REPRODUCTIVE SYSTEM



REPRODUCTIVE SYSTEM

MALE REPRODUCTIVE SYSTEM

1. THE AMAZING PENIS

This organ can vary in size from 1” to 6” in seconds, while maintaining the integrity of the blood vessels, nerves, and lymphatics.

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FUN FACTS

Lions have sex every 15 minutes for an entire week. However, this only occurs every two years. The pig has the longest orgasm; it can last up to 15 minutes.

A. BODY of the penis is the exposed region

B. GLANS is the tip of the penis.

Surrounding the glans is the PREPUCE (foreskin), a continuation of the skin of the penis that extends over the glans.

CIRCUMCISION is removal of the foreskin, exposing the glans. There is not much bleeding, not very vascular. This is the most common surgical procedure done in the US, although there is no medical reason to have it done, and having it done actually increases the risk of certain cancers there. It is not done routinely anywhere in the world except in Jewish cultures for religious reasons, and in some areas where the climate is like a desert and water is scarce. Hardly anyone from the European countries is circumcised.

ORGASM IN MALES

The erectile tissue is lined by tissue which extends into itself, creating vascular spaces which can fill with blood, causing the penis to become more rigid and expand. The erection is due to vasodilation, with blood moving into erectile tissue.

Viagra is a medicine which allows vasodilatation (to encourage a penile erection), but if you have heart disease, it can give you a heart attack. Viagra can also cause vision problems.

An erection squeezes the veins shut so the blood can’t leak out. If Viagra (or anything else) causes an erection for longer than four hours, the erection decreases the blood flow, and the tissue is killed.

This is a complex organ system; lots of plumbing issues.

2. SCROTUM

A. TESTICLES makes sperm.

B. VAS DEFERENS is the tube that the sperm goes into.

C. PROSTATE GLAND is where the vas deferens passes through.

D. SEMINAL FLUID is the liquid that carries the sperm. It is made by the prostate gland.

E. SEMEN is the seminal fluid plus the sperm. The semen is then dumped into the urethra during ejaculation. The urethra is the same tube that excretes urine.

In order for sperm to be produced, the temperature has to be a few degrees lower than normal (35˚C or 94˚F instead of 37˚C or 98˚F). To insure a lower temperature, the testes are located outside of the body, in the scrotum (outside of the pelvis). The temperature is maintained by muscles that elevate and depress the testes.

PROBLEMS

There is an opening in the groin area called the INGUINAL CANAL. If you do heavy lifting, it increases the abdominal pressure, and intestine gets pushed into it = INGUINAL HERNIA (surgery). To check for hernia, feel scrotum, and cough. Should be a little movement, but the testes should not move all the way up.

VASECTOMY is the #1 birth control method in the US and is the most effective form of birth control. An incision is made in back of the scrotum, cut out a piece of the vas deferens. It is possible to reverse it, but it is assumed permanent. Only 1 in a million grows back together in 5-10 years.

Infertility

The most frequent cause of infertility in males is low sperm count and/or abnormal sperm. Disease, radiation, chemicals, high testes temperature, and drug abuse can also contribute to this condition.

PROSTATE

The urethra goes through the middle of the prostate, which continues to grow throughout life. By the time men are older, most of them have PROSTATIC HYPERTROPHY (enlarged prostate). It can constrict the urethra, making it hard to urinate. Needs surgery to open.

Prostate cancer affects 10% of the male population. To check for cancer of the prostate, do a rectal exam. A finger is placed in the rectum and the prostate can be palpated. It should be part of a routine physical.

If the prostate needs to be removed, there are nerves that might be severed that run along it, causing erectile dysfunction.

FEMALE REPRODUCTIVE SYSTEM

Consists of the following:

1. Ovaries

2. Fallopian Tubes

3. Uterus

4. Vagina

5. External genetalia

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1. OVARIES

These are about one inch around.

OVARIAN CYCLE

This is the process of egg development on a monthly basis.

Eggs develop during fetal development. A woman is born with all the eggs she will ever have; about half a million. At puberty there is a change in hormones which causes development of some of these eggs.

The two hormones that influence the development of female secondary sex characteristics are estrogen and progesterone.

The average ovarian cycle is 28 days.

Day 1

This is the first day of menstruation. The new eggs in the ovary begin to develop.

Day 7

ESTROGEN starts to be produced, which starts to build up the lining of the uterus and also inhibits the development of other eggs. It’s like a race that lasts a week; the first one to reach this stage of maturation wins, the rest of the maturing eggs die so there is only one remaining. In some races, there can be a tie, so if that happens here, you get multiple births.

Day 14

The egg is fully mature, is still producing estrogen, and has become so big that it forms a blister on the outside of the ovary which then expands and pops, so the egg breaks through the ovary. This process is called OVULATION. Can be some cramping.

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Day 28

Menstruation starts as the uterine lining breaks down ( Day 1

A woman is only fertile when the egg is released, but there is an OVARIAN REFLEX which is ovulation in response to sex (not necessarily with orgasm). In addition, sperm live for 7-10 days. That means that you can have sex during menstruation, and the sperm might live inside past ovulation. There is no safe time to have unprotected sex. Unprotected sex once a week = 90% chance of pregnancy.

Infertility

One of the most common causes of infertility in women is STD (sexually transmitted disease). We’ll talk about that later. Also, Fat is needed to have the menstrual cycle. Skinny and athletic women may not menstruate.

Women who have trouble conceiving take fertility pills, which causes 100 eggs to develop, 4-5 of which may mature ( multiple births. Therefore, fertility pills frequently result in multiple births.

Birth Control Pills are made of estrogen, so they inhibit the development of the eggs, but the uterine lining still grows. You take them for 3 weeks, and then take one week off to allow for menstruation. They are 99% effective if taken properly. You have to be careful to take the pill not only every day, but at the same time every day, to keep from getting pregnant. Some of the new estrogen pills can cause a period only every 3 months instead, but there are side effects. Stop BCP 6-12 months before planning conception, or there may be birth defects.

Implantable birth control = NORPLANT, etc (capsules of estrogen surgically implanted under the skin of the arm), releases tiny amount of estrogen continually.

Condoms are also 99% effective if used correctly; if not, only 85% effective. Solution = put the woman in charge of the condom, and the failure rate drops dramatically.

2. FALLOPIAN TUBES

When the egg is released, it goes into the fallopian tube. .

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ECTOPIC PREGNANCIES

The egg is normally fertilized in the fallopian tube, goes down into the uterus and implants there. If it implants in the fallopian tube = ECTOPIC PREGNANCY. This is fatal to the mother and embryo, but nowadays there are few deaths of the mother because it is very painful, so she will go to the ER and they will do surgery. A woman who goes into the ER with abdominal pain will always get a pregnancy test.

Sperm swim out of the opening of the fallopian tube and into the body cavity.

That means any STD can also enter there, causing PELVIC INFLAMMATORY DISEASE (PID), where it spreads to all organs in the pelvis. This STD is chronically extremely painful for the rest of the woman’s life, and there is no cure and no treatment.

The most common cause of infertility in women is STD. The inflammation and scarring closes off the fallopian tube.

TUBAL LIGATION is a method of birth control where a piece of the fallopian tube is cut out, and there’s no way for the sperm to reach the egg. It is more complicated than a vasectomy, so it is done less often than a vasectomy.

3. UTERUS

The uterus consists of a BODY, CERVIX, and VAGINA. The cervix is the neck of the uterus.

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When a woman stands upright, the uterus sits on top of the urinary bladder.

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PROBLEMS WITH THE UTERUS

ENDOMETRIOSIS is a very strange condition. Pieces of the uterus wall (endometrium) are supposed to fall down the vagina during menstruation, but sometimes its cells go up the fallopian tube and enter the body cavity. They can lodge anywhere; on top of the lung, kidney, etc. These cells still respond to hormone changes, grow, and break down and die, causing a lot of weird pain during menstruation. It’s difficult to diagnose because the pain goes away before the doctor appointment. The symptoms vary, depending on the location. One lady had it on her lung and got a collapsed lung every month. Treatment is to give hormones to prevent menses.

FIBROIDS

These are benign tumors like scar tissue. They can get large and be painful, especially during contraction of menses and pregnancy. Fibroids are the most common reason for hysterectomy (surgical removal of the uterus).

HYSTERECTOMY comes from the Greek “hysteria”. It was thought that only women get hysterical because they have a uterus. Now we know that’s not true. They get hysterical because they have ovaries! The surgery involves going through the abdominal wall, cut the fallopian tubes, and yank the uterus out through the vagina.

4. VAGINA: At the vaginal opening the skin extends into the opening = HYMEN. It is thin and rubs away during first sexual intercourse.

5. EXTERNAL GENITALIA = VULVA

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Parts of the vulva

A. LABIA MAJORA are thick folds of tissue around the labia minora. It is the female equivalent of the scrotum.

B. CLITORIS (equivalent of the penis), which also has erectile tissue

During childbirth the vaginal opening enlarges, so it will either stretch or tear. If it tears all the way back to the anus, it will get badly infected. The surgeon can do a controlled cut on the vagina to enlarge the birth canal = EPISIOTOMY. Local anesthesia is given first.

BIRTH CONTROL METHODS

This is a list of some contraceptives in order of effectiveness

Abstinence

Vasectomy

Tubal ligation

Birth Control pills

Intrauterine device (IUD)

Diaphragm

Condom

Jellies, creams, foams

Rhythm Method

Penis withdrawn before ejaculation

The most reliable method of birth control is abstinence, that is, the absence of sexual intercourse. This form of birth control has the added advantage of preventing transmission of a sexually transmitted disease.

Oral contraception (birth-control pills)

Involves taking a combination of estrogen and progesterone for 21 days a month.

They prevent ovulation. There can be some serious side effects: increased

risk of heart attack.

Intrauterine device (IUD)

This is a small piece of mold plastic that is inserted into the uterus by a physician. It prevents implantation. Problem is that it can harbor bacteria and become infected.

Diaphragm

This is a soft latex cup with a flexible rim that fits over the cervix and can be inserted into the vagina two hours at most before sexual relations. It must be used with spermicide. Jelly or cream and should be left in place at least six hours after sexual relations. Problem is that it takes some skill to use; must be exactly in the proper position.

Condom

A condom, when used in conjunction with a spermicide, the protection is better than with the condom alone. It also protects against sexually transmitted diseases. Problems occur unless air must be squeezed out of the tip after it is in place or it will break. Use of hand creams will also cause it to break. Only K-Y Jelly (water-based lubricant) is safe to use near a condom.

The least effective method is withdrawing the penis before ejaculation. Statistics say that there is a 30% chance of pregnancy with this method.

Is possible for a baby to have five parents:

(1) sperm donor, (2) egg donor, (3) surrogate mother, and (4) and (5) adoptive mother and father.

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