Variants of the physiological norm of the menstrual cycle. Physiology of menstruation. Cyclic changes in a woman's body during the menstrual cycle

The female body is an incredible creation of nature, fraught with many features and mysteries. The sex hormones that are produced in the female body determine all the main differences between men and women: appearance, emotional background, way of thinking, and so on. Every month, a woman's body undergoes cyclical changes that affect the activity of all its organs and systems. Knowing these features and understanding what happens to the body in a certain period is very important for every woman. the site offers to understand the physiology of the menstrual cycle.

Cyclic changes in a woman's body during the menstrual cycle

For about 30 years, the body of every woman is in the reproductive period, that is, a woman aged on average from 17 to 50 years old is able to bear and give birth to a child. Every month a woman's body provides her with such an opportunity through the production of an egg and the creation of optimal conditions for its fertilization and the transformation of an embryo into a fetus. The reproductive function of the female body is carried out due to the activity, first of all, of the uterus and ovaries. In the ovaries, an egg matures every month, and hormones are produced that prepare the uterus to receive a fertilized egg. All these changes occur every month and are called the menstrual cycle.

Menstrual cycle:

• the concept of the menstrual cycle and menstruation: what is it;
• what changes occur in the ovaries during the menstrual cycle;
• what changes occur in the uterus during the menstrual cycle.

The concept of the menstrual cycle and menstruation: what is it

Very often, women confuse the concept of the menstrual cycle and menstruation. An important point is also that it is necessary to analyze the state of the hormonal background of a woman strictly on certain days of the menstrual cycle. The menstrual cycle is called cyclical changes in all parts of the female reproductive system. The menstrual cycle begins with the first menstruation and continues until the menopause. Menstruation is the external manifestation of the menstrual cycle. This is bloody discharge from the genital tract of a woman, which periodically occurs as a result of rejection of the endometrium of the uterus, into which a fertilized egg has not implanted. The first day of menstruation coincides with the first day of the menstrual cycle. The duration of each menstrual cycle is the number of days that have passed between the first days of the next two periods.

What changes occur in the ovaries during the menstrual cycle

During each menstrual cycle in the ovaries of a woman, the growth and maturation of an egg occurs, which can be fertilized by penetrating the sperm of a man into the uterus. All this happens under the influence of hormones in several main stages:

• in the ovary, the primordial follicle matures, which consists of an immature egg located in the follicular and granular epithelium;
• later, the follicle passes into the preantral stage, while the egg increases and is surrounded by a membrane;
• the antral follicle is characterized by an increase in the number of cells in the granulosa layer that produce follicular fluid;
• the dominant follicle is formed from many antral follicles by the 8th day of the menstrual cycle;
• By about the 12-14th day of the menstrual cycle, ovulation occurs: the dominant follicle ruptures and a mature and ready-to-fertilize egg cell enters the fallopian tube cavity.

What changes occur in the uterus during the menstrual cycle

In parallel with the growth of the egg, cyclical changes during the menstrual cycle also occur in the uterus. The mucous membrane of the uterus is called the endometrium and it is in it that the fertilized egg is embedded and develops. From the first day of menstruation until the moment of ovulation, proliferative changes in the endometrium occur. In this period, the cells of the basal layer of the endometrium actively multiply, forming a loose superficial and thick layer containing tubular glands. After ovulation, the endometrial glands become more tortuous, their lumen expands and the production of glandular secretion increases. If fertilization of the egg does not occur, the endometrium is rejected and, together with the unfertilized egg, comes out in the form of bloody discharge, which is called menstruation. After menstruation, all changes in the ovaries and uterus that occur during the menstrual cycle are repeated anew.

From lat. menstruus ("lunar cycle", monthly) - periodic changes in the body of a woman of reproductive age, aimed at the possibility of conception. The beginning of the menstrual cycle is conventionally considered the first day of menstruation.

The duration of the menstrual cycle

The duration of the menstrual cycle (on average) is 28±7 days.

The duration of the cycle is determined by the physiological processes in the body of a woman.

Terminology

Menarche - the first menstrual cycle - is the central event in the period of sexual development, indicating the ability of the female body to reproduce. In humans, the average age of menarche is considered to be 12-14 years, with a norm of 9 to 15 years (9 years - early menarche, the onset of menarche after 15 years - primary amenorrhea). The timing of the first menstrual bleeding depends on factors such as heredity, nutrition, and general health.

The cessation of menstruation occurs at the age of 40-58 years (on average, at 47-50 years), during menopause, the reproductive function fades. The time of onset of menopause (menopause - a period characterized by irregular or complete cessation of menstruation) depends more on heredity, but some diseases and medical interventions can cause early menopause.

Phases

The processes occurring during the menstrual cycle can be described as phases corresponding to changes in the ovaries (follicular, ovulatory and luteal) and in the endometrium (menstrual, proliferative and secretory phases).

Follicular/menstrual phase

The beginning of the follicular phase of the ovary or the menstrual phase of the uterus is considered the first day of menstruation. The duration of the follicular phase, during which the final maturation of the dominant follicle occurs, is individual for each woman: from 7 to 22 days, on average 14 days.

ovulatory

Approximately by the seventh day of the cycle, the dominant follicle is determined, which continues to grow and secrete an increasing amount of estradiol, while the remaining follicles undergo reverse development. A follicle that has reached maturity and is capable of ovulation is called a Graafian vesicle. During the ovulatory phase, which lasts about three days, luteinizing hormone (LH) is released. Within 36-48 hours, several waves of LH release occur, and its concentration in plasma increases significantly. The release of LH completes the development of the follicle, stimulates the production of prostaglandins and proteolytic enzymes necessary to break the wall of the follicle and release a mature egg (ovulation itself). At the same time, the level of estradiol decreases, which is sometimes accompanied by ovulatory syndrome. Ovulation usually occurs in the next 24 hours after the largest wave of LH surge (from 16 to 48 hours). During ovulation, 5-10 ml of follicular fluid is released, which contains the egg.

Luteal/secretory phase

The period of time between ovulation and the onset of menstrual bleeding is called the luteal phase of the cycle (also known as the corpus luteum phase). Unlike the follicular phase, the duration of the luteal phase is more constant - 13-14 days (± 2 days). After rupture of the Graaffian vesicle, its walls collapse, its cells accumulate lipids and luteal pigment, which gives it a yellow color. The Graafian-transformed follicle is now called the corpus luteum. The duration of the luteal phase depends on the period of functioning (10-12 days) of the corpus luteum, at which time the corpus luteum secretes progesterone, estradiol and androgens. Elevated levels of estrogen and progesterone alter the characteristics of the two outer layers of the endometrium. As the endometrial glands mature, proliferate and begin to secrete (secretory phase), the uterus prepares for the implantation of a fertilized egg. Progesterone and estrogen levels peak in the mid-luteal phase, and LH and FSH levels decrease in response.

When pregnancy occurs, the corpus luteum begins to produce progesterone until the placenta develops and secretes estrogen and progesterone.

If pregnancy does not occur, the corpus luteum ceases to function, the level of estrogen and progesterone decreases, which leads to swelling and necrotic changes in the endometrium. A decrease in progesterone levels also enhances the synthesis of prostaglandins. Prostaglandins (PG) cause vasospasm and uterine contraction, the two outer layers of the endometrium are rejected. A decrease in the level of estrogen and progesterone also contributes to a decrease in GRF and the resumption of the synthesis of LH and FSH, a new menstrual cycle begins.

As soon as every healthy girl at the age of 11-15 begins to menstruate, which is an indicator of her body's readiness for childbearing, then there are problems associated with counting the days of the menstrual cycle and the legitimate question why menstruation does not occur, or vice versa, why the long-awaited pregnancy does not occur. . This makes a woman think and wait all the time, be in the dark about what happens to her every month. And so every month for decades.

An ideal period lasts 3-5 days and repeats every 28 days. However, for some women, this cycle takes 19 days or even less, while for others it lasts from 35 to 45 days, which is a feature of their body, and not a violation of menstrual function. The duration of menstruation also, depending on the organism, can vary within a week. All this should not cause alarm in a woman, but a delay of more than two months, called opsometry or more than six months - amenorrhea, should alert the woman and make sure to find out the cause with a gynecologist.

Menstrual cycle - This is a complex physiological process that continues in women up to 45 - 55 years. It is regulated by the so-called sex centers located in the middle part of the diencephalon - the hypothalamus. The changes that occur during the menstrual cycle are most pronounced in the uterus and ovaries. In the ovary, under the influence of hormones produced by the ovarian follicles, partly by the adrenal cortex and testes, the main follicle, which contains the egg, grows and matures. The mature follicle ruptures and the egg, together with the follicular fluid, enters the abdominal cavity, and then into the fallopian tube. The process of rupture of the follicle and the release of a mature (suitable for fertilization) egg from its cavity is called ovulation, which, with a 28-day cycle, occurs most often between the 13th and 15th days.

A corpus luteum forms at the site of the ruptured follicle. These morphological changes in the ovary are accompanied by the release of sex steroid hormones - estrogen and progesterone. Estrogens are secreted by the maturing follicle, and progesterone by the corpus luteum.

The release of estrogen has two maxima - during ovulation and during the period of maximum activity of the corpus luteum. So, for example, if the normal estrogen content is about 10 µg/l, then during ovulation it is about 50 µg/l, and during pregnancy, especially towards the end of it, the estrogen content in the blood increases to 70–80 µg/l per day. due to a sharp increase in the biosynthesis of estrogens in the placenta.

Together with progesterone, estrogens contribute to the implantation (introduction) of a fertilized egg, maintain pregnancy and promote childbirth. Estrogens play an important role in the regulation of many biochemical processes, are involved in carbohydrate metabolism, lipid distribution, stimulate the synthesis of amino acids, nucleic acids and proteins. Estrogens contribute to the deposition of calcium in bone tissue, delay the release of sodium, potassium, phosphorus and water from the body, that is, increase their concentration both in the blood and in electrolytes (urine, saliva, nasal secretions, tears) of the body.

The secretion of estrogens is controlled by the anterior pituitary gland and its genadotropic hormones: follicle-stimulating (FSH) and luteinizing (LH).

Under the influence of estrogen in the first phase of the menstrual cycle, called folliculin, regeneration occurs in the uterus, that is, the restoration and growth of its mucous membrane - the endometrium, the growth of glands that stretch in length and become convoluted. The mucous membrane of the uterus thickens 4-5 times. In the glands of the cervix, the secretion of mucous secretion increases, the cervical canal expands, and becomes easily passable for spermatozoa. In the mammary glands, the epithelium grows inside the milk ducts.

In the second phase, called luteal (from the Latin word luteus - yellow), under the influence of progesterone, the intensity of metabolic processes in the body decreases. The growth of the mucous membrane of the body of the uterus stops, it becomes loose, edematous, a secret appears in the glands, which creates favorable conditions for attaching a fertilized egg to the mucous membrane and developing the embryo. The glands stop secreting mucus, the cervical canal closes. In the mammary glands, from the overgrown epithelium of the end sections of the milk ducts, alveoli arise, capable of producing and secreting milk.

If pregnancy does not occur, the corpus luteum dies, the functional layer of the endometrium is rejected, and menstruation occurs. Monthly bleeding varies from three to seven days, the amount of blood lost is from 40 to 150 g.

It should be noted that different women have a noticeable difference in the timing of ovulation. And even for the same woman, the exact timing of the onset fluctuates in different months. In some women, cycles are characterized by exceptional irregularity. In other cases, cycles may be longer or shorter than the average - 14 days. In rare cases, it happens that in women with a very short cycle, ovulation occurs around the end of the period of menstrual bleeding, but still, in most cases, ovulation occurs quite regularly.

If, for one reason or another, ovulation does not occur, the endometrial layer in the uterus is thrown out during menstruation. If the fusion of the egg and sperm has occurred, then the cytoplasm of the egg begins to vibrate very strongly, as if the egg is experiencing an orgasm. Sperm penetration is the final stages of egg maturation. All that remains of a spermatozoon is its nucleus, where 23 chromosomes are densely packed (half the set of a normal cell). The sperm nucleus is now rapidly approaching the egg nucleus, which also contains 23 chromosomes. The two cores are slowly touching. Their shells dissolve and they merge, as a result of which they are divided into pairs and form 46 chromosomes. Of the 23 chromosomes of the sperm, 22 are completely analogous to the chromosomes of the egg. They determine all the physical characteristics of a person except gender. In the remaining pair from the egg there is always an X chromosome, and from the sperm there can be an X or Y chromosome. Thus, if there are 2 XX chromosomes in this set, then a girl will be born, if XY, then a boy.

Studies conducted at the National Institute of Environmental Medical Problems (North Carolina) showed that not only the actual conception of a child, but also its gender depends on the time of conception in relation to the time of ovulation.

The probability of conception is maximum on the day of ovulation and is estimated at about 33%. A high probability is also noted on the day before ovulation - 31%, two days before it - 27%. Five days before ovulation, the probability of conception is estimated to be 10%, four days - 14% and three days - 16%. Six days before ovulation and the day after it, the probability of conception during sexual intercourse is very small.

Considering that the average "lifespan" of spermatozoa is 2-3 days (in rare cases it reaches 5-7 days), and the female egg remains viable for about 12-24 hours, then the maximum duration of the "dangerous" period is 6- 9 days and the "dangerous" period correspond to the phase of slow rise (6–7 days) and rapid decline (1–2 days) before and after the day of ovulation, respectively. Ovulation, as we noted above, divides the menstrual cycle into two phases: the follicle maturation phase, which, with an average cycle duration of 10–16 days, and the luteal phase (corpus luteum phase), which is stable, independent of the duration of the menstrual cycle and is 12 -16 days. The corpus luteum phase is referred to as the period of absolute infertility, it begins 1-2 days after ovulation and ends with the onset of a new menstruation.

Menarche - first menstruation

Menopause - last period

Menstrual cycle- monthly, cyclic, changes in the whole body of a woman during her puberty and especially in her genital area. The duration of the menstrual cycle is counted from the first day of menstruation to the first day of the next menstruation. On average 28 (norm 21-35 days). The phases of the menstrual cycle proceed in connection with changes in the ovaries. In the premenstrual period, the functional and basal layers can be clearly distinguished in the endometrium.

Phases of the ovarian cycle:

1. Folliculin (follicular) phase. Lasts from 1 to 14 days of the menstrual cycle. During this period, the growth and development of the follicle from primordial to mature (graafian vesicle) occurs. This process occurs under the influence of the pituitary follicle stimulating hormone (FSH). Estrogens are produced in the ovaries during this phase.

2. Ovulation. It occurs in the middle of the menstrual cycle (about day 14). Ovulation is the rupture of a mature follicle and the release of a mature egg from its cavity, suitable for fertilization.

3. Luteal phase. Occurs after ovulation and until the end of the menstrual cycle. In the ovary, under the action of luteinizing hormone (LH), a corpus luteum forms at the site of the burst follicle, which begins to produce the hormone progesterone.

Phases of the uterine cycle:

1. Desquamation (menstruation). It lasts from 1 to 5 days of the menstrual cycle - this is the rejection of the functional layer of the endometrium. The functional layer breaks down under the influence of enzymes, is torn away and released outside in a place with the contents of the uterine glands and blood from the opened vessels.

2. Regeneration. Continues from 1st to 7th day of the MC. There is a restoration of the functional layer due to the growth of the epithelium

3. Proliferative. Lasts from 7 to 14 MTs. Angiogenesis (growth of blood vessels), growth of the uterine glands. Proliferation of cells of the basal layer. New epithelial lining. and thickening layer

4. Secretory. From the middle of the cycle to the end of the cycle. In the uterus, glycogen increases, vascularization increases, the glandular structure of the uterine mucosa acquires a mature form. If pregnancy does not occur, then the functions are the same! lung body and prohysterone levels are significantly reduced. The endometrium is losing its hormonal support and is ready to shed. And a new menstrual cycle begins.

The levels of estrogen and progesterone are low towards the end of the MC, which causes cyclical changes in the hypothalamic and pituitary structures. What is the cause of the new MC.

The reproductive system is organized on a hierarchical basis. There are 5 levels, each level is regulated by the higher standing structures by the feedback mechanism.

Cells of the hypothalamus integrate information received from different parts of the central nervous system. Cells of the hypothalamus are mediators for the pituitary gland. They are secreted in a pulsatile manner and transported to the anterior pituitary via the hypotheliorhypophyseal vessels. The pituitary gland produces ganadotropic hormones that stimulate the growth, development and endocrine function of the follicles and corpus luteum. Under the influence of hormones, the proliferation phase occurs, and the corpus luteum hormone causes a secretory transformation of the uterine mucosa.

If pregnancy does not occur yellow, the body undergoes a reverse development: the functional layer of the uterine mucosa undergoes desquamation, and a new MC begins.

The action of ovarian hormones.

Estrogens:

The development of female secondary sexual characteristics during puberty, including breast and lactiferous duct lobules, body hair and fat

Activation of the proliferation of the epithelium of the reproductive system, including the regeneration and growth of the endometrium in the first phase of the menstrual cycle

Stimulation of the secretion of cervical mucus of low viscosity, which facilitates the penetration of sperm during ovulation

Hypertrophy and increased contractile activity of the smooth muscles of the genital tract

Approach of the fimbriae of the fallopian tube to the ovulating follicle. What promotes egg transfer

Increased libido in the middle of the cycle

Actions of progesterone:

Progesterone is synthesized in significant quantities only during a certain period of the MC. It is synthesized by the corpus luteum and the placenta during pregnancy. Progesterone is a pregnancy hormone and its main function is to prepare the genital tract. It happens like this:

Transformation of proliferating endometrium into secretory

Discharge of thick, viscous cervical mucus that makes it difficult for sperm and presumably bacteria to enter

The formation of a full-fledged secretion phase promotes implantation and prolongation of pregnancy through various mechanisms, including blockade of the contractile activity of the uterus

A slight rise in basal temperature in the second phase of the cycle

Stimulation of breast growth

Proliferation(from lat. proles - offspring, and fero - I carry) - the growth of body tissue by cell reproduction.

TSH-thyroid stimulating hormone

AG-adrenocorticohormone

Written control on the issues: "female reproductive organs, the degree of purity of the vagina, the action of ovarian hormones"

Orally regulation of the menstrual type.

Physiology of the menstrual cycle - section Sociology, Fundamentals of sexology and sexopathology The beginning of the menstrual cycle is usually considered the day of the appearance of menstrual flow ...

The beginning of the menstrual cycle is usually considered the day of the appearance of menstrual flow (the 1st day of the cycle), and the end is the day preceding the beginning of the next menstruation. Cycle length varies from 21 to 40 days, with an average of 28 days (Vollman, 1977). Only a few women have such a regular cycle that they can accurately predict the day of the onset of menstruation.

The menstrual cycle is divided into three phases, which we describe in relation to the "average" 28-day cycle.

1. The first one is called the folliculin phase.. In the ovary, follicles begin to mature - oval-shaped vesicles formed by epithelial cells and containing a young egg. At the beginning of this phase, blood levels of estrogen and progesterone are quite low, and endometrial detachment occurs in the uterus, so that the bleeding surface is exposed. The exfoliated tissue of the endometrium, together with the blood, forms menstrual flow, lasting 3-6 days.

In the middle of the follicular phase (approximately between the 7th and 10th days of the cycle), estrogen secretion by the ovaries increases and, under the combined influence of these hormones, the developing follicle begins to prepare for ovulation.

2. Ovulation phase - release of the egg from the ovary - as a rule, in most cases, it occurs on the 14th day (with a 28-day cycle). However, we know examples of 28-day cycles in which ovulation occurred on a variety of days from the 9th to the 19th, as well as cases where it did not occur at all. The ovulation phase is the shortest phase of the menstrual cycle.

3. The third phase of the menstrual cycle, called the luteal, occurs immediately after ovulation and continues until the start of the next cycle. Its name comes from the Latin name for the corpus luteum (corpus luteum) - a cell mass that forms in the ovary at the site of rupture of the follicle after ovulation. The corpus luteum secretes large amounts of progesterone and estrogen, these changes prepare the uterus to receive a fertilized egg.

If fertilization of the egg does not occur, the corpus luteum degenerates 10-12 days after ovulation, the secretion of hormones drops sharply and the next menstruation occurs. Thus, menstruation occurs as a result of an abrupt cessation of hormonal stimulation of processes in the endometrium.

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St. Petersburg, 2012
As a result of studying the discipline, the student must: Know: the history of the development of sexual relations of people and the development of the science of sexology, psychophysiological aspects of sexual

Volume of discipline and types of educational work
Type of study work Total hours Semesters Auditor

Questions for self-examination of knowledge
Topic 1. Introduction. The concept of sexology as a science. Development of scientific sexology. 1. Why does a psychologist need to study and know sexology? 2. sec value

Topic 1.
Introduction. The concept of sexology as a science. Development of scientific sexology. There are many different reasons that I do

Sexuality is experienced and expressed
· in thoughts, · fantasies, · desires, · beliefs, · attitudes, · values, · actions, · roles and relationships.

In behavior, constructive sexuality is manifested by the ability
enjoy the variety and richness of experiences that arise in a situation of sexual interaction while simultaneously delivering pleasure to a partner, freedom from sexual prejudices

Destructive sexuality manifests itself in behavior
inability to establish deep, intimate relationships, avoidance of emotional intimacy as a burdensome duty or threat of losing one's own freedom, trust

A person with pronounced destructive sexuality is characterized by
Ø inability to spiritually and emotionally filled sexual partner interaction, to sexual "game", Ø perception of a partner only as an object (tool) for

Deficient sexuality manifests itself in behavior
low sexual activity or its absence; avoidance of real sexual contacts, up to the complete rejection of them, a tendency to replace real sexual relations

A person with severe deficient sexuality is characterized by
Ø lack of sexual desires, Ø poverty of erotic fantasizing, Ø weak emotionality even in personally significant relationships, Ø

Imelinsky K. (Sexopathology and sexology. M. 1986.)
In the development of sexology, 4 periods can be distinguished: the prehistoric period, characterized by few information about the sexual life of prehistoric people;

prehistoric period
Primitive man was not indifferent to the sexual sphere. Rock paintings of the early Paleolithic (1 million - 100,000 years BC), which include the first stage in the development of human culture, testify

Period of observation and pre-scientific research
In ancient times - in Western, Chinese, Indian and Arab cultures, they wondered about the value of sexuality, tried to classify various sexual behaviors with a philosophy

The period of sexological knowledge covers the 19th century, in which sexology was born, but has not yet emerged as an independent discipline.
... In the 20th century, various branches of science began to study the manifestations of sexuality related to their competence. And although the methodology of these studies was still meager, many facts came to light,

Ancient times
Although we have written historical records dating back almost 5000 years, information about sexual behavior and attitudes towards sex in different societies before the first millennium

The Ancient East
In other parts of the world, ideas about sex were very different from those just described. Much more positive was the attitude towards sex among the followers of Islam, Hinduism and in the Ancient East.

Middle Ages and Renaissance
During the twelfth and thirteenth centuries, as the Church gained more and more influence, early Christian attitudes towards sexuality were strengthened in Europe. Theology is often

Eighteenth and nineteenth centuries
When we discuss the customs that existed in this or that historical era, it must be remembered that they differed in different countries, in different strata of society or religious groups.

Multidimensionality of gender determination. Sexual dimorphism, Sexual differentiation
1. Determination of sex. In accordance with the modern multi-level model of sex determination (G.S. Vasilchenko et al., 1977), the following are distinguished

Genetic disorders
A true hermaphrodite is a person who has both testicular and ovarian tissues. Some hermaphrodites have a fully formed testicle and ovary, sexes

The effect of drugs on the developing fetus
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After the birth of a child, the biological factors of sexual differentiation are supplemented by social factors.
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Interaction of biological and social factors
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Sexual dimorphism, Sexual differentiation
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Masculinity and femininity
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Androgyny
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Birth and infancy
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Masculinity
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male reproductive system
It is much easier for a man to see and feel his genitals than it is for a woman to see her own. It is unlikely that a boy can remain ignorant of the sexual aspects of this organ. He learns about them

A mature human sperm is much smaller than an egg; its length reaches 0.06 mm, and in volume it is thousands of times smaller than the egg
The sperm can only be seen under a microscope; it consists of three parts: the head, body and tail. The head of the sperm contains the genetic material, i. chromosomes, and

female reproductive system
Vulva. The external genital organs of a woman, forming the vulva, consist of large and small labia, clitoris and perineum. Although the vagina has an external opening (entrance to the moisture

Menstruation
Menstruation refers to spotting that occurs about once a month in most women between the ages of 12 and 48. Although menstruation is part of the reproductive cycle

conception process
Pregnancy occurs as a result of the meeting of the sperm and the egg. For this to happen, the sperm must enter the vagina shortly before ovulation. At the same time, the sperm

Fusion of sperm and egg
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Fertilization
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Pregnancy
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Masters and Johnson's work on the physiology of sexuality
To get a general idea of ​​the nature of the sexual response, Masters interviewed 18 female prostitutes and 27 male prostitutes. Then, instruments were installed in the laboratory, traditionally used

From a scientific point of view, sexual arousal can be defined as the activation of a complex system of reflexes that involves the genitals and the nervous system. Goals

female orgasm
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Resolution phase
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Three-Phase Model of the Sexual Response Cycle
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The concept of the sexual constitution
In sexological practice, there is a need to correlate the intensity of the sexual life of an individual who has applied for help, not only with his age, but also with objective parameters that are determined by

The scale of the vector definition of the sexual constitution of women was proposed by I.L. Botneva
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achieve 50-100% orgasm
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Social aspects of sexuality and gender psychology
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Gender roles and sexual behavior
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double standard
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Sex and gender equality
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Gender identity means that a person accepts the definitions of masculinity and femininity that exist within their culture.
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Etiological factors and pathogenetic mechanisms of homosexuality are completely unknown
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Isaev D.D. holds a slightly different opinion. In particular, he writes the following
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Researchers who adhere to this approach emphasize that the development of sexual behavior is influenced by a wide variety of factors.

Universal theoretical model of psychosexual development
Researcher John Bancroft (Bancroft, 1990) proposed a universal theory of psychosexual development, which takes into account the various stages of physical and mental development.

Stages of formation and development of libido
LIBIDO (lat. libido - attraction, desire, desire; synonym - sexual desire): the desire for sexual intimacy. Mature sex drive is characterized by

Children's sexuality
Childhood is an unknown page in sex studies, since there are no reliable data on sexual behavior during this period for objective reasons. conclusions based on

Sexuality in infancy
The results of ultrasound examination indicate that reflex erection in male fetuses occurs several months before birth, i.e. during fetal development

Sexuality at school age
Six- and seven-year-old children usually already know very well about the main anatomical differences between people of different sexes and, as a rule, understand the inappropriateness of exposing the body in public. Undoubtedly

Hormones of puberty and sexuality
The increasing production of hormones during puberty contributes to the awakening of sexual sensations, erotic thoughts and fantasies in both boys and girls. John Money follows

The relationship between sexual development and the idea of ​​one's own bodily and spiritual appearance
Teenagers want to look attractive. This desire is most directly related to how they perceive their own body, what kind of image they have for themselves.

Knowledge of one's own body, its sensual and sexual needs and reactions
Teenagers are concerned not only with their appearance, but also with the study of their own bodies. This is not as easy as it may seem, because adults do not always take the trouble to explain all aspects to them.

Formation of gender identity
Renowned psychologist Erik Erickson (1968, 1985) believed that gaining a sense of gender and overcoming the insecurities that accompany this process are central to the development of

Knowledge of sexual and love relationships between people
The child begins to learn sexual and love relationships between people in early adolescence, when boys and girls develop the necessary social communication skills in the process of growth.

Formation of an individual system of sexual values
The formation of an individual system of sexual values ​​occurs in parallel with the search for oneself and is an important aspect of the development of a teenager. Answering the question: "What am I

Psychosocial characteristics of adolescence
1. Sexual fantasies Sexual fantasies and dreams are more common and more pronounced in adolescents than in younger children; often they accompany masturbators

Features of sexual behavior. Masturbation
Despite the widespread occurrence of this phenomenon, feelings of guilt and anxiety do not cease to torment adolescents involved in masturbation. According to Sorenson (1973), such negative

homosexual relationships
Kinsey's research has shown that many men in their teenage years have at least one homosexual relationship. Among adolescent girls, such relationships are much more common.

Consequences of sexual activity
Most of the authors who have studied the consequences of sexual activity in adolescents have focused on cases of unforeseen pregnancy. Social and psychological consequences of ra

Aspects of sexual identification in youth
For some young people, sexual identification is a major part of the overall identity, for others it is a minor part. Like many adults, most adolescents have both

“As much as we might wish otherwise, children are born sexually motivated, and parents constantly give them sex education lessons, consciously or unconsciously.

Principles of Sex Education
Ø The most important thing in the sexual education of children is the formation of a positive attitude towards lovers, intimate relationships and the birth of a child. Already at an early preschool age, children begin to form

Conversations with children 3-5 years old
At this age, children acquire knowledge about their body and basic life facts, they develop a consciousness of belonging to a particular gender. They start asking where babies come from and

Conversations with children 6-8 years old
Children of this age understand the more complex aspects of such phenomena as health, illness, death. They are interested in such things as birth, marriage, the father's role in childbearing. All children show sec

Conversations with children 9-12 years old
In the body of children of this age, the changes inherent in puberty are already taking place. Adolescents are extremely interested in their own body, appearance, which should be considered the norm. For some

Essential Elements of Compulsory Sex Education Programs
It would be a mistake to prescribe any specific sex education program to a school, since planning the thematic content of the program and choosing the main approaches to presenting the material is

The absence of organic disorders, diseases that interfere with the implementation of sexual and reproductive functions
The ability to enjoy and control sexual behavior is formed gradually in the process of psychosexual development, therefore, before a certain maturity, from a formal point of view, the subject

Identity and identification
The most important mechanism for the formation and maintenance of the stability of self-consciousness is identification. On the one hand, this concept means assimilation, identification with someone or something, with

gender identity
A particular aspect of self-awareness is gender identity. I.S.Kon (1988) defines gender identity as "the unity of behavior and self-awareness of an individual who

The reason for this, he believes, is the repressive attitude of the environment towards the masculine behavior of boys in the masculine orientation of sexual culture as a whole.
In boys with feminine traits, the risk of psychological maladjustment increases with age, their systemic organization of character is represented by more conflicting and potentially pathogenic combinations.

Gender role, gender identity
The gender role is understood as a model of behavior, a system of prescriptions that an individual must learn and comply with in order to be recognized as a man.

Middle age crisis
In the context of sexual life, men seem to experience such a crisis especially often. There is an opinion that at the age of forty men bypass the peak of "sexual form". After hearing about it,

sexual burnout
Another significant feature of the midlife crisis, which is usually forgotten, is sexual burnout - a phenomenon that affects up to 20% of all persons in this age group (Kolodny, 1983

Other aspects
Most men "discover" their sexuality in that joyful time when they are not yet twenty years old. At the same time, a significant part of women (at least in the past

Menopause
With age, a woman loses the ability to bear children. The weakening of the reproductive function begins after 30 years and is initially expressed in a decrease in the probability of conception and an increase in the number of spontaneous

Elderly age
In America, it is generally accepted that sex is an activity for young, healthy and attractive people. People who have just entered puberty usually feel uncomfortable at the very idea of ​​sex.

Biological aspects of aging
Aging does not in itself reduce a woman's sexual interests or her potential ability to respond to sexual stimuli, as long as her general well-being is normal.

Psychosocial aspects
Society's negativism about love and sex in old age is partly generated by a phenomenon called ageism - prejudice against people on the grounds that they are old.

Pathological sexual deviations
A. Progressive forms (sexual perversions). B. Impulsive forms. Sexual disorders will be discussed in detail below, in the relevant topics. Here and gave

Paraphilia
(from the Greek words "para" - near, near, and "philia" - attraction), that is, "wrong attraction." Paraphilia does not necessarily violate social norms or is

But if the same irritant becomes an indispensable condition for sexual satisfaction, then this is already a deviation
A person's awareness of their differences in behavior and feelings often leads to the emergence of an internal conflict, the strength of which depends on the attitude of society towards that.

sadistic personality
For a sadist, sexual pleasure is possible only with complete dominance, unlimited dominance over a partner, mastering him and subordinating him to such an extent that he can even be hurt

Sexual crime, according to some modern data, is the result of the development of aggressive-sadistic inclinations of the individual.
Ø In the old works, it was stated that sexual offenses are the result of an irresistible desire to immediately satisfy one's sexual passion. Ø

There are simpler explanations
Ø The child experienced the first erotic sensations during the spanking, and in the future he associates sexuality with spanking or a belt. This is one of the most dangerous and unpredictable

Varieties of sadomasochism
Name Description Dippoldism

Sexual deviations in relation to the object. Pedophilia; gerontophilia; bestiality; fetishism; transvestism
Pedophilia (from the Greek words "pedes" - child and "philia" - attraction) - sexual attraction to children - occurs both among heterosexual and among

Ephebophilia (from the Greek word "epheb" - teenager, youth) - sexual attraction to persons of adolescence and youth
Attraction to 14-16-year-olds is not a psychiatric diagnosis, although in most countries, including Russia, sexual relations between adults and persons of this age are prohibited by law. AT

Gerontophilia - sexual attraction to the elderly and senile age
At the origins of gerontophilia lies the attitude of a child to an adult as an ideal, an idol, a role model. Lack of attention to oneself, disruption of communication with parents, lack of care with hundred

Necrophilia - sexual attraction to corpses and sexual acts with them. Occurs extremely rarely
Orgasm in children of both sexes is often combined with the affect of fear and anxiety, which is why an initially neutral anxiety state (for example, upcoming class work) can cause an orgasm. For sex

True transvestism is a perversion in which dressing in the clothes of the opposite sex causes sexual pleasure.
For transvestites, it is women's clothing that gives maximum sexual pleasure, while the rest of the time they dress and behave like other men. Dressing up is often combined with self-gazing.

Transvestism can have different causes and motives
Ø In one case, it is directly related to the circumstances that caused the first strong sexual arousal: the boy puts on his older sister's underwear, an unusual situation causes him a strong

Transsexualism. Gender identity disorders
Transsexualism is an emotional and mental characteristic of a person who denies his biological sex. In recent years, the prevailing opinion among specialists is that sexual

The phenomenon of transsexuality
In 1953, the world was shocked by the news that Christine Jorgensen, a former US Marine, had been operated on in Denmark to change his gender from male to female. Since then trans

It is assumed that both biological and psychological factors are involved in the formation of the transsexual state.
In the best-studied cases of transsexuality, subjects were characterized by a lifelong sense of inadequacy as to what gender they perceive themselves to be and who they are.

Transsexualism
Desire to exist and be accepted as a person of the opposite sex, usually combined with a feeling of inadequacy or discomfort from one's anatomical sex and the desire to receive a hormone

Dual role transvestism
Wearing clothing that is appropriate for the opposite sex as part of a lifestyle in order to enjoy the temporary feeling of belonging to the opposite sex, but without the slightest desire

Gender identity disorder in children
Includes a range of disorders that first appear in childhood and always before the onset of puberty, which are characterized by a constant pronounced dissatisfaction with the sex of registration, which is accompanied by

Features of sexual disorders (dysfunctions). "Norma" and sexual health
Sexual health. It is quite difficult to define the concept of human sexual health. It should include not only psychological, physiological and

Norm in sexology
First of all, it is necessary to remember that the concept of the norm is ambiguous in clinical psychology. A meaningful definition of the clinical norm as a theoretical construct is a great methodology

B.S. Bratus (1988) developed the concept of "normal development"
The conditions and criteria for this development are: Ø attitude towards another person as a value in itself, as a being that embodies the infinite potential of the "human" kind

Disorders associated with the phase of sexual desire (desire)
Sexual desire, or libido, is the desire for sexual intercourse associated with erotic-sexual activity. abnormal increase

sexual anorexia
A complete loss of sexual desire (sexual anorexia) can be caused by psychogenic factors, but it can equally become a biological manifestation of depression, alcoholism, and cancer intoxication.

Sexual avoidance disorders and sexual phobias
The immediate manifestations of sexual avoidance disorders are the patient's irrational fear or complete aversion to sex. Obsessive fear of the patient

The implementation of sexual intercourse. Phase of sexual arousal
For sexual intercourse, a man must have an appropriate erection that appears involuntarily during sexual arousal. Insufficiency of erection or its absence, as well as its short

Orgasm phase
Achieving orgasm can be greatly facilitated or difficult. The rapid achievement of orgasm in a woman rarely becomes a subject of her concern, since she can continue without any difficulty.

erectile dysfunction
For sexual intercourse, a man must have an appropriate erection, which appears involuntarily during sexual arousal. Insufficiency of erection or its absence, as well as its short

Psychogenic impotence
The leading pathogenetic link in psychogenic impotence is a decrease in the sensitivity of the cavernous tissue to the effects of erection neurotransmitters as a result of the direct inhibitory effect of the cortex of the head.

Diseases and other causes
It is important to keep in mind that about 50% of patients on extracorporeal dialysis suffer from erectile dysfunction. At the same time, after a successful kidney transplantation, the potency is restored in

Psychological factors
There is an opinion that about 50% of men experience certain difficulties with erection, and on an organic basis, these difficulties occur in 15% of cases. Contributing

Then the organic cause of impotence is excluded, and you can not spend money on an unnecessary and expensive diagnostic test.
The signs that distinguish functional changes from organic ones are the following: Ø the occurrence of an erection during sleep, due to the phase of rapid eye movements, in advance

For those who have sexual experience, in the absence of any failures in their sexual life, there is disbelief in the success of the upcoming copulation
Against the background of an excessive concentration of attention on the sexual sphere and the functioning of the genital organs, attempts at constant self-control, a fear of sexual life, coitus, and people who are opposed to sex develops.

Priapism condition requires medical intervention
Orgasm disorders (orgasmic dysfunction) It should be noted that normally orgasm in men is closely associated with ejaculation, therefore,

The inability to control ejaculation to the extent that is sufficient for both partners to enjoy sexual intercourse
Premature ejaculation can be caused by psychogenic and organic factors (diseases of the male genital organs, organic lesions of the brain).

There are absolute and relative forms of premature ejaculation
ü In the first case, the duration of sexual intercourse is less than one minute (less than 20 frictions) against the background of regular sexual activity, ü in the second case, the duration of sexual intercourse is

Psychotherapeutic treatment of psychogenic and combined sexual disorders in men should be based on the reasons that caused them.
It is extremely important to determine: ü whether the disorders are individual or ü partner. Personally oriented psychotherapy is shown, it is possible

Adopted in 1999 by WHO, the nosological unit of sexual dysfunctions in women combines a wide range of sexual disorders in women: disorders of the phase of desire, arousal, and achievement

Frigidity
Frigidity (sexual coldness) is the complete absence or decrease in a woman's sexual desire, specific sexual sensations and orgasm. In some cases, frigidity may be accompanied by cravings.

However, orgasmic phase disturbances are possible in the absence of disorders of the first two phases.
Occasionally, women with reduced sex drive may experience arousal and orgasm due to effective sexual stimulation, although this is very rare. From Russian

Mental and physical fatigue are the most common causes of a temporary weakening of a woman's sexual desire.
With symptomatic frigidity of libido caused by gynecological diseases, erotic dreams, extracoital orgasm and sensitivity of erogenous zones can remain intact.

anorgasmia
Anorgasmia refers to the absence of a sensual “peak” (orgasm) during sexual stimulation. As an independent sexual disorder

There are 3 degrees of severity of vaginismus
Ø In the extreme form, the entrance to the vagina is compressed so much that it is impossible to enter not only the penis, but even a finger into it. Ø With a milder form of vaginismus, any attempt

Sexual disharmony can manifest itself in different ways.
In one case, there is an uneven level of sexual desire: he wants to have intercourse more often than she does, or vice versa. This is the most common partner dysfunction; by subs

Unconscious causes of sexual disharmony
SA Chernysheva (Moscow)] Proceedings of the scientific-practical conference "Sexual culture and sexual health of the nation". May 12, 2002, P

Multidimensionality of gender determination. Sexual dimorphism. Sexual differentiation
Issues to be discussed: 1. Determination of gender. The sequence of sex formation in humans: chromosomal (genetic) sex, gonadal, hormonal sex. 2. Shaping

Social aspects of sexuality and gender psychology. Homosexual personality orientation
Issues for discussion: Sociocultural approach in sexology. Psychosexual culture, its possibilities, forms of transmission. Permissive (permissive) and r

Sex education and education. Sexual consciousness. sexual health
Issues for discussion: Repressive, avoidant, obsessive and expressive types of parental attitudes towards gender issues. Sex education as a process of gender

Psychosexual identification and gender role identity
Issues for discussion: 1. Concepts of identity and identification. 2. E.Erickson's identity theory. 3. Gender identity as a unity of behavior and self-consciousness

Sexual deviations "according to the method of implementation." Sadism, masochism, sadomasochism. Exhibitionism, voyeurism
Issues for discussion: Sadism - definition, origin of the term. Sadistic tendencies - realization in action and fantasy. Combination with other deviations.

Sexual deviations in relation to the object. Pedophilia, gerontophilia, bestiality, fetishism, transvestism
Issues for discussion: Pedophilia, definition of the concept, causes. Negative consequences for pedophilic objects. Attraction to 14-16-year-olds is ephebophilia.

Sexual disorders in men
Issues for discussion: Erectile dysfunction. Primary, secondary erectile dysfunction, (selective) erectile dysfunction. Classification of erectile dis

Sexual disorders in women
Issues to be discussed: Decreased sex drive. Frigidity Classification of frigidity. Anorgasmia. Prevalence. Primary and Secondary

Family-sexual disharmony (dysgamy)
Issues for discussion: 1. Diagnosis of family and sexual disharmony. 2. The most characteristic signs of dysgamy. 3. The variety of causes of partnership dysfunctions

Transsexualism
conviction in the "wrongness" of one's biological sex, the desire to belong to the opposite sex. Accompanied by the desire to change sex (surgically) and behavior imitation