FEMALE REPRODUCTIVE SYSTEM

A) Internal Female Reproductive Organs:
Vagina
• Known as the birth canal
• Elastic muscular tubular tract
• Facilitates sexual intercourse and childbirth.
• Serves as a passage for mentrual flow from uterus.
• PH

Uterus (womb)
• About 6 to 8 cm (2.4 to 3.1 inches) long
• Pear-shaped, hollow, thick-walled, muscular organ that houses and nourishes a developing fetus
• Has four parts:
• a) The fundus
• b) The body (major part of the uterus)
• c) The isthmus
• d) The cervix (narrow part of the uterus)
Its wall has 3 layers:
• a) perimetrium
• b) myometrium
• c) endometrium

Cervix
• Lower portion of the uterus, that connects the vagina and uterus
• About 1 inch long
• Produces cervical mucus that changes in amount and consistency to allow or prevent pregnancy.
• Remains firmly closed throughout pregnancy to hold the fetus inside the uterus during its development.
• During childbirth, the cervix softens and opens wide enough to allow the baby to be pushed out.
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Uterine Tubes (oviducts or fallopian tubes)
• Passageway for the ova (egg cells) to travel from the ovaries to the uterus
• Normally the place of conception, where a sperm fertilize an egg.

Ovaries
• Oval shaped glands found on both sides of the uterus
• Called the Female Gonads
• Produces the sex hormones called Estrogen and Progesterone
• Produces the female gametes ( egg cells or ova )

B). External Female Reproductive Organs:

Perineum
• Area between the opening of the vagina and the anus in a woman,
• Area between the scrotum and the anus in a man.

Mons pubis
• Rounded fleshy fatty tissue situated over the pubic bones
• Becomes enlarged and covered with pubic hair during puberty

Clitoris
• Small, button like protrusion located above the opening of the urethra
• Female’s most sensitive erogenous part, synonymous with a male penis.
• For sexual purpose only

Urethral (urinary) meatus
• Opening of the urethra
• Located above the vaginal opening

Labia majora
• Sometimes called the large lips
• Two large fleshy skin outer folds of the vagina, encloses the labia minora.
• Are covered with pubic hair after puberty
• Encloses and protect the inner parts of the vagina and urethra by keeping bacteria from entering

Labia minora
• Sometimes called the small lips
• Two thin inner folds of the vagina

Greater vestibular (Bartholin) glands
• Produces mucus for lubricating the vagina
• Equivalent to bulbourethral glands in males

Skene glands
• Other names: lesser vestibular glands, periurethral glands, paraurethral glands, female prostate
• Equivalent to male prostate glands
• Part of the G-spot
• Believed to be the source of female ejaculation.

THE BREASTS:

Breasts:
• Left breast and right breast
• Contains the mammary glands that secrete milk.
• Both men and women develop breasts but, at puberty, female’s breasts become more prominent than male because of female sex hormones, namely estrogen.
Three hormones- estrogen, progesterone, and prolactin – play an important role in the development and enlargement of the breast in order to produce milk during pregnancy
Glandular tissue – specialized tissue responsible in producing milk
• a. Lobules- small round sacs that produce milk
• b. Ducts- canals or tube that carry milk from the lobules to the nipple

Areola:
• The dark circular area surrounding the nipple.
• Changes in hormones related to menstruation, menopause and pregnancy can change the color of the areola

Nipples:
• Button like tip of the breast, the nipple is where milk is released.
• Each breast has one nipple present.

Mammary Glands:
• Glands located in the breasts of females that are responsible for producing milk during pregnancy.
• Colostrum – first small amounts of milk dispensed from the nipples of a pregnant woman after childbirth. This milk is rich in antibodies to protect the newborn against diseases and nutrients to sustain the infant for the first few days.

ABNORMALITIES OF FEMALE REPRODUCTIVE SYSTEM:

Bacterial vaginosis (BV):
• A mild infection caused by the disruption in the balance of good or healthy bacteria in the vagina.
• The healthy vagina has lots of good or healthy bacteria and few bad bacteria. The healthy ones help control the growth of the bad bacteria. In bacterial vaginosis, the balance is disturbed. Bad bacteria increases in numbers and outnumber the good bacteria.
• Can be treated with antibiotics as prescribed by your PMD.

Risk factors for getting BV are the following:
• a) Having multiple sex partners
• b) Smoke and smoking
• c) Douche
• Symptoms:
• a) Smelly grayish or yellowish discharge.

Endometriosis:
It is a condition in which the endometrial cells or tissues that lines the inside of the uterus grows outside the uterus.

Symptoms:
• Pain in the lower abdomen, vagina, rectum, pelvis, or lower back,
• Irregular menstruation, heavy menstruation, or painful menstruation
• Painful urination
• Painful sexual intercourse
• Infertility

Treatments:
• Medications: Hormones
• Home remedies: Heating pad
• Surgery

Genital warts: (condylomata acuminata, venereal warts, anal warts and anogenital warts)
• Flesh-colored, pink, or red soft, small bumps in or around the genitals. They look like a tiny cauliflower
• Caused by sexually transmitted disease, human papillomavirus (HPV)
• Highly contagious
• Spread through sexual contact by an infected partner
• May affect the vulva, vagina and cervix.
• Can be found in anal or genital area (vulva, vagina, cervix, penis or scrotum)
• May occur singly or in clusters and may grow and spread fast
• They may cause mild pain

Treatments:
• Prescribed medicines that can be applied directly to genital warts.
• Cryotherapy – freezing the warts
• Electrocauterization- burning off the warts
• Surgery
• Lasers

Pelvic inflammatory disease (PID):
• Infection of the female reproductive organ
• Most serious complications of STDs, like chlamydia and gonorrhea
• Other non STD infections can also cause PID.

Predisposing factors for PID:
• Have an untreated STD
• Have a history of PID
• Have more than one sex partner
• Have a sex partner who has multiple sex partners
• Sexually active woman younger than 25 years
• Use of an intrauterine device (IUD) for birth control
• Douche

Symptoms:
• Lower abdominal pain
• High fever and chills
• An unusual vaginal discharge with a foul odor
• Pain or bleeding during sex
• Burning urination

Treatments:
• Antibiotics
• Surgery is needed when pus or abscess have developed.
• Surgery is needed to get rid of the abscesses to prevent them from rupturing and causing infection throughout the abdominal cavity
• If abscesses have formed on the uterus or ovaries, hysterectomy (removal of the uterus) or oophorectomy (removal of the ovaries) may be recommended by your physician

Untreated PID can lead to:
• Formation of scar tissue and collection of pus in the fallopian tubes that can block the tubes and damage your reproductive organs
• Ectopic pregnancy
• Infertility
• Chronic pelvic/abdominal pain

Prolapsed uterus
Uterine prolapse is a condition in which the ligaments/muscles that holds the uterus (womb) of a woman in proper anatomical position weakens, causing the uterus to sag or slips out of its normal position
• Incomplete Prolapse – The uterus may herniates partially into the vagina (birth canal), creating a bulge.
• Complete prolapse – the uterus protrudes from the vaginal opening

Symptoms:
• Pressure/pain in the pelvis,abdomen
• Lower back pain
• Pain during intercouse
• Chronic bladder infection
• Unusual vaginal discharges
• Difficulty with urination
• Urinary incontinence
• Urinary frequency or urgency
• Prolonged standing or walking can worsen the symptoms due to the pressure on the pelvic muscles caused by the pull of gravity

Conditions associated with prolapsed uterus are Cystocele, Enterocele and Rectocele.

Conditions that can cause a prolapsed uterus:
• Pregnancies
• Multiple childbirths with normal or complicated vaginal delivery
• Advance age – loss of muscle tone
• Menopause
• Natural loss of hormone estrogen
• Obesity/overweight
• Too much weight lifting
• Caucasians have a higher risk
• Obesity
• Chronic coughing or
• Straining and chronic constipation can worsen the symptoms due to the added tension

Treatments:
Non Surgical: (for mild cases of prolapsed uterus)
• Exercise – Kegel exercises, can help strengthen the pelvic muscles. In addition, maintain a healthy weight and avoid heavy lifting of objects.
• Vaginal pessary – A pessary is a rubber or plastic device that fits inside the vagina to keep the uterus in place. It can be removed and cleaned. In some cases vaginal pessary can cause vaginal tissues irritation.
• Estrogen replacement therapy (ERT) as prescribed by your doctorSurgical: (for severe cases of prolapsed uterus)
• Hysterectomy – Uterine prolapse may be treated by removing the uterus in a surgical procedure called hysterectomy. The procedure may be done through the vagina or through the abdomen
• Uterine suspension – This procedure can be done abdominally, vaginally, or laparoscopically. The surgeon will put the uterus back into its normal position by reattaching the ligaments. This procedure, according to studies, is not as successful as hysterectomy and the possibility of having another surgery in the future is seen as a high possibility

***To do Kegel exercises***
• Empty your bladder
• Lie on your back
• Tighten your pelvic floor muscles, just like when you are trying to hold back your urine
• Hold the contraction for a few seconds and then release and relax
• Repeat 6-10 times as tolerated
• Work on increasing sets until capable of completing a set of 10 at least 3x a day

Sexually Transmitted Diseases (STD) or sexually transmitted infections (STIs):
Are acquired through sexual contact with, or by having sex with someone who is already infected with a STD.

Kinds of STDs:
Chlamydia: The bacterium Chlamydia trachomatis causes this sexually transmitted infection. It is one of the common sexually transmitted diseases because it often has no symptoms.

Symptoms:
• Abdominal or vaginal pain
• Vaginal/penile discharges with foul smell
• Painful urination

Treatment:
• Antibiotics
• Partner(s) are also recommended to be treated by your doctor to prevent re occurrence of infection and spread of the disease.

Gonorrhea:
• A contagious disease that is also called the “clap” or “drip”
• Caused by Neisseria gonorrhoeae, a bacterium that can grow and multiply easily in mucus membranes of the body
• Can grow in the cervix, uterus, fallopian tubes, urethra (of both men and women), mouth, throat and anus.
• Mother can infect her newborn during childbirth.

Symptoms:
• Greenish yellow or whitish discharge from the vagina/penis
• Itching around the genitalia
• Lower abdominal or pelvic pain
• Burning urination (both men and women)
• Conjunctivitis (red, itchy eyes)
• Bleeding between periods
• Swelling of the vulva
• Burning in the throat both men and women due to oral sex.
• Painful or swollen testicles

Treatment:
• Antibiotics as prescribed by your doctor

Herpes Simplex Virus (HSV):
Commonly known as Herpes
HSV 1 (oral herpes) – sores around the mouth and lips
HSV 2 (genital herpes) – sores around the genital area or rectum
Pregnant woman with Genital Herpes can infect their newborn during childbirth.

Symptoms:
• Sores around the infected area
• Pain, burning and difficulty in urinating
• Pains around the genitals
• Vaginal/penile discharges

Treatment:
• There is no cure for Herpes Simplex but it can be treated with medications to relieve and lessen the symptoms.
• Antiviral medications like Zovirax, Valtrex and Acyclovir

Human Papillomavirus (HPV)
Sexually Transmitted Disease that is primarily spread by having vaginal, anal, or oral sex with someone who is infected with the virus. HPV causes warts in different parts of the body. To lower your chance of getting HPV, get vaccinated. HPV vaccines are safe and effective.

Conditions Related to HPV:
• Genital Warts
• Cervical Cancer

Syphillis
Caused by the bacteria Treponema pallidum and is a highly contagious disease. It can be spread by sexual contact, oral, and anal sex. Pregnant woman can pass the infection to her baby and is called congenital syphilis. It can cause birth defects or death to the child.

Symptoms:
• Early or primary syphilis: one or more small painless sores that occurs on the genitals, in side or around the mouth. They heal with or without treatment without within 6-8 weeks..
• The secondary stage: rashes on the palms of the hands and soles of the feet It may last 4 – 12 weeks. Infected person also have patches around the mouth, swollen lymph glands, and fever. Secondary syphilis will resolve without treatment just like primary syphilis
• Latent syphilis. The infection is not active and is asymptomatic.
• Tertiary syphilis. Untreated syphilis can result in  heart, brain, and nerves damage that can lead to paralysis, blindness, impotence, and even death if left untreated.

Trichomoniasis:
Is a sexually transmitted disease caused by a microscopic parasite called trichomonas vaginalis, a protozoan. Most often occur in women and usually found in their vagina.
It is the most common curable STD worldwide.

Symptoms:
• Smelly, itchy, and typically frothy or foamy vaginal discharge
• Vaginal itching
• Yellow or gray-green vaginal/penile discharge
• Painful urination ( both for men and women)
• Pain and swelling in the scrotum for men.

Treatment:
• Antibiotics as prescribed by your doctor
• Vinegar douche

*** Many types of Female Reproductive Disorders can be prevented by following a healthy lifestyle.
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