Female Reproductive System
Functions
 Release ovum at puberty
 Coitus process
 Implantation in uterus and support of pregnancy
(placenta)
 Parturition and puerperium (uterine involution)
 Lactation
Reproductive organs
 Ovary
 Oviduct (Fallopian tubes)
 Uterus
 Cervix
 Vagina
 External genitalia
Fetal Reproductive System
 Two undifferentiated gonads
 Two pairs of ducts
 Urogenital sinus
 Genital tubercle
 Vestibular folds
Ovary
 Develop from gonadal cortex
 During fetal development, oogonia is formed by
mitosis followed by meiosis with the
production of millions of oocytes
 Atresia occurs due to hipoxia resulting in less
number of oocytes
 Woman are born with a fix number of oocytes
 Function – to produce ova and the hormones
progesterone and estrogen
Oviduct
 Floats in mesosalpinx
 Consists of four segments:
fimbriae – at the periphery of oviduct,
functions to assist in supporting uterus
infundibulum – funnel shaped sturcture near
ovary, functions to catch ovulated ovum
ampulla – distal oviduct and is enlarge ,
functions as site of fertilization
- isthmus – proximal oviduct and is narrow,
functions to connect oviduct to uterine cavity
Uterus
 Simplex form in human
 Three layers – serus membrane, miometrium
(thickest) and endometrium
 Functions for embryo implantation and to support
and house fetus throughout pregnancy
Cervix
 Sphincter muscle situated between uterus and vagina
 Most cervix have annular ring structure
 Contains goblet cells that secrete mucus and
consistency varies with menstrual cycle
 Mucus consistency can be used to detect fertility
 Functions to stop entry of bacteria into uterine cavity
 Cervical canal usually closes, only opens during
parturition
 Cervix also functions to form cervical plug during
pregnancy
Vagina

1.
2.




Divided into 2 parts:
Vestibule (external)
Posterior vagina (internal)
Hymen is a thin connective tissue which forms a
transverse fold to partially close vaginal opening in
virgins
Functions to accept ejaculated semen from penis
during coitus
Also have an acidic environment to kill bacteria and
foreign bodies
Can also kill sperm
External genitalia
 Consists of clitoris (small erectile organ at the end of the vulva –







contains high number of sensory receptors – organ that causes
orgasm – same function as penis and can be erected because has
corpus cavernosa tissues), mons pubis, labia majora and minora,
vestibular glands and vestibular vagina
All these structures are grouped and called vulva
Bartolin and vestibular glands secrete mucus for ease of coitus
Mons pubis is the part that has the pubic hair
Labia majora is the long fold on mons pubis with a labia minora in
between
Contains fats, smooth muscles, areolar tissue, oil glands and
sensory receptors
Labia minora has no fatty tissue and is not covered with hair
Both labia forms the opening to vagina and urethral opening
Oogenesis
 Process of ovum formation
 Occurs during fetal stage
 Primordial germ cells from genital ridge enters
gonad to undergo mitosis and produce millions
of oogonia, then undergoes meiosis
 Stops at meiotic prophase at 4N
 Resumption of meiosis occurs at puberty
Folliculogenesis
 Occurs at puberty
 Arrested oogonia resumes meiosis
 Follicles containing the primary oocytes undergoes development to
become secondary follicles
 One follicle becomes the Graffian or tertiary follicle, other follicles
may undergo atresia and dies
 Ovum released from Graffian follicle through a process called
ovulation and the production of a first polar body (PB)
 Remaining follicle left becomes corpus hemarrhagicum then
corpus luteum then regress to become corpus albicans
 Ovum then becomes 2N with the other 2N in Ist PB
 1 PB becomes 3 and 4 PB of which each is N
 Secondary oocyte or ovum once fertilized then will released 2 PB
st
rd
th
nd
and ovum becomes haplod before fusion with sperm
Hormonal influence
 FSH and LH released from anterior pituitary on
directions from Gn-RH from hypothalamus
 FSH – promotes follicles to grow
 Mature follicles produces estrogen (granulosa cells) and
androgens from thecal cells
 LH surge comes with positive feedback of high estrogen
in blood
 Ovulation occurs
 Corpus luteum produces progesterone (P4) to maintain
pregnancy if conception occurs, high P4 inhibit FSH
release by negative feedback mechanism
 If not pregnant, prostaglandin 2 from uterus released
to kill CL, P4falls and cycle starts all over again
Menstrual Cycle
Menstrual cycle
 Normal menstrual cycle - 28 days but cycles with
19 / 35 days still considered normal
 Cycle not regular at puberty,(maybe long/short,
sometimes heavy or light)
 May get pre-menstrual syndromes - changes in
physical and psychological - aggravated by
smoking, high salt and sugar diets and caffeine
 Hygiene is very important during menses
 Cycle may change if stressed, diseased or
change in lifestyle
 Divided into endometrial cycle and ovarian cycle
Hormonal influence







FSH and LH released from anterior pituitary on
directions from Gn-RH from hypothalamus
FSH – promotes follicles to grow
Mature follicles produces estrogen (granulosa cells)
and androgens from thecal cells
LH surge comes with positive feedback of high
estrogen in blood
Ovulation occurs
Corpus luteum produces progesterone (P4) to
maintain pregnancy if conception occurs, high P4
inhibit FSH release by negative feedback mechanism
If not pregnant, prostaglandin 2 from uterus
released to kill CL, P4falls and cycle starts all over
again
Endometrial cycle
 Menstrual phase: 1 – 5 days (Dead tissue
from endometrial walls sloughed off with blood
due to no implantation)
 Proliferative phase : Day 6-13 (Endometrium
starts to thickened due to high levels of
estrogen)
 Secretory phase: Day 14-28 (Thickened
endometrial wall with high glycogen deposits
and blood vessels (spiral arteries) in
anticipation of zygote implantation)
Ovarian cycle
 1.
Follicular phase: Day 1 – 13. FSH and LH
release with follicular formation. Mature
follicles produces estrogens
 2. Ovulatory phase: Day 14. LH surge
causes ovulation (release of ovum from
follicle)
 3. Luteal phase: Day 15 to 28. CL releases
progesterone to build endometrium in
readiness for implanting zygote
Ovulatory Dysfunction
30-40% of female infertility
Ovulation requires the coordination of several
endocrine glands hypothalamus, pituitary, thyroid,
adrenal glands, ovary
Disorders of the hypothalamus (anorexia, bulimia,
excessive exercise)
Disorders of the pituitary (elevated prolactin)
Disorders of the ovary: most common causes of
ovulatory dysfunction, polycystic ovaries (PCO)
Menstrual Cycle Problems
 Ammenorhea
 What is amenorrhea?
 Amenorrhea is a menstrual


condition characterized by
absent menstrual periods for more than three monthly
menstrual cycles. Amenorrhea may be classified as
primary or secondary.
primary amenorrhea - from the beginning and usually
lifelong; menstruation never begins at puberty.
secondary amenorrhea - due to some physical cause
and usually of later onset; a condition in which menstrual
periods which were at one time normal and regular
become increasing abnormal and irregular or absent.
 What causes amenorrhea?
 Several possible causes of amenorrhea, including:


Pregnancy
ovulation abnormality
- cause of very irregular or frequently missed menstrual
periods.
birth defect, anatomical abnormality, or other medical
condition
If a young woman has not started to menstruate by the age
of 16, a birth defect, anatomical abnormality, or other
medical condition may be suspected.
eating disorder
Anorexia nervosa and/or bulimia nervosa causes
amenorrhea as a result of maintaining a body weight that
would be too low to sustain a pregnancy. As a result, as a
form of protection for the body, the reproductive system
"shuts down" because it is severely malnourished.
 over-exercise or strenuous exercise
Experience absent menstrual cycles due to low
body fat content.
 thyroid disorder
Hypothyroidism or hyperthyroidism
 obesity
result of excess fat cells interfering with ovulation
Dysmenorrhea
 What is dysmenorrhea?
 A menstrual condition characterized
by severe and
frequent menstrual cramps and pain associated with
menstruation. Dysmenorrhea may be classified as
primary or secondary.
 primary dysmenorrhea - from the beginning and
usually lifelong; severe and frequent menstrual
cramping caused by severe and abnormal uterine
contractions.
 secondary dysmenorrhea - due to some physical
cause and usually of later onset; painful menstrual
periods caused by another medical condition present
in the body (i.e., pelvic inflammatory disease,
endometriosis)
 What causes dysmenorrhea?
 Primary – due to chemical imbalance
in the body
(particularly prostaglandin and arachidonic acid - both
chemicals which control the contractions of the
uterus).
 Secondary - caused by other medical conditions,
most often endometriosis (a condition in which tissue
that looks and acts like endometrial tissue becomes
implanted outside the uterus resulting in internal
bleeding, infection, and pelvic pain). Other possible
causes of secondary dysmenorrhea include pelvic
inflammatory disease (PID), uterine fibroids
 abnormal pregnancy (i.e., miscarriage, ectopic),
infection, tumors, or polyps in the pelvic cavity
 Who is at risk for dysmenorrhea?
 females who smoke, drink alcohol during
menses (alcohol tends to prolong menstrual
pain), overweight, menstruating before the
age of 11
 What are the symptoms of dysmenorrhea?
 Symptoms may include: cramping in the lower
abdomen, pain in the lower abdomen, low
back pain, pain radiating down the legs,
nausea, vomiting, diarrhea, fatigue,
weakness, fainting, headaches etc.
Pre-menstrual syndrome (PMS)
 What is premenstrual syndrome?
 Most females experience some unpleasant or
uncomfortable
symptoms
during
their
menstrual cycle.
 Some are significant, some short, some long
and disturb normal function. Although the
symptoms usually cease with onset of the
menstrual period, in some females, symptoms
may last through and after their menstrual
periods.
 Who is affected by PMS?
 75 % of females, during their reproductive years.
 What are the symptoms of PMS?
 psychological symptoms – irritability, nervousness, lack of
control, agitation, anger, insomnia, difficulty in concentrating,
lethargy, depression, severe fatigue, anxiety, confusion,
forgetfulness, decreased self-image, paranoia, emotional
hypersensitivity, crying spells, moodiness, sleep disturbances
 fluid retention - edema (swelling of the ankles, hands, and feet),
periodic weight gain, oliguria (diminished urine formation), breast
fullness and pain
 respiratory problems – allergies, infections
 eye complaints - visual disturbances, conjunctivitis
 gastrointestinal symptoms - abdominal cramps, bloating,
constipation, nausea, vomiting, pelvic heaviness or pressure,
backache
 skin problems – acne, neurodermatitis (skin
inflammation with itching), aggravation of other skin
disorders, including cold sores
 neurologic and vascular symptoms – headache,
vertigo, syncope (fainting), numbness, prickling,
tingling, or heightened sensitivity of arms and/or legs,
easy bruising, heart palpitations, muscle spasms
 Others - decreased coordination, painful
menstruation, diminished libido (sex drive), appetite
changes, food cravings, hot flashes
 What causes PMS? - related to fluctuations in
estrogen and progesterone levels in the body,
hyperprolactinemia, excessive aldosterone, or ADH,
carbohydrate metabolism changes, retention of
sodium and water by the kidneys, hypoglycemia,
allergy to progesterone, psychogenic factors
 Preventing
premenstrual
syndrome
symptoms:
 simple lifestyle changes helps to reduce the
occurrence of PMS symptoms eg., regular
exercise, well-balanced diet (increase their
intake of whole grains, vegetables, and fruit,
while decreasing their intake of salt, sugar,
caffeine, and alcohol).
 adequate sleep and rest
 How to diagnose premenstrual syndrome:
 Complete medical history and physical and
pelvic examination, diagnostic procedures for
PMS are currently very limited. Knowing your
menstrual cycle is very important.
 Treatment for PMS:
 Specific treatment for PMS will be determined
based on: age, overall health. and medical
history, extent of the condition, severity of
symptoms, tolerance for specific medications,
procedures, or therapies
 Give prostaglandin inhibitors to reduce pain
 Sedatives
 Dietary modifications
 Vitamin supplements (i.e., vitamin B6,
calcium, and magnesium)
 Regular exercise
 Antidepressants (or other medications)
Infections of the Reproductive Tract
 Vaginitis – infections of the vagina
Most common types of vaginitis:
 candida or "yeast" infection
 bacterial vaginosis
 trichomoniasis vaginitis
 chlamydia
 gonococcal vaginitis
 viral vaginitis
 noninfectious vaginitis
Sexually Transmitted Diseases
 20 altogether
 Common ones – AIDS, Gonorrhea, Chlamydia
infections, Trichomoniasis, Syphillis, Genital
Herpes, Genital Warts
 Other diseases that may be sexually transmitted
include the following:
 bacterial vaginosis, chancroid, cytomegalovirus
infections, granuloma inguinale (donovanosis),
lymphogranuloma venereum, molluscum contagiosum,
pubic lice, scabies, vaginal yeast infections