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 精囊, prostate gland, bulbourethral glands 尿道球腺, 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) 性传播疾病

• 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 衣原体感染

• 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 排尿困难 , odor-less yellow discharge with a burning sensation, itching, abdominal pain, dyspareunia 性交困难, cervicitis
  • men: thin, watery discharge from penis with a burning sensation and itching, burning sensation when urinating (urethritis); swollen scrotum 阴囊, 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 淋病

• 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 输卵管炎 is the most common comp

1.3 Trichomoniasis 滴虫病

• 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 多泡的, 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 生殖器疱疹

• 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