Female Sexuality Facts

Facts, Theories, And Information on Female Sexuality:  
The Female Breasts

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The Female Breasts

There are three important aspects of women's breasts: they often give erotic pleasure, they have a large part to play in shaping a woman's self-image, and a woman can feed a baby with them. Men's breasts can give erotic pleasure, but they have little influence on self-image.

It is a normal reaction to stimulation for a woman's nipples to erect. Until menopause, if she has not breastfed a child, her breasts will increase in size under sexual stimulation. On the outside there are nipples, each surrounded by areola. Inside there are milk glands, which produce milk after delivery of a child, and milk ducts, which convey milk from the milk glands to the nipples. The remainder of the breasts is composed of fatty tissue and fibrous connective tissue that binds the breasts together and gives them shape.

Nipples

Nipples may point out prominently, they may have a flattened appearance, they may be set a bit deeper in the breast or they can be inverted. The normal range of variety in appearance is large. The milk ducts leading from the mammary glands in each breast converge and empty into the nipple, allowing a baby to suckle. Each nipple is supplied with nerve endings, which make it very sensitive to touch.

The thin muscle fibers present in each nipple enable it to become erect during sexual excitement, and in response to other stimuli such as cold.

Areolae

The areola (plural: areolae) is the darker pigmented area around each nipple; its color varies from woman to woman. It is quite normal to have small bumps in the areola - they are oil-producing glands that secrete a lubricant to make breastfeeding easier. During pregnancy the areolae become darker and remain that way to a degree after pregnancy. The size of the areolae varies from person to person.

Milk Glands

Inside each breast are 15 to 25 small milk-producing sacs. The milk they produce passes through ducts to the nipple, ready for the baby to suckle. Regardless of breast size, the milk glands are about the same size in each woman and they produce about the same amount of milk.

Milk Ducts

These ducts connect the milk glands in each breast to the nipple. The milk is produced in the glands, passes through the ducts and collects around the middle. Milk is produced in response to the action of two hormones, prolactin and oxytocin. Prolactin stimulates the milk glands to make milk, and as a baby suckles, more prolactin is released into the bloodstream to cause more milk to be produced.

Oxytocin causes the milk to move from the glands to the nipples in the process called 'let down." Sometimes a newborn baby does not suckle vigorously enough during the first day or two, so insufficient amounts of oxytocin are released into the bloodstream and "let down" is inadequate. Once the mother and baby learn the breastfeeding routine, everything works out properly.

The breasts produce a further substance, colostrum. Colostrum is not milk, but it is extremely nutritious. It is thick and yellowish and Is liable to drip from the nipples occasionally during the final weeks of pregnancy.

How breasts produce milk

Babies rely on colostrum for the first few days, until the proper milk flow arrives. Not only is colostrum rich in proteins but it also contains important protection against certain diseases to which newborn children are particularly liable. a

Q: "I have hair round my breasts. Do I have a hormone problem?"

A: "No. Many women have hair around their nipples. It is a perfectly normal part of being a woman. Many women accept the appearance of hair on the nipples as they accept pubic hair or leg hair, though some women remove it for cosmetic reasons. If you decide to remove yours, do it carefully as it is easy to irritate sensitive breast tissue."

Q. "Do women produce milk all the time?"

A: "No. Milk starts to be produced only when a woman is pregnant. The milk-producing glands in her breasts respond to the particular hormone changes that occur during pregnancy, and by the time the baby is born the woman will be ready to give milk. She will continue producing milk as long as the baby is breastfeeding. "

Q. "I don't get any thrills from having my breasts fondled or kissed. Am I normal?"

A: "Yes, you are. A lot of women find that they get very little erotic pleasure from their breasts, despite popular belief that all women do. It is often the case that a woman's breasts do more to turn her partner on than they do for her."

Q. "My breasts really get sore and swell up just before my period. Is that normal?"

A: "Yes, it happens to a lot of women. The shift In hormone levels and fluid build up and retention are the chief causes. If you avoid excessive salt, alcohol and refined carbohydrates, you may feel some relief."

Breast Size

Because of the enormous importance we attach to breasts, their size and shape, many women worry that their breasts are too small, too large, or just the "wrong" shape. As a culture, we often think of breasts as sex objects, not as living parts of someone's body, and that gives rise to all sorts of anxieties. The fact is that breasts vary just as much as faces - and for the same reason: that we are all unique.

Occasionally - and only occasionally surgery is desirable to reduce the size of uncomfortably large breasts. Only very rarely is there justification for surgery to increase the size of a woman's breasts.

Q. "What is the normal breast size?"

A: "There is no normal size. Breast size and shape are determined by heredity, but remember that regardless of size and shape It is impossible to tell anything from the size and shape of a woman's breasts. Almost every woman can breastfeed, and many can be aroused by touch as well."

Q. "Can exercise increase the size of my breasts?"

A: "No and yes. No amount of exercise can increase the amount of breast tissue you naturally possess, but exercise can tone up the chest muscles (pectoral muscles) and firm up the breasts, making some change in their measurement."

Q. "A friend of mine is taking the pill to make her breasts larger. Does that work?"

A: "It may. There is a slight increase in some women who take the pill, but there are risks in taking the pills indefinitely. She should have regular checkups."

Q: "My lover just started to take the pill to regulate her period, and I've noticed her breasts have enlarged, and she complains of tenderness. Is this common, or is there a problem?"

A: "It is quite common. A lot of women find that in the first few months of using oral contraceptives their breasts become tender. If the discomfort is severe, she should consult a doctor. Perhaps a different pill will overcome the problem. Slight breast enlargement is also common among women who use the pills. She should consult a doctor though if her breasts enlarge so much she needs to change bra size."

Q "I'm 15, overweight and very busty. One of my friends in the same situation lost weight and has these terrible stretch marks around her breasts. What can I do to avoid this?"

A: "Stretch marks around the breasts occur when the fibers of the skin lose their elasticity and ability to contract. So when weight is lost rapidly these marks show up and they remain. If you lose weight slowly over a long period of time, there is less likelihood of obvious stretch-marking. Also stretch marks that do appear tend to become less noticeable over time."

Q: "Can I make a woman come by breast stimulation alone?"

A: "Yes. Masters and Johnson found that a very small percentage of women can do this, but it is not sufficiently arousing for most women. It seems that in general it is partners who get more turned on by breasts." Because breasts have achieved such enormous importance as sex symbols, there are numerous common myths about them. Each of these is totally wrong:

  • larger breasts mean a woman is sexually active

  • breastfeeding causes breasts to sag

  • breast cancer is caused by a bruise or blow to the breast

  • a real woman's breasts stand out and her nipples protrude

  • smaller breasts are not good for breastfeeding

  • women aren't really concerned about their breast size - it's only men that care

  • hair around her breasts means a woman is manly

  • breastfeeding changes the shape of breasts permanently

  • women with smaller breasts are less interested in sex

  • men are always attracted to women with larger breasts

  • women do not get any feeling from touching their own breasts

  • all women enjoy having their breasts stimulated

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Women's breasts begin to develop at puberty; estrogen, a hormone produced by the ovaries, causes the nipples to bud and the milk glands and fatty tissue to grow. Breast development is often uneven, in that one may start to develop before the other, and no-one can say precisely when it will happen as there is no set order in which the events of puberty occur.

Under stimulation, a woman's nipples will normally erect, though the extent of the erection varies widely from person to person. A woman who has not breastfed and who has not yet reached menopause will probably experience some increase in breast size as she becomes sexually excited. The veins will become more obvious and the areolae will enlarge too and become darker.

This is due to vasocongestion, an increased blood flow - just the same thing as happens to her vagina. After menopause women still have nipple erection, but there is no increase in the size of the breasts, whether they have had children or not.

During pregnancy the areolae and nipples darken. Breast size increases rapidly during the first three months, so much so that most women have to change to a larger bra. At this time, a number of women report that their breasts feel tender when they are sexually excited.

A little over 50 percent of men report nipple erection when they are excited (but no increase in breast size), though they tend to lose this characteristic after the age of 55 or so.

Q. "My daughter's breasts started to develop a bit when she was three years old. Is anything wrong?"

A: "Probably not. Have your doctor check your daughter to see if her hormone level is proper for her age. It probably is, so don't alarm your daughter or make her feel self-conscious or abnormal. Puberty will occur as usual and development will be normal. If your daughter's hormone level is higher than it should be for her age, a hormone specialist (an endocrinologist) should be consulted. As a special case, it has happened that small children have eaten someone's birth control pills. Check that this is not the case with your daughter, but check with your doctor anyway."

Q: "My 11-year-old daughter's left nipple is developed and the breast enlarged."

A: "Sometimes the left breast will begin to develop sooner than the right. We don't know why this happens but we do know that it is not unusual. The other breast will probably catch up in size by age 15 or so. Reassure your daughter if she is concerned and try to prevent her from feeling too self-conscious about it."

Q: "I'm 13 and my breasts haven't begun to grow yet. I'm ashamed to go to a doctor and I'm worried."

A: "It is natural to worry when your breasts haven't developed when you want them to. You need to be patient for a bit because your body has its own timetable that triggers breast growth, and your time will come soon. If you go to a doctor, she or he will tell you to try to relax and allow your biological clock to respond in its own way. Incidentally, many adult women will remember the time when they were younger and felt the way you do now, and soon afterward they felt the relief you will when their breasts developed."

Q. "I'm 14 and flat-chested. One of my friends told me to wear a padded bra. I just don't know what to do."

A: "Wearing a padded bra ("falsies" as they are sometimes known) may give you some temporary comfort. Padded bras have been used by many women who weren't satisfied with their breast size. However, in your case you still have several years of development ahead of you. It may very well be that your natural breast development program hasn't been triggered yet. Remember also it is important for you to accept your own unique shape. Only you can look the way you do, and becoming content with your individuality will help your growing self-image and your ability to relate to others."

Q: "My brother is 15 and his breasts look like they have grown a little. Is that normal?"

A: "Yes. Around puberty the breasts of many boys do develop slightly. This is called gynecomastia and is probably due to very small amounts of estrogen in their bodies. As puberty goes on, hormone levels settle down and other parts of the body grow to balance up any breast increase."

Breasts in Relationships

As women and men said: "I used my breasts in relationships, they gave me power." "I felt nobody would want to go out with me because I was flat chested." "As I got older the importance of my breasts, and especially how other people felt about them, really diminished." "I felt men liked me only for my breasts." "I'm a breast man, so it is important for me to be in a relationship with a woman with big breasts." "Guys really started to go out with me when my breasts developed."

"For years I didn't want to expose my breasts because I was afraid to be judged by my lovers." "I think her breasts were more of an issue to her than to me." "As I learned to accept myself as a woman I didn't care how others liked my breasts or any other part of me." "Although her breasts were important to me when we were first together, our relationship has become much deeper." "Sometimes I get a sad feeling when I look at my sagging breasts - but life goes on."

One can see from these comments how the significance of breasts varies from person to person, and from relationship to relationship. There is also a distinct connection between the significance people attach to breasts and their stage in the life cycle. It is not unusual for young women to be seriously concerned about their breast size and shape as predictors of whether they can become involved in a relationship.

Some young women overcome feelings of anxiety and inadequacy by using their breasts as lures or as weapons in relationships. Men sometimes assign such importance to the size of a woman's breasts that just that one attribute may be the reason for starting a relationship - even for continuing one.

Although these values linger in some people, most are able to move beyond the simple physical aspects of a relationship. The beginning of this wisdom is the ability to accept yourself completely, recognizing that the kind of a person you are arises from the deepest parts of your personality and not from a single part of your body.

This is not easy when, as now, society's messages about who is successful in relationships concentrate on superficial, cosmetic aspects and not on people's more fundamental qualities. Even if it is difficult, it is one of the keys to a mature, lasting, fulfilling relationship in which sexual dysfunction like premature ejaculation is not a problem.

Ours is a culture in which "tits sell." The notion has overwhelmed advertising and the media. It has also made breasts perhaps the most commercialized aspect of sexuality. Despite the statements of many women who say they really aren't concerned about their own breast size, and similar protests from men regarding the relative lack of importance of women's breasts, the evidence is that breast size and shape matter enormously to a great many people. Breasts affect self-esteem, relationships - in fact sexuality in general to a profound degree: "It's what's up front that counts."

Unfortunately, many women (and men) feel that breasts need to be a certain size and shape in order to fit our culture's current standards of beauty and desirability. Standards change from decade to decade, so that recently we have gone from pointed bras and the sweater look of the 1950s to bra-lessness or natural-look bras in the 1960s and 70s.

Large breasts are sometimes in style, then smaller breasts, full looks, and understated looks, and so on. Women rush to keep in style and many men expect that the women with whom they relate will do so. Whether the need to change is commercially inspired or not, a great many people obviously feel that this is what they should do, however arbitrary it may seem.

Young girls express very strong feelings about their breast development. Such self-questioning also reflects the pressures young people feel to fit in and be like the popular image of sexy women. Of course they would like their breasts to be just right, but achieving that ideal is not something many young girls believe will happen to them.

At the same time that girls are beginning to worry privately about their breasts, family members and contemporaries start to comment and show a greater interest in their general development, but especially in their breasts. Imagine the feelings of humiliation when a parent, a brother or a sister points out the 12-year-old girl's two tiny mosquito bites.

On the other hand, having well-developed breasts can signal comments from peers about alleged early sexual activity and this leads some girls to overdo intellectual and academic interests as a compensation. Not being an early developer can lead to embarrassment and self-consciousness, and perhaps a withdrawal from relationships with friends.

Of course, some young girls develop at their own pace without too much fuss being made about size and shape and some young girls are very fortunate in being able to see their friends naked while changing for sporting events. This helps them to realize how varied breast size, shape and development can be.

During this period boys become very interested indeed in breasts, and sometimes obsessed with them. This comes from their own growing sexual interest but is also greatly influenced by our social and media attitudes; it is the beginning of how boys become "breast men." Around puberty boys learn words for breasts - jugs, tits, and so on - and by the time they have done that, they are well on the road to absorbing the breast lore that Western cultures are saddled with.

Much breast lore says that women's breasts are singularly sensitive to erotic touch, but some women find that this is not so, which may lead them to worry about their normality. At the same time men seem to be very interested in breasts, and one must wonder who this interest is for.

Men are truly shocked if they discover that all the time they may have been spending on their partners' breasts gave pleasure to themselves alone. Some people by the time they reach adulthood are imprisoned by conventional ideas about what is normal, average, sexy.

And in some cases women will have their breasts enlarged, reduced or shaped in a certain way to please someone else. It is true that this kind of surgery may positively influence a woman and her self-image but it stands out as a poor reflection on the character of a culture, when any person must alter her or his physical appearance to conform to the changeable standard of a society, in order to gain acceptance from others and personal value.

Problems that can occur with breasts fall into two categories. The more common, by far, is lumps. The less common is anxieties over breast size that affect a woman's mental health or prevent her from leading a fulfilling life.

Breast Lumps

When a woman discovers a lump in her breast, she isn't much comforted to know that 75 to 80 percent of lumps are benign and not cancerous. She is likely to be flooded with anxiety. She may hope that it will not be there tomorrow, that it will just go away. Ultimately, though, she will see her doctor, and probably be examined in one of the following ways:

Mammography: an X-ray of the breast which allows the doctor to evaluate the size, nature and depth of the lump. This test can detect breast tissue changes before they form a lump or before it spreads, but the risks of being exposed to X-rays prevent mammography from being used for routine screening.

Thermography: a temperature survey of all parts of the breast - it is quite safe. Cancer causes an increased blood flow to the area affected and therefore a higher temperature at that place. Thermography avoids the need for radiation, but it is not an absolutely accurate technique.

Needle Biopsy: usually done in the doctor's office with a local pain killer. The doctor inserts a needle into the breast and draws out fluid from the lump. The lump may break down or collapse immediately, indicating it was a fluid cyst. The fluid will be sent to a pathologist for examination. Usually this type of cyst is benign and soon disappears.

Surgical Biopsy: this is a surgical procedure usually done under general anesthesia, although local anesthesia can sometimes be used if the patient prefers. An incision is made in the breast and the lump is removed, leaving a scar on the breast about an inch or two long. The operation does not change the shape of the breast.

The tissue from the lump is then analyzed by a pathologist at a cancer center or university hospital. If the tissue is benign, the major concern is over and a routine treatment for the lump will be conducted.

 If the tissue is malignant (cancerous) the woman can discuss the type of surgery and/or other treatment she requires for her situation. The short delay in scheduling new treatment after a decision has been made does not complicate future treatment or affect the recovery.

Frozen Section: tissue is taken from a suspicious area, frozen immediately and examined to determine if it is benign or cancerous. This can be done in 15 minutes, but it is not as reliable as the routine pathologist's examination, which takes a day or two. When possible, the standard, longer tissue examination and diagnosis should be done.

Many women elect to have only a biopsy first and then surgery, if required, at a later date. This gives an opportunity to seek second opinions and allows the woman to prepare herself and her family for her surgery.

Noncancerous Lumps

Seventy-five to 80 percent of breast lumps are not cancerous. These are the two common benign conditions:

Fibroadenoma. This is a tumor made up of gland tissue and fibrous cells. It is firm, round, painless and movable, and is common in women between 15 and 40. Fibroadenomas may indicate a higher risk of cancer later in life, although this is not certain.

Fibrocystic Disease. These are painful cysts and produce a sense of fullness in the breast. The cysts contain fluid, which can be drawn off (aspirated) in the doctor's office if they grow large. The symptoms tend to be more obvious just before menstruation when the body generally retains fluid; they diminish after the period. As with fibroadenomas, the presence of fibrocysts may suggest a greater risk of developing cancer later in life.

Cancerous Lumps

Lumps in the breast that are cancer may feel solid, painless and immovable. They may appear in any part of the breast. Mastectomy, the surgical removal of the breast, is the most common form of treatment for breast cancer. There are several different types of mastectomy:

Radical Mastectomy. This is the oldest treatment for breast cancer and involves the removal of the entire breast, the chest muscles in that area, and the surrounding lymph nodes. This method has become very controversial and doctors and patients are questioning its long-term effectiveness compared with other, less severe types of surgery.

Modified Radical Mastectomy. In this operation the breast, near and superficial lymph nodes are removed.

Total or Simple Mastectomy. This is the removal of the breast alone. Lymph nodes and muscle tissue remain untouched.

Lumpectomy. The removal of the lump and the bare minimum of surrounding tissue - occasionally called a tumorectomy. This is controversial, as many doctors feel it is not enough to halt the reappearance or spread of the disease. The same objections are raised to partial mastectomy. In this procedure more tissue is removed than in a lumpectomy - as much as half the breast may be taken away.

Then there are three nonsurgical methods of treatment:

Chemotherapy, the use of powerful drugs that kill cancer cells. It may be used right after breast surgery or later, should the cancer reappear, and should only be given at a special cancer center.

Radiation Therapy. Generally, this treatment is used in addition to mastectomy. Powerful X-rays are focused on the cancerous areas to kill the cells and prevent their spreading. In some limited cases doctors may decide to use radiation first in an effort to avoid mastectomy.

Immunotherapy. A new technique designed to help the woman's body to use its own immune system to destroy cancer cells. This is done by using drugs to trigger the patient's immune system to combat the cancer cells.

Each of these methods has its advocates and detractors. It is clear that not enough is known about breast cancer and which kind of treatment is best for which person. However, people must think carefully and discuss fully the treatments available from local cancer care centers or university medical teaching centers and the consequences of each. The signs are that the medical profession is trying to improve and expand non-surgical treatment, so breast surgery may well begin to be used less.

After surgery, a woman with breast cancer must learn to live with her surgery. The normal medical concerns right after a mastectomy are to do with drainage of blood and tissue fluid, controlling the post-operational pain, and beginning to exercise the arm and shoulder, which is important in reducing any swelling of the arm that may have occurred.

These physical aspects are painful and distressing and must be attended to, but for many women the principal distress is the emotional impact of losing such a sexually significant part of the body.

In the broadest sense, mastectomy challenges a woman's sexuality because her body image, gender identity and role, and her erotic possibilities and her ability to become involved intimately with a partner can be profoundly affected: "I always found an excuse not to have sex - I felt like half a woman." "For a long time, my lover wouldn't look at me when I was nude." "During lovemaking I couldn't lean or take any pressure on that of my body." "I wondered what people were thinking when they looked at me." "I was glad I was alive, but sometimes I wondered if I could live with how I looked."

This is real pain and real suffering. Not every woman experiences it, but many do, and in order to overcome the effects of these feelings understanding, continuing support and communication are essential. Women do overcome the physical and emotional effects of mastectomy, but it isn't easy and the trauma to their sexual identity can be enduring.

The sooner sexual relationships can be resumed, with appropriate recognition of the surgery, the more easily problems will be avoided and overcome. And if sexual problems do occur, the quicker they are acknowledged and discussed candidly and sensitively, the more likely they are to be resolved without creating barriers.

The effects of mastectomy on longevity and on various physical aspects of functioning are being studied thoroughly, but research into the effects on sexual identity and sexual expression is far from complete. Getting through the trauma of mastectomy therefore requires genuinely creative understanding from the patient's partner; mastectomies can be concealed very effectively with pads and clothes.

Although it is quite obvious when the woman is undressed that she has had a mastectomy, we don't yet have rules to help, so each situation has to be worked through by the people concerned on their own terms.

What is clear, though, is that many relationships are strengthened by the process - the effort of understanding and sharing the problem often brings two people closer together.

Q: "I heard that a discharge from a woman's nipples is a sign of cancer. Is this true?"

A: "If a discharge from a breast is bloody or brown a woman should see her doctor immediately, as she should if the discharge is heavy and continuous or if it is milky/clear and she is not pregnant or breastfeeding. A discharge is normal prior to birth, and shortly after birth if the woman is not nursing. Sometimes a watery discharge can result from manipulating the breast vigorously. Some discharges are due to hormonal imbalances, so even if a woman does have an inappropriate discharge it does not mean automatically that she has cancer."

Q. "What is mastitis?"

A: "Mastitis is an infection of the breast caused by bacteria that enter through the nipple or a crack in the nipple. Fever, tenderness of the breasts and generally feeling low are the common indicators. More than half the cases of mastitis occur while a woman is breastfeeding, but traumatic mastitis may follow breast surgery (this very occasionally occurs in men too). A painful swelling of the breasts may occur at puberty which is sometimes known as puberty mastitis; it disappears after a few weeks. Mastitis may also occur during the menopause because of changes in hormone levels.

Q: "I'm 18, and I felt a movable lump in my breast just before I got my period one month. My doctor told me to wait a month and then to see her. Is it wise for me to wait?"

A: "Usually yes. In your case your physician probably felt that since it was so close to your period, some of the normal fluid that builds up at that time could have been trapped in the ducts of your breast. The chances are great that after your period you will notice first a reduction, then a disappearance of the cyst. But do go back to check with your doctor as she advised."

Q: "Do men get breast cancer too?"

A: "Yes, rarely. The forms of treatment are the same."