Female Reproductive System Disorders

What organs are included in the female reproductive system?

• Ovaries

• uterus

• fallopian tubes

• vagina

• breasts

What is the primary function of the ovaries?

To produce estrogen and progesterone and to trigger ovulation.

What hormones are produced by the ovaries?

Estrogen and progesterone.

What is the role of estrogen and progesterone in the uterus?

They build and maintain the endometrial lining to prepare for possible pregnancy.

What is the endometrium?

The inner lining of the uterus that thickens to support implantation of a fertilized egg.

What happens to the endometrial lining if pregnancy does not occur?

It sheds, resulting in menstruation.

What is the menstrual cycle?

A cyclical process of hormonal, ovarian, and uterine changes that prepares the body for pregnancy

What does the menstrual cycle depend on?

Hormonal, ovarian, and uterine changes

How long is a typical menstrual cycle?

About 28 days (can vary between individuals)

When does the menstrual cycle usually begin and how long does it last?

Starts at puberty, around age 13 and ends around menopause, approximately age 55

What is thelarche?

The development of breast tissue (breast buds) during puberty.

What stimulates thelarche?

Pituitary and ovarian hormones during puberty.

What are lobules in the breast?

Glandular structures (15–25 per breast) that produce milk.

What type of tissue makes up breast lobules?

Tubuloalveolar glandular tissue and adipose (fat) tissue.

What is the function of lactiferous ducts?

They carry milk from lobules to the nipple surface (Each lobule drains into a duct)

What are lactiferous sinuses?

Expanded areas of ducts that temporarily store milk during breastfeeding.

What hormone stimulates milk production?

Prolactin

What hormone stimulates milk release?

Oxytocin

What can breasts commonly develop?

Masses, cysts, or infections.

What is the name of the first phase (Days 1-14) of the Menstrual Cycle?

Follicular phase

What happens during the follicular phase (Days 1–14)?

FSH stimulates ovarian follicles to grow and produce estrogen.

What is the role of estrogen in the follicular phase?

It helps thicken the uterine lining and prepares for ovulation.

What is the name of the second phase (Day 14) of the menstrual cycle?

Ovulation

What happens during ovulation?

The ovum (egg) is released from the ovary.

What triggers ovulation?

A surge in FSH and LH caused by positive feedback from high estrogen levels.

What is the third phase (Days 14-28) of the menstrual cycle?

Luteal phase

What is the luteal phase (Days 14–28)?

The phase after ovulation where the corpus luteum forms and secretes progesterone.

What does the corpus luteum produce?

Progesterone

What is the role of progesterone in the luteal phase?

It maintains the uterine lining for possible implantation.

What happens if pregnancy does not occur?

The corpus luteum breaks down, progesterone drops, and menstruation begins.

What hormone controls early follicle development?

FSH (follicle-stimulating hormone).

Uterine Cycle

1. Menstruation → Endometrium lining sheds lower levels of estrogen and progesterone

2. Proliferation → Estrogen rebuilds uterine lining, uterues thickens and repairs

3. Secretory Phase → Progesterone from corpus luteum dominates, which helps the endometrium become thick, vascular, and nutrient-rich (along with some estrogen)

4. Prementstrual Phase → Progesterone and estrogen drop as corpus luteum breaks down, endometrium is no longer maintained, endometrial blood vessels constrict, and endometrium starts to break down; Prostaglandins increase → may cause cramping; PMS symptoms may occur (Bloating, mood changes, breast tenderness)

What is perimenopause?

The transitional period before menopause when estrogen levels gradually decline and menstrual cycles become irregular

What hormonal change occurs in perimenopause?

Decreasing estrogen with increasing FSH levels.

What causes irregular periods during perimenopause?

Fluctuating and declining estrogen levels affecting ovulation and endometrial cycles.

What is atrophic vaginitis?

Thinning and dryness of the vaginal tissue due to decreased estrogen, leading to reduced lubrication.

What are vasomotor symptoms of perimenopause?

Hot flashes and night sweats.

What emotional and cognitive symptoms can occur in perimenopause?

Depression, irritability, anxiety, insomnia, and “brain fog” (memory difficulties).

What is menopause?

Permanent cessation of menstrual cycles due to ovarian failure and decreased estrogen production.

How is menopause clinically defined?

No menstrual period for 12 consecutive months.

What causes menopause?

Normal degeneration of ovarian follicles leading to reduced estrogen production.

What is female puberty?

A normal developmental stage where the female body matures to allow fertility and reproduction.

What is the typical age range for female puberty and how long does it last?

About 10–15 years old and for 3-5 years

What are the main physical changes during female puberty?

Breast development, growth spurt, menarche, and onset of fertility.

What is menarche?

The first menstrual period.

What system initiates puberty?

The hypothalamic-pituitary-ovarian (HPO) axis.

What hormone does the hypothalamus release to start puberty?

Gonadotropin-releasing hormone (GnRH).

What hormones does the pituitary release in response to GnRH?

FSH (follicle-stimulating hormone) and LH (luteinizing hormone)

What do FSH and LH stimulate in the ovaries?

Production of estrogen and progesterone.

What is precocious puberty?

The onset of puberty (hormonal and physical changes) earlier than the normal age range.

What is the normal concern in precocious puberty?

Early activation of puberty processes leading to premature physical and hormonal development.

What age defines precocious puberty in European American girls?

Puberty beginning before age 8.

What age defines precocious puberty in Hispanic and African American girls?

Puberty beginning before age 7.5.

What is happening hormonally in precocious puberty?

Early activation of the hypothalamic-pituitary-ovarian (HPO) axis leading to early secretion of GnRH, FSH, LH, estrogen, and progesterone.

What are the two types of precocious puberty?

Central precocious puberty and peripheral precocious puberty

What is central precocious puberty?

Early activation of the hypothalamic-pituitary-ovarian (HPO) axis leading to true puberty.

Is central precocious puberty gonadotropin-dependent or independent?

Gonadotropin-dependent.

What happens in central precocious puberty hormonally?

Early release of GnRH → increased FSH and LH → ovarian estrogen production → full puberty development.

What is peripheral precocious puberty?

Early puberty caused by hormone production outside the normal HPO axis control.

Is peripheral precocious puberty gonadotropin-dependent or independent?

Gonadotropin-independent.

What causes peripheral precocious puberty?

Excess estrogen production from the ovaries, adrenal glands, or pituitary gland

What is delayed puberty in females?

When secondary sex characteristics have not appeared by age 13.

What physical feature commonly accompanies delayed puberty?

Short stature

What is the most common cause of delayed puberty?

Inherited (about 95% of cases).

What is constitutional growth delay (CGD)?

A hereditary form of delayed puberty where development is slow but ultimately normal.

hat is the long-term outcome of constitutional growth delay?

Individuals typically catch up and reach normal adult development.

What are Tanner stages?

A scale used to describe the physical development of puberty regarding stage of thelarche and menarche

What do Tanner stages describe in females?

Breast development (thelarche) and pubic hair development.

How are Tanner stages assessed in females?

Through physical inspection of breast development and pubic hair growth.

What is the purpose of Tanner staging?

To track and classify stages of pubertal development.

What is primary amenorrhea?

The absence of menstruation by age 15.

What is a normal variation related to delayed menses in primary amenorrhea?

Breast development by age 13 may still be normal even if menses has not started.

Other causes of Primary Amenorrhea

• Birth defects of female reproductive system

• Genetic disorder

• Imperforate hymen

• Problem with hypothalamus or pituitary gland

• Ovarian failure

What is secondary amenorrhea?

The absence of menstruation for more than 3 months in someone who previously had regular periods.

Causes of Secondary Amenorrhea

• Drastic weight loss/ or weight gain (including obesity)

• Eating disorders

• Pregnancy

• Stress and anxiety

• Hormonal imbalance (PCOS)

• Endocrine disorders such as thyroid disease or pituitary disease/tumor

• IUD

• Excessive Exercise

• Primary ovarian insufficiency

• Menopause (normal over age 45)

• Birth control methods

• Uterine Scarring

What is menorrhagia?

Excessive menstrual bleeding (>80 mL) or bleeding lasting more than 7 days.

Metrorrhagia

Excessive uterine bleeding, both during a menstrual period and at more frequent intervals

Oligomenorrhea

Irregular periods with long spans of time between periods.

Dysmenorrhea

Painful menstrual periods

Premenstrual Syndrome (PMS)

Occurrence of distressing physical, emotional, and behavioral changes that interfere with activities of daily living during the luteal phase of the menstrual cycle.

Endometritis

Infection of the endometrium and can occur with inflammation of the fallopian tubes, ovaries, and pelvic peritoneum.

Polycystic Ovarian Syndrome (PCOS)

Complex changes involving the hypothalamus, pituitary, and ovary result in an overproduction of androgens and cause the ovary not to release ova or produce insufficient progesterone