1. Reproductive System Diseases and Disorders
Lindsea Vaudt Shelby Engel

2. Female Anatomy and Physiology

3. Male Anatomy and Physiology

4. Common Signs and Symptoms
Female
Abdominal and pelvic pain
Fever and malaise
Abnormal vaginal drainage
Burning, itching, or both of the genitals
Pain during sexual intercourse
Any change in breast tissue
Abnormal discharge from the nipple
Male
Urinary disorders, including frequency, dysuria, nocturia, and incontinence
Pain in the pelvis, groin, or reproductive organs
Lesions on the external genitalia
Swelling or abnormal enlargement of the reproductive organs
Abnormal penile discharge
Diagnosis – Physical examinations, bimanual examinations, pap smears, biopsy, laparoscopy, x-rays, blood testing, mammograms, digital rectal examinations, cystoscopy, and lab testing

5. Female Reproductive System Diseases
Menstrual abnormalities
Premenstrual syndrome
Amenorrhea
Dysmenorrhea
Menorrhagia
Metrorrhagia
Menopause
Vaginitis

6. Vaginitis Inflammation of the vagina and vulva Symptoms:
Redness and swelling of the vagina and vulva
Unusual vaginal discharge
Vaginal and genital burning
Vaginal and genital itching
Can increase risk for
HIV, AIDS, and other STDs
Infertility
Pelvic inflammatory disease
Premature birth low birth weight, stillbirth, and complications

7. Causes Infectious Noninfectious Bacterial vaginosis Chlamydia
Genital herpes
Gonorrhea
Poor genital hygiene
Trichomoniasis, a STD caused by a parasite
Yeast Infection
Noninfectious
Irritating substances to genitals
Leaving tampons in too long
Sexual abuse in girls
Antibiotics
Wearing thongs or tight fitting underwear, pants

8. Prevention Abstaining from sexual activity
Avoiding exposure of the genitals to irritating substances
Changing tampons frequently
One sexual relationship in which neither partner has an infection
Getting regular, routine medical care, including pelvic exams
Not wearing tight fitting bottoms
Wiping from front to back after bowel movements
Using a new condom for sexual acts

9. Treatment Antibiotic medications
Antifungal creams or pills for yeast infection
Antiviral medications for genital herpes
Topical crams may be prescribed to ease the discomfort of itching and burning

10. Amenorrhea
Absent menstrual periods for more than 3 monthly menstrual cycles
Primary: menstruation never starts
Secondary: menstrual periods become abnormal, irregular or absent
Causes
Natural reasons: Pregnancy, breast feeding, menopause
Ovulation abnormality
Birth defect, anatomical abnormality, or other medical conditions
Eating disorder
Over exercise or strenuous exercise
Thyroid disorder
Obesity

11. Amenorrhea cont. Signs and symptoms:
Headache
Milky nipple discharge
Hair loss
Excess facial hair
Vision changes
Weight gain or loss
Can cause infertility or osteoporosis (with low estrogen levels)
Prevention – Maintaining a normal weight
Treatment
Progesterone supplements (hormone treatment)
Oral contraceptives (ovulation inhibitors)
Dietary modifications (to increase caloric and fat intake)
Calcium supplementation to reduce bone loss

12. Dysmenorrhea
Menstrual condition: severe and frequent cramps and pain during menstruation
Primary: from beginning and usually lifelong
Secondary: due to physical cause or another medical condition
Causes
Primary:
Chemical imbalance in the body: particularly prostaglandin and arachidonic acid
Secondary:
Other medical conditions: endometriosis (tissues becomes implanted outside the uterus),
Resulting in internal bleeding, infection, and pelvic pain.

13. Treatment Aspirin and ibuprofen
Oral contraceptives (ovulation inhibitors)
Progesterone (hormone treatment)
Dietary modifications
Vitamin supplements
Regular exercise
Heating pad across the abdomen
Hot bath or shower
Abdominal massage
Endometrial ablation: a procedure to destroy the lining of the uterus
Endometrial resection: a procedure to remove the lining of the uterus
Hysterectomy

14. Dysmenorrhea cont. Symptoms: Prevention and risks:
Cramping in the lower abdomen
Pain in the lower abdomen
Low back pain
Pain radiating down the legs
Nausea
Vomiting
Diarrhea
Fatigue
Weakness
Fainting
Headaches
Prevention and risks:
Don’t smoke
Don’t drink alcohol during menses
Stay a healthy weight
Greater risk are those who started menstruating before 11 years old

15. Diseases of the Breast Quite uncommon Screening
1 in 8 women in the United States ranging from mild to life-threatening
Men can also be affected
Screening
Self-examinations and mammography
Any change from normal in tissue shape or appearance in males or females should be called to the attention of a physician
Disease and Disorders
Fibrocystic Disease
Mastitis
Breast Cancer

16. Fibrocystic Disease
Most common breast disorder of premenopausal women between ages 30-55
Thought to be linked to estrogen levels
Causes an increased risk of cancer
Symptoms:
Irregular, lumpy feeling in the breast (usually in the upper outer quadrant area)
Breast discomfort that is persistent or occurs on and off (peaking around the menstrual period and receding after)
Breast often feeling heavy, full, and tender
A tendency to run in families

17. Fibrocystic Disease cont.
Diagnosis – Made by feeling, or palpation, or lumpy areas in the breast
Multiple cysts make it difficult to detect
Breast ultrasounds
If there is a suspicious area a surgical biopsy can be performed
Treatment – Measures to decrease breast pain include:
Elimination of caffeine in the diet
Reduction of salt intake
The use of a mild diuretic the week prior to menstruation
Use of mild analgesics
Prevention – Often not preventable, but decreasing dietary fat and caffeine intake can help
Research showed that 90% of women who stopped wearing a bra showed improvement in symptoms

18. Mastitis Inflammation on the breast tissue
Broad term covering a variety of diseases and disorders
Type commonly thought of is puerperal (childbirth)
Occurs when bacteria from the nursing baby’s mouth or mother’s hands enter the breast tissue through the nipple
Symptoms:
Redness
Heat
Swelling
Pain
Bloody discharges from the nipple
Diagnosis – Made on the basis of symptoms
Treatment – Antibiotics, application or heat, analgesics, and a firm support brassiere to decrease discomfort
Prevention – Emptying breast completely when breast feeding

19. Breast Cancer Adenocarcinoma of the breast ducts
Most common neoplasm affecting breast tissue and occurs in 1 out of 8 females
Early detection = monthly self-examinations and routine mammograms
Cause is unknown, but risk factors include:
Age 40 and over
Family member affected with breast cancer
Onset of menses before age 13
Menses continuing after age 50
Nullipara (none or no births)
First child after age 30
Obesity
Chronic breast disease
Brassiere wear time

20. Breast Cancer cont.
Symptoms: Nontender lump of varying size…often no visual symptoms
Diagnosis – Presence of lump, mammogram, and biopsy (definitive test that can be performed by aspiration or surgery)
Treatment – Usually surgical removal of the mass or the breast followed by chemotherapy, radiation therapy, or both
Lumpectomy – removal of the lump only
Simple or total mastectomy – removal of the breast and nipple
Modified radical mastectomy – removal of the breast, nipple, and lymph nodes
Radical mastectomy – removal of the breast, nipple, lymph nodes, and underlying chest muscles

21. Disorders of Pregnancy
Ectopic Pregnancy
Spontaneous abortion (miscarriage)
Morning sickness
Hyperemesis Gravidarum
Toxemia
Abruptio placentae
Placenta previa

22. Ectopic Pregnancy
Ectopic pregnancies occur in 1 in every 40 to 1 in every 100 pregnancies.
Hormones may play a role
Most common site is with in one of the tubes where the egg passes from the ovary to the uterus.

23. Causes Birth defect in the fallopian tubes
Complications of a ruptured appendix
Having an ectopic pregnancy before
Scarring from past infections or surgery
Age over 35
Had surgery to untie tubes (tubal sterilization) to become pregnant
Having had many sexual partners
In vitro fertilization
Having your tubes tied (tubal ligation) - more likely 2 or more years after the procedure

24. If ruptures and bleeds symptoms may get worse:
Abnormal vaginal bleeding
Low back pain
Mild cramping on one side of the pelvis
Pain in the lower belly or pelvic area
If ruptures and bleeds symptoms may get worse:
Fainting or feel faint
Intense pressure in the rectum
Low blood pressure
Pain in the shoulder area
Severe, sharp, and sudden pain in the lower abdomen

25. Prevention
Avoiding risk factors for pelvic inflammatory disease (PID) such as having many sexual partners, having sex without a condom, and getting sexually transmitted diseases (STDs)
Early diagnosis and treatment of STDs
Early diagnosis and treatment of salpingitis and PID
Stopping smoking
Treatment
Ectopic pregnancies is a life-threatening condition
If ruptures--- shock--- Blood transfusion
Surgery is done to stop blood loss, repair tissue damage

26. Hyperemesis Gravidarum
Severe
Nausea
Vomiting
Weight loss
Electrolyte disturbance
Signs and symptoms:
Severe nausea and vomiting
Food aversions
Weight loss of 5% or more of pre-pregnancy weight
Decrease in urination
Dehydration
Headaches
Confusion
Fainting
Jaundice
Extreme fatigue
Low blood pressure
Rapid heart rate
Loss of skin elasticity
Secondary anxiety/depression

27. Treatment Dietary changes Rest Antacids More severe
Stay in the hospital
Mother receives fluid and nutrition through a IV
No known prevention

28. Abruptio Placentae
Separation of the placenta from its attachment to the uterus wall before the baby is delivered
Direct causes are rare but include
Injury to the belly area
Sudden loss of uterine volume

29. Risk Factors Blood clotting disorders Smoking Cocaine use Diabetes
Alcohol
High blood pressure during pregnancy
About half of placental abruptions that lead to the baby's death are linked to high blood pressure
Large number of past deliveries
Older mother
Premature rupture of membranes
The bag of water breaks before 37 weeks into the pregnancy

30. Symptoms: Prevention: Treatment: Abdominal pain Back pain
Frequent uterine contractions
Uterine contractions with no relaxation in between
Vaginal bleeding
Prevention:
Don’t drink alcohol
Don’t smoke
Don’t use recreation drugs
Early and regular prenatal care
Manage conditions like diabetes and high blood pressure
Treatment:
Fluids through IV
Blood transfusions
Unborn baby watched for signs of distress
C section may be needed

31. Male Reproductive System Diseases
Most common diseases affecting the male reproductive system include infection and diseases affecting the prostate
Diseases
Prostatitis
Benign Prostatic Hyperplasia
Prostatic Carcinoma
Epididymitis
Orchitis
Testicular tumors
Cryptorchidism (undescended testicle)

32. Prostatitis Inflammation of the prostate gland
More common in men over 50 years old
Cause can be unknown or result of a urinary tract infection or infection by STDs
Symptoms:
Dysuria (painful urination)
Pyuria (pus in urine)
Fever
Lower back pain
Diagnosis – Made on the basis of urinalysis, urine culture, and digital rectal examinations
Treatment – Depends on the cause, but antibiotic therapy with penicillin, warm sitz baths, increased fluid intake, and analgesics
Prevention – Avoid smoking, drinking plenty of fluids, seek early treatment for urinary symptoms, and practice good hygiene by keeping the penis clean

33. Benign Prostatic Hyperplasia
Enlargement of the prostate due to normal cells overgrowing and enlarging
Common in men over 60
About 50% of males over 65 have some degree of prostate enlargement
Cause is unknown, but is thought to be due to hormonal changes
Alterations in testosterone, estrogen, and androgen levels (associated with aging)
Symptoms:
Nocturia (frequently getting up in the night to urinate)
Inability to start urination
Weak urinary stream
Inability to empty bladder (can cause frequent urinary tract infections)
Diagnosis – Made on the basis of symptoms and digital rectal examinations

34. BPH cont.
Treatment – Symptomatic and might include prostatic massage, sitz baths, and catheterizations
Regular sexual intercourse can be helpful in reducing prostatic congestion
Transurethral – Chisel away the excess prostate tissue causing urinary obstruction
Prevention – No known preventative measures
Annual prostate exam after age 40

35. Prostatic Carcinoma
Neoplasm of the prostate usually affects men over 50
Cause is unknown…some believe testosterone levels are involved
Caucasian men are affected with prostate cancer 10 times more often than Oriental men
Environmental and lifestyle factors involved and diets high in fat
Grows in the outer layer or the prostate and often shows no symptoms until it has metastasized
Common sites = bones of the spine and pelvis
Symptoms: Similar to BPH as the urethra becomes obstructed

36. Prostatic Carcinoma
Diagnosis – Digital rectal examination will reveal a hard, abnormal mass and blood testing…biopsy is the definitive test
Treatment – Depends on the age and physical condition of the individual and the degree of metastasis
Administration of estrogen to counteract testosterone
Surgical orchiectomy – removal of the testicles to halt testosterone production (many urologists do not believe this improves the survival rate)
A combination of both treatments
Chemotherapy and radiation therapy might also be beneficial
Over 60 – most likely outlive the cancer and die of some other disease process
Younger individuals and those with extensive metastasis do not have such a positive prognosis
50%-75% live 5 years or more
Prevention – No preventative measures…annual prostate examination is recommended for early detection

37. Epididymitis Inflammation of the epididymis
Common causes include prostatitis, urinary tract infection, mumps, and STDs (chlamydia, syphilis, and gonorrhea)
Most common disease of the male reproductive system and usually only effects one epididymis
Symptoms:
Swollen, hard, and painful epididymis
Scrotal pain and swelling
Makes walking difficult
Diagnosis – Made on the basis of symptoms, urinalysis, and urine culture
Treatment – Prompt, appropriate antibiotic therapy, bed rest, analgesics, use of a scrotum support, and avoidance of alcohol, spicy foods, and sexual stimulation
Delay in treatments can cause sterility (inability to impregnate a female)
Prevention – Sexual absitenence, use on condoms to prevent STDs and prompt treatment of causative infections

38. Orchitis Inflammation of one or both testes
Usually due to bacterial or viral infection or trauma
Viral mumps is the most common cause in adult males
Commonly occurs in conjunction with or as a complication of epididymitis
Symptoms:
Swelling, pain, and tenderness in one or both testes
Fever
Malaise
Diagnosis – Made on the basis of symptoms, blood testing, and urinalysis
Treatment – Depends on the cause, but antibiotic therapy is usually effective…when caused by mumps it is treated symptomatically and includes bed rest and analgesics and antipyretic medications
Prevention – Aimed at causative factors and includes mumps vaccinations and prevention of infection from STDs

39. Sexually Transmitted Diseases
Acquired immunodeficiency syndrome
Hepatitis
Genital herpes
Gonorrhea
Syphilis
Tertiary (late or latent)
Chlamydial infection
Trichomoniasis
Genital warts

40. Gonorrhea
Bacterium
Grows in warm, moist areas of the reproductive tract
Cervix, uterus, fallopian tubes, urethral
Mouth, throat, eyes, anus
Annually about 820,000 people in the US
570,000 among years of age
Causes:
Having sex with someone who has the disease
Anal, vaginal, or oral sex
Can spread from mother to baby during childbirth

41. Gonorrhea cont. Very mild or no symptoms
Men: burning sensation when urinating
White, yellow, or green discharge
Painful or swollen testicles
Women:
Painful or burning sensation when urinating
Increased vaginal discharge
Vaginal bleeding between periods
Treatment – ASAP especially if pregnant…medication
Prevention:
Condom use
Avoid having sexual intercourse
One partner who is not infected

42. Syphilis Serious STD Can become chronic, life threatening disease
Bacterium
Annually 55,400 people in the US
In 2011, 72% occurred among men who have sex with men
360 reports of children in 2011
Causes
Person to person by direct contact with syphilis sores
Genitals
Vaginal
Anus
Rectum
Lips
Mouth
During vaginal, anal, or oral sexual contact
Pregnant women can pass it to unborn child

43. Symptoms First symptom can appear in 10 to 90 days PRIMARY stage:
Single sore--- multiple sores
Where syphilis entered the body
Firm, round, painless
Will go away without treatment
Infection can progress to the secondary stage
if no treatment
SECONDARY stage:
Skin rashes or sores in the mouth, vagina, anus
Not itchy
Rough, red, or reddish brown spots on palms or bottom of feet
Large, raised, gray or white lesions on mouth, underarm, groin
Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue

44. Latent and Late Stage
Symptoms will go away without treatment BUT… without appropriate treatment, the infection will progress to the latent or late stages
Can last for years
15% of people not treated
bad muscle movements, paralysis, numbness, gradual blindness, and dementia
Damages internal organs, including brain, nerves, eyes, heart, blood vessels, liver, bones, and joints
Death
Treatment – Easy to treat in early stages, no over the counter drugs, antibiotics
Prevention – Not by washing genitals after sex, condom use, abstain from sex when infected, and one partner without infection

45. Chlamydial Infection Most commonly reported STD in the US
Sexually active females 25 years and younger need testing every year
Bacterium
Can cause serious damage to a woman’s reproductive organs
In 2011, 1,412,781 cases where reported in the US
1 in 15 sexually active females age years have Chlamydia
Causes:
Having sex with someone infected
Anal, vaginal, oral
Pregnant woman to her baby during childbirth

46. Symptoms “Silent Infection” Can damage a woman’s reproductive organs
Women:
Infects the cervix and urethra
Abnormal vaginal discharge
Burning sensation when urinating
Untreated---- spread up to uterus and fallopian tubes
Pelvic inflammatory disease
Lead to infertility
Men:
Discharge from penis
Pain and swelling in one or
both testicles

47. Treatment Prevention: Antibiotics Condom use
Abstain form vaginal, anal, and oral sex
One partner who is not infected

48. Sexual Dysfunction
Can limit the ability of the individual to reproduce and to develop a close, nurturing sexual relationship with a significant other
Human sexual cycle – Arousal…sexual intercourse…climax…feelings of pleasure and relaxation
Any disorder that interrupts this cycle can be considered a dysfunction
Disorders
Dyspareunia
Female Arousal-Orgasmic Dysfunction
Impotence (erectile dysfunction)
Premature Ejaculation (rapid ejaculation or rapid climax)
Infertility

49. Dyspareunia
Condition of experiencing pain or discomfort with sexual intercourse
Can affect both males and females, but more common in women
Not considered a disease but, rather, a symptom of a psychological or physical disorder
Female - Intact hymen, vaginal deformity, insufficient lubrication, sensitivity to spermicide, presence of an STD, bladder infection, pelvic inflammatory disease, and endometriosis
Male – Penile deformity, presence of an STD, abnormally tight foreskin (phimosis), prostatitis, and epididymitis
Psychological conditions – history of past sexual abuse, anxiety, guilt, and fear of pregnancy
Symptoms: Pain can be mild to severe and appear in genitals, pelvis, and low back…females might feel pain specifically in the clitoris, labia, and vagina

50. Dyspareunia cont.
Diagnosis – General examination, description of pain, and time of occurrence
Treatment – Restrictions of extended foreplay, use of lubricating jelly, and manual stretching of the vaginal opening prior to intercourse
Infections need to be treated appropriately and surgery may be needed to correct deformities, remove tumors, and treat endometriosis
Counseling
Prevention – Not preventable when caused by sexual trauma or abuse…avoid vaginal yeast infections, STDs, bladder infections, and sex on days near menstruation due to increased tenderness

51. Female Arousal-Orgasmic Dysfunction
Lack of sexual desire or responsiveness in a female
Commonly due to psychological conditions such as stress, depression, fatigue, past sexual abuse, guilt, and anxiety
Symptoms: Inability to produce and maintain adequate vaginal lubrication and vasocongestive response
Diagnosis – History or complaint of the inability to reach orgasm
Treatment – Physical exam to rule out physical disorders and possible sex therapy
Prevention – Education on healthy sex attitudes and sexual stimulation techniques

52. Infertility
Inability of a couple to achieve pregnancy after 1 year of unprotected sexual intercourse
Can be due to male or female disorders or both
About 1 in 10 couples experience infertility
Common causes:
Female
Presence of STD
Hormonal disorders
Abnormality of reproductive organs
Endometriosis
Scarring from PID or blockage or fallopian tubes
Development of vaginal antibodies that kill sperm
Male
Chronic genitourinary infection or blockage of the tract
Structural abnormalities
Hormone imbalances
Diagnosis – Female = complete medical and gynecologic history and examination; Male = complete medical history and physical examination with semen analysis

53. Infertility cont.
Treatment – Surgery to correct anatomical abnormalities or remove blockages or medication therapy to correct endocrine and hormone imbalances and treat infection
Fertility drugs, artificial insemination with husband sperm (AIH), artificial insemination with donor sperm (AID), and in vitro fertilization (IVF)
Prevention:
Avoid smoking and drinking
Eat a healthy diet
Avoid excessive exercise
Avoid STDs
Maintain proper body weight to reduce possibility of hormone imbalance
Check with doctor if taking and medications or herbal remedies

54. Trauma and Rare Diseases
Rape – Sexual intercourse (vaginal or anal) without consent or against the will of the involved individual
Victims – Any age and either sex, but is primarily and act of violating females
Recovery from rape is difficult and crisis intervention counselors are often needed
Vaginal Cancer - Rare form of cancer that occurs in the daughters of mothers who used the synthetic hormone diethylstilbestrol (DES) to prevent spontaneous abortion
Puerperal Sepsis - Infection in the endometrium, usually with streptococcus bacteria, following childbirth
Other names = Puerperal fever and childbed fever
Hydatidiform Mole - Formation of grape-like cysts in the uterus that fill the uterus and give indications of pregnancy

55. Effects of Aging Females Males
Internal organs shrink in size, vaginal secretions diminish, and there is less elasticity of the vagina
Women over 65 should be screened regularly for disorders such as cancer of the uterus and ovaries
Males
Production of testosterone and the formation of sperm decreases
Size of the testes can also diminish, some loss of elasticity of the penis and scrotum causing them to look more wrinkled and sagging
Prostate slowly enlarges around age 50
Routine rectal examination for all adult males over age 50

56. References
Neighbors, M. & Tannehill-Jones, R. (2010). Human diseases (3rd ed.) Clifton Park, NY: Delmar Cengage Learning.