0. Normally Functioning

• organs of the reproductive system
  • gonads (testes and ovaries): produce germ cells and hormones
  • series of ducts necessary for the transportation of the germ cells
• male:
  • testes produce the sperm and the hormones necessary for the development and maintenance of the secondary sex characteristics
  • sperm transportation: epididymis, ductus deferens, ejaculatory ducts
  • accessory organs that help to propel the sperm: seminal vesicles, prostate gland, bulbourethral glands, penis
• female:
  • nourishes and enables the development of the fertilized ovum
  • ovaries produce and release the egg and the hormones necessary for the development of secondary sex characteristics and the maintenance of a pregnancy
  • ductal system for transport, nourishment, growth of fertilized ovum: fallopian tubes and uterus
  • cervix, vagina, external genitalia
  • accessory organs: breasts
• pregnancy:
  • the egg is met in the fallopian tube by the sprem
  • zygote travel down the fallopian tube to the uterus; attaches to the uterine lining to be nourished and grow
  • placenta forms within the uterine wall and provides a mechanism for the exchange of nourishment and waste products
  • 38 wks after conception, 40wks after the start of last menstrual period
• menstruation
  • anterior pituitary glands produce gonadotropic hormones that causes the ovaries to produce estrogen and progesterone
  • endometrium is shed via the vagina, followed by the next cycle of ovarian production of estrogen, produced from maturing ovarian follicles
  • corpus lutreum then develops after release of the ovum, and progesterone is secreted into the blood stream to stabilize the growth of the endometrium

1. Sexually Transmitted Diseases (venereal diseases)

• the most common contagious diseases in the US, major public health problem
• incidence: is increasing among women as well as in men having sex with men (MSM)
• some are asymptomatic, cause “silent epidemic”
• long-term consequences especially for young women and adolescent girls
• no one is immune, one can have more than one STD at a time, recurrent is common
• transmitted through bodily fluids (blood, semen, vaginal secretions), direct contact with skin, clothing, bedding, infected hairs; infected mother to a fetus or newborn
• there are no cure for viral STDs (herpes, HIV)

1.1 Chlamydia

• most commonly reported notifiable STD in the us
• signs & symptoms:
  • women often no symptoms before dangerous complications
  • 75% of men have symptoms 1~3wks after exposure
  • major cause of sterility and pelvic inflammatory disease (PID)
  • female: dysuria, odor-less yellow discharge with a burning sensation, itching, abdominal pain, dyspareunia, cervicitis
  • men: thin, watery discharge from penis with a burning sensation and itching, burning sensation when urinating (urethritis); swollen scrotum, fever
  • either sex: enlarged inguinal lymph nodes; small transient lesion & skin irritation
  • newborn could be infected from mother during birth: conjunctivitis, blindness, arthritis, overwhelming infection
• etiology:
  • Chlamydia trachomatis, an intracellular bacterium
  • transmitted by sexual contact
  • primary infection is usually around genitals, but can be oral or anal
  • organism can be found in cervix, throat, rectum
  • prevalent in adolescents & young adults
• diagnosis: DNA-probe test
• treatment:
  • antibiotic given to both partners: beginning with a single injection and/or followed with a course or oral tr (azithromycin, erythromycin, 7day regimen of doxycycline)
  • severe cases: hospitalization, IV antibiotics
  • treatment can cure infections & pre complications (PID & problematic pregnancy)
• prognosis: can be cured

1.2 Gonorrhea

• second most commonly reported notifiable disease in the US
• infection of the genitourinary tract
• signs & symptoms:
  • purulent discharge from the male/female genitourinary tract, dysuria
  • 50% of patients are asymptomatic in early stages
  • can also infect eyes & throat / become systemic
• etiology:
  • Neisseria gonorrhoeae (bacterium)
  • usually results from sexual transmission, possible during birthing (newborns must be protected from eye infections that can lead to blindness; prophylactic erythromycin salve is administered routinely at birth)
  • drug resistance is on the rise
• diagnosis:
  • lab culture from infected site (cervix, rectum, throat) of infectious body secretions
  • microscopic examination of exudate with a Gram stain
  • PCR
• treatment: for both partners
  • ciprofloxacin, ceftriaxone+azithromycin, doxycycline
  • many strains have become resistant to tetracycline, penicillin, sulfa, and quinolones
  • follow-up culture after antibiotics
  • if untreated: PID, septicemia, infertility, septic arthritis; salpingitis is the most common comp

1.3 Trichomoniasis

• protozoal infection of the lower genitourinary tract; usually vaginal in the woman and urethral in the man
• signs & symptoms:
  • common among people who are sexually active
  • most patients asymptomatic
  • urethritis with dysuria & itching
  • women may notice profuse, frothy, greenish yellow odorous discharge from the vagina & vulvar irritation; strawberry cervix observed by colposcopy
  • man may note think whitish discharge from the penis
• etiology:
  • Trichomonas vaginalis
  • usually transmitted sexual contact
  • incubation period: 5~28d
• diagnosis:
  • wet preparation of vaginal secretions/discharge from the male urethra & urinalysis studied for microorganism
  • cervix examined for the presence of small hemorrhages with a strawberry-like appearance
• treatment:

1.4 Genital Herpes

• incurable, recurrent infection of the skin of the genital area, ulcerations spread by direct skin-to-skin contact, causing sores similar to cold sores

2. Sexual Dysfunction

• individuals must be free from organic disease & psychosexual disorders
• state of desire or arousal, through orgasm, to resolution or a feeling of well-being and relaxation

3. Male Reproductive Diseases