Psychosexual
Development
• Freud proposed that personality development in
childhood takes place during five psychosexual
stages:
– Oral
– Anal
– Phallic
– Latency
– Genital stages.
Factors That Effect Sexual Functioning

• Family
• Culture
• Religion
• personal expectations and Ethics
• disease processes
• Medications
• relationship problems
Common Risks and Alteration in Sexuality
➢General health status ( chronic disease )
➢Sexual dysfunction.
➢Sexual abuse
➢ejaculatory dysfunction
 PLISSIT model
• The PLISSIT model was developed by Annon as a framework
for care providers to assist in the ordering and treatment of
sexual problems

• PLISSIT is an acronym for the four stages of the model:

1. Permission
2. Limited Information
3. Specific Suggestions
4. Intensive Therapy
 Assessment
Female health history
• Current Genitourinary Health:
❖Urinary symptoms including infection and
voiding (dysuria, Frequency, Urgency, hematuria,
stress incontinence.)
• Menstrual history:
❖Age of monarchy, last menstrual period, interval of
frequency( regular or irregular) duration, menstrual
flow, light, medium, heavy ( no of pads use).

11/11/2019 Sexuality pattern 27

• Menorrhagia: ( increase amount or duration of flow)

• Dysmenorrhoea:( pain in menstruation)

• Post menopausal bleeding

• post menstrual syndrome symptoms(weight gain, headache, breast

tenderness)

• Obstetrical history: gravida, term, number of birth, premature

birth, alive child, abortion.

11/11/2019 Sexuality pattern 28

• Vulvovaginal problems:
Any discharge, color, amount ,and odour, vaginal itching, lesion or
lumps, dyspareunia (is painful sexual intercourse).

• Type of deliveries:
✓ vaginal
✓ Forceps
✓ C – section.

11/11/2019 Sexuality pattern 29

•Health promotion practices:
• Family planning methods(any side effects)
• Self breast examination
• Personal hygiene.
• Family history:
• History of medication taken.
• Hysterectomy
• Oophorectomy
• Repair of rectocele
• Salpingectomy
• Tubligation.

11/11/2019 Sexuality pattern 30

 Male Assessment
• Genitourinary Health Status
▪ Urinary symptoms including infection and voiding dysfunction
▪ Prostate problem
▪ Nocturia
▪ True incontinence
▪ Stress incontinence
▪ Urinary retention

Sexuality pattern 31
11/11/2019
Screen for problems with penis such as skin lesions, cancer or STD

Assess for the hydrocele, hernia, lump, swelling in testes, swelling in

scrotum, change in size of scrotum.

Assess Sexual Health

Sexual activity

Monogamous ,polygamous ,satisfaction or problem related sexual

activity

11/11/2019 Sexuality pattern 32

 Nursing Diagnosis
• Altered/ineffective sexuality • Body image disturbance
pattern
• Chronic self esteem
• Sexual dysfunction
• Decisional conflict
• Altered family process
• Ineffective denial
• Altered nutrition less than body
• Ineffective individual coping
requirement
• Sleep pattern disturbance
• Altered sexuality problem
• Social isolation
• Altered through processes
• Spiritual distress
• Anxiety

11/11/2019 Sexuality pattern 33

 Planning
• Maintain, restore, or improve sexual health

• Increase knowledge of sexuality and sexual health prevent

the occurrence of sexually transmitted disease

• Prevent the spread of an existing STD

• Improve sexual self – concept

11/11/2019 Sexuality pattern 34

 Implementation
• Provide sexual health teaching

• Sex education

• Responsible sexual behaviors

• Self examination (TSE AND SBE)

• STD prevention

• Counseling for altered functions

11/11/2019 Sexuality pattern 35

 References
• Delaune, S. C., & Ladner, P. K. (2002). Fundamentals of
Nursing: Standards and Practice. (2nd ed.) Canada: Delmar.

• Erb, G. K., B. (2000). Fundamentals of Nursing: Concepts,

Process and Practice (5th ed.) Addison: Wesley.

• Potter, P. A & Perry, A. G. (2003). Basic Nursing: Essentials

for Practice (5th ed.) St. Louis: Mosby.

11/23/2023 Misbah Khan 36