SEXUAL RESPONSE, MENSTRUATION & MENS DISORDERS

Excitement

• Psychological & physical stimulation

• PNS mainly responsible

Plateau

• Reached just before orgasm

• All VS up

Orgasm

• reached peak of stimulation/langit ( 🤪)

• Contraction of pelvic cavity (M: 3-7; F: 8-15)

Resolution

• return to normal VS & reproductive phase

Refractory period

• happens to make after resolution

Menstrual cycle

Episode of uterine bleeding

• ovum maturity

• renew uterine tissue

Purpose of menstruation

Menarche

first menstruation

Onset: 12.4 y/o range: 9-17 y/o

Average onset of menstruation and average range

28 days; 25-35 days

Interval between cycles average and range

4-6 days; range: 2-9 days

Duration of menstruation average and range

30-80 ml

Amount of menstrual flow

Dark-red

Color of menstrual flow

Marigold

Odor of menstrual period

hypothalamus, Ovaries, Uterus

Organs involve in the menstruation

Hypothalamus - GnRH - APG - FSH & LS

Hormones in the hypothalamus that stimulates menstruation

Estrogen, progesterone

Hormones in the ovaries

G FELP

flow of hormones in the menstruation

GnRH

hormone that initiate menstruation

Adenohypophysis

Other term for APG

FSH

• secreted by APG & early in the cycle

• Follicular maturation

Graafian follicle

Mature follicle

Estrogen

• Produce in the ovaries

• secreted by FSH & Graafian follicle

• Thickening of endometrium

• Causes myometrium contraction

LH

• APG

• Secreted midpoint in the cycle

• Causes ovulation

Corpus luteum

Ruptured Graafian follicle

Ruptured of the Graafian follicle

What is ovulation

Progesterone

• Produced by the ovaries

• secreted LH & corpus luteum

• Secreted after ovulation

• Increase vascularity of the endometrium

• Causes relaxation of myometrium

No. Of cycle - 14 days

Formula to determine ovulation

14 days

The Luteal phase is always ___ days

• hypothalamic-pituitary

• Ovarian

• Endometrium

What are the feedback mechanism of menstruation

down E-P → hypothalamus→ GnRH → APG → FSH →Ovaries → follicular mature → Graafian follicle → up E

What happens in the follicular phase of hypothalamic - pituitary feedback mechanism

Up E down P → hypothalamus→ GnRH → APG →LH → Ovaries → ovulation → corpus luteum → up Pe

What happens in the Luteal phase of hypothalamic - pituitary feedback mechanism

down E-P →FSH → Graafian → up E down P → LH (ovulation)

What happens to the pre ovulatory phase in ovarian feedback mechanism

After ovulation → up Pe → C.Luteum (if no implantation) → C. Albicans → down Pe

What happens to the post ovulatory phase in ovarian feedback mechanism

14th day

In what day does ovulation occurs

1-13 days

When does pre ovulatory phase occurs

15-28 days

When does post ovulatory occurs

8-10th day

What day does does implantation occurs

Menstrual, proliferative, secretory, ischemic

Acronym “MENS PO SI INDAY” for endometrium feedback mechanism

• Days 1-4

• endometrial shedding, immature E-P

What happens in the menstrual phase of endometrium feedback mechanism

• Day 5-14

• FSH → Thickening of endometrium → Graafian follicle → up E down P

What happens in the proliferative phase of endometrium feedback mechanism

• Days 15-25

• LH → vascularization (corkscrew) → C.luteum → up Pe

What happens in the secretory phase of endometrium feedback mechanism

• days 26-28

• no implantation→ necrosis → C. Albicans → down Pe

What happens in the ischemic phase of endometrium feedback mechanism

Basal body temperature (BBT)

• assess the core temperature

• Done every day at the same time each day before activities

37

In BBT what is the temperature before ovulation

Slightly drop to 0.5

In BBT what is the temperature before during

Up temp d/t Progesterone (relax)

In BBT what is the temperature after

Down temp due to c.albicans

In BBT what is the temperature ischemic or 2-3 days before menstruation

Thick mucus

Result of the cervical mucus before ovulation

Thin, stretchable, slippery, elastic

Result of the cervical mucus during ovulation

Think, viscous

Result of the cervical mucus after ovulation

Spinnbarkeit test

This test will tell if the cervical mucus is Thin, stretchable, slippery and elastic

Symptothermal method

Combination of BBT and cervical mucus method

Amenorrhea

Absence of menstruation

Primary

no menstruation since birth

Secondary

Cassation of menstruation

Dysmenorrhea

Severe pain elicited during menstruation

Primary

Types of dysmenorrhea in which there is an increase prostaglandins that results to contraction or tightening of the uterus

Secondary

Type of dysmenorrhea that is pathological cause

Oligomenorrhea

Infrequent menstruation that is > 6-8 period/yr

Hypomenorrhea

<30ml if menstruation flow and in < 2 days period

Hypermenorrhea

>80ml menstruation flow and occurs >9 days period

Metrrhogia

a type of menstrual disorder in which period occurs in between

Endometriosis

Presence if endometrioma outside the uterus that can grow on ovaries, behind uterus, bowel or bladder

Retrograde menstruation

Theory about the endometriosis in which the shedded endometrium, instead to going outside the vagina, goes back to the uterus and travels, stick and grows

Pain: dysmenorrhea, during exercise, during sex, (dyspareunia), when pooping (dyschezia), infertility

• Signs and symptoms of endometriosis

• 5Ps

1 year

How long a couple <35 y/o trying to conceived can be considered infertile

6 months

How long a couple >35 y/o trying to conceived can be considered infertile

NSAIDs

Meds to relieve pain in endometriosis

GnRH analogues

This med suppresses FSH & LH which lowers E and P (no thickening & vascularization)

Bone demineralization

This causes __ if too much or long used if GnRH analogue

Danazol

• This is an androgenic synthetic steroid that produces testosterone up

Hysterosalpingogram (HSG)

Visualization of uterus and fallopian tube using a device & dye to see blockage and open it up

Laparoscopy

• Gold standard procedure for endometriosis

• It inflates the abdomen (uterus) to visualized endomatriomas to remove it

Artificial reproductive techniques

a variety of medical procedures used to help individuals or couples with infertility achieve pregnancy.

Hysterectomy; salpingo-oophorectomy

Surgeries for endometriosis

Thelarche

Breast development is called