3. Anatomy and Physiology
The female
reproductive system
consists of external
and internal structures
and organs.
Function of Female
Reproductive System
-Produces sex hormones
and functional ova
-Protects and supports
developing embryo
-Nourishes newborn infant dr.Shaban
4. External Sex Organs
Vulva – entire female region of external sex organs
Mons pubis
-protective, fatty cushion over the pubic bone;
-covered with pubic hair
Vestibule. consists of the clitoris, urethral meatus, and the
vaginal introitus.
Labia Majora
outer lips; tissue folds from mons to perineum
surrounding the rest of the female genitals;
Labia Minora
inner lips; pink tissue folds between vestibule and
labia majora; no hair; many oil glands;
dr.Shaban
5. External Sex Organs- Cont.
The clitoris is a short erectile organ at the top of the vaginal
vestibule whose function is sexual excitation (analogous to the
penis).
The urethral meatus is the opening of the urethra.
The vaginal introitus is the vaginal entrance
Perineum. This is the skin covered muscular area between the
vaginal opening (introitus) and the anus. It aids in constricting
the urinary, vaginal, and anal opening. It also helps support the
pelvic contents.
Bartholin's Glands. The Bartholin's glands lie on either side of
the vaginal opening. They produce a mucoid substance, which
provides lubrication for intercourse.
Fourchette: Trauma provides forensic evidence in rape
trials. dr.Shaban
7. The hymen
Separate external organ from internal
A membrane covered by stratified squamous
epithelium on both sides that partially closes
the vaginal orifice. Congenitally, it may have
no opening (imperforate hymen), also rarely it
may be absent. The shape and size of the
openings vary. It is torn with the first sexual
intercourse (unless the opening is unusually
large or the hymen is elastic).
dr.Shaban
8. The Breasts
The breasts are also part of the external female
reproductive system.
Their external structure include the nipple, areola
(darker area around the nipples) and
Montgomery tubercles (glands that produce a
lubricant to keep the nipple soft and supple).
Primary function: Lactation
Influence of hormones (Estrogen-develop. of
breasts , Progesterone-secretion of milk)
Sucking stimulates pituitary gland to release
prolactin (begin milk synthesis) and oxytocin
(release of milk) dr.Shaban
11. Internal Structures: Vagina
Elastic, thin-walled muscular
accordion-like tube; 3-4 inches
long (7.5–9 cm )
Opening is the vaginal orifice
covered by the hymen to the
cervix
pH is 3.5 – 4.5 restricts growth of
pathogen
tilted back; Posterior to the
bladder/Anterior to the rectum
Function: Receives penis &
semen and serves as birth canal
& passage for menstrual flow. dr.Shaban
12. Internal Sex Organs
Uterus – 1-inch thick walls, 3 inches long, 2 inches wide
;hollow, muscular organ between the bladder and rectum;
Normally anteverted anteflexed
3 uterine wall layers: Perimetrium ; Myometrium
; Endometrium
The major portion of the uterus is called the body or
corpus.
The fundus is the superior, rounded region above the
entrance of the fallopian tubes.
The cervix is the narrow, inferior outlet that protrudes into
the vagina. Os – opening leading into the uterus
The isthmus is the slightly constricted portion that joins the
corpus to the cervix.
dr.Shaban
13. Function: Provides passageway for sperm,
receives blastocyst, retains & nourishes fetus
& expells fetus at term.
Uterus
dr.Shaban
14. Fallopian Tubes
Two 4-inch (8 to 13 cm ) length that extend from
the sides of the uterus and curve up to and
around the ovaries
Infundibulum – has fimbriae finger-like
projections at the distal end surrounding the
ovaries to collect an egg upon release
Millions of tiny hair-like cilia line the fimbria that
beat in waves hundreds of times a second
catching the egg at ovulation and moving it
through the tube to the uterine cavity (takes 3–4
days) .
dr.Shaban
16. The Ovaries
The female sex
glands
Are small, almond-
shaped organs:
near lateral walls of
pelvic cavity
5 cm long, 2.5 cm
wide, 8mm thick
Male Homolog = testes
Function: Produce
oocytes (ova) & the
hormones estrogen
and progesterone.
dr.Shaban
17. Estrogen:
Sources: Maturing Follicles & Corpus Luteum
Targets & Functions:
Body in general
• Stimulates the development of
female secondary sexual chs
Uterus
• Stimulates proliferative phase
of uterine cycle
Ovaries
• Promotes oogenesis
Breasts
• Stimulates development of milk
ducts and sinuses
Anterior Pituitary
• Stimulates release of LH dr.Shaban
18. Progesterone:
Source: Corpus Luteum & Placenta
Targets & Functions:
Females - Uterus
• Maintains thickened
endometrium
• Stimulates nutrient release
Females - Breasts
Corpus luteum
• Stimulates development of
alveoli for milk production
Females - Anterior Pituitary
• Inhibits production & release of
FSH & LH
dr.Shaban
19. Oxytocin:
Sources: Manufactured by hypothalamus.
Stored & released by Posterior Pituitary
Positive Feedback Mechanisms:
1. Childbirth - Stretching of uterus and cervix
2. Suckling - Milk letdown reflex
Targets & Functions:
Uterus
• Stimulates contraction of uterine
myometrium causing lowering of fetus &
labor
Breasts
• Stimulates contraction of milk ducts
and sinuses, releasing milk dr.Shaban
20. Puberty
Is the stage at which the individual first becomes
capable of sexual reproduction
A girl has entered puberty when she begins to
menstruate
A Boy enters puberty when he begins to produce
spermatozoa
Puberty occur between 11-14 years
Puberty lasts about 3 to 5 years
Begins when pituitary gland initiates release of FSH
and LH, which increases the ovaries production of
estrogen; Pelvis widens; Pubic hair grows;
Menarche occurs during this time, although it may
be a few months before or after ovulationdr.Shaban
begins
21. Menstruation
Menstruation – uterine lining is shed if no
pregnancy; tissue and blood exit the introitus
Four body structures are involved in physiology
of MP: Hypothalamus; Ovaries; Pituitary glands;
and Uterus
Menstrual cycle has four phases:
Follicular phase
Ovulation phase
Luteal phase
Menstrual phase
dr.Shaban
22. Normal menstrual cycle
Beginning Average age of
(menarche ) onset 12 or 13 ,
average range is
9-17 years
Interval between Average 28 days
cycles , cycles between
23-35 not unusual
dr.Shaban
23. Duration of 2-7 days , but
menstrual flow range from 1-9
days not
Amount of abnormal
menstrual flow From 30 – 80 ml
per menstrual
Color of menstrual
flow Dark red ,
combination of
blood , mucus ,
and endiometrical
cells
dr.Shaban
25. Menstrual Cycle Days 6 - 13
Preovulatory Phase
This is known as the proliferative phase and/or
follicular phase.
A drop in progesterone and estrogen stimulates the
release of FSH from the anterior pituitary.
FSH stimulates the maturation of an ovum with
graafian follicle.
The growing follicle becomes a temporary endocrine
gland, secreting increasing amounts of estrogen which
inhibits FSH production in the pituitary.
The follicular phase: During the follicular phase, a
certain number of follicles start to grow, and usually
only one succeeds to continue through the pre-
ovulatory follicle stage. dr.Shaban
26. Menstrual Cycle Day 14
Ovulation
Again, day 14 is only an average; ovulation occurs
anywhere from 12 – 16 days before the next menstrual
flow.
When estrogen levels reach their peak, the pituitary
releases a surge of LH, the release of LH increases
causing a release of the ovum, which is known as
ovulation.
The LH surge signals the onset of ovulation within 12 to 24
hours.
Signs of Ovulation
-Increase in body temperature
-Changes in cervical mucus
-Cervix softens
-Some women will experience slight pain
dr.Shaban
27. Menstrual Cycle Days 15 - 28
Postovulatory Phase
This phase is also called the luteal or secretory
phase because the cells of the follicle remain in the
ovary, renamed the “corpus luteum,” where they will
produce large amounts of progesterone under the
effects of high levels of LH
Progesterone inhibits release of LH from the pituitary
gland and further prepares the endometrial lining of
the uterus to receive a fertilized egg.
Corpus luteum translated means “yellow body.”
> This structure forms after the egg is expelled from
the follicle.
>If pregnancy does not occur it will degenerate.
dr.Shaban
28. Menstrual Cycle Days 1-5
Menses phase.
A lack of signal from a fertilized egg influences
the drop in estrogen and progesterone
production.
A drop in progesterone results in the sloughing
off of the thick endometrial lining which is the
menstrual flow.
Menstrual phase – endometrial buildup is
expelled through uterine contractions for 3-7
days; volume of menses is about 50 ml blood
dr.Shaban
29. Menstrual Cycle: In Summry
Follicular phase
Egg matures
Ovulation
Egg released
Luteal phase
Corpus luteum
Endometrium
Prep for blastocyst
No Pregnancy
Menses
dr.Shaban
31. Menstrual Problems –
Premenstrual Syndrome (PMS)
3 to 14 days prior to the menstrual period, during the
postovulatory/luteal phase, and are relieved by onset
of the menses.
Experienced by one-third to one-half of women
between 20 and 50.
Symptoms include weight gain, irritability, mood
swings, edema, headache, inability to concentrate,
food cravings, acne, and many others.
Can be alleviated by pharmacological interventions,
diet, and exercise, Eat „real‟ food! Eliminate „junk‟ food
(caffeine, soda, alcohol, processed foods, sugar),
Decrease salt intake to relieve bloating and edema.
dr.Shaban
32. Amenorrhea
Absence of menstruation. Can be primary or
secondary.
Primary amenorrhea defined as absence of
menstruation by age of 17. Can be related to
anatomical or genetic abnormalities.
Secondary amenorrhea is the absence of
menstrual flow in a woman who has had previous
menstrual periods, may result from nutritional
deficits (anorexia nervosa), excessive exercise,
emotional disturbances, endocrine dysfunction, side
effects of medication, pregnancy, and lactation.
dr.Shaban
33. Dysmenorrhea
Painful menstruation, also called “menstrual
cramps,” is more common in nulliparous women and
in women who are not having intercourse.
S&S Painful abdominal cramping, backaches,
headaches, feeling bloated and nausea
Management. NSAIDS (nonsteroidal anti
inflammatory drugs). Analgesia (aspirin mild
prostaglandin inhibitor ; Adequate rest and sleep
and regular exercise, showers and heating pad.
dr.Shaban
34. Menorrhagia
Excessive bleeding during a menstrual
period
Either in terms of the amount of blood lost or
the number of days that bleeding lasts
Hormonal disturbances, infections, and growths
inside the uterus can cause menorrhagia
Excessive bleeding for an extended period of
time can cause a woman to become anemic
from the chronic blood loss
dr.Shaban
35. Metrorrhagia
Is bleeding between menstrual period
Its normal in some adolescence whose
spotting at the time of ovulation
It may occur in client on oral contraceptive
drugs
Vaginal irritation from infection may cause
mid cycle spotting
low level of progesterone production and
endometrial sloughing
dr.Shaban
36. Inflammatory Disorders:
Toxic Shock Syndrome
A condition most often associated with
Staphylococcus aureus, which enters the
bloodstream.
A strong relationship found between the use
of tampons during menstruation and the onset
of TSS symptoms.
Symptoms include fever, vomiting, diarrhea,
and progressive hypotension (flu-like
symptoms).
TSS can lead to death if not treated properly.
dr.Shaban
37. Infections
Non-sexually transmitted infections can occur
Bartholin‟s glands
Urinary tract
May be due to poor hygiene practices and/or
frequent intercourse
Treated by draining infected gland (if
necessary) and use of antibiotics
Douches change the vaginal pH level and
can increase risk of infection
dr.Shaban
38. Care of Female Reproductive
Organs
Wash outer genitalia regularly and thoroughly
Don‟t use feminine hygiene spray
Go to a doctor if infection
Don‟t use douches
Change pads and tampons regularly during
menstruation
Genital self-exams are recommended for
women to be familiar with their genitals and any
possible abnormalities
Routine gynecological examinations
recommended once menstruating dr.Shaban
39. In case of fertilization
At time of ovulation, the cervical mucous becomes less
viscous and providing channels for sperms passage.
The sperms ascent through the uterine cavity and
Fallopian tubes to reach the site of fertilization in the
ampulla
The ovum leaves the ovary after rupture of the Graafian
follicle, the ovum is picked up by the fimbrial end of the
Fallopian tubes and moved towards the ampulla
After penetration of the ovum by a sperm, resistant to
penetration by another sperms occur
dr.Shaban
40. Sex Determination:
Ovum usually fertilized within 12 hours of ovulation,
however sperm remain alive for up to 72 hours within
the female genital tract.
The moment the sperm penetrates the egg is called
conception, creating a new and separate cell called
the Zygote.
The mature ovum carries 22 autosomes and one X
chromosome, while the mature sperm carries 22
autosomes and either an X or Y chromosome.
If the fertilizing sperm is carrying X chromosome the
baby will be a female (46 XX), if it is carrying Y
chromosome the baby will be a male (46 XY).
dr.Shaban
41. Fraternal (dizygotic) twins: Two separate ova
fertilized by two different sperm
Identical (monozygotic) twins: Single fertilized ovum
dr.Shaban
42. Human Development before
Implementation
On its way to the uterine cavity, the fertilized
ovum (zygote) divides into 2,4,8 then 16
cells (blastomeres).
This cleavage starts within 24 hours of
fertilization and occurs nearly every 12 hours
repeatedly
The resultant 16 cells mass is called morula
which reaches the uterine cavity after about 4
days from fertilization.
dr.Shaban
44. Implantation
• Process of blastocyst • Three cell layers are
adhering to the uterine formed:
wall. Slow process – Ectoderm
occurring 5 - 9 days after • brain, nerves, skin
the beginning of – Mesoderm
fertilization. • cartilage, muscle,
• Trophoblast cells produce blood vessels,
enzymes that allow heart, kidneys
blastocyst to burrow into – Endoderm:
endometrium. • digestive tract,
• Trophoblast cells secrete respiratory tree,
hCG. liver, pancreas
dr.Shaban
45. Human Chorionic Gonadotropin (HCG):
Source: Trophoblasts of blastocyst &
Chorion (effects similar to LH).
Target & Functions:
Corpus Luteum
• Maintains corpus luteum & causes it to
continue producing progesterone in the
absence of LH through first four months of
pregnancy till placenta produces sufficient
estrogen & progesterone to maintain the
pregnancy
• This maintains endometrium, prevents
menstruation
• Can be detected by week 3 with a home
pregnancy test (Basis of pregnancy dr.Shaban
test).
46. In Vitro Fertilization and
Embryo Transfer
Fertilized ovum introduced into the uterus (fertilization to
implantation (7days)
Preembryonic period
First 14 days of human development starting at the time
of fertilization
Embryonic period
Beginning of the third week through approximately 8
weeks
Fetal period
From 9 weeks until birth (at approximately 40 weeks
after the last normal menstrual period).
dr.Shaban
