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Reproductive System Diseases and Disorders

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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.

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