Reproductive System
Amy McDonald MSN, RN
Female External Organs
Female Internal Organs
Female Reproductive Hormones
Male Reproductive System
Menstruation and Menopause
•
•
•
•
•
•
•
Menarche
Menses
Menopause
Climacteric
Biological changes with menopause
Artificial menopause
“hot flashes” – lack of estrogen, inc. other
hormones, = surge & dilation of bld vessels
HRT
• Risks
• Benefits
• Contraindications
–
–
–
–
–
–
Estrogen dependent cancer
Undx abnormal vaginal bld
DVT
Liver disease
Hx breast ca
Heart disease
Male Menopause
Testosterone polypeptide structure
vs. HCG polypeptide structure
• Testosterone
• HCG
Pap Smear
• No sexual intercourse for at least 24 hours
before test
Colposcopy
Laparoscopy
Laparoscopy vs. Laparotomy
Hysteroscopy
Cervical Exam
Mammogram
Breast Biopsy
Needle Biopsy of Prostate
Who’s at Risk?
•Just about all
of us
Syphilis
• Primary- chancre, painless, weeping
• Secondary- 6 wks to 6 mo. Flu-like sx
• Latency- shows on bld test? Maybe
• Tertiary- CNS involvement, balance, gait
• VDRL
• PCN
Syphilis
Syphilis
Syphilis
Syphilis
Secondary Syphilis
Congenital Syphilis
Gonorrhea
• “the clap”
• Urethral culture
• Gram stain (immediate but not as accurate,
•
•
•
•
usually id’s bacteria causing clap
Tx with antibiotics
Women- can lead to infertility
Men- can lead to infertility (epididymitis)
Sexual partners need to be treated!!!
Herpes
• No cure
• #1 nsg dx ~ pain
Genital Warts
• Strongly assoc. with dysplasia and cervical
cancer
• May be “silent” for women
HPV
HPV
HPV
HPV
Vaginitis
• What’s the number one nursing dx?
Trichomonas Vaginalis
• Treat sexual partners
• No alcohol Flagyl (severe N/V, liver
damage)
Pelvic Inflammatory Disease
• Can cause sterility by scarring enough to
permanently block fallopian tubes
• Lower abd pain
• Vaginal d/c
• Abnormal vaginal bld
• Dysuria
• Intrauterine devices contraindicated
Intrauterine Devices (IUD)
• Progesterone thickens mucous of cervix
Toxic Shock Syndrome
• Uncommon
• Assoc with use of tampons
• Wash hands before insertion of tampons
Bartholinitis
• What is the function of the Bartholin
glands?
Uterine Fibroids
• Menorrhagia
More Fibroids
Uterine Prolapse
Endometriosis
• Can result in infertility
• Danazol ~ side effects ~ hot flashes
Cystocele
Rectocele
Vaginal Fistula
• Leakage of urine, flatulence, or feces into
vagina
Ectopic Pregnancy
Abdominal Pregnancy
Tubal Ligation
Tubal Ligation
Hysterectomy
• When would an abdominal hysterectomy
be needed?
Orchitis
• Complication of mumps if not vaccinated
Hydrocele
Hydrocele
Hydrocele Transillumination
Orchitis Transillumination
“Don’t let it get this bad”
Hydrocele
“Definitely don’t let it get this bad”
Hydrocele
Varicocele
Varicocele
Testicular Torsion
Phimosis
Epididymitis
ED
• Men who take Viagra should NOT take
Nitroglycerin~ can cause a sudden
decrease in BP
BPH
• Enlargement of tissue of prostate causing
compression on the urethra and thus
urinary retention
TURP
Perineal
Suprapubic Catheter
Prostatectomy
• Will have catheter at least one day
regardless of type of surgery
• Avoid caffeine and spicy foods
Vasectomy
• Is sperm production or transport
disrupted?
Vasectomy
Fibroadenoma vs. Fibrocystic
Breast Disease
Breast Disorders
• Keep in mind that 90% of lumps are
benign
• #1 nsg dx- anxiety r/t potential
malignancy
Oral Contraceptives
• Inhibits endometrial development
• Pros
– 90-95% effective
– Few serious short-term side effects
• Cons
– Back up method needed if taken late
– Ectopic pregnancies and ovarian cysts
Side effects of BCP
• Estrogen- nausea, breast tenderness,
headache
• Progesterone- acne, weight gain, oily skin
• Both- no menses, mood changes
Teaching
• Antibiotics decrease effectiveness
• > 35, smoke, bld clots, breast endometrial
cancer
• Missed pill = 1-2 pills immediately, backup
7 days
• 3 pills missed- start over after menses,
use backup
• Contact healthcare provider if ACHES
ACHES
• A- abdominal pain, problem with GB or
liver
• C- chest pain, shortness of breath
• H- headaches
• E- eye problems
• S- severe leg pain
Ortho Evra
• Pros
– Convenient
– 99% effective
• Cons
– Less effective > 198 lbs.
– Risk of bld clot, heart attack, stroke
– Exposure to 60% more estrogen
Nuvaring
• Pros
– 99.7% effective
• Cons
– Side effects same as pill, patch
• Contraindications
– Vaginal irritation, ulceration
Depo Provera
• Pros
– 99.7% effective
• Cons
– 4 lbs wt gain per year
– High risk bone loss, contributing to
osteoporosis
IUD
• Progestasert- good for one year
– Not as effective as Mirena
• Mirena- good for 5 years
IUD Pros and Cons
• Pros
– 98-99% effective
– Convenient
• Cons
– Must have given birth
– Incr. risk PID, uterine perforation, abnormal
bleeding, ectopic pregnancy
IUD Contraindications
• Pelvic disease
• Abnormal bleeding
• Abnormally shaped uterus
Paragard
• Pros
– 99% effective
– Convenient
– No hormones used
• Cons
– Longer, heavier periods
– $450
Diaphragm
• Pros
– 80-94% effective
– No hormones
– May help with STDs and PID
• Cons
– Custom fit
– Interrupted relations
– Incr. risk UTIs
Diaphragm
Cervical Cap
• Pros
– 84-91% effective (never given birth)
– Good for 48 hours
• Cons
– 68-74% effective (given birth)
– Cervical ulcers
– Fitted
– Good manual dexterity
Cervical Cap
Sponge
• Pros
–
–
–
–
OTC
Good for 24 hrs
Hormone free
Inexpensive
• Cons
– 84% effective with typical use
– 91% effective with proper use
– Can slip out of place during sex
Sponge
Female Condom
• Helps protect against STDs
• OTC
• 79-95% more effective
• More sensation for male than regular
condom
Female Condom
Male Condom
• Helps protect against STDs
• 64-98% effective
Spermicides
• Chemical action kills sperm
• OTC
• Good for one hour
• inexpensive
Natural Family Planning
• 80% effective
• Calendar method
• Measure basal body temp
• Predictor tests for ovulation
Non-Surgical Sterilization
• Essure Permanent Birth Control System
• Takes about 3 months
Emergency Contraception
• “morning after pill”
• Controversial
• 75-89% effective
• Inhibits fertilization