1. Female Reproductive System

2. Suspensory ligament of ovary Infundibulum Uterine tube Ovary Fimbriae
Peritoneum
Uterus
Uterosacral
ligament
Round ligament
Vesicouterine
pouch
Perimetrium
Rectouterine
pouch
Urinary bladder
Pubic symphysis
Rectum
Mons pubis
Posterior fornix
Cervix
Urethra
Anterior fornix
Clitoris
Vagina
External urethral
orifice
Anus
Hymen
Urogenital diaphragm
Labium minus
Greater vestibular
(Bartholin’s) gland
Labium majus
Figure 27.10

3. Ovaries Held in place by several ligaments
Ovarian ligament: anchors ovary medially to the uterus
Suspensory ligament: anchors ovary laterally to the pelvic wall
Mesovarium: suspends the ovary
Broad ligament: supports the uterine tubes, uterus, and vagina; also contains the suspensory ligament and the mesovarium

4. Uterine (fallopian) tube Uterine tube Ovarian blood vessels Fundus
Suspensory
ligament of ovary
Uterine (fallopian) tube
Uterine
tube
Ovarian blood
vessels
Fundus
of uterus
Lumen (cavity)
of uterus
Ampulla
Mesosalpinx
Ovary
Isthmus
Mesovarium
Infundibulum
Broad
ligament
Fimbriae
Mesometrium
Round ligament of uterus
Ovarian ligament
Endometrium
Body of uterus
Myometrium
Wall of uterus
Ureter
Uterine blood vessels
Perimetrium
Isthmus
Internal os
Uterosacral ligament
Cervical canal
Lateral cervical
(cardinal) ligament
External os
Vagina
Lateral fornix
Cervix
(a)
Figure 27.12a

5. Ovaries
Blood supply: ovarian arteries and the ovarian branch of the uterine artery
Follicle
Immature egg (oocyte) surrounded by
Follicle cells (one cell layer thick)
Several stages of development
Primordial follicle: squamouslike follicle cells + oocyte
Primary follicle: cuboidal or columnar follicle cells + oocyte
Secondary follicle: two or more layers of granulosa cells + oocyte
Late secondary follicle: contains fluid-filled space between granulosa cells; coalesces to form a central antrum

6. Ovaries Vesicular (Graafian) follicle Ovulation
Fluid-filled antrum forms; follicle bulges from ovary surface
Ovulation
Ejection of the oocyte from the ripening follicle
Corpus luteum develops from ruptured follicle after ovulation

7. Late secondary follicle Degenerating corpus luteum (corpus albicans)
Tunica
albuginea
Oocyte
Granulosa cells
Late secondary follicle
Degenerating corpus
luteum (corpus
albicans)
Cortex
Mesovarium and
blood vessels
Germinal
epithelium
Vesicular
(Graafian)
follicle
Primary
follicles
Antrum
Oocyte
Ovarian
ligament
Zona
pellucida
Theca
folliculi
Medulla
Ovulated
oocyte
Corpus luteum
Developing
corpus luteum
Corona
radiata
(a) Diagrammatic view of an ovary sectioned to reveal the follicles in its interior
Figure 27.11a

8. Female Duct System
Uterine (fallopian) tubes or oviducts
Uterus
Vagina

9. Uterine Tubes
Ampulla
Distal expansion with infundibulum near ovary
Usual site of fertilization
Ciliated fibriae of infundibulum create currents to move oocyte into uterine tube
Isthmus: constricted region where tube joins uterus
Oocyte is carried along by peristalsis and ciliary action

10. Uterine (fallopian) tube Uterine tube Ovarian blood vessels Fundus
Suspensory
ligament of ovary
Uterine (fallopian) tube
Uterine
tube
Ovarian blood
vessels
Fundus
of uterus
Lumen (cavity)
of uterus
Ampulla
Mesosalpinx
Ovary
Isthmus
Mesovarium
Infundibulum
Broad
ligament
Fimbriae
Mesometrium
Round ligament of uterus
Ovarian ligament
Endometrium
Body of uterus
Myometrium
Wall of uterus
Ureter
Uterine blood vessels
Perimetrium
Isthmus
Internal os
Uterosacral ligament
Cervical canal
Lateral cervical
(cardinal) ligament
External os
Vagina
Lateral fornix
Cervix
(a)
Figure 27.12a

11. Uterus Body: major portion Fundus: rounded superior region
Isthmus: narrowed inferior region
Cervix: narrow neck, or outlet; projects into the vagina
Cervical canal communicates with the
Vagina via the external os
Uterine body via the internal os
Cervical glands secrete mucus that blocks sperm entry except during midcycle

12. Uterine Wall Three layers
Perimetrium: serous layer (visceral peritoneum)
Myometrium: interlacing layers of smooth muscle
Endometrium: mucosal lining

13. Endometrium Stratum functionalis (functional layer)
Changes in response to ovarian hormone cycles
Is shed during menstruation
Spasms of spiral arteries leads to shedding of stratum functionalis
Stratum basalis (basal layer)
Forms new functionalis after menstruation
Unresponsive to ovarian hormones

14. Vagina Birth canal and organ of copulation
Extends between the bladder and the rectum from the cervix to the exterior
Urethra embedded in the anterior wall

15. Vagina
Layers of wall
Fibroelastic adventitia
Smooth muscle muscularis
Stratified squamous mucosa with rugae
Mucosa near the vaginal orifice/opening forms an incomplete partition called the hymen
Vaginal fornix: upper end of the vagina surrounding the cervix

16. External Genitalia Mons pubis: fatty area overlying pubic symphysis
Labia majora: hair-covered, fatty skin folds
Labia minora: skin folds lying within labia majora
Vestibule: recess between labia minora
Greater vestibular glands
Release mucus into the vestibule for lubrication
Homologous to the bulbourethral glands

17. External Genitalia Clitoris Perineum
Erectile tissue hooded by a prepuce
Glans clitoris: exposed portion
Perineum
Diamond-shaped region between the pubic arch and coccyx
Bordered by the ischial tuberosities laterally

18. Inferior ramus of pubis
Clitoris
Labia minora
Labia majora
Inferior ramus of pubis
Pubic symphysis
Anus
Body of clitoris,
containing corpora
cavernosa
Clitoris (glans)
Crus of clitoris
Urethral orifice
Vaginal orifice
Greater
vestibular
gland
Bulb of
vestibule
(b)
Fourchette
Figure 27.14b

19. Mammary Glands Modified sweat glands consisting of 15–25 lobes
Areola: pigmented skin surrounding the nipple
Suspensory ligaments: attach the breast to underlying muscle
Lobules within lobes contain glandular alveoli that produce milk
Milk  lactiferous ducts  lactiferous sinuses  open to the outside at the nipple

20. Pectoralis major muscle Suspensory ligament
First rib
Skin (cut)
Pectoralis major muscle
Suspensory ligament
Adipose tissue
Lobe
Areola
Nipple
Opening of
lactiferous duct
Lactiferous sinus
Lactiferous duct
Lobule containing
alveoli
Hypodermis
(superficial fascia)
Intercostal muscles
(a)
(b)
Figure 27.15

21. Breast Cancer Usually arises from the epithelial cells of small ducts
Risk factors include:
Early onset of menstruation and late menopause
No pregnancies or first pregnancy late in life
Family history of breast cancer
10% are due to hereditary defects, including mutations to the genes BRCA1 and BRCA2

22. Breast Cancer: Detection and Treatment
70% of women with breast cancer have no known risk factors
Early detection via self-examination and mammography
Treatment depends upon the characteristics of the lesion:
Radiation, chemotherapy, and surgery followed by irradiation and chemotherapy

23. (a) Mammogram procedure
Malignancy
(b) Film of normal breast
(c) Film of breast with tumor
Figure 27.16

24. Oogenesis Production of female gametes Begins in the fetal period
Oogonia (2n ovarian stem cells) multiply by mitosis and store nutrients
Primary oocytes develop in primordial follicles
Primary oocytes begin meiosis but stall in prophase I

25. Oogenesis
Each month after puberty, a few primary oocytes are activated
One is selected each month to resume meiosis I
Result is two haploid cells
Secondary oocyte
First polar body (benign…reabsorbed)
The secondary oocyte arrests/stops in metaphase II and is ovulated
If penetrated by sperm the second oocyte completes meiosis II, yielding
Ovum (the functional gamete)
Second polar body

26. Figure 27.17 Meiotic events Follicle development in ovary Before birth
Oogonium (stem cell)
Follicle cells
Mitosis
Oocyte
Primary oocyte
Primordial follicle
Growth
Infancy and
childhood
(ovary inactive)
Primary oocyte
(arrested in prophase I;
present at birth)
Primordial follicle
Each month from
puberty to
menopause
Primary follicle
Primary oocyte (still
arrested in prophase I)
Secondary follicle
Spindle
Vesicular (Graafian)
follicle
Meiosis I (completed
by one primary oocyte
each month in response
to LH surge)
Secondary oocyte
(arrested in
metaphase II)
First polar body
Ovulation
Meiosis II of polar
body (may or may
not occur)
Sperm
Ovulated secondary
oocyte
Meiosis II
completed
(only if
sperm
penetration
occurs)
In absence of
fertilization, ruptured
follicle becomes a
corpus luteum and
ultimately degenerates.
Polar bodies
(all polar bodies
degenerate)
Second
polar body
Ovum
Degenating
corpus luteum
Figure 27.17

27. Ovarian Cycle
Monthly series of events associated with the maturation of an egg
Two consecutive phases (in a 28-day cycle)
Follicular phase: period of follicle growth (days 1–14)
Ovulation occurs midcycle
Luteal phase: period of corpus luteum activity (days 14– 28)

28. Primordial follicles 1 Theca folliculi Primary oocyte Zona pellucida3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5 1
Primordial
follicles 8 6
Secondary oocyte 7
Corona radiata
Figure (1 of 7)

29. Primary follicle 2 Theca folliculi Primary oocyte Zona pellucida3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5
Primary
follicle 2 8 6
Secondary oocyte
Corona radiata 7
Figure (2 of 7)

30. Secondary follicle 3 Theca folliculi Primary oocyte Zona pellucida4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5 3
Secondary
follicle 8 6
Secondary oocyte 7
Corona radiata
Figure (3 of 7)

31. Theca folliculi Primary oocyte Zona pellucida Antrum Secondary oocyte3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5 8 6
Secondary oocyte 4
Late secondary
follicle 7
Corona radiata
Figure (4 of 7)

32. Theca folliculi Primary oocyte Zona pellucida Antrum Secondary oocyte3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte
Mature vesicular
follicle carries out
meiosis I; ready to
be ovulated 5 5 8 6
Secondary oocyte
Corona radiata 7
Figure (5 of 7)

33. Follicle ruptures; secondary oocyte ovulated Theca folliculi3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5 6
Follicle ruptures;
secondary oocyte
ovulated 8 6
Secondary oocyte 7
Corona radiata
Figure (6 of 7)

34. Luteal Phase Ruptured follicle collapses
Granulosa cells and internal thecal cells form corpus luteum
Corpus luteum secretes progesterone and estrogen

35. Luteal Phase
If no pregnancy, the corpus luteum degenerates into a corpus albicans in 10 days
If pregnancy occurs, corpus luteum produces hormones until the placenta takes over at about 3 months

36. Corpus luteum (forms from ruptured follicle) Theca folliculi3 4 2
Primary oocyte 1
Zona pellucida
Antrum
Secondary
oocyte 5 7
Corpus luteum
(forms from
ruptured follicle) 8 6
Secondary oocyte 7
Corona radiata
Figure (7 of 7)

37. Establishing the Ovarian Cycle
During childhood, ovaries grow and secrete small amounts of estrogens that inhibit the hypothalamic release of GnRH
As puberty nears, GnRH is released; FSH and LH are released by the pituitary, and act on the ovaries
These events continue until an adult cyclic pattern is achieved and menarche occurs
During childhood, until puberty
Ovaries secrete small amounts of estrogens
Estrogen inhibits release of GnRH

38. Establishing the Ovarian Cycle
At puberty
Leptin from adipose tissue decreases the estrogen inhibition
GnRH, FSH, and LH are released
In about four years, an adult cyclic pattern is achieved and menarche occurs

39. Hormonal Interactions During a 28-Day Ovarian Cycle
Day 1: GnRH  release of FSH and LH
FSH and LH  growth of several follicles, and estrogen release
 estrogen levels
Inhibit the release of FSH and LH
Stimulate synthesis and storage of FSH and LH
Enhance further estrogen output

40. Hormonal Interactions During a 28-Day Ovarian Cycle
Estrogen output by the vesicular follicle increases
High estrogen levels have a positive feedback effect on the pituitary at midcycle
Sudden LH surge at day 14

41. Hormonal Interactions During a 28-Day Ovarian Cycle
Effects of LH surge
Completion of meiosis I (secondary oocyte continues on to metaphase II)
Triggers ovulation
Transforms ruptured follicle into corpus luteum

42. Hormonal Interactions During a 28-Day Ovarian Cycle
Functions of corpus luteum
Produces inhibin, progesterone, and estrogen
These hormones inhibit FSH and LH release
Declining LH and FSH ends luteal activity and inhibits follicle development

43. Hormonal Interactions During a 28-Day Ovarian Cycle
Days 26–28: corpus luteum degenerates and ovarian hormone levels drop sharply
Ends the blockade of FSH and LH
The cycle starts anew

44. (a) Fluctuation of gonadotropin levels: Fluctuating LH
FSH
(a) Fluctuation of gonadotropin levels: Fluctuating
levels of pituitary gonadotropins (follicle-stimulating
hormone and luteinizing hormone) in the blood
regulate the events of the ovarian cycle.
Figure 27.20a

45. Primary follicle Vesicular follicle Corpus luteum Degenerating
Secondary
follicle
Ovulation
Follicular
phase
Ovulation
(Day 14)
Luteal
phase
(b) Ovarian cycle: Structural changes in the ovarian
follicles during the ovarian cycle are correlated with
(d) changes in the endometrium of the uterus during
the uterine cycle.
Figure 27.20b

46. Uterine (Menstrual) Cycle
Cyclic changes in endometrium in response to ovarian hormones
Three phases
Days 1–5: menstrual phase
Days 6–14: proliferative (preovulatory) phase
Days 15–28: secretory (postovulatory) phase (constant 14- day length)

47. Uterine Cycle Menstrual phase
Ovarian hormones are at their lowest levels
Gonadotropins are beginning to rise
Stratum functionalis is shed and the menstrual flow occurs

48. Uterine Cycle Proliferative phase
Estrogen levels prompt generation of new functional layer and increased synthesis of progesterone receptors in endometrium
Glands enlarge and spiral arteries increase in number

49. Uterine Cycle Secretory phase Progesterone levels prompt
Further development of endometrium
Glandular secretion of glycogen
Formation of the cervical mucus plug

50. (c) Fluctuation of ovarian hormone levels:
Estrogens
Progesterone
(c) Fluctuation of ovarian hormone levels:
Fluctuating levels of ovarian hormones (estrogens
and progesterone) cause the endometrial changes
of the uterine cycle. The high estrogen levels are
also responsible for the LH/FSH surge in (a).
Figure 27.20c

51. (d) The three phases of the uterine cycle:
Endometrial
glands
Blood vessels
Menstrual
flow
Functional layer
Basal layer
Days
Menstrual
phase
Proliferative
phase
Secretory
phase
(d) The three phases of the uterine cycle:
• Menstrual: Shedding of the functional layer of the
endometrium.
• Proliferative: Rebuilding of the functional layer of
the endometrium.
• Secretory: Begins immediately after ovulation.
Enrichment of the blood supply and glandular secretion of
nutrients prepare the endometrium to receive an embryo.
Both the menstrual and proliferative phases occur before ovulation, and
together they correspond to the follicular phase of the ovarian cycle. The
secretory phase corresponds in time to the luteal phase of the ovarian cycle.
Figure 27.20d

52. Uterine Cycle If fertilization does not occur
Corpus luteum degenerates
Progesterone levels fall
Spiral arteries kink and spasm
Endometrial cells begin to die
Spiral arteries constrict again, then relax and open wide
Rush of blood fragments weakened capillary beds and the functional layer sloughs

53. Menopause Has occurred when menses have ceased for an entire year
There is no equivalent to menopause in males

54. Menopause Declining estrogen levels 
Atrophy of reproductive organs and breasts
Irritability and depression in some
Hot flashes as skin blood vessels undergo intense vasodilation
Gradual thinning of the skin and bone loss
Increased total blood cholesterol levels and falling HDL

55. Effects of Estrogens
Promote oogenesis and follicle growth in the ovary
Exert anabolic effects on the female reproductive tract
Support the rapid but short-lived growth spurt at puberty

56. Effects of Estrogens Induce secondary sex characteristics
Growth of the breasts
Increased deposit of subcutaneous fat (hips and breasts)
Widening and lightening of the pelvis

57. Effects of Estrogens Metabolic effects
Maintain low total blood cholesterol and high HDL levels
Facilitates calcium uptake

58. Effects of Progesterone
Progesterone works with estrogen to establish and regulate the uterine cycle
Effects of placental progesterone during pregnancy
Inhibits uterine motility
Helps prepare the breasts for lactation

59. Female Sexual Response
Initiated by touch and psychological stimuli
The clitoris, vaginal mucosa, and breasts engorge with blood
Vestibular gland secretions lubricate the vestibule
Orgasm is accompanied by muscle tension, increase in pulse rate and blood pressure, and rhythmic contractions of the uterus

60. Female Sexual Response
Females do not have a refractory period after orgasm and can experience multiple orgasms in a single sexual experience
Orgasm is not essential for conception

61. Sexually Transmitted Infections (STIs)
Also called sexually transmitted diseases (STDs) or venereal diseases (VDs)
The single most important cause of reproductive disorders

62. Gonorrhea
Bacterial infection of mucosae of reproductive and urinary tracts
Spread by contact with genital, anal, and pharyngeal mucosae

63. Gonorrhea Signs and symptoms
Males
Urethritis, painful urination, discharge of pus
Females
20% display no signs or symptoms
Abdominal discomfort, vaginal discharge, or abnormal uterine bleeding
Can result in pelvic inflammatory disease and sterility
Treatment: antibiotics, but resistant strains are becoming prevalent

64. Syphilis
Bacterial infection transmitted sexually or contracted congenitally
Infected fetuses are stillborn or die shortly after birth
Infection is asymptomatic for 2–3 weeks
A painless chancre appears at the site of infection and disappears in a few weeks

65. Syphilis
If untreated, secondary signs appear several weeks later for 3–12 weeks, and then disappear: pink skin rash, fever, and joint pain
The latent period may or may not progress to tertiary syphilis, characterized by gummas (lesions of the CNS, blood vessels, bones, and skin)
Treatment: penicillin

66. Chlamydia Most common bacterial STI in the United States
Responsible for 25–50% of all diagnosed cases of pelvic inflammatory disease
Symptoms: urethritis; penile and vaginal discharges; abdominal, rectal, or testicular pain; painful intercourse; irregular menses
Can cause arthritis and urinary tract infections in men, and sterility in women
Treatment: tetracycline

67. Viral Infections Genital warts Caused by human papillomavirus (HPV)
Second most common STI in the United States
Increase the risk of cancers in infected body regions

68. Viral Infections Genital herpes Caused by human herpes virus type 2
Characterized by latent periods and flare-ups
Congenital herpes can cause malformations of a fetus
Treatment: acyclovir and other antiviral drugs