Reproductive Flashcards
Final exam prep
____________ is the specialized branch of medicine concerned with the diagnosis and treatment of diseases of the female reproductive system.
Gynecology
__________ is the study of the urinary system but also includes diagnosis and treatment of diseases and disorders of the male reproductive system.
Urology
The ________ of reproduction are grouped as gonads (that produce gametes and secrete hormones), ducts (transport, receive, and store gametes), and accessory sex glands (produce materials that support gametes).
organs (gonads, ducts, accessory sex glands)
What are male gametes called
sperm
what are female gametes called
eggs or oocytes
Sex cells are produced by a special type of division called ____________
meiosis
The ______ structures of reproduction include the testes, a system of ducts (epididymis, vas deferens, ejaculatory duct, urethra), accessory sex glands (seminal vesicles, prostate gland, bulbourethral glands), and several supporting structures, including the penis.
male
The scrotum and penis constitute the external genitalia of the male and occupy the ___________, a diamond-shaped area between the thighs bordered by the pubic symphysis, ischial tuberosities, and coccyx.
perineum
________ : The external sace that encloses the testes
scrotum
_______ ________: divides the scrotum right and left halves, providing one compartment for each testis
medial septum
______ ________: a tube of fascia that also contains the testicular vessels and nerves
spermatic cord
The left testis is usually suspended _______ than the right so that the two are not compressed against each other between the thighs.
lower
The reproduction and survival of spermatozoa require a temperature that is ____° C lower than normal core body temperature.
3° C
____________ muscle: bands of skeletal muscle that extend inferiorly from the internal oblique muscles of the trunk, are responsible for elevating the testes
cremaster
__________: A varicose vein in the scrotal circulation disrupts venous return. In 15% of men and in 40% of men being evaluated for fertility treatments.
veriocele
______ _________ : highly convoluted tubules within the testes that form sperm
seminiferous tubules
_________: septal extensions of the tunica albuginea project inward to divide the testis into 250-300 wedge-shaped compartments
lobules
_________(______)________: spherical cells that make and secrete the male sex hormones or androgens
interstitial (Leydig) cells
A ________ ___________: highly convoluted tubules within the testes that form sperm
seminiferous tubule
what are the 2 types of cells in the spermatogenic cells
- spermatogenic cells
- sertoli (sustentacular) cells
- ____________ cells: are in the process of forming sperm (spermatogenesis) which begins at puberty
spermatogenic
- ________ (____________) Cells: they assist the sperm production by conveying nutrients to the spermatogenic cells, actively move them toward tubule lumen, and eat the cytoplasm that is shed during sperm formation
- Sertoli (sustentacular) cells
It takes about _____ days for a spermatogonium to become a mature spermatozoa.
70
300,000 mature sperm are produced every minute, or _____ million per day, in a young male.
400
_____________ is the process by which the seminiferous tubules of the testes produce haploid sperm.
spermatogenesis
________: Sperm function to fertilize a secondary oocyte (a female egg).
sperm
A mature sperm contains…
a head (acrosome), midpiece, tail
- The ______: Contains the nucleus
head
- The _________: the helmet for the head made of highly condensed chromatin, a vesicle containing enzyme that enable the sperm to penetrate and enter the egg
acrosome
- The __________: contains mitochondria spiraled tightly around the core of the tail
midpiece
- The ______ : elaborate flagellum, produce whiplike movements of the tail that propel the sperm through the female reproductive tract
tail
Once ejaculated, sperm have a life expectancy of ____ hours within the female reproductive tract.
48
A. The duct system of the testes includes the…
seminiferous tubules, straight tubules, and rete testis.
The seminiferous tubules lead into a network called the ______ ___________, embedded in the capsule on the posterior side.
rete testis
Sperm partially mature in the rete and are moved along by _______
cilia
After leaving the testis, sperm travel through a series of spermatic ducts to reach the _________
urethra
__________ : comma-shaped structure in the scrotum adjacent to the testis; contain a duct in which the sperm mature
epididymis
pseudostratified ciliated columnar ET that secrete __________ and nutrients for sperm.
glycogen
The epididymis is a site of
sperm maturation and storage
After 10-14 days sperm become mobile and fertile. The sperm remain fertile for _____ to _____ days; if not ejaculated, they disintegrate and are reabsorbed.
40-60
The _______ (_____) _________: stores and transports sperm during ejaculation
ductus (vas) deferens
what is vas deferens lined with
Lined w/ pseudostratified columnar ET and a thick wall of smooth muscle innervated by sympathetic nerve fibers.
What is the site of the vasectomy
Small incisions into both sides of the scrotum, transects both ductus deferens, and then closes the cut ends, either by tying them off or fusing them shut by cauterization
_______ _________: Coils of intestine of the greater omentum can be forced anteriorly through these areas (the inguinal triangle – weaker areas of muscle) , into the inguinal canal, sometimes pushing all the way into the scrotum
inguinal hernia
The _______ ________ : short tubes formed by the union of the seminal gland and the ductus deferens within the prostate
ejaculatory ducts
__________: Carries sperm from the ejaculatory ducts to the outside of the body as well as urine
urethra
What are the 3 sets of accessory glands are found in the male reproductive system
the seminal vesicles, prostate gland, and bulbourethral (Cowpers) glands.
They secrete most of the liquid portion of semen - The yellowish secretion is about 60% of the fluid in semen.
seminal vesicles
Seminal vesicles secrete an _________, viscous fluid that contains fructose, prostaglandins, and clotting proteins.
alkaline
The ducts of the gland open through about 20 pores into the urethra. what gland?
Prostate gland
what kind of fluid does the prostate secrete?
Secretes a milky, slightly acidic fluid that contains enzymes.
What do enzymes do after ejaculation? How might this help?
Enzymes coagulate semen shortly after ejaculation – protection - then clot breaks down approx 15-30 min afterwards.
Prostate secretion enhances fluid mobility and contributes about ____% of semen fluid.
33%
Size of peas and lie on either side of urethra inferior to the prostate gland.
Bulbourethral (cowper) glands
_______ also lubricates end of penis just prior to ejaculation
Mucus
Fluid released in response to sexual ___________
stimulation
_________(seminal fluid) is the fluid the urethra conveys to the outside during ejaculation.
semen
what is semen a mixture of?
a mixture of spermatozoa and accessory sex gland secretions
_________ provides the fluid in which spermatozoa are transported, provides nutrients, and neutralizes the acidity of the male urethra and female vagina.
semen
Semen is the fluid expelled during _______
orgasm
What is a typical sperm count?
sperm count of 50 – 120 million sperm/ml
What amount is associated w/ infertility?
lower than 20-25 million/ml is associated with infertility (sterility).
What does semen contain that can kill certain sperm attacking bacteria
Semen contains an antibiotic that can kill certain sperm attacking bacteria, seminal plasmin, and prostatic enzymes that coagulate and then liquefy semen to aid in its movement through the uterine cervix.
Once ejaculated, liquid semen coagulates within _____ minutes due to the presence of clotting proteins from the seminal vesicles.
5
After about ____-_____ minutes, semen re-liquefies because PSA and other proteolytic enzymes produced by the prostate gland break down the clot. The sperm now become very active, thrashing their tails and crawling up the mucosa of the vagina and uterus.
10-20 minutes
pH of semen is 7.2-7.6 which ___________ vaginal acidity (pH 4-5) – sperm motility is poor below pH 6
neutralizes
Volume is ___-____ milliliters of semen per ejaculation composed of about 10% sperm and spermatic duct secretions, 30% prostatic fluid, 60% seminal vesicle fluid, and a trace of bulbourethral fluid.
2-5 mL
Most of the sperm emerge in the first _____ or _____ jets of semen.
1 or 2
Average ejaculation speed:
27 mph
What are the 3 main parts of the penis?
internal root, shaft, glans
________ ________: attached to the pelvic bones and extends internally, base structures that anchor the penis to the body
internal root
________: is elongated, cylindrical part of the penis that extends from the body to the glans
shaft
________: enlarged tip, the most sensitive part, which is covered by loose skin known as the foreskin
glans
Which the dorsal side and which is the ventral side
- dorsal side - one that faces anteriorly when flaccid
- ventral side - faces posteriorly (urethra passes thru this side)
The penis consists mainly of ______ cylindrical bodies called erectile tissues that fill with blood during arousal and bring about enlargement and erection.
3
What are the 3 cylindrical bodies?
- 2 corpora cavernosa
- 1 corpus spongiosum
2 ________ ___________: the paired, dorsal erectile bodies, make up most of the mass of the penis
corpora cavernosa
1 ________ ____________: the midventral erectile body surrounding the spongy urethra, is enlarged distally where it forms the glans penis, and proximally where it forms a part of the root called the bulb of the penis
corpus spongiosum
___________, propulsion of semen from the urethra to the exterior, is a sympathetic reflex.
ejaculation
Is the skin tight or loose around the penis?
The skin is loosely attached to the penile shaft, allowing for expansion during erection.
________: The skin covering the penis is loose and extends distally around the glans to form a cuff called this
prepuce
_______________: the surgical removal of the foreskin that is typically performed shortly after birth, controversial procedure
circumcision
The ________ organs of reproduction include the ovaries (gonads), uterine (Fallopian) tubes, uterus, vagina, vulva, and mammary glands.
female
What ligaments make up the ovaries
broad, suspensory, and ovarian ligament
_______ __________ : a large fold of peritoneum that hangs from the uterus and the uterine tubes like a tent
broad ligament
The _________ ligament : a lateral continuation of the broad ligament, attaches the ovary to the lateral pelvic wall
suspensory
The ________ ligament : a distinct fibrous band enclosed within the broad ligament
ovarian
Ovaries ontain: Ovarian __________ with primordial eggs (oogonia)
follicles
________ ___________: Ovarian follicles are fluid-filled sacs located in the ovaries, each containing an immature egg (oocyte).
ovarian follicles
Egg production is called ___________
oogenesis
Like spermatogenesis, it produces a haploid gamete by means of ____________
meiosis
What is the main difference though?
There are, however, numerous differences between the two. The most obvious, perhaps, is that males produce sperm continually, whereas oogenesis is a distinctly cyclic event that normally releases only one egg per month.
T or F: oogenesis begins before a girl is born
TRUE
A human female is born with all the eggs she will ever have (over a million) and by puberty, only ____________ remain.
400,000
At puberty, the anterior pituitary gland secretes increased amounts of ______, and the ovaries enlarge in response. Egg development resumes, and follicles develop when FSH stimulates monthly cohorts of primary oocytes to complete meiosis I.
FSH
Typically only the dominant (_______) follicle fully develops and the others degenerate.
Graafian
(___________) follicle: a mature, fully developed ovarian follicle that contains a secondary oocyte ready for ovulation
Graffian
the ________ __________: is an immature egg cell that is produced during the process of oogenesis (ovulation and is arrested in metaphase II of meiosis, only completing meiosis if fertilization occurs)
secondary oocyte
The uterine (_________) tubes: receive the ovulated oocyte and are the site for fertilization
fallopian
What are the 3 layers of the uterine tubes
- internal mucosa
- middle mucularis
- outer mucosa
________ cells and peristaltic contractions help move a secondary oocyte toward the uterus.
ciliated
What is pelvic inflammatory disease? Can it cause infertility?
A widespread infection that originates in the vagina and uterus and spreads to the uterine tubes, ovaries and ultimately the pelvic peritoneum. Generally caused by chlamydial or gonorrheal infection. Occurs in 10% of women and can cause infertility in 25% of patients.
The ________(womb) is an organ the size and shape of an inverted pear that functions in the transport of spermatozoa, menstruation, implantation of a fertilized ovum, development of a fetus during pregnancy, and labor.
uterus
Anatomical subdivisions of the uterus include (3)
- fundus
- body
- isthmus
- cervix
The uterus is normally held in position by a series of _________
ligaments
the uterus consists of what layers
- outer (perimetrium)
- middle (myometrium)
- inner (endometrium)
_________ : the thick later of smooth muscle in the wall in the uterus
myometrium
____________ : mucous membrane lining the uterus
endometrium
_____________ : the outer serous membrane, is the peritoneum
perimetrium
________ __________: is the passage that runs through the cervix, connecting the uterus to the vagina
cervical canal
Secretory cells of the mucosa of the cervix produce a cervical __________ (a mixture of water, glycoprotein, serum-type proteins, lipids, enzymes, and inorganic salts) which, prevent spread of microbes from vagina to uterus.
mucus
Is the mucus more receptive to sperm when it is thick or thin?
When mucus is thin, it is more receptive to sperm and which, when thick, forms a cervical plug that physically impedes sperm penetration
If the ovulated oocyte (secondary oocyte) is fertilized, it will move into the uterus and imbed itself into the ____________ and begin the process of fetal development.
endometrium
If fertilization does NOT occur, then the endometrium of the uterus is sloughed off each month (called ____________) carrying the unfertilized egg with it.
menstruation
______________ is a condition where fragments of endometrial tissue spread to the fallopian tubes, ovary and even peritoneum of the pelvic cavity. These tissue cells respond to female hormone changes and develop endometrial tissue and bleeding. The blood accumulates in the pelvic cavity, forms cysts and exert pressure. 10% of women have it and it causes infertility in 33% of all cases.
Endometriosis
The ________ functions as a passageway for spermatozoa and the menstrual flow, the receptacle of the penis during sexual intercourse, and the lower portion of the birth canal.
vagina
________ : transverse folds or ridges in the mucosal lining of certain organs, such as the stomach and vagina, that allow for expansion.
rugae
the _______: mucosa elaborates to form an incomplete diaphragm (tends to bleed during first intercourse)
hymen
The external genitalia of the female occupy most of the perineum and are collectively called the _______(pudendum)
vulva
what is included in the vulva?
- mons pubis
- labia majora and minora
- clitoris
- vaginal orifice
- accessory glands and erectile tissues
________ _________: is a fatty, rounded pad overlying the pubis symphysis
mons pubis
________ _________: 2 long, hair-covered, fatty skin folds “larger lips: which are the female counterpart of the scrotum (they derive from the same embryonic structure)
Labia majora
_________ __________ : enclose two thin, hairless folds of the skin, “smaller lips” which enclose the vestibule
labia minora
__________: very sensitive organ that is composed of erectile tissue and is associated with sexual pleasure in females
clitoris
___________: “entrance hall” housing the external openings of the urethra and vagina
vestibule
_______ _________ (Bartholin’s) glands (secrete a small amount of mucus to lubricate the vaginal canal during sexual arousal -> reduce friction)
great vestibular
During childbirth the emerging fetus may cause excessive stretching and tearing of the perineum. The central tendon is sometimes torn by the infant’s head during childbirth. A physician may make a surgical incision (___________) in the vulva to prevent excessive, jagged tears. The incision is stitched after birth.
episiotomy
The __________ glands are modified sudoriferous (sweat) glands that lie over the pectoralis major and serratus anterior muscles.
mammary
Mammary glands enlarge at puberty and remain for life, but do they contain that much mammary gland?
contain very little mammary gland
The mammary gland develops within the breast during pregnancy, remains active in the lactating breast, and _________ when a woman ceases to nurse.
atrophies
Internally, the nonlactating breast consists mostly of
adipose / collagen tissue
_______: are tiny, sac-like structures in the lungs where gas exchange occurs
alveoli
________: a ring of pigment skin that surrounds the nipple
Areola
The essential functions of the mammary glands are _________ of milk, secretion and ejection of milk, which constitute lactation.
synthesis
_______ ________: Breast tumors begin with cells of the mammary ducts and may metastasize to other organs by way of the mammary and axillary lymphatics.
breast cancer
T or F: The general term, female reproductive cycle, encompasses the ovarian and uterine cycles, the hormonal changes that regulate them, and cyclical changes in the breasts and the cervix.
True
The ovarian cycle is a series of events associated with the maturation of an ______
ovum
The uterine (menstrual) cycle involves changes in the ___________ to prepare for the reception of a fertilized ovum.
endometrium
The menstrual and ovarian cycles are controlled by _______ from the hypothalamus
GnRH
What does GnRH stimulate?
which stimulates the release of FSH and LH by the anterior pituitary gland.
FSH stimulates the initial development of ovarian follicles and secretion of __________ by the ovaries.
estrogens
_____ stimulates further development of ovarian follicles, ovulation, and the secretion of estrogens and progesterone by the ovaries.
LH
Estrogens have several important functions:
- Promotion of the development and maintenance of female reproductive structures, secondary sex characteristics, and the breasts.
- Under the influence of increasing estrogen levels (secreted by maturing primordial follicles) the basal layer of endometrium generates a new functional layer.
__________ works with estrogens to prepare the endometrium for implantation and the mammary glands for milk synthesis
Progesterone
Progesterone also maintains the endometrium during pregnancy – remember progesterone “promotes _________”.
gestation
What are the 4 phases the female reproductive cycle is divided up into?
- mentruation
- preovulatory phase
- ovulation
- postovulatory phase
The menstrual cycle is approximately the first _____ days of the cycle
5
During this phase, small secondary follicles in each ovary begin to develop. The ________ phase of the ovarian cycle occurs between days 1 – 14 of the female cycle, and overlaps with menstruation and the proliferative phase in the uterus.
follicular
Also during this phase, the stratum functionalis layer of the endometrium is shed, discharging blood, tissue fluid, mucus, and epithelial cells as a result of low ________ and ____________ levels.
estrogen and progesterone
The preovulatory phase, or proliferative phase, is the time between menstruation and ovulation. This phase is more variable in length that the other phases, lasting from days ___-_____ in a 28-day cycle.
6-13
uring this phase primary follicles in the ovary (follicular phase of the ovarian cycle (days 1-14)), develop into secondary follicles and a single secondary follicle (occasionally more than one) develops into a vesicular ovarian (Graafian) follicle, or mature follicle. This follicle produces a bulge on the surface of the ______.
ovary
During the preovulatory phase, what is being repaired?
endometrial repair
Ovulation is the rupture of the vesicular ovarian (________) follicle with release of the secondary oocyte into the pelvic cavity, usually occurring on day 14 in a 28-day cycle. The LH surge brings about the ovulation.
graafian
The ___________ phase is the most constant in duration and lasts from days 15-28 in a 28-day cycle, the time between ovulation and onset of the next menstrual period.
postovulatory phase
With reference to the ovaries, this phase of the cycle is also called the luteal phase, during which both estrogen and progesterone are secreted in large quantities by the now empty follicle called the ________ _________
corpus luteum
With reference to the uterus, this phase is also called the ________ phase because of the secretory activity of the endometrial glands as the endometrium thickens in anticipation of implantation.
secretory
If fertilization and implantation do not occur, the corpus luteum degenerates and becomes the _______ ___________ or white body. The decreased secretion of progesterone and estrogens then initiates another menstrual phase (uterine and ovarian cycle).
corpus albicans
If fertilization and implantation do occur, the corpus luteum is maintained until the ________ takes over its hormone-producing function. Once the placenta begins its secretion, the role of the corpus luteum becomes minor.
placenta
Women athletes who train intensively may develop three conditions which disrupt their reproductive cycle. This is known as female athlete triad - what are the 3 components?
- amenorrhea (no period)
- disordered eating
- premature osteoporosis
_________ is the presence of a developing offspring in the uterus and begins with a fertilized oocyte and ends with production of offspring nine months later.
Pregnancy
How many trimesters is a pregnancy
It consists of three periods, or trimesters, each three months long
Before fertilization can occur, a _________ oocyte must be ovulated and enter a uterine tube
secondary
T or F: Ovulated secondary oocyte is still not finished with meiosis and is surrounded by a group of cells called the corona radiata (granulosa cells).
True
Oocytes are viable for how long after ovulation?
for 12-24 hours after ovulation.
Egg releases chemicals that attract sperm, ___-___ hours for sperm to reach uterine tubes.
1-2
Only _____ of between 200 to 600 million sperm reach a secondary oocyte
200
Sperm meet secondary oocyte about one-third down the uterine tube usually 12-24 hours after ovulation. Spermatozoa can reach uterine tube within ____ minutes of ejaculation
10
Spermatozoa bind to receptors on the _____ __________ around the oocyte (10 hours for this process to occur)
zona pellucida
Conception of a child can occur during a window of time spanning 48 hours before ovulation to ____ hours after.
14
Spermatozoa release enzymes (__________reaction) to penetrate corona and digest zona pellucida around secondary oocyte.
acrosomal
When a single sperm contacts oocyte membrane, the sperm nucleus is engulfed by the oocyte and causes the ________ __________. The oocyte secretes enzymes that destroy the sperm receptors preventing any other sperm from binding to or entering the egg.
cortical reaction
___________ begins and the oocyte completes meiosis
fertilization
Haploid female nucleus and haploid male nucleus fuse, forming new diploid nucleus and the Chromosomes of 2 gametes mix. New organism is called a _______
zygote
________ period is from fertilization to birth
prenatal
__________: cell division (early series of rapid cell divisions that occur after fertilization)
cleavage
__________: a solid ball of cells resulting from the division of the zygote after several rounds of cleavage
morula
What are the two components of the blastocytes
- Trophoblast – “nourishment generator” a layer that will soon provide the embryo with nourishment from the mothers uterus
- Inner cell mass – the future embryo
________ stage: begins after implantation and lasts from the third week to the eighth week of development (basic structures and organs of the embryo form)
embryonic
______ stage: starts at the ninth week of pregnancy and continues until birth. This stage is characterized by rapid growth, further development of tissues and organs, and the maturation of the fetus
fetal
Postnatal period is from birth to _______
death
what is the difference is fertilization between fraternal and identical twins
- Fraternal (dizygotic) twins: Independent release of two oocytes which are each fertilized by its own sperm
- Identical (monozygotic) twins: Two individuals develop from a single fertilized ovum
Implantation of blastocyst into endometrium occurs around day seven after fertilization (describe the process)
- Trophoblast cells form the placenta.
- Endometrium grows over (encloses) implanting embryo.
What are the Four Extraembryonic Membranes
- yolk sac
- amnion
- allantosis
- chorion
_____ ______ – provides early nourishment to the developing embryo before the placenta is fully functional
yolk sac
_________- a membrane that surrounds and protects the developing embryo/fetus by enclosing it in a fluid-filled sac, known as the amniotic sac (acts as a cushion)
amnion
________ - a structure that forms early in development, involved in the exchange of gases and waste between the embryo and the environment
Allantois
_________ - is the outermost of the extraembryonic membranes and plays a key role in the formation of the placenta (exchange nutrients, gases, and wastes)
chorion
What is an ectopic pregnancy?
Blastocyst implants somewhere other than uterus (1 out of 300 pregs)
most cases occur in _______ _______ (tubal pregnancy)because of tubal obstruction from previous pelvic inflammations, repeated abortions or tubal surgery
uterine tube
Tube cannot expand enough & ruptures by 12 weeks and usually requires an ________
abortion
__________ exchanges materials (nutrients, gases, wastes), forms hormones, stores nutrients & acts as a barrier to some microbes and some drugs.
placenta
Formation of the placenta occurs from 11 days to 12 weeks (which has maternal part and fetal part) completely formed by ______ month (end of first trimester).
third
What things does the umbilical cord contain in terms of transportation (OPPOSITE)
- 2 umbilical arteries that carry “waste” blood from the fetus to the placenta
- 1 umbilical vein that carries “fresh” blood from the placenta to the fetus
________ trimester - Tissues and organ systems mature and increase in complexity
second
______ trimester – organs systems fully functional
third
_________ or parturition, the act of giving birth, occurs an average of 266 days after fertilization and 280 days after the last menstrual period; the stages of labor include dilation, expulsion, and the placental stage.
childbirth
What are the signs of labor
- Dilation: the first stage that begins with the first regular contractions of the uterus and ends when the cervix is fully dilated (10 cm in diameter) by the babys head
- Expulsion: the second stage lasts from full dilation to delivery, or actual childbirth
- Placental: third stage or the delivery of the placenta, is accomplished within 15 minutes after birth of the infant
What are the most 2 common types of reproductive cancer in men
- Testicular cancer affects approximately 1 of 50,000 males, most often in the age bracket of 15–35 years; this cancer is cured in 95% of all cases.
- Prostate cancer is a slow-growing cancer that is the second most common cause of cancer death in men; lung cancer is first.
What are the reproductive cancers in females
- ovarian cancer
- endometrial caner
- cervical cancer
- breast cancer
Ovarian cancer affects 1.4% of women and is the ______ most common cause of cancer death in women.
fifth
_________ cancer affects 2% of women and is the fourth most common cause of cancer death in women (after lung, breast, and colorectal cancers).
endometrial
________ cancer occurs in 1% of women between ages 30–50 years; survival rates improve with early detection.
cervical
_______ cancer, the second most common cause of cancer deaths in women, kills 3% of the women in the United States.
breast
Embryonic development of the sex organs of both males and females begins during week _____
5
The gonads descend in both sexes after forming in the dorsal abdomen; testes descend into the ________, and ovaries descend into the ________
scrotum
pelvis
Puberty generally occurs between ages ____-______, when reproductive organs mature and reproduction is possible.
10-15
___________ in women occurs normally between ages 46 and 54 and marks the end of ovulation and menstruation.
menopause
