1. Female Sexual Anatomy and Physiology
Chapter 5

2. Figure 5.1 The external genital structures of the mature female.

3. Figure 5.2 Side inner view of the erect clitoris.

4. Figure 5.3 The female internal reproductive system (side view).

5. This photo shows the release of a mature ovum at ovulation
This photo shows the release of a mature ovum at ovulation. The ovum (orange) is surrounded by remnants of cells and liquid from the ruptured ovarian follicle. Mature ova develop in the ovaries from follicles that remain dormant until sexual maturity.

6. Figure 5.4 The female internal reproductive system (front view).

7. Figure 5.5 The Female Breast

8. Female Puberty Menarche: As early as age 7, usually 11-12 yrs
Pituitary gland FSH and LH estrogen
size of Fallopian tubes, uterus, vagina, breasts, buttocks, thighs
Pelvis widens
Pubic hair grows
Mittelschmerz – slight pain in some women with ovulation

9. Menstruation
Menstruation – uterine lining is shed if no pregnancy; tissue and blood are released
Menstrual cycle – about 24 to 35 days; average is 28 days
Menstrual cycle has four phases:
Follicular phase
Ovulatory phase
Luteal phase
Menstrual phase

10. Figure 5.7 The ovarian and menstrual cycles.

11. Figure 5.8 The cycle of female hormones.

12. Variations in Menstruation
Amenorrhea – absence of menstruation
Primary amenorrhea
Secondary amenorrhea
Dysmenorrhea
Dysfunctional uterine bleeding (DUB)
Menorrhagia

13. Variations in Menstruation (Cont.)
Premenstrual Syndrome (PMS)
Premenstrual Dysphoric Disorder (PMDD)

14. Menopause
Climacteric – period of decreased estrogen production and menstruation stops; years, average 51 years
Irregular cycles, rather than a sudden stop
Hormonal changes – hot flashes, headaches, sleep disturbances
Sexual complaints
Menopause can be induced by surgically by removing the ovaries; doctors try to keep at least one in if surgery is necessary

15. Menopause (Cont.)
Hormone replacement therapy – was a standard treatment, but there are a lot of health risks and not typically used today
Newer therapies with lower levels of hormones may be used
Nutritional, vitamin, and herbal remedies are commonly used today

16. Female Reproductive and Sexual Health
Genital self-exams are recommended for women to be familiar with their genitals and any possible abnormalities
Routine gynecological examinations recommended once menstruating
Medical history and checkup
Pelvic examination (internal and external)
Breast examination
Pap smear – cervical swab

17. Gynecological Health Concerns
Most prevalent:
Endometriosis
Menstrual Toxic Shock Syndrome
Polycystic Ovarian Syndrome

18. Gynecological Health Concerns (cont.)
Most prevalent:
Uterine Fibroids
Vulvodynia

19. Cancer of the Female Reproductive Organs
Breast Cancer
Uterine Cancer
Cervical Cancer
Endometrial Cancer
Ovarian Cancer

20. Breast Cancer One of most common cancers
Early detection is critical: breast self-examinations, gynecological checkups, mammography beginning at age 40
Symptoms: breast lump, breast pain, nipple discharge, puckering of skin, change in nipple shape
If untreated, the cancer will spread to other parts of the body - Metastasize

21. Breast Cancer (cont.)
Treatment: partial/modified mastectomy, radical mastectomy, lumpectomy, radiation, chemotherapy
Risk factors: fat intake, aging, early menarche, prolonged estrogen, inactive lifestyle, alcohol consumption, genetics
Breastfeeding, early pregnancy reduces risk

22. Cervical Cancer Rates decreased over past several decades
Pap smear is used for detection
High cure rates
HPV is main cause
Risk factors: early intercourse, many sexual partners, teenage mothers, cervicitis, genital viral infections, extended oral contraceptive use
Treatment: surgery, radiation, hysterectomy

23. Endometrial Cancer Symptoms: abnormal bleeding, spotting
Detection most successful with dilation and curettage
Treatment: surgery, radiation, hormones, chemotherapy
Over 90% survival rate
Oral contraceptives decrease risk

24. Ovarian Cancer Less common than breast, uterine cancers Most deadly
Symptoms: few early signs, ovarian cyst, slight abdominal discomfort, appetite loss, indigestion, abdominal swelling, nausea, vomiting
Risk factors: childlessness, early menopause, high-fat diet, higher SES, lactose-intolerant, use talc powder on the vulva

25. Ovarian Cancer (Cont.)
Decreased risk with having children and using birth control pills, tubal ligation
Detection techniques: blood tests, pelvic exams, ultrasound
Unfortunately, most diagnosed after cancer has spread beyond the ovary because of the lack of early warning signs
Treatment: remove ovaries, radiation, chemotherapy