NOTE:
This is Handout #1 of 2
Be sure to also print out Handout #2
April 9, 2012
Nursing 330
Human Reproductive Health
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Office Hours
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Turnitin
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Mondays, 5:30pm – 6pm
Room TBA
Class ID: 5011311
Password: NURS330
Course Packets
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Course Website
Syllabus
 Reading Assignments
 Essay
 Extra Credit
 Quarter Schedule
 Lecture Notes
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Print out or download on to laptop
 May be taken down at anytime so it is your
responsibility to print or download before each
lecture
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Essay
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Reproductive Health issue in a current
mainstream newspaper or magazine article
(journal articles are not acceptable)
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50 points
Due 5/147/12 ( Turnitin –AND- In Class)
Article
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Should be dated between March 1, 2012 – May 14, 2012
Bring articles to class for approval (4/9/12 – 5/7/12)
Essay (cont)
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Sample topics:
Puberty, Menopause, Male Climacteric Syndrome, Cancer – breast, cervical,
testicular, prostate, Rape, Sex Education, Abortion, Female Genital Mutilation,
Pregnancy, STDs & HIV, Infertility, Breast Feeding, Contraception, Population
Control, Same Sex Marriages, Sexuality.
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If you have other topics not listed here, submit it to the instructor for review
and approval
Answer specific questions
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Refer to course website for detailed assignment
instructions
Extra Credit (EC)
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Up to 25 points
To be done throughout the quarter
May only submit one EC per lecture
Last day to submit EC: 5/21/12
Extra Credit (cont)
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Five Options
5.
Reproductive Health Exam/STD screening – 15 points
5K/10K Health Walk/Run/Bike Ride– 15 points
Volunteer Work – 10 points
Attend a Workshop – 10 points
Humor – 5 points
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May only complete one option once
1.
2.
3.
4.
Important Dates
Mid-term: April 30, 2012
Essay Due: May 14, 2012
 Electronically [Turnitin]
 Hard Copy + Article [In Class]
Extra Credit Due: May 21, 2012
Final Exam: June 11, 2012
Announcements

Course syllabus updated
Now includes detailed information about in-class
assignment
 Be sure to use/print this updated version
 As explained during lecture last week,
In class assignments are open book assignments,
completed in class only. They cannot be taken outside
the classroom or after the class time during which they
are assigned. Students who miss an in-class assignment
may use extra credit work to make up those points.
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IMPORTANT
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NURS 330 covers a variety of topics related to
the Human Reproductive Health.
Students are expected to be sensitive and mature
in their discussions, questions and mannerisms.
Any personal information disclosed by students
in the class is considered confidential and should
not be repeated outside the classroom.
I reserve the right to eliminate any person, from
the class, who I deem disruptive at any time.
Puberty
Puberty
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Not a synonym for adolescence
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Defined as the biological state when
reproduction becomes possible
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Refers to physical changes that occur during
adolescence
Puberty (cont)
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Pubertal changes in girls begin between
ages 9 and 14.
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Pubertal changes in boys generally begin
about 2 years later than in girls.
Physical occurrences from puberty
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Growth Spurt
The primary sex characteristics develop
The secondary sex characteristics develop
Growth Spurt
1. Limbs
2. Body’s trunk
3. Shoulders and chest
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Bones become harder and more dense
Muscle and fat contribute to an adolescent
increase in weight
Body Composition
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Girls
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Develop Breast
Acquire Hips
Higher fat to muscle
ratio
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Boys
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Wider shoulders
More muscular neck
Lose fat during
adolescence
Primary Sex Characteristics
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Differences in male and female anatomy which
are present at birth
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–ovaries and testes
Defined as the change necessary to prepare girls’
and boys’ bodies to produce children
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Marker events
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Girls
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Boys
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Menarche
Spermarche
As the primary sex organs mature, the secondary
sex characteristics distinguish males from females
Secondary Sex Characteristics
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Defined as changes that make boys and
girls look like mature men and women
 Girls
-Breast Development
-Body fat
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-Body Odor
-Body Hair
Boys
-Voice Deepens
-Shoulders broaden
-Body Odor
-Body Hair
Phases of Development - girls
Usual Age Range
Earliest Age
Latest Age
1. Beginning of
breast
development
8 – ¾ years
13 – ¼ years
11 years
2. Appearance of
pubic hair
9 years
13 ½ years
11 years
3. Beginning of
most rapid
growth
10 ½ years
14 ½ years
12 years
4. Menarche
10 ¾ years
15 ½ years
12 ½ years
2-3 years after
signs of puberty
1st
Approximate
Average Age
Phases of Development
- boys
Usual Age Range
Earliest Age
Latest Age
Approximate
Average Age
1. Beginning of
enlargement
of testes
9 ½ years
13 ½ years
12 years
2. Growth of the
penis
10 years
14 years
12 ¼ years
3. Appearance of
pubic hair
9 ½ years
14 years
12 ½ years
4. Beginning of
most rapid
growth in
height
11 ½ years
16 years
14 years
Nocturnal Emissions
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Aka
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Wet Dreams
Involuntary Orgasm
An ejaculation of semen experienced
during sleep
Hormones
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Estrogen
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Responsible for many changes that occur during
puberty.
Cause the breasts, uterus, and vagina to mature and
the body to take feminine proportions
Contribute to regulation of the menstrual cycle
Testosterone
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Responsible for changes of male puberty
Leads to muscle growth, body and facial hair, and
other male sex characteristics
Contributes to gains in body size
Sexual Anatomy &
Physiology
Female Sex Organs:
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All embryos appear as female at first.
Genetic and hormonal signals trigger the
development of male organs in those
embryos destined to be male.
Sex organs serve a reproductive purpose,
but they perform other functions also:
giving pleasure, attracting sex partners, and
bonding in relationships.
Vulva
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The external female genitals are known
collectively as the vulva. It includes:
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Mons pubis
Clitoris
Clitoral Hood (or Prepuce)
Labia Majora
Labia Minora
Urethral Opening
Anus
Vulva (cont)
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mons pubis is a pad of fatty tissue that covers the
area of the pubic bone.
clitoris is the center of sexual arousal in the female.
labia majora (outer lips) are two folds of spongy flesh
extending from the mons pubis and enclosing the
other external genitals.
labia minora (inner lips) are smooth, hairless folds
within the labia majora that meet above the clitoris.
Female Genital Mutilation (FGM)
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aka Female Circumcision
What is it?
Types
Areas where it is practiced
What is FGM?
Types of FGM
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Type I
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excision of the prepuce, with or without
excision of part or all of the clitoris
Type II
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excision of the clitoris with partial or total
excision of the labia minora
Types of FGM (cont)
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Type III
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Aka infibulation; the most extreme
excision of part or all of the external genitalia and
stitching/narrowing of the vaginal opening
Type IV
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pricking, piercing or incising of the clitoris and/or
labia; stretching of the clitoris and/or labia;
cauterization by burning of the clitoris and
surrounding tissue
Where is FGM practiced?
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Over 28 African countries
Parts of the Middle East
Parts of Asia
Internal Organs
The internal female sexual structures and
reproductive organs include:
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Vagina
Uterus
Cervix
Ovaries
Fallopian tubes
The Vagina
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A flexible muscular organ, approximately 3-4
inches long (in unaroused state) that has the
vaginal opening at one end and the cervix at the
other.
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Purpose of the vagina:
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Menstruation
Childbirth
Intercourse
The Vagina (cont)
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Introitus or Vaginal Os
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The opening of the vagina
Hymen
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a thin, perforated membrane, that covers the introitus
prior to first intercourse or other intrusion.
a Greek word meaning "virginal membrane" or "thin
skin".
Cervix
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Located between the vagina and the uterus
Cervical Os
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Opening to the vagina
Allows menstrual blood to flow out of the
uterus into the vagina
Uterus
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Also known as the womb
A pear-shaped organ located between the bladder and the
lower intestine
Consists of three parts
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Body of the uterus (about the size of a fist in a non-pregnant
female)
Cervix
Fundus
Endometrium
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Lining of the uterus
is built up and then shed and expelled through the cervical os
(opening) during menstruation.
Ovaries
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Egg-producing organs
Hold between 200,000 and 400,000
follicles (sacks)
Found on each side of the uterus
Fallopian Tube
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Also known as the Uterine Tube or Oviduct
Two leading off each side of the uterus
Site of fertilization
G-Spot
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Controversial
research has posited
the existence of an
erotically sensitive
area, the
Grafenberg spot
(G-spot), on the
front wall of the
vagina midway
between the
introitus and the
cervix.
Female Sexual Physiology
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At birth, the human female’s ovaries contain
400,000-700,000 female gametes (sex cells).
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During puberty hormones trigger the
completion of oogenesis, the production of
oocytes, commonly called eggs or ova.
The Menstrual Cycle
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Follicular (Proliferative) phase
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Luteal (Secretory) phase
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aka premenstrual phase
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Days 1 through 6
Beginning of menstrual flow to end of blood flow
Days 7 – 13 endometrium thickens
Days 15 to 28
The endometrium thickens to prepare the egg for
implantation
These two phases are separated by:
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Ovulation
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Day 14
Ovulation
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The process in the menstrual cycle by which a
mature ovarian follicle ruptures and releases an
ovum (also known as an egg or an oocyte)
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The released egg, unless fertilized, only lasts 12
to 24 hours.
Menstrual Cycle
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Order of the Menstrual Cycle:
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Menstrual → Proliferative → Secretory
The menstrual cycle is divided into 3 phases.
1. Menstruation
2. Proliferative Phase: Endometrial tissue builds up
during this phase
3. Secretory Phase: Produces nutrients to sustain an
embryo
Menstrual Phases
Typical No. of Days
Hormonal Actions
Follicular (Proliferative)
Phase
Also known as
Pre-ovulatory phase
Cycle Days 1 through 6
Beginning of menstruation to end
of blood flow
Estrogen and progesterone start
out at their lowest levels
FSH levels rise to stimulate
maturity of follicles. Ovaries start
producing estrogen and levels
rise, while progesterone levels
remain low.
Cycle Days 7 -13: The
endometrium (the inner lining of
the uterus) thickens to prepare for
the egg implantation
Ovulation
Cycle Day 14
Surge in LH. Largest follicle
bursts and releases egg into
fallopian
Luteal (Secretory)
Phase
Also known as
Premenstrual phase
Cycle Days 15 – 28
Depends on whether fertilization
occurs or not.
Corpus Luteum
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A mound of yellow tissue
Develops as a result of the ruptured follicle
During pregnancy, it serves to produce
estrogen and progesterone
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If fertilization occurs,
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Fertilized egg attaches to blanket of blood
vessels which supplies nutrients for the
developing placenta. Corpus luteum
continues to produce estrogen and
progesterone.
If fertilization does NOT occur:

Corpus luteum deteriorates. Estrogen and
progesterone levels drop. The blood vessel
lining sloughs off and menstruation begins.
Hormones
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Hormones are chemical substances that
serve as messengers, traveling through the
bloodstream.
Hormones
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Pituitary Hormones
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Luteinizing Hormone (LH)
Follicle Stimulating Hormone (FSH)
Ovarian Hormomes
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Estrogen
Progesterone
The Path of the Egg
Reaches uterus about 2-4 days after ovulation
Moves slowly toward uterus
Swept into fallopian tube
Released from follicle
The egg, unless fertilized, only survives 12-24 hours.
PMS
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Premenstrual syndrome (PMS) is a group
of symptoms related to the menstrual cycle
PMS
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Physical and emotional disorder
Caused by hormonal changes
Widely recognized as a medical condition
85% of menstruating women have at least
one symptom
5-10% debilitating symptoms
Symptoms present two weeks before
menstruation
Remedies:
Dietary Recommendations
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Low fat
High fiber
3 meals a day and 3 snacks containing starchy
foods
Drink plenty of water
Avoid caffeine
Low salt
High calcium
Menstrual Conditions
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Two types
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Amenorrhea
Dysmenorrhea
Amenorrhea
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Primary
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failure to start having a period by the age of 16
Secondary
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temporary or permanent ending of periods in a woman who
has menstruated normally in the past
Menstrual Disorders (Cont)
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Dysmenorrhea - Painful menstrual periods (aka
cramps)

Primary
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no physical abnormality and usually begins within
three years after you begin menstruating
Secondary
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involves an underlying physical cause, such as
endometriosis or uterine fibroids