Posts Tagged ‘Skene’s glands’

Understanding Female Sexual Fluids

August 11, 2018

Andrew Siegel MD  8/11/2018

Women are capable of releasing a “cocktail” of genital fluids during sexual activity. Controversy exists regarding the nature, volume, and composition of these secretions and their mechanisms of expulsion. Today’s entry delves into the origins of female sexual fluids—vaginal, glandular (Skene and Bartholin glands) and the urinary bladder—and the means of their release.  In the image below, the anatomical structures in boldface are those responsible for the genital fluids.

Image below: note Swedish “slida” is vagina (literally “sheath”); note Skenes and Bartholins gland  openings, “urinrorsmynning” = urethra; “klitoris” = clitoris

Skenes_gland-svenska.jpg

Attribution of image above: By Nicholasolan (Skenes gland.jpg) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5 (https://creativecommons.org/licenses/by-sa/2.5)%5D, via Wikimedia Commons

 

Vaginal secretions

Lubrication that originates from the vagina is an ultra-filtrate of blood resulting from the increased blood flow and pelvic congestion that happens with erotic and tactile stimulation. The surge of blood to the genitals at the time of arousal results in the seeping of this natural lubrication fluid. There is often a substantial drop in the amount of vaginal lubrication that occurs after menopause with the sudden cessation of estrogen production by the ovaries.  By the way, if you are interested in testing your knowledge of female anatomy, visit: how high is your vaginal I.Q.?

Skene gland secretions…the female “prostate”

The Skene glands (a.k.a. para-urethral glands) are homologous to the male prostate gland.  These paired glands are located within the top wall of the vagina near the urethra and drain into the urethra and to tiny openings near the urethral opening (see image above). At the time of sexual climax, they can release a small amount of fluid into the urethra, paralleling the male release of prostate fluid at the time of ejaculation.

Bartholin gland secretions…the female “bulbourethral” glands

The Bartholin glands (a.k.a. greater vestibular glands) are paired, pea-size structures located in the superficial perineal pouch.  These glands open below and to the sides of the vagina (see image above).  They are homologous to the male bulbourethral glands that produce a clear, sticky fluid that lubricates the male urethra, often referred to as “pre-cum.”  The Bartholin glands secrete mucus that functions to provide lubrication to the inner labia that helps moisten the opening into the vagina.

Bladder and urethra

Because of the anatomical proximity of the bladder and urethra to the vagina, urine stored in the urinary bladder can be involuntarily released at the time of sexual activity.  Urine can be expelled during initial vaginal penetration, in the midst of the act of sexual intercourse, or at the time of sexual climax.

Urinary discharge that occurs during initial vaginal penetration and/or during sexual intercourse often occurs because of the presence of the penis in the vagina that displaces and elevates the bladder (anatomically situated directly above the vagina) and the massaging effect of penile thrusting.  This is not uncommonly seen in women who have either stress urinary incontinence, the involuntary leakage of urine with exercising, coughing, sneezing, etc., or bladder prolapse, a condition in which weakened bladder support allows descent of the bladder into the vaginal space.

Urine can also be involuntarily expelled from the urethra at the time of sexual climax.  For many women it is unpleasant, highly frustrating and embarrassing  situation for which they seek treatment, a condition known as coital incontinence. This orgasmic release of urine often occurs in women who suffer with overactive bladder, a condition in which the bladder contracts without its owner’s permission (a.k.a., involuntary bladder contractions).  For other women, the release of urine at the time of climax is viewed positively, correlated with intensive sexual arousal and a powerful and cathartic orgasm.  Under these circumstances, this situation is known as “squirting.”

(Excellent reference: Differential diagnostics of female “sexual” fluids: a narrative review   Z Pastor and R Chimel, Intern Urogynecological Journal (2018) 29:621-629)

Wishing you the best of health,

2014-04-23 20:16:29

A new blog is posted weekly. To receive a free subscription with delivery to your email inbox visit the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.

Dr. Siegel has authored the following books that are available on Amazon, iBooks, Nook and Kobo:

MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health

Cover

PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

These books are written for educated and discerning men and women who care about health, well-being, fitness and nutrition and enjoy feeling confident and strong.

Dr. Siegel is co-creator of the male pelvic floor exercise instructional DVD (female version is in the works): PelvicRx

New video on female pelvic floor exercises:  Learn about your pelvic floor

 

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Men Are From Mars, Women From Venus, But There’s Not Much Difference Between A Vagina And A Penis

December 10, 2016

Andrew Siegel MD 12/10/2016

What is it that most distinguishes a male from a female? The obvious answer is the genitals, with the penis/scrotum having a vastly different appearance from a vagina/vulva.  Despite the male and female genitals being the feature that most characterizes the difference between a male and female, there are striking similarities. The genitals of both sexes are biologically homologous– similar in structure and having a common embryological origin–with development into male versus female based simply on the hormonal environment at the time of development.  Today’s entry discusses the similarities (as opposed to the differences) between the genitals and the “homologues,” the specific anatomical structures that are of common embryological origin and are more alike than are commonly recognized. 

Whether one develops a penis or a vagina is determined at the moment the sperm penetrates the egg. The egg contains an X chromosome and the sperm either an X or Y chromosome. When the coupling results in an XX, the blueprint for female development is established; when the coupling results in an XY, the blueprint for male development is established. The bottom line is that the father determines the sex of the child.

Several weeks later, when the fertilized egg has turned into an embryo, the external genitals are identical. Female genitals are the “default” model, which will remain female, absent the presence of the male hormone testosterone (T). T is activated to dihydrotestosterone (DHT) that causes conversion of what would be a vulva and vagina into a penis and scrotum. Biochemical magic! The bottom line is that the developing embryo will remain female unless T/DHT are available to masculinize the external genitals.

In the young embryo there are three key genital structures: the “tubercle,” the “folds” and the “swellings.” In the absence of T/DHT, the genital tubercle (a midline swelling) develops into a clitoris. The urogenital folds (two vertically-oriented folds of tissue below the genital tubercle) become labia minora (inner lips). The labio-scrotal swellings (two vertically-oriented bulges outside the urogenital folds) fuse to become labia majora (outer lips). In the presence of T/DHT the genital tubercle morphs into a penis, the urogenital folds become the urethra and part of the penile shaft and the labio-scrotal swellings fuse to become a scrotum.

Genital Homologues

The penis is the homologue of the clitoris. Both structures are highly sensitive organs with a tremendous concentration of nerve fibers and contain erectile tissue (corpora) that enables them to expand in size and rigidity with stimulation. Both the penis and clitoris have a head (glans) and shaft and deep internal roots. Both are covered with a layer of skin that can be pulled back to expose the underlying anatomy. In the male this is referred to as the foreskin, which is the homologue of the female clitoral hood.

penile-clitoral_structure

Comparison of penis (left) and clitoris (right)–note similar shape and internal structure, Attribution: Esseh, Wikipedia Commons

The male scrotal sac is the homologue of the female labia majora. The raphe (the seam that runs vertically up the perineum, scrotum and penis) is the homologue of the pudendal cleft (the slit between the labia) in the female.

vulva_vs_scrotum

 

Comparison of vulva (left) and scrotum (right); note similarity of outer labia to scrotum and female pudendal cleft to male raphe,  by Richiex (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)%5D, via Wikimedia Commons

The male prostate gland is the homologue of the female Skene’s glands. Both produce fluid that is released at the time of sexual climax. The male Cowper’s glands are the homologue of the female Bartholin’s glands, both of which secrete fluid at the time of sexual stimulation, pre-ejaculate fluid in the male and vaginal lubrication fluid in the female.

 

male_anatomy_en-svg

Male anatomy, note prostate gland and Cowper’s glands, by Male_anatomy.png: alt.sex FAQ derivative work: Tsaitgaist (Male_anatomy.png) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)%5D, via Wikimedia Commons

skenes_gland-svenska

Note Skene’s gland and Bartholin’s glands openings below and to side of urethra and vagina respectively, by Nicholasolan (Skenes gland.jpg) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)%5D, via Wikimedia Commons

Bottom Line: As different as female and male anatomy are, so they are similar.  The study of comparative genital anatomy and embryological origin is fascinating.  Next week’s entry addresses when this process of differentiation into male versus female goes awry, leading to “ambiguous” genitalia, and how the study of one such particular genetic defect led to the creation of a billion dollar blockbuster drug in common use for purposes of shrinking enlarged prostates and growing hair in men with male pattern baldness.   

Wishing you the best of health,

2014-04-23 20:16:29

www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Andrew Siegel MD practices in Maywood, NJ.  He is board-certified in both urology and female pelvic medicine/reconstructive surgery and is Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and attending urologist at Hackensack University Medical Center. He is a Castle Connolly Top Doctor New York Metro area and Top Doctor New Jersey.

Dr. Siegel is the author ofTHE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health (www.TheKegelFix.com) and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health (www.MalePelvicFitness.com). 

The Ins And Outs Of The Vagina

November 19, 2016

Andrew Siegel MD 11/19/16

Chances are that you may be clueless about female genital anatomy and for good reason, as you had no formal instruction…no “vagina-ology” class exists. Education often involves knowledge imparted from friends and schoolmates and perhaps a talk from a parent on the “birds and the bees,” generally less than adequate means. “Sex Ed” classes in junior high school (a.k.a. middle school) were cursory and insufficient. Your dad’s Playboy, your mom’s Cosmo and other magazines may have provided some insight, but were certainly not the gospel. Pornography offers a totally skewed perspective. As a consequence, most people have been educated through practical experience with their own vagina or with those of sexual partners. Although there is no substitute for “hands on” experience, a bit of vaginal academics is certainly a good addition to practical experience.

For many men—and women for that matter—the vagina is a dark and mysterious place, a “black hole” of human anatomy, hidden in the deep recesses of the body. This landscape is complex terrain and unfortunately does not come with a topographical map explaining its intricate subterranean geography.

The following are quotes about the vagina from Tom Hickman’s book: “God’s Doodle: The Life and Times of the Penis”:

“A place of procreative darkness, a sinister place from which blood periodically seeped as if from a wound.”

“Even when made safe, men feared the vagina, already attributed mysterious sexual power – did it not conjure up a man’s organ, absorb it, milk it, spit it out limp?”

The objective of this entry is to explore and demystify the vagina to help you comprehend and navigate its complexities. Knowledge is power and whether female or male, a greater understanding and appreciation of the anatomy, function and nuances of this curious and special female body part will most certainly prove useful.

Female Genital Anatomy 101

The hidden female nether parts and their inner workings are a mystery zone to a surprising number of women. Many falsely believe that the “pee hole” and the “vagina hole” are one and the same…not surprising given that lady parts are much more unexposed, subtle and complex than the more obviously exposed man parts. However, what lies between the thighs is more complicated and intricate than one might think…. three openings, two sets of lips, swellings, glands, erectile tissue, muscles and more.

Let’s first set the record straight on the difference between the vagina and vulva, geography that is often confused. When referring to external visible “girly” anatomy, most people incorrectly speak of the “vagina”—this is actually the “vulva,” divided in half by a midline slit known in medical jargon as the pudendal cleft or cleft of Venus or in slang terms, “camel toe.” The “vagina,” on the other hand, is the internal, flexible, cylindrical, muscular passageway that extends from vulva to cervix (neck of the uterus). The vaginal opening on the vulva is known in medical terms as the vaginal introitus. Further down south is the landscape between the vulva and the anus known in medical jargon as the perineum or in slang terms, “taint.”

vulva

(Anatomy of the vulva by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original)

Bottom Line: The vulva is external, the vagina internal. Good to remember.

Fact: The word “vulva” derives from the Latin “cunnus” (hence the derivation of the slang C-word. The word “vagina” derives from the Latin word for “sheath,” a cover for the blade of a knife or sword, an apt term.

vagina-collage-public-domain

Above image (public domain) entitled “Vagina Collage”…note that it should be entitled  “Vulva Collage”

Many Functions Of The Vagina

The vagina is an amazingly versatile and multifunctional organ that is truly a “cave of wonders.” Beyond being a sexual organ, it is an inflow pathway and receptacle for semen, an exit pathway for menstrual blood, and a birth canal. It is not simply a passive channel, but an active and dynamic, highly responsive passageway that has the capacity for voluntary muscular contraction.

Anatomy Of The Vagina

The average depth of the vagina (without sexual stimulation) is 3-4 inches or so, but with sexual stimulation and arousal, the vagina is capable of considerable expansion and distension to a much greater potential. The elasticity of the vagina is truly impressive (perhaps the most elastic and stretchable organ in the body), with the ability to stretch to accommodate a full-term infant and then return to a relatively normal caliber. The width of the vagina varies throughout its length, narrowest at the vaginal opening and increasing in diameter throughout its depth. It is typically about 1 inch in diameter at the external opening.

Joke from Maxim.com:

  1. Just how deep is the average vagina?
  2. Deep enough for a man to lose his house, his car, his dog and half of all his savings and assets…

All vaginas are unique with a great variety in shape, size and even color, similar to variations in penile anatomy. The vagina is a banana-shaped structure and when a woman lies down on her back, the more external part of the vagina (closest to the vaginal opening) is straight, and the inner, deeper part angles/curves downwards towards the sacral bones (the lower part of the vertebral column that forms the back bony part of the pelvis). This vaginal “axis” often changes with aging and childbirth.

banana-25239_960_720

Banana representing vaginal axis, with inner portion curved towards sacrum and outer portion straight (Thank you Pixabay for image)

Fact: Although the vagina recovers remarkably well after childbirth, anatomy does generally change to some extent. Pelvic examination is usually easily able to distinguish between women who have and have not had children vaginally. Of note, elective C-section (no labor) preserves vaginal anatomy. Women who have an enlarged vaginal outlet due to childbirth may have difficulty in satisfactorily “accommodating” the penis, resulting in the vagina merely “surrounding” the penis rather than firmly “squeezing” it, with the end result being diminished sensation for both partners.

The vagina has pleats and corrugations called rugae that maximize the elasticity and stretchiness of the vagina. They are accordion-like ruffles and ridges that supply texture, which increase friction for the penis during sexual intercourse. In a young woman they are prominent, but with aging they tend to disappear.

Fact: Vaginal rugae are like tread on a tire…in young women they appear like deep grooves on a new snow tire, whereas in older women they appear like thinning tire tread, completely bald at their most extreme…aging can be cruel.

The vaginal wall has an inner lining of “skin” known as epithelium, which is surrounded by connective tissues and a muscular coat. The vaginal muscle is comprised of an inner layer that is circular in orientation and an outer layer that is oriented longitudinally. Contraction of the inner muscle tightens the vagina. Contraction of the outer muscle shortens and widens the vagina. The vagina is secured within a “bed” of powerful pelvic floor muscles.

To better understand  vaginal anatomy, it is useful to divide it arbitrarily into thirds: outer, inner and middle. The outer and inner thirds are where “all the action is,” the outer third being the hub of sexuality, the inner third the hub of reproduction and the middle third essentially a connection between the inner and outer thirds.

Outer third: The outer third of the vagina is rich in nerve fibers and is the most sensitive part of the vagina. The “orgasmic platform” is the Masters and Johnson term for the anatomical “base” that responds to sexual arousal and stimulation with pelvic blood congestion. It consists of the outer third of the vagina and the engorged inner lips.

Middle third: The middle third is a conduit connecting the outer and inner thirds.

Inner third: The cervix (opening to the uterus) sits in the inner third of the vagina. Its presence within the deep vagina defines the deepest recesses of the vagina, which are referred to as the fornices (singular fornix), derived from the Latin word for “arches.” The largest fornix is the one behind the cervix (posterior fornix) with the two smaller fornices above and to the sides of the cervix (anterior and lateral fornices).

Question: What do you think is the origin of the word “fornicate”?

sobo_1906_508

Image above:  Uterus, Cervix and Inner Third Vagina from Dr. Johannes SobottaSobotta’s Atlas and Text-book of Human Anatomy 1906, note the vaginal rugae and the relationship of the cervix with the inner vagina

Fact: In the man-on top sexual intercourse position, the penis reaches the anterior fornix, while in the rear-entry position it reaches the posterior fornix.

The Pelvic Floor Muscles And The Vagina

The pelvic floor muscles play a pivotal role with respect to vaginal and sexual function, their contractions facilitating and enhancing sexual response. They contribute to arousal, sensation during intercourse and the ability to clench the vagina and firmly “grip” the penis. The strength and durability of their contractions are directly related to orgasmic potential since the pelvic muscles are the “motor” that drives sexual climax and can be thought of as the powerhouse of the vagina. During orgasm, the pelvic floor muscles “shudder.”

There is great variety in the bulk, strength, power and voluntary control of the pelvic floor muscles that support the vagina. Some women are capable of powerfully “snapping” their vaginas, whereas others cannot generate even a weak flicker.

3-superficial-and-deep-pfm

Image above: Female pelvic floor muscles, illustration by Ashley Halsey from The Kegel Fix

Fact: “Pompoir” is a sexual technique in which a woman contracts her pelvic floor and vaginal muscles rhythmically to stimulate the penis without the need for pelvic motion or thrusting. Women who diligently practice Kegel exercises can develop powerful pelvic floor muscles and become particularly adept at this technique resulting in extreme vaginal “dexterity” and the ability to refine pulling, pushing, locking, gripping, pulsing, squeezing and twisting motions, which can provide enough stimulation to bring a male to climax.  

Fact: “Penis Captivus” is a rare condition in which a male’s erect penis becomes stuck within a female’s vagina. It is thought to be on the basis of intense contractions of the pelvic floor muscles, causing the vaginal walls to clamp down and entrap the penis. It usually is a brief event and after female orgasm and/or male ejaculation, withdrawal becomes possible. However, it sometimes requires medical attention with a couple showing up in the emergency room tightly connected, like Siamese twins. Not a good call to 911!

Sexual Function And The Vagina

Under normal circumstances, the vagina is not “primed” for sex and is little more prepared for intercourse than is a flaccid penis. The un-stimulated vagina is essentially a closed “potential space” in which the vaginal roof and floor are in contact. With sexual stimulation, the vagina expands with lengthening and widening of its inner two-thirds and flattening of the rugae. The cervix and uterus pull up and back. Pelvic blood flow increases and the vaginal walls undergo a “sweating-like” reaction as a result of pelvic blood congestion, creating a slippery and glistening film. Most of the lubrication is based upon seepage from this increased blood flow, but some comes from Bartholin’s and Skene’s glands. Bartholin’s glands are paired, pea-size glands that drain just below and to each side of the vagina. During sexual arousal they secrete small drops of fluid, resulting in moistening of the opening of the vagina. Skene’s glands are paired glands that drain just above and to each side of the urethral opening. They are the female equivalent of the male prostate gland and secrete fluid with arousal.

With sexual excitement and stimulation, in addition to vaginal lubrication from increased pelvic blood flow, there is congestion and engorgement of the vulva, vagina and clitoris.

Fact: The profound vaginal changes that occur during sexual arousal and stimulation are entirely analogous to the changes that occur during male arousal: expansion of penis length and girth, retraction of the testicles towards the groin, and the release of pre-ejaculate fluid.

With increasing stimulation and arousal, physical tension within the genitals gradually builds and once sufficient intensity and duration of sexual stimulation surpass a threshold, involuntary rhythmic muscular contractions occur of the vagina, uterus, anus and pelvic floor muscles, followed by the release of accumulated erotic tension (a.k.a. orgasm) and a euphoric state. Thereafter, the genital engorgement and congestion subside, muscle relaxation occurs and a peaceful state of physical and emotional bliss and afterglow become apparent.

Fact: Anatomy can affect potential for experiencing sexual climax.

Sexual intercourse results in indirect clitoral stimulation. The clitoral shaft moves rhythmically with penile thrusting by virtue of penile traction on the inner lips, which join together to form the hood of the clitoris. However, if the vaginal opening is too wide to permit the penis to put enough traction on the inner lips, there will be limited clitoral stimulation and less satisfaction in the bedroom. Furthermore, studies have suggested that a larger clitoris that is closer to the vaginal opening is more likely to be stimulated during penetrative sexual intercourse.

At the time of sexual climax, some women are capable of “ejaculating” fluid. The nature of this fluid has been controversial, thought by some to be hyper-lubrication and others to be Bartholin’s and/or Skene’s gland secretions. There are certain women who “ejaculate” very large volumes of fluid at climax and studies have shown this to be urine released because of an involuntary bladder contraction that can accompany orgasm.

Fact: “Persistent genital arousal disorder” is a rare sexual problem characterized by unwanted, unremitting and intrusive arousal, genital engorgement and multiple orgasms without sexual interest or stimulation. It causes great distress to those suffering with it and there are no known effective treatments. It typically does not resolve after orgasm.

The G-Spot—named after German gynecologist Ernst Grafenberg—was first described in 1950 and was believed to be an erogenous zone located on the upper wall of the vagina, anatomically situated between the vagina and the urethra (urinary channel). Stimulation of this spot was thought to promote arousal and vaginal orgasm.

Fact: There is little scientific support for the existence of the G-spot as a discrete anatomical entity; however, many women feel that they possess an area on the roof of the vagina that is a particularly sensitive pleasure zone. Although its existence remains controversial, the G-spot is certainly a powerful social phenomenon.

Regular sexual activity is vital for maintaining the ability to have ongoing satisfactory sexual intercourse with the vagina staying fit and healthy if one remains sexually active, as nature intended. Vaginal penetration increases pelvic and vaginal blood flow, optimizing lubrication and elasticity, while orgasms tone and strengthen the pelvic floor muscles that support vaginal function. “Disuse atrophy” is a condition when the vagina adapts to not being used, with thinning and fragility of the vaginal walls and weakness of the pelvic floor muscles. Use it or lose it!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery. Much of the content of this entry was excerpted from his recently published book: The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health. For more info: http://www.TheKegelFix.com.

He has previously authored Male Pelvic Fitness: Optimizing Sexual & Urinary Health; Promiscuous Eating: Understanding And Ending Our Self-Destructive Relationship With Food; and Finding Your Own Fountain Of Youth: The Essential Guide For Maximizing Health, Wellness, Fitness & Longevity. Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro. Area and Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

The Kegel Fix is available in e-book format on the Amazon Kindle, iPad (Apple iBooks), Barnes & Noble Nook and Kobo and in paperback, all accessible via the following website: www.TheKegelFix.com. The e-book offers discretion, advantageous for books about personal issues, is less expensive, is delivered immediately, saves the trees, has adjustable fonts, as well as numerous hyperlinks—links to other sites activated by clicking—that access many helpful resources.  The book was written for educated and discerning women who care about health, well being, nutrition and exercise and enjoy feeling confident, sexy and strong.

Ejaculation: His and Hers

March 12, 2016

Andrew Siegel, MD   3/12/2016

One of the advantages of the specialty of urology is that it encompasses patients of both genders, unlike gynecology, which strictly involves females. Since I am board certified in Urology as well as in Female Pelvic Medicine, my practice allows me to have an equal balance of male and female patients. This gives me the opportunity to appreciate comparative male and female pelvic anatomy and function, which in reality are remarkably similar–a fact that may surprise you.

 A Few Brief Words on the Embryology of the Genitals.

Who Knew? Female and male external genitals are remarkably similar. In fact, in the first few weeks of existence as an embryo, the external genitals are identical.

The female external genitals are the “default” model, which will remain female in the absence of the male hormone testosterone. In this circumstance, the genital tubercle (a midline swelling) becomes the clitoris; the urogenital folds (two vertically-oriented folds of tissue below the genital tubercle) become the labia minora (inner lips); and the labio-scrotal swellings (two vertically-oriented bulges outside the urogenital folds) fuse to become the labia majora (outer lips).

Gray1119

(Comparison of genital anatomy,  1918 Gray’s Anatomy, Dr. Henry Gray, public domain)

In the presence of testosterone, the genital tubercle morphs into the penis; the urogenital folds fuse and become the urethra and part of the shaft of the penis; and the labio-scrotal swellings fuse to become the scrotal sac.  So, the clitoris and the penis are essentially the same structure, as are the outer labia and the scrotum.                                                                                              

Ejaculation

Ejaculation is the expulsion of fluids at the time of sexual climax. The word “ejaculation” derives from ex, meaning out and jaculari, meaning to throw, shoot, hurl, cast. We are all familiar with male ejaculation, an event that is obvious and well understood and well studied. However, female ejaculation is a mysterious phenomenon and a curiosity to many and remains poorly understood and studied.

Male Ejaculation

Men often “dribble” before they “shoot.” The bulbo-urethral glands, a.k.a. Cowper’s glands, are paired, pea-sized structures whose ducts drain into the urethra (urinary channel). During sexual arousal, these glands produce a sticky, clear fluid that provides lubrication to the urethra. (These glands are the male versions of Bartholin’s glands in the female, discussed below).

Once a threshold of sexual stimulation is surpassed, men reach the “point of no return,” in which ejaculation becomes inevitable. Secretions from the prostate gland, seminal vesicles, epididymis, and vas deferens are deposited into the urethra within the prostate gland. Shortly thereafter, the bladder neck pinches closed while the prostate and seminal vesicles contract and the pelvic floor muscles (the bulbocavernosus and ischiocavernosus) spasm rhythmically, sending wave-like contractions rippling down the urethra to forcibly propel the semen out in a pulsatile and explosive eruption. Ejaculation is the physical act of expulsion of the semen, whereas orgasm is the intense emotional excitement and climax, the blissful emotions that accompany ejaculation.

Male_anatomy

(Male Internal Sexual Anatomy, permission CC BY-SA 3.0, created 18 April 2009)

What’s in the Ejaculate?

Less than 5% of the volume is sperm and the other 95+% is a cocktail of genital secretions that provides nourishment, support and chemical safekeeping for sperm. About 70% of the volume comes from the seminal vesicles, which secrete a thick, viscous fluid and 25% from the prostate gland, which produces a milky-white fluid. A negligible amount is from the bulbo-urethral glands, which release a clear viscous fluid that has a lubrication function. The average ejaculate volume is 2-5 milliliters (one teaspoon is the equivalent of 5 milliliters).

Who Knew?  While a huge ejaculatory load sounds desirable, in reality it is correlated with having fertility issues. The sperm can literally “drown” in the excess seminal fluid.

Female Ejaculation

This is a much less familiar subject than male ejaculation and a curiosity to many. Only a small percentage of women are capable of expelling fluid at the time of sexual climax.

The nature of this fluid is controversial, thought by some to be excessive vaginal lubrication and others to be glandular secretions. Although the volume of ejaculated fluid is typically small, there are certain women who ejaculate very large volumes of fluid at climax. Expulsion of fluid at climax may come from four possible sources: vaginal secretions; Bartholin’s glands; Skene’s glands; and the urinary bladder.

Skenes_gland

(Skene’s and Bartholin’s Glands, created 22 January 2007, original uploader Nicholasolan  en.wikipedia, Permission: CC-BY-SA-2.5, 2.0, 1.0; GFDL-WITH-DISCLAIMERS; CC-BY-S)

During female arousal and sexual stimulation, the vaginal walls lubricate with a “sweating-like” reaction as a result of the increased blood flow to the genitals and pelvic blood congestion, creating a slippery and glistening film. The amount of this lubrication is highly variable. Some women with female ejaculation can release some of this fluid at the time of climax by virtue of powerful contractions of the vaginal and pelvic floor muscles.

Bartholin’s glands are paired, pea-size glands that drain just below and to each side of the vaginal opening. They are the female versions of the male bulbo-urethral glands and during sexual arousal they secrete small drops of fluid, resulting in moistening of the opening of the vagina.

Skene’s glands (para-urethral glands) are paired glands that drain just above and to each side of the urethral opening. They are the female homologue of the male prostate gland and secrete fluid with arousal.

Scientific studies have shown that those women who are capable of ejaculating very large volumes are actually having urinary incontinence due to an involuntary contraction of the urinary bladder that accompanies orgasm. This is often referred to as “squirting.”

Bottom Line: In the animal kingdom (including human beings), sex is a clever “bait and switch” scheme. In the seeming pursuit of a feel-good activity, in reality—determined by nature’s evolutionary sleight of hand—participants are hoodwinked into reproducing. The ultimate goal of the reproductive process is the fusion of genetic material from two individuals to perpetuate the species.

The penis functions as a “pistol” to place DNA deeply into the female’s reproductive tract with ejaculation a necessity for the process. Similarly, the female genitals need to be sufficiently lubricated to optimize this process and the combination of vaginal lubrication from enhanced blood flow contributed to by Skene’s and Bartholin’s secretions will optimize nature’s ultimate goal.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

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