2. Female & Male Hormones
Female Sex Hormones
The ovaries secrete two hormones, oestrogen and
progesterone
Male Sex Hormones
Testosterone & determines the primary and secondary sex
characteristics.
The male reproductive system is controlled by hormones
from the hypothalamus and from the anterior pituitary
gland.
04/04/14 FI
6. Hormonal control of the female
reproductive cycle.
The two cycles are the ovarian cycle and the
uterine cycle. The cycles are interrelated and
average 28 days.
The ovarian cycle is divided into the follicular
phase and the luteal phase.
During the follicular phase the ovarian follicle
matures primarily in response to FSH. The
follicular phase ends with ovulation and is
dominated by oestrogen.
04/04/14 FI
7. The uterine cycle is divided into the menstral
phase, the proliferative phase and the secretory
phase.
Menstral – loss of part of the endometrial lining and
blood (menstruation)
Proliferative – endometrial lining thickens and becomes
vascular (primarily in response to oestrogen)
Secretory – endometrial lining becomes lush and moist
from increased secretory activity (primarily in response
to progesterone)
04/04/14 FI
11. Hormonal and
Menstrual Alterations
Polycystic ovarian syndrome
Leading cause of infertility in the United States
Oligo-ovulation or anovulation
Elevated levels of androgens or clinical signs of
hyperandrogenism and polycystic ovaries
Multifactorial
Hyperinsulinism, hypertension, dyslipidemia
Dysfunction of follicle development
04/04/14 FI
12. Infection and Inflammation
Pelvic inflammatory disease (PID)
Acute inflammatory disease caused by infection
May involve any organ of the reproductive tract
Salpingitis
Oophoritis
Sexually transmitted diseases migrate from the
vagina to the upper genital tract
Polymicrobial infection
04/04/14 FI
15. Pelvic Relaxation Disorders
The bladder, urethra, and rectum are supported
by the endopelvic fascia and perineal muscles
The muscular and fascial tissue loses tone and
strength with aging
Fails to maintain organs in proper position
04/04/14 FI
18. Benign Growths and
Proliferative Conditions
Endometriosis
Presence of functioning endometrial tissue or
implants outside the uterus
Responds to hormone fluctuations of the menstrual
cycle
Possible causes
Retrograde menstruation, spread through vascular or
lymphatic systems, stimulation of multipotential
epithelial cells on reproductive organs or genetic
predisposition
04/04/14 FI
21. Breast Cancer
Reproductive factors
Hormonal factors
Environmental factors and lifestyle
Radiation
Diet
Chemicals (xenoestrogens)
Physical activity
Familial factors and tumor-related genes
04/04/14 FI
22. Breast Cancer
Manifestations
Painless lump, dimpling of skin, edema
Treatment
Based on stage of cancer
Surgery, radiation, chemotherapy, hormone
therapy, biologic therapy and bone marrow
transplantation
04/04/14 FI
23. Aging and the Female
Reproductive System
Perimenopause
Ovarian, uterine, and systemic changes
Vasomotor flush
Menopause
Breast tissue, urogenital, skeletal, and cardiac
changes
04/04/14 FI
27. 04/04/14 FI
TESTES:
Located on a pouch like scrotum.
Suspended outside the body behind the penis.
This exposed location provides an environment
about 1° cooler than normal core body temperature
This is an important requirement for the normal
production and survival of sperm
28. 04/04/14 FI
Each testes is a small oval gland approx 3.8cm long
and 2.5 cm wide.
Shaped like and egg that has been slightly flattened
from side to side
Surrounded by a tough whitish membrane called the
tunica albuginea
29. 04/04/14 FI
This membrane covers the testicle and also enters the
gland to form the many septa that divide it into
sections or lobules.
Each lobule consists of a narrow, long coiled
seminiferous tubule.
31. 04/04/14 FI
These coiled structures form the bulk of the testicular
mass
Interstitial cells are the small specialised cells lying
near the septa that separate the lobules.
These cells secrete the male sex hormone
Testosterone.
32. 04/04/14 FI
Each seminiferous tubule is a long duct with a central
lumen or passageway.
Sperm develop in the walls of the lumen and begin
their journey to the exterior of the body.
33. 04/04/14 FI
Spermatogenesis
Sperm production
Produced from puberty until death
Number of sperm produced each day decreases with
age
Sperm precursor cells called spermatogonia are
increased prior to puberty, to prepare for sperm
production.
35. 04/04/14 FI
They increase by mitotic cell division.
That is, the parent cell divides into 2 daughter cells,
each identical to the parent cell and each containing a
complete copy of the genetic material represented in
the normal number of 46 chromosomes
36. 04/04/14 FI
When a boy enters Puberty, circulating levels of FSH
(follicle stimulating hormone) cause the
spermatogonium to undergo this unique type of cell
division.
Of the 2 daughter cells, one remains as a
spermatogonium and the other forms into a more
specialised cell called the primary spermatocyte.
37. 04/04/14 FI
The daughter cells are called spermatids.
Unlike the 2 daughter cells that result from mitosis,
the 4 spermatids, which will develop into
spermatozoa, only have half the genetic material and
half the chromosomes (23) of other body cells.
38. 04/04/14 FI
Spermatozoa
Highly specialised and among the smallest in the
body
All the characteristics that a baby will inherit from it’s
father at fertilisation are contained in the condensed
nuclear ( genetic) material found in each sperm head.
39. 04/04/14 FI
The sperm must then travel a very long road to meet
and fertilise an ovum
To assist with the travel, sperm are equipped with
tails for motility and are designed to penetrate the
outer membrane of the ovum when it comes into
contact with it.
40. 04/04/14 FI
The sperm head contains the nucleus with the
genetic material from the father.
The nucleus is covered by the acrosome, a specialised
structure containing enzymes to assist the sperm to
break down the covering of the ovum and allow entry
if contact occurs.
41. 04/04/14 FI
In addition to the head, each sperm has a mid section
and an elongated tail.
The mitochondria in the midpiece break down
adenosine triphosphate (ATP) to provide energy for
the tail movements required for the long swim
through the female reproductive tract.
45. 04/04/14 FI
Production of Testosterone:
Other function of the testes.
Carried out by the interstitial cells of the testes.
Testosterone: masculinises, promotes and maintains
the development of the male accessory organs
( prostate gland, seminal vesicles etc).
46. 04/04/14 FI
Testosterone also has a stimulating effect on protein
anabolism.
Responsible for the greater strength of the male.
48. Disorders of the Male
Reproductive System
Disorders of the penis
Phimosis
Inability to retract foreskin from the glans of the
penis (distal to proximal)
Paraphimosis
Inability to replace or cover the glans with the
foreskin (proximal to distal)
Frequently caused by poor hygiene or chronic
infections
04/04/14 FI
50. Disorders of the Scrotum,
Testis, and Epididymis
Disorders of the scrotum
Varicocele
Inflammation/dilation of veins in the spermatic cord
Caused by inadequate or absent valves in the spermatic veins
Hydrocele
Scrotal swelling caused by collection of fluid within the tunica
vaginalis
Imbalance between fluid secretion and reabsorption
Spermatocele
Painless diverticulum of the epididymis located between the head
of the epididymis and the testis
Contains milky fluid that contains sperm and does not cover the
entire anterior scrotal surface
04/04/14 FI
51. Disorders of the Scrotum,
Testis, and Epididymis
Disorders of the testis
Cryptorchidism
Failure of one or more of the testes to descend from
the abdominal cavity into the scrotum
Treatment
Hormone therapy or surgery (orchiopexy)
04/04/14 FI
52. Disorders of the Scrotum,
Testis, and Epididymis
Disorders of the testis
Torsion of the testis
Rotation of the testis
The rotation causes the twisting of the blood vessels in the
spermatic cord
Painful and swollen testis
Condition may be spontaneous or follow physical exertion or
trauma
Surgical emergency
04/04/14 FI
53. Disorders of the Prostate Gland
Benign prostatic hyperplasia
Enlargement of the prostate gland
Symptoms associated with urethral compression
Relationship to aging
Evaluation
Digital rectal exams
Prostate-specific antigen (PSA) monitoring
PSAD levels
04/04/14 FI
54. Disorders of the Prostate Gland
Cancer of the prostate
Accounts for 29% of all cancers in males
Prostatic cancer is asymptomatic until its advanced
stages
04/04/14 FI
55. Disorders of the Prostate Gland
Cancer of the prostate
Dietary factors
Hormones
Vasectomy
Chronic inflammation
Familial factors
04/04/14 FI
56. Male Sexual Dysfunction
Vascular, endocrine, and neurologic disorders
Chronic diseases
Renal failure and diabetes mellitus
Penile diseases and penile trauma
Iatrogenic factors
Surgery and pharmaceuticals
Treatment both medical and surgical
Viagra
04/04/14 FI
57. Disorders of the Male Breast
Gynaecomastia
Overdevelopment of the breast tissue in a male
Results from hormone alterations
Idiopathic and system disorders, drugs, or neoplasms
Male breast cancer
Most commonly seen after age 60
Tumors resemble carcinomas of the breast in women
Crusting and nipple discharge are common clinical
manifestations
04/04/14 FI
58. Aging and the Male
Reproductive System
The male’s reproductive capacity is longer than the
female’s
There is not an event comparable to menopause – Who
said!
Decreased erectile and ejaculatory function
Testes atrophy, decrease in weight, and soften
Decreased levels of testosterone; gonadotropins increase
04/04/14 FI
