Female Anatomy and Physiology 2 Anth/Soc 390 Sexuality and Gender Issues Female Anatomy and Physiology 2

Internal Sex Organs The Vagina The tubular female sex organ Menstrual flow and babies pass through it Contains penis during intercourse Extends 3-5 inches back and upward from vaginal opening Has three layers Inner lining (vaginal mucosa) (endometrium) Middle layer (muscular) (myometrium) Outer (deeper) layer (connects vagina to other pelvic structures) (perimetrium) Few nerve endings, especially beyond the outer 1/3

Internal Sex Organs Vaginitis Vaginal inflammation - inflammation (irritation, redness, and swelling caused by the presence of extra immune cells) of the labia majora, labia minora, or perineal area, vaginal discharge, foul vaginal odor, discomfort or burning when urinating, pain/irritation with sexual intercourse Infectious vaginitis accounts for 90% of all cases in reproductive age women: Candidiasis albicans (a yeast), Gardinerella (a bacterium). Other less common infections are caused by gonorrhea, chlamydia, mycoplasma, herpes, campylobacter or some parasites Ways to prevent vaginitis Wash vulva and anus regularly with mild soap Wear cotton underwear Avoid pants tight in the crotch Be certain that sex partner’s genitals are clean or use a condom Use only a water-soluble jelly, such as K-Y jelly, for lubrication Avoid diets high in sugar and refined carbohydrates Keep track of general health

Internal Sex Organs The Cervix Lower end of the uterus Os Pap test Opening in the middle of the cervix About the width of a straw; allows passage of menstrual blood and sperm Permits passage of baby from the uterus to the vagina during childbirth (expands to width of a fist – 10 cm) Pap test Sample of cervical cells that screens for cervical cancer and other abnormalities

Internal Sex Organs The Uterus Hollow, muscular, pear-shaped organ in which a fertilized ovum implants and develops until birth Cervix is the opening to the uterus and connects it to the vagina Fundus: Uppermost part of the uterus

Internal Sex Organs Layers of the Uterus Endometrium Myometrium Innermost layer of the uterus Endometriosis A condition caused by the growth of endometrial tissue in the abdominal cavity or elsewhere outside the uterus, characterized by menstrual pain and, if untreated, may lead to infertility Endometrial cancer Myometrium Middle, well-muscled later of the uterus Perimetrium Outer layer of the uterus, provides an external cover

Internal Sex Organs The Fallopian Tubes Tubes that extend from the upper uterus toward the ovaries Help nourish and conduct ova to uterus Cilia (hairlike projections) help move ova through tube Ectopic pregnancy A pregnancy in which the fertilized ovum implants outside the uterus, usually in the fallopian tube Risk increases with age, pelvic inflammatory disease, tubal surgery, or the use of intrauterine devices (IUDs)

Internal Sex Organs The Ovaries Almond-shaped organs that produce ova and female sex hormones Estrogen Female sex hormones that promote the development of female sex characteristics and regulate the menstrual cycle Progesterone Steroid hormone that stimulates development of the endometrium and regulates menstruation Follicle Capsule within an ovary that contains an ovum Ovarian cancer

Internal Sex Organs Hysterectomy Surgical removal of the uterus Complete hysterectomy Surgical removal of ovaries, fallopian tubes, cervix, and uterus Partial hysterectomy Surgical removal of the uterus only May be performed when women develop cancer of the uterus, ovaries, or cervix and can relieve symptoms associated with various gynecological disorders Many gynecologists believe that hysterectomies are performed too frequently (e.g., in the U.S., one woman in three by the age of 60).

Internal Sex Organs The Female Reproductive System

Internal Sex Organs

Internal Sex Organs The Pelvic Examination Recommended once a year External examination of genitalia Internal exam Speculum: instrument that holds vaginal walls open Pap smear: sample of cervical cells taken Internal palpations to examine position, size, and possible growths on internal organs

Internal Sex Organs Pelvic Examination

The Breasts Secondary sex characteristics Traits that distinguish women from men Are not directly involved in reproduction Mammary glands Milk-secreting glands Areola Dark ring on the breast that encircles the nipple Breasts sensitive to stimulation

The Breasts

The Breasts Breast Cancer Mammography Risk factors A special type of X-ray test that detects cancerous lumps in the breast Risk factors Risk increases with age Genetic factors linked with contraction and prognosis Prolonged exposure to estrogen Early onset of menstruation, late menopause, delayed childbearing or never giving birth, high amounts of fatty tissue Heavy alcohol use

The Breasts Detection and Treatment of Breast Cancer Breast cancer is detected by having a lump in the breast, but most breast lumps are not cancerous. Cysts: sac-like structures filled with fluid or diseased material Benign tumors do little or no harm and are called fibroadenomas. Malignant lumps are lethal, causing or likely to cause death. Lumpectomy: surgical removal of a lump from the breast Mastectomy: surgical removal of the entire breast

Breast Self Exam http://video.yourtotalhealth.ivillage.com/player/?id=975341&ice=th|vid_tout|1

The Menstrual Cycle Menstruation Cyclical bleeding that stems from the shedding of the uterine lining (endometrium) Regulated by follicle stimulating hormone (FSH), luneinizing hormone, estrogen and progesterone Divided into four phases Averages about 28 days but variations are common Can be influenced by psychological and physical factors

The Menstrual Cycle Regulation of the Menstrual Cycle Hypothalamus Brain structure that regulates body temperature, motivation, emotion, and hormone production Releases gonadotropin releasing hormone (Gn-RH) which stimulates the pituitary to release gonadotropins Pituitary hormones that stimulate the gonads

The Menstrual Cycle Pituitary gland Gland that secretes growth hormone, prolactin (stimulates milk production), oxytocin (stimulates uterine contractions in labor and the ejection of milk during nursing), and Gonadotropins (stimulate the ovaries) Follicle-simulating hormone (FSH) (stimulates development of follicles in the ovaries) Luteinizing hormone (LH) (helps regulate the menstrual cycle by triggering ovulation)

Hypothalamus and Pituitary Glands

The Menstrual Cycle Phases of the Menstrual Cycle The Proliferative Phase (9-10 days) The first phase during which the endometrium proliferates Follicles develop and prepare for ovulation The Ovulatory Phase Second phase during which a follicle ruptures and releases a mature ovum

The Menstrual Cycle The Secretory (luteal) Phase The Menstrual Phase Due to the influence of LH, the corpus luteum, the follicle that has released an ovum, secretes large amounts of progesterone and estrogen. Hormones signal the secretion of nutrients to sustain an implanted ovum The Menstrual Phase If the ovum is not fertilized, estrogen and progesterone levels decline and the endometrium is removed from the body during menstruation. Low estrogen levels result in the release of FSH, which starts the process of another proliferative phase.

Brain Ovary Uterus Hormone Levels

The Menstrual Cycle Menopause The cessation of menstruation An event in the climacteric, the gradual decline in the reproductive capacity of the ovaries Commonly occurs between the ages of 46 and 50 Perimenopause: the beginning of menopause, which is characterized by several months of irregular or missing periods Involves a loss of estrogen, which may have unpleasant consequences

The Menstrual Cycle Symptoms that may result from estrogen loss Night sweats and hot flashes Headaches Decreased vaginal lubrication during sexual arousal Osteoporosis, which is characterized by a decline in bone density; bones become porous and brittle

The Menstrual Cycle Hormone replacement therapy (HRT) Synthetic replacement of estrogen and/or progesterone Reduce symptoms of menopause Associated risks: Increased risk of breast cancer, stroke, and blood clots May make diagnosis of breast cancer more difficult

Chemical Structure of Human and Synthetic Estrogen

Menstrual Problems Dysmenorrhea Pain or discomfort during menstruation Most common type of menstrual problem Primary dysmenorrhea Occurs in the absence of known organic problems Secondary dysmenorrhea Caused by identified organic problems Endometriosis, pelvic inflammatory disease, ovarian cysts Menstrual cramps can be a cause of secondary dysmenorrhea – prostaglandins cause contractions

Menstrual Problems Amenorrhea The absence of menstruation Primary amenorrhea Lack of menstruation in a woman who has never menstruated Secondary amenorrhea Lack of menstruation in a woman who has previously menstruated Is frequently associated with being underweight and/or with excessive exercise Is a symptom of anorexia nervosa Sometimes happens to female athletes

Menstrual Problems Premenstrual Syndrome (PMS) Physical and psychological symptoms that may afflict women during the four- to six-day interval that precedes menstruation Premenstrual Dysphoric Disorder (PMDD) A diagnosis used by the American Psychiatric Association to describe cases of PMS that are characterized by severe changes in mood and impaired functioning at work or school or in social relationships

Menstrual Problems Symptoms of PMDD: Feeling sad, hopeless, or worthless Tension, anxiety, feeling on edge Frequent crying, significant mood changes Irritability and anger, causing interpersonal conflict Decreased interest in activities and relationships Difficulty concentrating Fatigue, lethargy, lack of energy Notable changes in appetite (increased, decreased, cravings) Sleeping too much or difficulty sleeping Feeling overwhelmed or out of control Other physical symptoms: headache, pain, weight gain