SEX EDUCATION TO ADOLESCENTS

( By Dr. Vithal Prabhu )

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Sex Organs

Sex organs are the organs that are involved in the process of reproduction. It is nature's way to produce progeny of its own kind, so as to maintain the propagation of life. The sex organs are also called as “genitals”.

Male Sex Organs:

Testes, vas deferens seminal vesicles, prostate, cowper’s glands and penis are the male sex organs. Penis and testes are visible, while the vas deferens seminal vesicles, prostate and cowper's gland lie inside the lower abdomen.

Penis:
Penis is a tubular organ drooping on the scrotum. When stimulated it gets filled up with blood and becomes rigid, flaccid elongated and straight. The urinary passage called ‘urethra’ passes through the penis. Semen is also thrown out through the same passage. There is no muscle or bone in the penis. The length of the flaccid penis (rigid as well as flaccid) varies from person to person, just as the height of different persons vary. The average length of a rigid penis is about 5 inches. Even a 2.5 inches long and rigid penis is considered to be normal, since it can effectively perform all the necessary functions (i.e., urination, ejaculation of semen and intercourse).

The penis is made up of three long spongy tubes. The upper two tubes are called “corpora cavernosa” and lower one is called “corpus spongiosum” through which the urethra passes out. All the three tubes are enveloped in a sheath called “Tunica Albuginea” which limits the girth and length of the penis. In an unstimulated state the penis is filled with little blood and remains flacid like a deflated balloon.

During the stimulation, the blood vessels open up and the blood rushes to the tubes and gets locked up. The penis, like an inflated balloon, becomes long and erect. After the ejaculation of semen (or when the stimulation stops) the locked up blood rushes back to the body and the penis becomes flaeid once again. The bulbous portion at the tip of the penis is called “Glans Penis.” The rest of the penis is called “Shaft of the Penis.”

The groove between the glans and the shaft is called “Neck of the Penis.” The glans and a thin fold of skin underneath, called “Frenulum” are most sensitive to sexual stimuli.

The entire penis is covered with skin. The part of the skin covering the glans, called “foreskin” or “prepuce”, can be moved to and fro like a sleeve. The foreskin can be retracted over the glans except at the frenulum where it remains attached to the glans, nearly upto the urethral opening.

After puberty (coming of age or beginning of the adolescence) a thick white pasty secretion is produced by the skin over the glans penis. This secretion is called “Smegma.” It has an offensive odour and therefore should be cleaned every day by retracting back the foreskin, while taking bath. The urine from the urinary bladder and the semen from reproductive glands come out through the same passage in the penis called “urethra.” However, they do not mix with each other, since there is a “bivalve” mechanism.

When the semen has to come out, the urinary bladder outlet gets closed and vice versa. The semen contains spermatozoa (sperms), the male reproductive cells. Boys get unnecessarily anxious about the girth, length, angle, rigidity or shape of the penis. This is because of the myth that the pleasure of sex for men and women depends on the size and shape of the penis. The function of the penis is merely like a dropper to drop the semen upto the mouth of the uterus to facilitate fertilization.

The nature has combined “procreation” with “recreation”, so as to make propagation of life effective. It is only the glans in the males that is sensitive to sexual stimuli; and only outer one inch of vagina in females that can perceive sensation. Therefore, neither for males nor for females, the sexual pleasure will depend upon the size and shape of the penis.

The girls love the person and not his sex organ. Penis is not their pleasure instrument; the person is. In fact, some girls have a fear in their mind that the insertion of penis in the vagina may be painful. They fail to realise the fact that the vagina is so stretchable that any size of the penis can be accommodated without any pain. Boys fail to realise that the vagina is not so sensitive to sexual stimuli, but the clitoris is.

The size of the penis and the duration of the intercourse have no place in sexual satisfaction of a woman. Sexual intercourse for her is more of caring and sharing of the love rather than mere penetration of the penis in the vagina.

Testes:
The bag of skin under the penis is called “Scrotum”, which contains two testes (testicles). Each is of the size of a marble. Each testis constantly produces innumerable spermatozoa or sperms, (the male gamates) in a number of seminiferous tubules. It also produces the male hormone called “Testosterone.” This hormone is poured into the blood and it circulates throughout the body. It is the testostorone that brings about physical and psychological changes at puberty in males and is also responsible for the production and maturity of the sperms.

In some boys, one testis is little lower down than the other. This is quite normal. Some boys have only one testis in their scrotum, the other being in the abdomen. One testis produces enough number of sperms and the man can very well father a child. However, the undescended testis may shrink and later may develop cancer.

It is wise to bring down the testis into scrotum by surgery before the age of six years. The nature has judiciously brought the testes of the man outside his body so as to make its temperature two degrees F. less than the rest of the body. This is to facilitate fast production of the sperms. There are muscles in the scrotal wall which contract or relax depending upon the temperature of the surroundings and hence regulate the temperature of the testes.

We human beings undo this natural regulation of temperature of testes by using a “langot” (or a tight underwear). Langot is used with an idea to prevent hernia or hydrocoele. The fact remains that langot cannot prevent hernia or hydrocoele, but it does harm by raising the temperature of the testes and interfering with the production of the sperms. Therefore, it is wise not to use a langot or a tight underwear. Testis is not a vital organ. A man can survive even after the testes are removed. If removed before puberty, the boy will not develop the changes that take place at puberty and during the adolescence. If removed in the adulthood, he will not produce sperms.

In some individuals the scrotum feels as if it is a bag of worms. There are dilated veins in the scrotum. Due to the warmth of the blood in these veins, the sperm production may deteriorate and may lead to infertility. In that case an operation to ligate the veins may be necessary. The sperms from the testis pass through a hollow tube called “Vas deferens” up into the lower abdomen and are stored in a dilated end portion of the Vas deferens called as “ampula” till they are mixed up with the other secretions to form semen.

Seminal Vesicles and Prostate:
Near the ampula on each side is a hollow pouch which produces a colourless secretion for nutrition of the sperms. This pouch is called “Seminal Vesicle”. The contents of the ampula and of the seminal vesicle are thrown into the urethra through a common tube called “Ejaculatory Duct.” Prostate is gland of the size of a betal nut situated around the urethra and below the urinary bladder. It produces a milky secretion for the motility of the sperms and pours it in the urethra.

The sperms, along with the secretions of the seminal vesicles and the prostate, get mixed up in the urethra to form the “semen” at the time of the sexual climax. Cowper's Glands (Bulbo-Urethral Glands) These are two pea-sized glands each situated on either side of the urethra. The colourless secretion produced by it on sexual stimulation is poured into the urethra through a small duct. This secretion serves as a lubricant and also neutralizes the acidity of the urinary passage.

Female Sex Organs

Vulva, vagina, Bartholin’s glands, uterus, fallopian tubes and ovaries are the female sex organs. All the sex organs of the female, except vulva are inside her body.

Vulva:
“Vulva” is a collective term for the external sex organs that can only be seen on separation of the thighs of a female. Just above the vertical cleft in the midline is “Mons Pubis”, a pad of fat over the pubic bone, under the hairy skin. The vertical cleft in the midline is guarded on either side by “Labia Majora” (major lips) which stretch from Mons Pubis to the lower end of the cleft, in front of the anus.

They are pads of fat covered with skin and hair. When major lips are separated, two vertical thin folds of skin without hair are seen. These are sensitive and are called “Labia Minora” (minor lips). The minor lips unite upward to form a hood where small budlike projection is seen. This is called “Clitoris”, which is the counterpart of the penis and is equally sensitive to sexual stimuli. Clitoris swells up slightly during the sexual stimulation. The clitoris is partly covered by the hood of the labia minora, which produces smegma as in males, and therefore needs cleaning daily. At the lower end of the vertical cleft is the vaginal opening, guarded on either side and below by labia minora. This opening is covered by a thin membrane with one or more openings in it for the menstrual flow, and is called “Hymen.”

Between the clitoris above and vaginal opening below, there is a small opening, small enough to allow the tip of a ball pen. This is the opening of the “Urethra” through which urine is thrown out.

Bartholin's Glands (Greater Vestibular Glands):
There are two small openings of the Bartholin’s (greater vestibular) glands, one on either side of the vaginal entrance. These glands are situated under the major lips and produce a sticky and colourless secretion on sexual stimulation, that acts as a lubricant.

Vagina:
Vagina is a three inches long hollow muscular tube in the female. The outer vaginal opening is situated at the lower end of the midline vertical cleft of the vulva, about two inches in front of the anus. The opening is covered by a thin membrane called “Hymen” having one or more apertures for the menstrual flow. At the inner end of vagina, the cervix of the uterus enters into it.

The direction of the vaginal barrel is upwards and backwards, i.e., towards the spine. The entire vaginal barrel is lined by a velvety, soft and multifolded layer of mucus membrane which remains wet like our mouth. On receiving the sexual stimuli, the vagina produces profuse watery secretion (like saliva in the mouth) which acts as a lubricant during the intercourse. This secretion decreases after the menopause, i.e., around the age of 45 years when the menstrual periods stop. When the sexual stimuli continue, the inner two-third of the vagina dilates and the outer one-third narrows, turning the vagina into a pitcher like structure. This is nature’s way to hold the pool of semen. If the woman gets orgasm, the outer one-third of the vagina contracts rhythmically. It is only outer third of vagina that is sensitive to touch. The inner two-third is insensitive.

Sensuous stimuli are appreciated by the clitoris and not by the vagina. Vagina serves as a passage for the following three functions:


  1. At the intercourse, for the passage of semen inside.


  2. At the menstruation, for the passage of menstrual flow outside.


  3. At the delivery, for the passage of the baby outside.

The vagina is highly stretchable. It can accommodate a penis of any length and any girth. Not only the penis but also the head of the child which has a circumference of 35 cms. Normally, the two walls of vagina remain collapsed over one another, like a deflated balloon. Boys have a misconception that the vagina is a pleasure-organ for the girls. It is not.

Girls at puberty or later complain of white discharge from the vagina. Normal vagina is always moist. The vaginal discharge normally increases just prior to the menstruation, during the ovulation (i.e., 14th day after the commencement of the period) and on receiving sensuous stimuli, e.g., petting, seeing a romantic scene or reading a romantic novel. This is absolutely normal. However, the vaginal discharge also increases during the infection by Monilia or by Trichomonas. The monilial infection causes severe itching and milky white discharge. Trichomonal infection also causes itching, pain and greenish yellow foul-smelling discharge. In such a case the girl should contact the doctor and get treated.

A slight white or brown spotting on the underwear should not cause anxiety; but profuse, foul-smelling, yellowish green coloured discharge associated with pain or itching needs medical attention. Vaginal infection comes through the intestines or through the intercourse. If the male partner has a STD (sexually transmitted disease), or HIV/AIDS the female partner gets it and vice versa. To avoid the infection from the intestines, the girls have to take little care while washing and taking bath. They should wash the front side first, i.e., Mons, labia, clitoris, urinary and vaginal openings and then wash the rear, i.e., anus and buttocks. This will prevent the intestinal infection from entering into the urinary or the vaginal passage.

Uterus:
Uterus is a three inch long and a hollow muscular organ, looking like an inverted pear, over the inner end of the vagina. The lower narrow end protrudes in vagina and is called “Cervix” (neck). The opening of the uterus is called “Os” (mouth) of the cervix. The inner lining of the uterus is called “Endometrium.” This lining grows, disintegrates and is thrown out through the vagina in the form of “menstrual flow.” This happens every month during the fertility age (13 to 45 years) except when the woman is pregnant. The embryo grows here in the uterus for 263 days before entering into this world.

Fallopian (Uterine) Tubes:
The Fallopian tubes are the two long hollow tubes, one on either side of the broad upper side of the uterus. Each is the four inches in length. Its one end is attached to the uterus and the other end is free over the ovary of the same side. Free end of the Fallopian tube has finger like projections called “Fimbria” to attract the ovum. Fallopian tube has three important functions: reception, fertilization and transportation of ovum. It receives the ovum from the ovary, the ovum meets the sperm and gets fertilised here (a real birth place) and the fertilized ovum gets pushed forward into the uterus.

Ovaries:
The ovaries are two oval sex-glands situated one on either side of the uterus. The ovary is of the size of an almond and contain 5 to 10 lacs of “Graffian Follicles.” During the fertile life span of a woman, only 400 to 500 follicles mature and the rest of them degenerate. Every month one Graffian follicle matures and expels out one ovum (the female gamate). This process is called “ovulation.”

The ovaries produce two hormones in the Graffian follicles, called estrogen and progesterone. These hormones are responsible for the puberty changes in the girls, their menstrual cycle, pregnancy and delivery.

Pubic Hair
Hair begins to grow around the sex organs at the age of about 11 years. This is one of the first signs of puberty. Girls develop hair earlier than boys. Some have scanty while some have plenty of pubic hair. The distribution of hair differs in the males and in the females. The males develop hair on the scrotal sac, around the root of the penis and upwards upto the umbilicus (navel) in the midline.

The females develop hair on the libia majora and on the mons pubis only. The pubic hair should be washed well and kept clean. In a humid and warm country like ours, excessive perspiration may lead to itching due to fungus infection. Trimming the hair periodically is desired. Some are of the opinion that the hair stimulates the female sex-organs during the intercourse and hence should be preserved. The choice is theirs.

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