The document provides an introduction to women's health, covering topics like obstetrics, gynecology, the female reproductive system, and the menstrual cycle. It describes the major female reproductive organs including the ovaries, fallopian tubes, uterus, vagina, and breasts. It explains the hormones estrogen and progesterone and their roles in regulating the menstrual cycle and pregnancy. The menstrual cycle is divided into the menstrual, follicular, ovulation, and luteal phases, with descriptions of the key events that occur in each phase over a typical 28 day cycle.
The document provides an introduction to women's health, covering topics like obstetrics, gynecology, the female reproductive system, and the menstrual cycle. It describes the major female reproductive organs including the ovaries, fallopian tubes, uterus, vagina, and breasts. It explains the hormones estrogen and progesterone and their roles in regulating the menstrual cycle and pregnancy. The menstrual cycle is divided into the menstrual, follicular, ovulation, and luteal phases, with descriptions of the key events that occur in each phase over a typical 28 day cycle.
The document provides an introduction to women's health, covering topics like obstetrics, gynecology, the female reproductive system, and the menstrual cycle. It describes the major female reproductive organs including the ovaries, fallopian tubes, uterus, vagina, and breasts. It explains the hormones estrogen and progesterone and their roles in regulating the menstrual cycle and pregnancy. The menstrual cycle is divided into the menstrual, follicular, ovulation, and luteal phases, with descriptions of the key events that occur in each phase over a typical 28 day cycle.
The document provides an introduction to women's health, covering topics like obstetrics, gynecology, the female reproductive system, and the menstrual cycle. It describes the major female reproductive organs including the ovaries, fallopian tubes, uterus, vagina, and breasts. It explains the hormones estrogen and progesterone and their roles in regulating the menstrual cycle and pregnancy. The menstrual cycle is divided into the menstrual, follicular, ovulation, and luteal phases, with descriptions of the key events that occur in each phase over a typical 28 day cycle.
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INTRODUCTION TO
WOMEN HEALTH
WOMENS HEALTH
OBSTETRICS: Pregnancy related
problems/infertility.
GYNAECOLOGY: Problems pertaining to female reproductive system, menopause
Adolescence Puberty - Burst of hormones activate maturation of the gonads: ovaries Females - 8-13 yrs old Male 10 to 14 years old Abnormally early = precocious puberty Function of Female Reproductive System: 1. Produce sex hormones 2. Produce functioning ova 3. Support & protect developing embryo
General Physical Changes
Axillary & pubic hair growth
Changes in body conformation [widening of hips, development of breasts] Onset of first menstrual period [menarche] Mental changes
Each ovary is about the size and shape of an almond.
In young women the ovaries are about 1 - 2 inches long, 1
inch wide & 1/3 inch thick. They produce ovum, every female is born with a lifetime supply of eggs
They are among the first organs to be formed as a female baby
develops in the uterus. At the 20-week mark, there will be roughly 6 to 7 million potential egg cells.
The number begins to decrease with pregnancy.
A newborn infant has between 1 million to 2 million egg cells. By puberty the number has plummeted to 300,000. For every egg that matures and undergoes ovulation, roughly a thousand will fail, so that by menopause, only a few thousand remain.
During the course of an average reproductive
lifespan, roughly 300 mature eggs are produced for potential conception.
Ovaries produce hormones : Estrogen &
Progesterone
These hormones control the development of
female body characteristics, such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.
Estrogen controls the growth of the lining of the
uterus during the first part of the menstrual cycle, cause breast development in pregnancy and regulates various metabolic processes.
Fallopian tubes [uterine tubes]
stretch from the uterus to the ovaries and
measure about 8 to 13 cm in length. range in width from about one inch at the end next to the ovary, to the diameter of a strand of thin spaghetti. The ends of the fallopian tubes lying next to the ovaries feather into ends called fimbria.. Millions of tiny hair-like cilia line the fimbria and interior of the fallopian tubes. The cilia beat in waves hundreds of times a second catching the egg at ovulation and moving it through the tube to the uterine cavity. Fertilization typically occurs in the fallopian tube.
UTERUS
pear-shaped muscular organ in the upper
female reproductive tract. The fundus is the upper portion of the uterus where pregnancy occurs. The cervix is the lower portion of the uterus that connects with the vagina and serves as a sphincter to keep the uterus closed during pregnancy until delivery. the uterus expands considerably from 10 to 20 times its normal size during pregnancy.
The main body consists of a firm outer coat
of muscle (myometrium) and an inner lining of vascular, glandular material (endometrium).
Pregnancy occurs when the fertilized egg
implants successfully into the endometrial lining. If fertilization does not occur, the endometrium sloughs off and is expelled as menstrual flow.
ENDOMETRIUM
Functional zone adjacent to the
uterine cavity. This layer is built up after the end of menstruation during the first part of the previousmenstrual cycle. It is adapted to provide an optimum environment for the implantation and growth of theembryo. This layer is completely shed during menstruation. Basal zone adjacent to themyometriumand below the functional layer, is not shed at any time during the menstrual cycle, attaches functional layer to myometrial tissue, has terminal ends of
CERVIX
The lower portion or neck of the uterus.
The cervix is lined with mucus, the quality
and quantity of which is governed by monthly fluctuations in the levels of the estrogen and progesterone.
When estrogen levels are low, the mucus
tends to be thick and sparse, hindering sperm from reaching the fallopian tubes. But when an egg is ready for fertilization, estrogen levels are high, the mucus then becomes thin and slippery, offering a friendly environment to sperm
The cervical canal expands to roughly 50 times
its normal width in order to accommodate the passage of the baby during birth
a muscular, ridged sheath connecting the
external genitals to the uterus.
External genitalia
Vulvawhich runs from the pubic area downward
to the rectum.
Labia majora or "greater lips" are the part around
the vagina containing two glands (Bartholins glands)which helps lubrication during intercourse.
Labia minora or "lesser lips" are the thin hairless
ridges at the entrance of the vagina, which joins behind and in front. In front they split to enclose the clitoris
External genitalia
The clitoris is a small pea-shaped
structure The urethral orifice or external urinary opening is below the clitoris on the upper wall of the vagina and is the passage for urine The introitus or opening of the vagina is separate from the urinary opening (unlike males) and located below it. The hymen is a thin cresentic fold of tissue which partially covers the opening of the vagina.
Mammary Glands [ breasts]
Present in both sexes - normally only
functional in females Slightly below center of each breast is a ring of pigmented skin, the areola - this surrounds a central protruding nipple Internally - they consist of 15 to 25 lobes that radiate around and open at the nipple Each lobe is composed of smaller lobulesthese contain alveoli that produce milk when a women is lactating.
GLANDS
Lesser Vestibular (Paraurethral, Skene's)
located on the upper wall of the vagina. They drain into the urethra and near the urethral opening Function - mucus production to aid lubrication during intercourse Greater Vestibular (Bartholin's) located slightly below and to the left and right of the opening of the vagina. They secrete mucus to provide lubrication, during sexual arousal.
Muscles of the Pelvic Floor (Pelvic Diaphragm)
The pelvic diaphragm is composed of two
paired muscles levator ani and coccygeus These muscles: 1. 2. 3. 4.
Close the inferior outlet of the pelvis
Support the pelvic floor Elevate the pelvic floor to help release feces Resist increased intra-abdominal pressure
Pelvic Diaphragm is pierced by the rectum
and urethra and vagina in females Region inferior to the pelvic diaphragm is the perineum
PELVIC FLOOR MUSCLES
1. 2. 3. .
The right and left levator ani lie almost
horizontally in the floor of the pelvis. The levator ani is usually considered in three parts: pubococcygeus, Puborectalis iliococcygeus. The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.
Muscles of the Pelvic Floor: Pelvic Diaphragm
Figure 10.12a
Muscles Inferior to the Pelvic Floor:
The Urogenital Diaphragm
Muscles inferior to the pelvic floor
Stretches between two sides of the pubic arch in the anterior half of the perineum Contains Deep transverse perineal muscle Extrnal urethral sphincter muscle
menstruation and lasts till the 5th day of the menstrual cycle. The following events occur during this phase: The uterus sheds its inner lining of soft tissue and blood vessels which exits the body from the vagina in the form of menstrual fluid. Blood loss of 10 ml to 80 ml is considered normal. You may experience abdominal cramps. These cramps are caused by the contraction of the uterine and the abdominal muscles to expel the menstrual fluid.
Follicular phase (day 113)
This phase also begins on the first day of
menstruation, but it lasts till the 13th day of the menstrual cycle. The following events occur during this phase: The pituitary gland secretes a hormone that stimulates the egg cells in the ovaries to grow. One of these egg cells begins to mature in a saclike-structure called follicle. It takes 13 days for the egg cell to reach maturity. While the egg cell matures, its follicle secretes a hormone that stimulates the uterus to develop a lining of blood vessels and soft tissue called endometrium
Ovarian Cycle
Figure 27.20
Ovulation phase (day
14)
On the 14th day of the cycle, the
pituitary gland secretes a hormone that causes the ovary to release the matured egg cell. The released egg cell is swept into the fallopian tube by the cilia of the fimbriae. Fimbriae are finger like projections located at the end of the fallopian tube close to the ovaries and cilia are slender hair like projections on each Fimbria.
Luteal phase (day 15-28)
This phase begins on the 15th day and lasts
till the end of the cycle. The following events occur during this phase: The egg cell released during the ovulation phase stays in the fallopian tube for 24 hours. If a sperm cell does not impregnate the egg cell within that time, the egg cell disintegrates. The hormone that causes the uterus to retain its endometrium gets used up by the end of the menstrual cycle. This causes the menstrual phase of the next cycle to begin
PHYSIOLOGY OF MENSTRUAL CYCLE
The uterine cycle refers to the cyclical
changes that occur in the uterus in response to ovarian hormones. Days 1-5 are the follicular (menstrual phase), during which plasma progesterone will drop suddenly and the endometrium will start to shed. In response to this, the stratum functionalis will be shed and detached tissue and blood (menses) will slough out the vagina
Days 6-14 are the Ovulution (proliferative)
phase, during which plasma estrogen is rising. This causes the stratum functionalis to grow thicker and become more vascular and glandular. This is in preparation for the possibility of fertilization and pregnancy. Estrogen also causes cervical mucus to become less viscous. This will facilitate sperm entry.
Days 14-28 are the Luteal (secretory
phase) After ovulation, the egg only lives for 24 hours or less without fertilization while the remains of the dominant follicle in the ovary become acorpus luteum. Tthis body has a primary function of producing large amounts ofprogesterone. Under the influence of progesterone, the endometrium (uterine lining) changes to prepare for potential implantationof an
If implantation does not occur within
approximately two weeks, the corpus luteum will involute, causing sharp drops in levels of both progesterone and estrogen.
These hormone drops cause the uterus to
shed its lining and egg in a process termed menstruation.
FEMALE SEXUAL HORMONES
PROGESTERONE
Progesterone causes even more vascularization
of the stratum functionalis and causes the endometrial glands to twist, coil, and enlarge. Progesterone will cause cervical mucus to become more viscous. This helps prevent the embryo from being attacked by any pathogens that may migrate from the vagina.
ESTROGEN
Promotes bone lengthening and epiphyseal plate
closure in adolescents Inhibits bone resorption Promotes skin hydration Stimulates female pattern of fat deposit and growth of axillary and pubic hair Increases renal retention of sodium and consequently of water Enhances HDL cholesterol (good cholesterol) and reduces LDL cholesterol (bad cholesterol)
Male 1st observable events
enlargement of testes and penis Female 1st Thelarche development of breast 2nd-Puberche development of pubic & axillary hair 3rd-menarche 1st menstrual period
TERMINOLOGY
Puberty - period of life (typically btwn 10y
and 15y) during which the reproductive organs grow to adult size and become functional Menarche - first menstrual period. Menopause - normal cessation of menstrual cycle
