1. Nursing 330 Human Reproductive Health
NOTE: This is Handout #1 of 2 Be sure to also print out Handout #2
April 6, 2015
Nursing 330
Human Reproductive Health

2. Course Website Syllabus Reading Assignments Quarter Schedule
Evaluation Methods
Lecture Notes
Print out or download on to laptop
May be taken down at anytime so it is your responsibility to print or download before each lecture

3. Important Dates Mid-term: 4/20/15 Quiz: 5/11/15
Class Project/Presentation: 5/18/15
Pick group members by 4/20/15
Make up Assignment Due: 6/1/15 (if applicable)
Final Exam: 7:30pm

4. Puberty

5. Puberty Not a synonym for adolescence
When a child transforms into an adult normally capable of reproduction (procreation).
Refers to physical changes that occur during adolescence

6. Puberty Increase in body size Change in shape and body composition
Rapid development
Reproductive organs
Other characteristics marking sexual maturity

7. Puberty Beginning of pubertal changes occurs between ages 11 – 16.
Varies
Pubertal changes in boys generally begin about 2 years later than in girls.

8. Puberty in Girls Average peak age: 12
Duration/Maturation: 18 mos – 6 years
Phases of Development:
Breast Development
Pubic Hair can precede this stage (1/3 of girls)
Vagina and Uterus develop
Pubic Hair (2/3 of girls)
Height development/Peak in height
Menarche

9. Puberty in Boys Average peak age: 14
Duration/Maturation: 2 yrs. – 5 yrs.
Phases of Development:
Testes and scrotum
Pubic Hair
Penis Growth
Enlargement of:
Seminal Vesicles, Prostate, Bulbourethral Glands
Auxillary (Armpit) Hair
Voice Deepening

10. Puberty (cont) Other Sebaceous and sweat glands Enlargement of pores
Breast changes
Height spurt

11. Physical occurrences from puberty
Growth Spurt
The primary sex characteristics develop
The secondary sex characteristics develop

12. Growth Spurt 1. Limbs 2. Body’s trunk 3. Shoulders and chest
Bones become harder and more dense
Muscle and fat contribute to an adolescent increase in weight

13. Body Composition Boys Girls Wider shoulders Develop Breast
More muscular neck
Lose fat during adolescence
Girls
Develop Breast
Acquire Hips
Higher fat to muscle ratio

14. Primary Sex Characteristics
Differences in male and female anatomy which are present at birth
–ovaries and testes
Defined as the change necessary to prepare girls’ and boys’ bodies to produce children
Marker events
Girls
Menarche
Boys
Spermarche
As the primary sex organs mature, the secondary sex characteristics distinguish males from females

15. Secondary Sex Characteristics
Defined as changes that make boys and girls look like mature men and women
Girls
-Breast Development -Body Odor
-Body fat -Body Hair
Boys
-Voice Deepens -Body Odor
-Shoulders broaden -Body Hair

16. Secular Trend
Tendency for children to become progressively larger at all ages
Causes
Better nutrition
Lessening of disease

17. Hormones Estrogen Testosterone
Responsible for many changes that occur during puberty.
Cause the breasts, uterus, and vagina to mature and the body to take feminine proportions
Contribute to regulation of the menstrual cycle
Testosterone
Responsible for changes of male puberty
Leads to muscle growth, body and facial hair, and other male sex characteristics
Contributes to gains in body size

18. Sexual Anatomy & Physiology

19. Seven Essential Features of Human Reproduction

20. Female Sex Organs: Female gonads are the ovaries
All embryos appear as female at first. Genetic and hormonal signals trigger the development of male organs in those embryos destined to be male.
Sex organs serve a reproductive purpose, but they perform other functions also: giving pleasure, attracting sex partners, and bonding in relationships.

21. Vulva
The external female genitals are known collectively as the vulva. It includes:
Mons pubis
Clitoris
Clitoral Hood (or Prepuce)
Labia Majora
Labia Minora
Urethral Opening
Anus

22. Female Genital Mutilation (FGM)
aka Female Circumcision
What is it?
Types
Areas where it is practiced
Consequences

23. Types of FGM Type I Type II
excision of the prepuce, with or without excision of part or all of the clitoris
Type II
excision of the clitoris with partial or total excision of the labia minora

24. Types of FGM (cont) Type III Type IV
Aka infibulation; the most extreme
excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening
Type IV
pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning of the clitoris and surrounding tissue

25. Internal Organs The internal female sexual structures and
reproductive organs include:
Vagina
Uterus
Cervix
Ovaries
Fallopian tubes

26. Female Sexual Physiology
During puberty hormones trigger the completion of oogenesis, the production of oocytes, commonly called eggs or ova.
Follicles
Sac in which eggs are carried. Found inside the ovaries.

27. Female Sexual Physiology
At birth
150, ,000 follicles.
each containing an immature ova (egg)
By beginning of reproductive life
Diminishes to 34,000 follicles
During active childbearing years (ages 13 – 50)
follicles undergo maturation

28. The Menstrual Cycle Follicular (Proliferative) phase
Days 1 through 6
Beginning of menstrual flow to end of blood flow
Days 7 – 13 endometrium thickens
Luteal (Secretory) phase
aka premenstrual phase
Days 15 to 28
The endometrium thickens to prepare the egg for implantation
These two phases are separated by:
Ovulation
Day 14

29. Ovulation
The process in the menstrual cycle by which a mature ovarian follicle ruptures and releases an ovum (also known as an egg or an oocyte)
The released egg, unless fertilized, only lasts 12 to 24 hours.

30. Menstrual Cycle Order of the Menstrual Cycle:
Menstrual → Proliferative → Secretory
The menstrual cycle is divided into 3 phases.
1. Menstruation
2. Proliferative Phase: Endometrial tissue builds up during this phase
3. Secretory Phase: Produces nutrients to sustain an embryo

31. Follicular (Proliferative) Phase
Menstrual Phases
Typical No. of Days
Hormonal Actions
Follicular (Proliferative)
Phase
Cycle Days 1 through 6
Beginning of menstruation to end
of blood flow
Estrogen and progesterone start
out at their lowest levels
FSH levels rise to stimulate
maturity of follicles. Ovaries start
producing estrogen and levels
rise, while progesterone levels
remain low.
Cycle Days 7 -13: The
endometrium (the inner lining of
the uterus) thickens to prepare for
the egg implantation
Ovulation
Cycle Day 14
Surge in LH. Largest follicle
bursts and releases egg into
fallopian
Luteal (Secretory)
Cycle Days 15 – 28
Depends on whether fertilization
occurs or not.

32. Corpus Luteum A mound of yellow tissue
Develops as a result of the ruptured follicle
During pregnancy, it serves to produce estrogen and progesterone

33. If fertilization occurs,
Fertilized egg is implanted in the wall of the uterus. Corpus luteum continues to produce progesterone for several months and will remain in ovary until the end of pregnancy.
If fertilization does NOT occur:
Corpus luteum becomes smaller. Progesterone levels drop. Uterine lining sloughs off and menstruation begins.

34. Hormones
Hormones are chemical substances that serve as messengers, traveling through the bloodstream.

35. Hormones Pituitary Hormones Ovarian Hormones (aka sex hormones)
Luteinizing Hormone (LH)
Follicle Stimulating Hormone (FSH)
Ovarian Hormones (aka sex hormones)
Estrogen
Progesterone

36. The egg, unless fertilized, only survives 12-24 hours.
The Path of the Egg
Reaches uterus about 2-4 days after ovulation
Released from follicle
Swept into fallopian tube
Moves slowly toward uterus
Reaches uterus in about 4 days
Moves slowly toward uterus
Swept into fallopian tube
Released from follicle
The egg, unless fertilized, only survives hours.

37. PMS
Premenstrual syndrome (PMS) is a group of symptoms related to the menstrual cycle

38. PMS Physical and emotional disorder Caused by hormonal changes
Widely recognized as a medical condition
85% of menstruating women have at least one symptom
5-10% debilitating symptoms
Symptoms present two weeks before menstruation

39. Remedies: Dietary Recommendations
Low fat
High fiber
3 meals a day and 3 snacks containing starchy foods
Drink plenty of water
Avoid caffeine
Low salt
High calcium

40. Menstrual Conditions Two types Amenorrhea Dysmenorrhea Primary
failure to start having a period by the age of 16
Secondary
temporary or permanent ending of periods in a woman who has menstruated normally in the past

41. Menstrual Disorders (Cont)
Dysmenorrhea - Painful menstrual periods (aka cramps)
Primary
no physical abnormality and usually begins within three years after you begin menstruating
Secondary
involves an underlying physical cause, such as endometriosis or uterine fibroids