Female Reproductive Physiology

Question 1

Ovaries

Answer 1

Held in place by =
Broad ligament 
Suspensory ligament 
Ovarian ligament 
Mesenteries

Question 2

Functions of the ovaries

Answer 2

Follicle development = 700,000 at birth, mature 1-2 per month, puberty to menopause, ~400 per life
Estrogen and progesterone production = follicular cells, corpus luteum
LH stimulates theca cells to make androgens
FSH triggers granulosa cells to convert androgens to estrogen

Question 3

Oogenesis

Answer 3

Identical steps of chromosome replication and division during gamete production in both sexes
Quality vs. Quantity

Question 4

Follicle development

Answer 4

Primary oocyte = surrounded by singular layer of granulosa cells
Oocyte + granulosa cells = primary follicle
Primary follicle = several primordial follicles start to develop, one becomes the primary follicle
Follicle matures in ovary (secondary follicle)
At ovulation = pushes out of ovary wall

Question 5

Ovary tubes

Answer 5

~10 cm long
Site of fertilization
Fimbrae draw ovum into fallopian (ovarian) tubes
Cilia and smooth muscle help move ovum toward uterus

Question 6

Uterus

Answer 6

Muscular wall 
Endometrium = site of implantation 
Nasal layer (constantly dividing) 
Functional layer (shed each month)
Cervix = “neck” of uterus, dialates to 10cm and effaces in labour

Question 7

Vagina

Answer 7

Birth canal
Site of sperm deposition
Mucous and acid secretion = protective, mucous acids sperm survival

Question 8

Menstrual cycles

Answer 8

Ovarian cycle = prepares ova
Uterine cycle = prepares endometrium
Hormone controlled

Question 9

Ovarian cycle

Answer 9

28 days
2 phases
Follicular phase = day 1-14, maturing follicles, higher FSH, secretes estrogen
Ovulation = day 14
Luteal phase = day 14-28 corpus luteum, remaining follicular cells, secretes estrogen and progesterone

Question 10

Uterine or menstrual cycle

Answer 10

Averages 28 days
3 phases
Menstrual phase = day 1-7, shedding of functional layer, triggered by drop in estrogen/progesterone
Proliferative phase = day 7-14, higher estrogen, repairs uterine wall
Secretory phase = high estrogen/progesterone, endometrium thickens in readiness for implantation

Question 11

Corpus luteum

Answer 11

If egg is not fertilized = corpus luteum degenerates, estrogen and progesterone drop, menses
If egg is fertilized = secretes HCG, causes corpus luteum to be maintained, estrogen and progesterone stay high, endometrium kept (no menses)

Question 12

Fertility problems

Answer 12

Endometriosis = constant shedding - hard for egg to implant
Too acidic environment - kills all sperm
Mucous too thick for sperm to penetrate
Blocked tube
Hormone problems (E/P = uterus not ready, FSH/LH = ova not developed)

Question 13

Birth control

Answer 13

The pill = inhibits LH/FSH (by controlling E or P) no ovulation
Spermicide = acid
IUD = deforms uterine wall to stop implantation
Barrier methods = diaphragm, cervical cap, condom
Morning after pill = high E/P - when they drop, get menses

Question 14

Menopause

Answer 14

Cessation of women’s menstrual cycle 
~ages 45-55 
Triggered by hypothalamic change 
Preceded by period of progressive ovarian failure (peri-menopause = increasingly irregular cycles, dwindling estrogen levels = hot flashes, metabolism changes, weight gain, mucous loss) 
Transition called climacteric

Question 15

Pre menstrual syndrome (PMS)

Answer 15

Symptoms mid-cycle to menses 
High estrogen and progesterone 
Headache 
Nausea 
Edema and bloating 
Weight gain 
Breast tenderness 
Sleep disturbances irritability 
Mood swings 
Depression

Question 16

Menstrual abnormalities

Answer 16

Amenorrhea (no menses)
Dysmenorrhea (pain with menses)
Menorrhagia (heavy bleeding)
Metrorrhagia (irregular bleeding)

Question 17

Endometriosis

Answer 17

Abnormal growth of endometrial tissue outside of uterus
Common implantation sites = ovaries, Fallopian tubes, abdominal wall, intestine
Symptoms = dysmenorrhea, pelvic cramping, heavy menses, dysperunia (painful intercourse)
Treatment = hormones, remission (pregnancy, nursing, menopause), pan hysterectomy

Question 18

Pelvic inflammatory disease (PID)

Answer 18

Cervicitis 
Salpingitis (tubes)
Endometritis 
Oophoritis 
Caused by STDs
Symptoms = fever, chills, pelvic pain, leukorrhea (thick, white discharge)

Question 19

Ovarian cyst

Answer 19

Benign fluid filled sac

Symptoms = low back pain, pelvic pain (extreme on rupture), dyspareunia, nausea, vomiting

Question 20

Polycystic ovarian syndrome

Answer 20

Many cysts
Hormonal cause
Symptoms = oligomenorrhea, omenorrhea, infertility, hirsutism (hair)

Question 21

Fibroid tumours (uterine)

Answer 21

Aka leigomyomas
Symptoms = abnormal uterine bleeding, excessive menses, pain
Treatment = surgery, uterine embolization, hormone therapy

Question 22

Vaginitis

Answer 22

Inflammation of the vagina 
Symptoms = burning, itching, swelling 
Candida (yeast, fungal) 
Trichomonas (parasites)
Atrophic (post-menopausal)

Question 23

Uterine prolapse

Answer 23

Uterus protrudes into vagina
Symptoms = heaviness in pelvis, urinary stress, dysuria, low back pain
Treatment = hysterectomy

Question 24

Vaginal prolapse

Answer 24

Vagina everts (often after hysterectomy)

Question 25

Cystocele

Answer 25

Herniation of urinary bladder through anterior vaginal wall

Symptoms = pelvic pressure, urinary urgency, incontinence

Question 26

Rectocele

Answer 26

Herniation of rectum through posterior vaginal wall
Symptoms = discomfort, consitpation, fecal incontinence
Treatment = surgical repair