Chapter 27Female Reproductive System II

Lecture 20

Marieb’s HumanAnatomy and

Physiology

Marieb Hoehn

2

Lecture Overview

• Hormonal control of the female reproductive system

• Mammary glands

• Male and female climacteric

• Birth control

• Sexually transmitted disease (STD)

A brief review of the ovarian cycle before we begin…

3

Review of Female Reproductive Cycle

Figure from: Hole’s Human A&P, 12th edition, 2010

4

Ovarian Cycle – Preovulatory (Follicular) PhaseFigure from: Martini, Anatomy & Physiology, Prentice Hall, 2001

(FSH)Thecal and granulosa cells produce estrogens

8-10 days after beginning of cycle

10-14 days

Meiosis I

LH

Meiosis II started

Many OneFew

(Graafian)

1.5 cm

Estrogen

(FSH)

5

Ovarian Cycle – Postovulatory (Luteal) Phase

(Day 14)

LH

Lipids used to synthesize progestins, e.g., progesterone (prepares uterine lining for implantation)

12 days post ovulation

If fertilization has not occurred

Figure from: Martini, Anatomy & Physiology, Prentice Hall, 2001

LH

6

Hormonal Control of the Female Reproductive Cycle

• Ovarian and uterine (menstrual) cycles must be coordinated

• GnRH (Gonadotropin Releasing Hormone) is the controlling hormone of reproduction– Pulse frequency and amplitude (amount)– Without pulses, LH/FSH secretion (also in

pulses) will stop– Changes in GnRH pulse frequency are

controlled by estrogen (increase) and progestins (decrease)

7

Hormonal Regulation of Ovarian Activity

Figure from: Saladin, Anatomy & Physiology, McGraw Hill, 2007

8

Hormonal Regulation of Ovarian Activity

Figure from: Marieb, Anatomy & Physiology, Pearson, 2004

Estrogen is the predominant hormone prior to ovulation (follicular phase)

Progesterone is the predominant hormone after ovulation (luteal phase)

inhibits LH and FSH during most of the reproductive cycle

(Day 10)

16-24 GnRH pulses/day

48GnRH pulses/day

36 GnRH pulses/day

1-4 GnRH pulses/day

9

Pathways of Steroid Hormone Synthesis

Androstenedione is secreted by thecal cells (LH) of the primary follicles and then absorbed by the granulosa cells (FSH) and converted to estrogens.

Figure from: Martini, Anatomy & Physiology, Prentice Hall, 2001

Most abundant

10

Effects of Estrogens (20 sex characteristics)•development of breasts and ductile system of the mammary glands

• increased adipose tissue in breasts, thighs, and buttocks

• increased vascularization of skin

• Maintenance of the function of accessory reproductive glands/organs

• CNS effects, e.g., sex drive, “feminization”

•Repair/growth of endometrium (following menses)

11

Uterine (Menstrual) Cycle

Proliferative phase – functional layer of endometrium thickens under the influence of estrogen

Secretory phase – Arteries elaborate and uterine glands enlarge, coil, and begin secreting glycogen under progesterone’s influence

Functional

Basilar

*

Figure from: Hole’s Human A&P, 12th edition, 2010

12

Menarche and the Menstrual Cycle

• Menarche– First menstrual cycle (Latin mensis = month)– Typically begins around age 11-12– If menarche does not appear by age 16,

considered amenorrhea (rhe(o)- = flow)

• Menstrual cycles– Occur monthly unless interrupted by illness,

stress, starvation, or pregnancy– Lack of menstrual period for 6 months or more

is considered amenorrhea (secondary)– Painful menstruation is called dysmenorrhea –

may result from uterine inflammation or conditions involving adjacent pelvic structures

13

Overview of Female Reproductive Cycle

You should understand these events, and their timing, for the exam

Figure from: Hole’s Human A&P, 12th edition, 2010

14

Events of the Female Reproductive Cycle

Table 22.4 in Hole’s Anatomy & Physiology

Good textual review table for combined ovarian and uterine cycles

Figure from: Hole’s Human A&P, 12th edition, 2010

15

Male and Female Climacteric

• usually occurs in late 40s or early 50s (perimenopause)• reproductive cycles stop for 6 months to 1 year• ovaries no longer produce as much estrogen and progesterone due to depletion of ovarian follicles• some female secondary sex characteristics may disappear• sustained rise in GnRH and LH/FSH may produce hot flashes (LH) and fatigue• risk of atherosclerosis increases• hormone therapy may prevent effects on bone tissue

Female climacteric = menopause

Male climacteric (andropause)• more gradual than female climacteric • usually occurs after age 50• slowly declining levels of testosterone• sperm (gamete) production continues (even into 80s!)

16

Mammary Glands

Mammary glands as shown are for women in last trimester of pregnancy or who are nursing.

The areola, a ring of pigmented skin, covers large sebaceous glands that give it a bumpy appearance. Sebum reduces chapping and cracking of the nipple.

Figures from: Martini, Anatomy & Physiology, Prentice Hall, 2001

17

Mammary Glands

Milk production = lactation

Figures from: Martini, Anatomy & Physiology, Prentice Hall, 2001

Inactive (resting) mammary gland is dominated by a duct system rather than by active glandular cells. Size of mammary glands in a nonpregnant/nonlactating woman reflects amount of adipose tissue present.

18

Clinical Application – Breast Cancer

• Malignant cancer of the mammary gland (ducts/glands)• Second leading cause of death in women (exceeded only

by lung cancer)• Death rates declining, especially in women under 50

(perhaps due to better screening)• Risk factors

– Family history– Early menarche and/or late menopause– First pregnancy later in life– No proven link between oral contraceptive use, estrogen therapy,

fat consumption, or alcohol use; but these are suspected links

• About a 20% less risk after menopause in women who have nursed their babies

• Self examination and mammography help in early detection (< 2 cm) and reduction in mortality

Breast Cancer Screening Recommendations

19

Figure 3.1: Breast Cancer Screening Recommendations for Women at Average Risk 

   Susan G. Komen for the Cure® 

American Cancer Society  

 National Cancer Institute  

National Comprehensive Cancer Network  

U.S. Preventive ServicesTask Force  

Mammography 

 

Every year beginning at age 40.

Every year beginning at age 40.

Every 1-2 years beginning at age 40.

Every year beginning at age 40. 

Informed decision-making with a health care provider

ages 40-49.  Every 2 years 

ages 50-74.

Clinical Breast Exam 

   At least every 3 years ages 20-39

Every 3 years ages 20-39. 

 No specific recommendation.

Every 1-3 years ages 20-39.

Not enough evidence to recommend for or against.

  Every year beginning at age 40.

Every year beginning at age 40.

Every year beginning at age 40.

Note: Women at higher risk may need to get screened earlier and more frequently than recommended here. Find more on screening recommendations for women at higher risk of breast cancer.

Table source: http://ww5.komen.org/BreastCancer/GeneralRecommendations.html

In addition to guidelines below, women should consider having a baseline mammogram in their late 30s

20

Breast Cancer

Figures from: Saladin, Anatomy & Physiology, McGraw Hill, 2007

Figure from: Hole’s Human A&P, 12th edition, 2010

21

Birth Control

• abstinence (0%!!!)*• coitus interruptus (?!)• rhythm method (~25%)• mechanical barriers

• condom (6-17%)• diaphragm (5%)• cervical cap (8%)

• chemical barriers- spermicidal foams or jellies (~ 26%)

• oral contraceptives (2-3%)• hormonal

• injectable contraception (<1%)• hormonal

• contraceptive implants (<1%)• hormonal

• intrauterine devices (5-6%)• surgical methods (sterilization)

• vasectomy (.08%)• tubal ligation (.45%)

* Numbers in parentheses below indicate the approximate failure rate of the birth control method, i.e., percent of pregnancies

22

23

Prevalence of Birth Control Methods

Reality™ - the Female Condom

– Use a new Reality with each and every sex act.

– Read instructions carefully before using Reality.

– The booklet explains how to use Reality.

– Don't tear Reality.

– Reality only works when you use it.

– Make sure Reality is not twisted after insertion.

– Reality should not be noisy during sex.

– Reality may shift during sex.

– Keep Reality out of the reach of children.

24

Excerpts from the Instruction Booklet…

25

Surgical Methods of Birth Control

Vasectomy Tubal ligation

Newer techniques using silicone plugs may allow reversal of a vasectomy

Figure from: Hole’s Human A&P, 12th edition, 2010

26

When Other Methods of Birth Control Fail…

27

Sexually Transmitted Diseases (Infections)• silent infections (incubation period and communicable period)

• most are bacterial and can be cured

• herpes, warts, and AIDS are viral and cannot be cured

• many cause PID (women) and infertility

• AIDS causes death

• symptoms of STIs typically include• burning sensation or pain during urination• pain in lower abdomen• fever or swollen glands• discharge from vagina or penis• pain, itch, or inflammation in genital or anal area• sores, blisters, bumps or rashes• itchy runny eyes

Overall U.S. Trends in STDs

28

Figure from: http://www.avert.org/std-statistics-america.htmFigure from: http://www.dermnet.com/topics/genital-warts/overview/

Figure from: http://wellness-reviews.com/std-testing/top-5-reasons-people-avoid-std-testing/

29

Review

Figure from: Marieb, Anatomy & Physiology, Pearson, 2004

Estrogen is the predominant hormone prior to ovulation (follicular phase)

Progesterone is the predominant hormone after ovulation (luteal phase)

inhibits LH and FSH during most of the reproductive cycle

(Day 10)

Estrogen maintains secondary sex characteristics in females

30

ReviewFigure from: Hole’s Human A&P, 12th edition, 2010

31

Review

• Climacteric– Women

• Called menopause

• Occurs around 40-50 years of age

• Cessation of reproductive cycles – no oocytes

• Ovaries no longer produce much estrogen

– Men• Occurs more gradually

• Sperm production continues well into old age

• Levels of testosterone decline gradually