FEMALE

REPRODUCTIVE
SYSTEM
 FEMALE REPRODUCTIVE SYSTEM

Gynecology
▪ the study of the female reproductive
organs

Division:
1.External Reproductive System
2.Internal Reproductive System
EXTERNAL REPRODUCTIVE ORGANS

1. Mons Veneris
2. Labia Minora
3. Labia Majora
4. Vestibule
5. Clitoris
6. Skene Gland
7. Bartholin Gland
Mons Veneris
- Protects the symphysis pubis

Labia Majora
- Protects the labia minora and the vaginal
os

Labia Minora
- Protects the obscure and vestibule, urinary
meatus and vaginal os
Clitoris
- Significance in Obstetrics: serves as guide
to female catheterization

Bartholin’s / Vulvovaginal Glands

- Secretes alkaline mucus during coitus
which makes vagina less acidic and more
alkaline
Skene’s Ducts / Paraurethral Glands
- Secretes mucus to lubricate the vestibule

Hymen
- Protects the opening of the vagina;
separates internal from the external
reproductive organs
- MYRTIFORMES CARUNCLES, remnants
of the hymen after childbirt
EXTERNAL REPRODUCTIVE SYSTEM
The blood supply of the female external genitalia is mainly from
the pudendal artery and a portion is from the inferior rectus
artery.
The anterior portion of the vulva derives its nerve supply from
the ilioinguinal and genitofemoral nerves. The posterior
portions of rhe vulva and vagina are supplied by the pudendal
nerve.
The Female Internal Reproductive
Organs
INTERNAL REPRODUCTIVE
ORGANS

1.VAGINA
2.UTERUS
3.FALLOPIAN TUBE
4.OVARY
VAGINA
1.Female organ of copulation / sexual intercourse
2.Excretory canal of the uterus – uterine secretions and menstrual
flow
3.Soft birt canal during labor
UTERUS
1. Menstruation
2. Pregnancy: houses and nourishes the growing baby
3. Labor: propels the product of conception
FALLOPIAN TUBES / OVIDUCTS
1. Organ of normal fertilization
2. Ducts through which the ova travels from the ovaries to the uterus
OVARIES
1.Oogenesis: process of developing a mature ovum in a Graafian
follicle
2.Ovulation: monthly expulsion of mature ovum from the graafian
follicle into the pelvic cavity
3.Endocrine function: secretes Estrogen and Progesterone
Blood supply of the Uterus: from the two uterine and ovarian arteries
UTERINE NERVE SUPPLY
• Refer to your books, page 89.
UTERINE LIGAMENTS
1. Broad ligaments
2. Round ligaments
3. Ovarian ligaments
4. Cardinal ligaments – chief uterine support; also called transverse cervical ligament or
Mackenrodt’s ligaments
5. Uterosacral ligaments
6. Pubocervical ligaments
CYSTOCELE RECTOCELE
The bladder has herniated into the The posterior of the vagina
the anterior wall of the vagina is herniated.
UTERINE DEVIATIONS
A.Normal uterus
B.A Bicornuate uterus
C.A septum dividing uterus
D.A double uterus
 POSITIONAL DEVIATIONS OF THE UTERUS
A. ANTEVERSION B. ANTEFLEXION

C. RETROVERSION D. RETROFLEXION
LAYERS OF THE OVARY
• Tunica albuginea
• Cortex – main functional part
• Medulla – inner central part
BLOOD SUPPLY OF OVARY
blood flows through the ovarian arteries and veins
OVARIAN FOLLICLE
 MAMMARY GLAND
1.Lactation or milk secretion for nourishment and maternal
antibodies
2.Source of pleasurable sexual sensation

Nonpregnant breast Pregnant breast Lactating

breast
 MENSTRUATION

MENSTRUAL CYCLE (a female reproductive

cycle) is episodic uterine bleeding in
response to cyclic hormonal changes.
Physiology of Menstruation

Four body structures are involved in the

physiology of the menstrual cycle:

1. the hypothalamus,
2. the pituitary gland,
3. the ovaries, and;
4. the uterus
HYPOTHALAMUS
• Secrete gonadotrophin – releasing (GnRF) or inhibiting factor (GnIF)
that stimulate the pituitary gland to secrete or inhibit the secretion of
corresponding gonadotrophins

PITUITARY GLAND
1. FSH, a hormone that is active early in the cycle and
is responsible for maturation of the ovum, and

2. LH, a hormone that becomes most active at the midpoint of the cycle
and is responsible for ovulation, or release of the mature egg
cell from the ovary, and growth of the uterine lining during
the second half of the menstrual cycle
OVARY / OVARIAN HORMONES
1.Estrogen
2.Progesterone
Other
3. Prostaglandin

UTERUS
MENSTRUAL CYCLE STAGES / PHASES

UTERINE
1. MENSTRUAL PHASE / MENSTRUAL FLOW / BLEEDING PHASE
2. PROLIFERATIVE PHASE
3. SECRETORY

OVARIAN
4. FOLLICULAR PHASE
5. LUTEAL PHASE
 PHYSIOLOGY IN RELATION TO HUMAN REPRODUCTION 
DEFINITION OF TERMS
• Puberty – age at which the reproductive organs become functionally
active
• Menstruation (Menorrhea) – cyclic, physiologic uterine bleeding
recurring at 4 week interval during the entire reproductive period (in the
absence of pregnancy & lactation)
• Menarche – onset of first menstruation
• Infertility – sterility, unfruitful or barren
• Menopause – “cessation of menstruation”, “change of life or climacteric
period”
• Sexuality – refers to a person’s femaleness or maleness including
sexual feeling, attitudes & actions.
• Sexual gender – term used to denote chromosomal sexual
development (male or female)
• Sexual identity –the sex person thinks of him or herself as a being
(same or different with sexual gender)
Sexual responses (four stages)

2. EXCITEMENT – sexual stimulation leads to vasocongestion

& increasing muscular tension
Result to:
Women: - increase size of clitoris
- appearance of mucoid fluid in vaginal walls
- vagina widens & breast nipples become erect

Men: - penile erection

- scrotal thickening & elevation of testes.

Both: Increase 1 in HR, RR, BP

2. PLATEAU –stage before orgasm, formation of organic platform
(thickened area of congested tissue surrounding the lower vagina and
vaginal os

3. ORGASM – period of maximal sexual excitement

- vigorous contraction of muscles in the pelvic area

Woman: 8 – 15 contractions (1/0.8 sec.)

- expels blood and fluid from the area of congestion
Man: 3 – 7 ejaculatory contractions (1/0.8 sec.)
- Forces the semen out from the penis

4. RESOLUTION – period wherein the external & internal organs return to

quiet state
- lasts 30 minutes (both sex)
METHODS OF SEXUAL EXPRESSION/AROUSING SEXUAL
DESIRES

Method of sexual expression

• Masturbation – self stimulation for sexual pleasure
• Erotic stimulation – the use of visual materials (magazines or
photographs) for sexual arousal
• Coitus
Others:
• Heterosexuality –sexual fulfillment with a member of the
opposite sex
• Homosexuality – sexual fulfillment with a member of his/her own
sex
• Lesbian – homosexual man
• Gay - homosexual man
Methods of arousing sexual desire

• Foreplay – precoital activity

• Transvestism – sexual arousal by taking role or wear the clothes
of the opposite sex
• Fetishism – sexual arousal by use of certain objects (ex: rubber,
leather, fur, or other inanimate materials)
• Sadism – inflicting pain to achieve sexual satisfaction
• Masochism – receives pain to achieve sexual satisfaction

Atypical Sexual Behavior:

• Voyeurism (“Peeping Tom”)­­–an interest in viewing nude
women
• Making obscene telephone calls
SEXUALITY PROBLEMS

• Physical illness – ex: obesity & previous heart attack

• Impotence – inability to achieve & maintain erection
• Premature ejaculation – ejaculation prior to penile –
vaginal contract
• Vaginismus – involuntary contraction of the muscles at the
vaginal outlet when coitus is attempted
• Dyspareunia – pain during coitus
• Failure to achieve orgasm
OVULATION:
• present in the middle of the cycle: monthly growth
and release of a mature, non-fertilized ovum from
the ovary
• Usually happens in the middle of the menstrual
cycle; 13 to 15 days or an average of 14 days prior
to the next menstruation in regular cycles.
• Estrogen is high while progesterone is low.
OVULATION SIGNS

• Breast tenderness
• Slight rise in BBT (0.3 to 0.5°C or 0.4 to 0.8°F) 24
to 36 hour before. The most fertile time is 3 to 4
days before ovulation an d1 to 2 days after
(Littleton and Engrebertson, 2006)
• Positive Spinnbarkeit test (with stretchable mucus)
• Mittelshmerz (left or right lower quadrant paint
corresponding to the rupture of the Graafian
follicle)
• Positive Ferning test
ESTIMATING OVULATION TIME: Subtract 14 days from the
menstrual cycle length:

• In a 28-day cycle, ovulation occurs on the 14th day counting

from the first day of bleeding
• In a 30-day cycle, ovulation occurs on the 16th day counting
from the first day of bleeding.
• The period when the woman is most fertile is during
ovulation time, the period of absolute fertility.
• In a 28-day cycle, periods of fertility is from 11 to 19 days.
During these periods, pregnancy is likely to occur if the
woman engages in the unguarded coitus.
SPECIAL CONCERNS: MENSTRUAL PROBLEMS/DISORDERS
 
PREMENSTRUAL SYNDROME (“PMS” Syndrome)
• Complex physical signs and behavioral symptoms that occur during the
second half of the menstrual cycle and that resolve with the onset of
menses

 PMS SYMPTOMS
• Neurologic: migrane, vertigo, syncope
• Psychologic: lethargy, irritability, depression, sleep disorders,
tearfulness/crying spells, anxiety, hostility
• Respiratory: asthma, coryza, hoarseness
• Gastrointestinal: nausea, vomiting, constipation, bloating, craving for
sweets and salty foods
• Mammary: swelling, breast fullness and tenderness
• Urinary: oliguria, retention
• Dermatologic: acne
AMENORRHEA: absence of menstruation
DYSMENORRHEA: painful menstruation; usually corresponds to the
secretory phase of the endometrium indicating that ovulation has
occurred; absent when ovulation is suppressed
METRORRHAGIA: abnormal bleeding between menses/periods or
intercyclic bleeding
MENOMETRORRHAGIA: excessive or prolonged menstrual bleeding
which may lead to or cause hypovolemia and anemia
MENORRHAGIA: excessive, profuse menstrual flow; may be caused by
hormonal imbalance, infection, uterine tumors
OLIGOMENORRHEA: infrequent menses
POLYMENORRHEA: too frequent menses
HYPOMENORRHEA: abnormally short menstrual cycle
HYPERMENORRHEA: abnormally long menstrual cycle
MENARCHE is the first menstruation; occurs between 12 to
13 years; usually anovulatory, infertile, irregular.

• Duration of menstruation: variable with usual duration to 3

to 5 days or up to 4 to 6 days.

• Amount: 25 to 60 mL equivalent to about 0.4-1.0 mg of iron

loss for every day of the cycle.

• Menstrual blood is incoagulable because the blood,

coagulated as it is shed, is promptly liquefied by fibrinolytic
activity.
MENOPAUSE
 
DESCRIPTION: transitional phase for women marking the end
of their reproductive abilities. Menopause is to the
climacteric as menarche is to puberty (Olds et al., 1988).

• Change of life or climacteric period

• Occurs between 45 to 50 years in 50% of women; can be
from 35 to 60 years with an average of 53 years; not
completed until 2 years since the last periods.
• Ovulation ceases 1 to 2 years prior to menopause with
individual variation.