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American Medical Association Family Medical Guide - American Medical Association [237]

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committed by a friend, classmate, or coworker. There seems to be a strong association between alcohol and acquaintance rape: more than half of women and two out of three men involved in sexual assault had been drinking when the assault occurred. Sexual assault by an acquaintance shatters trust, and the victim (usually a female) does not always get the support she needs from friends, coworkers, classmates, or school officials, who may side with the attacker. Victims may become depressed or anxious, may abuse alcohol or other drugs, and may attempt suicide. As with dating violence, victims of any kind of sexual assault should report it as soon as possible to authorities and get counseling from a trained mental health professional.

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Sexuality

Sexuality is the way in which we experience and express affectionate or erotic feelings, which are influenced by biological, psychological, social, and cultural factors. A satisfying sexual relationship is one of the most important aspects of life. The shared intimacy of sex can be a physically and emotionally rewarding experience. Sexual arousal is influenced by our feelings of attraction to another person and involves physical responses such as an erection or vaginal lubrication.

Sexual arousal affects the whole body. The skin is highly sensitive to arousal, especially the skin over the upper and inner thighs, the lower back, and the buttocks. During arousal, the genitals, earlobes, and nipples in both men and women become erect, and the lining of the nose becomes swollen and engorged with blood. The contractions of orgasm affect many muscles in the body, including those in the legs, back, neck, face, and toes.

Because the female sex organs are more interior than the male sex organs, some women may be unfamiliar with their own genitals. If you are a woman who has never seen her external genitals, you can look at them with a small mirror held between your legs. Your pubic hair covers the protective tissue known as the mons pubis, which lies over the external genitals. Underneath are two folds of skin called the outer lips or labia. Inside the outer labia are two inner lips, which cover the openings to the urinary tract and the vagina. The clitoris, the principal site of female sexual stimulation, is at the top, where the inner lips meet; the clitoris, like a man’s penis, becomes erect and swollen during sexual arousal. The vagina is a long, muscular canal that extends (at an angle) from the outside of the body up to the uterus. At the upper end of the vagina is the cervix, which is the opening of the uterus. During arousal, the vagina produces a fluid that lubricates it and makes penetration by the penis easier.

The female sex organs

Most of the female reproductive system is internal—and only the genitals are visible. The outer, visible area is called the vulva, which includes the mons pubis (the hair-covered mound over the pubic bone); the outer, hair-covered lips (labia majora); and the smaller, inner lips (labia minora), which protect the opening to the vagina. The clitoris is a tiny, sexually sensitive mound of tissue. During sexual arousal, the clitoris, the labia minora, the vagina, and the network of connecting blood vessels and muscles swell with blood.

For the most part, the male sex organs are external. The penis passes urine out of the body and expels semen (a mixture of sperm and secretions from the seminal vesicles and prostate gland) at orgasm. When a male is unaroused sexually, the penis is soft, but during arousal, blood rushes into the penis, making it swollen and erect. Sperm are produced in the testicles, two round, firm spheres enclosed in a pouch of skin called the scrotum. The testicles are outside the body because they must be cooler than body temperature to produce sperm. The left testicle usually hangs slightly lower than the right testicle. On top of each testicle is a coiled tube called the epididymis, in which sperm develop.

From the back of each testicle, a long, thin tube called the vas deferens extends up into an organ called the ampulla

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