Womens Health 8


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Womens Health 8

  1. 1. Chapter Eight Examining Gynecological Issues
  2. 2. External and Internal Genitalia <ul><li>Mons Pubis </li></ul><ul><li>Labia Majora </li></ul><ul><li>Labia Minora </li></ul><ul><li>Clitoris </li></ul><ul><li>Urethral Opening </li></ul><ul><li>Vaginal Opening </li></ul><ul><li>Perineum </li></ul><ul><li>Vagina </li></ul><ul><li>Cervix </li></ul><ul><li>Uterus </li></ul><ul><li>Fallopian Tubes </li></ul><ul><li>Ovaries </li></ul>
  3. 3. Female Reproductive System
  4. 4. Breast Tissue <ul><li>The function of breasts are as follows: </li></ul><ul><ul><ul><li>Contain mammary glands for new-born nourishment </li></ul></ul></ul><ul><ul><ul><li>Sex organ for arousal </li></ul></ul></ul><ul><li>Each breast contains 15-25 clusters called lobes which connect to the nipple </li></ul><ul><li>The nipple (erectile tissue) are effected by temperature, sexual stimulation, and lactation </li></ul><ul><li>Breast size is determined by the following: </li></ul><ul><ul><ul><li>Genetics </li></ul></ul></ul><ul><ul><ul><li>Amount of fat and glandular tissue </li></ul></ul></ul><ul><li>Nearly 70% of women experience benign breast changes during the menstrual cycle, 85-90% of lumps are benign </li></ul>See Figure 8.1
  5. 5. Preventive Measures See Figure 8.2
  6. 6. Menstruation <ul><li>Menarche is the first menstrual cycle for young girls </li></ul><ul><li>The average age of onset are 12.8 years </li></ul><ul><li>Genetics, socioeconomic conditions, nutritional status, obesity, and exercise can affect menarche </li></ul><ul><li>6 primary hormones are involved in regulating the reproductive system: </li></ul><ul><ul><ul><li>Gonadotropin-releasing hormone (GnRH) </li></ul></ul></ul><ul><ul><ul><li>Follicle-stimulating hormone (FSH) </li></ul></ul></ul><ul><ul><ul><li>Luteinizing hormones (LH) </li></ul></ul></ul><ul><ul><ul><li>Estrogen </li></ul></ul></ul><ul><ul><ul><li>Progesterone </li></ul></ul></ul><ul><ul><ul><li>Testosterone </li></ul></ul></ul>
  7. 7. Luteal Secretion
  8. 8. Phases of the Menstrual Cycle <ul><li>Follicular (proliferatative) phase lasts 10-14 days and is considered the most variable part of the cycle </li></ul><ul><li>Ovulatory phase is when the largest follicle bursts, releasing a mature egg into the fallopian tubes </li></ul><ul><li>Luteal phase causes the secretion of progesterone, preparing for implantation of the fertilized egg </li></ul><ul><li>Menstruation phase occurs when estrogen and progesterone levels drop, allowing sloughing off of the endometrium </li></ul>
  9. 9. Menstrual Cycle Breakdown of the endometrial lining and discharge of tissue (menses)
  10. 10. Pelvic Examinations <ul><li>Pelvic exams include a visual screening to ensure that the reproductive organs look normal in size, shape, and location </li></ul><ul><li>Exams should be conducted annually for 3 consecutive years until your health provider decides otherwise </li></ul><ul><li>A speculum is inserted into the vagina to observe for internal organ normalcy </li></ul><ul><li>A pap test and bimanual exam (physical check of the ovaries and uterus), followed by a rectal exam is common procedure for pelvic exams </li></ul>
  11. 11. Pelvic Exam
  12. 12. Pap test <ul><li>A pap test consists of taking a sample of cells from the cervical area (squamous epithelium) </li></ul><ul><li>The primary purpose is to prevent invasive squamous cell carcinoma from occurring </li></ul><ul><li>The area is where 90% of all cervical cancers begin </li></ul><ul><li>A brush or thin-prep is used to scrape cells from the cervix and smeared onto a slide </li></ul><ul><li>Another sample is taken from the endocervical canal </li></ul><ul><li>Both slides are taken to the lab for analysis </li></ul>
  13. 13. Menstrual Disorders <ul><li>Endometriosis occurs when the lining of the endometrium fragments and lodges in other parts of the body </li></ul><ul><li>Dysmenorrhea describes painful menstrual cramps, believed to be a normal response to uterine contractions resulting from increased prostaglandin production </li></ul><ul><li>Amenorrhea is the absence of a menstrual cycle </li></ul><ul><ul><ul><li>Primary amenorrhea: significant physical disorder affecting young girls </li></ul></ul></ul><ul><ul><ul><li>Secondary amenorrhea: due to pregnancy or the onset of menopause </li></ul></ul></ul><ul><li>Polycystic Ovarian Syndrome occurs when the ovaries produce excessive amounts of male hormones and small cysts develop </li></ul>
  14. 14. Premenstrual Syndrome <ul><li>PMS is a disorder with an array of physical and psychological symptoms associated with the luteal phase of menstruation </li></ul><ul><li>Most symptoms taper off with menstruation, although some women continue to experience symptoms throughout their period </li></ul><ul><li>Researchers believe that the cyclical trigger are due to normal ovarian function </li></ul><ul><li>The best approach to dealing with PMS is to alleviate them through non-invasive strategies such as: </li></ul><ul><ul><ul><li>Biofeedback </li></ul></ul></ul><ul><ul><ul><li>Exercise </li></ul></ul></ul><ul><ul><ul><li>Nutritional changes </li></ul></ul></ul><ul><ul><ul><li>Vitamin/mineral supplementation </li></ul></ul></ul><ul><ul><ul><li>Relaxation techniques </li></ul></ul></ul><ul><ul><ul><li>Reducing salt, caffeine, and refined sugars </li></ul></ul></ul>Premenstrual Dysphoric Disorder (PMDD) is a severe Form of PMS that can occur one week prior to menses
  15. 15. Other Medical Concerns <ul><li>Female Athlete Triad </li></ul><ul><li>Uterine Fibroids </li></ul><ul><li>Hysterectomy </li></ul><ul><li>Toxic Shock Syndrome (TSS) </li></ul>
  16. 16. Menopause <ul><li>American women (1.25 million annually) experience the normal cessation of their menstrual cycle </li></ul><ul><li>Occurs normally between the ages of 40-58 years and most women experience this by age 50 </li></ul><ul><li>The 4 stages of menopause are: </li></ul><ul><ul><ul><li>Premenopause : periods are beginning to become irregular </li></ul></ul></ul><ul><ul><ul><li>Perimenopause : period of time (3-7 yrs.) before and after the last menstrual period during which the cycle becomes erratic and hot flashes begin </li></ul></ul></ul><ul><ul><ul><li>Menopause: results from normal aging of the ovaries, when estrogen levels fall and menstruation has ceased for 1 yr. </li></ul></ul></ul><ul><ul><ul><li>Postmenopause : Menstruation has ceased for over 1 yr. </li></ul></ul></ul>
  17. 17. Hormone Replacement Therapy (HRT) <ul><li>The risks of using combined estrogen and progestin have been surprising based upon the findings of the National Heart, Lung and Blood Institute </li></ul><ul><li>Study findings show that the increases in the following: </li></ul><ul><ul><ul><li>41% increase in strokes </li></ul></ul></ul><ul><ul><ul><li>29% increase in CHD events </li></ul></ul></ul><ul><ul><ul><li>100% increase in blood clots </li></ul></ul></ul><ul><ul><ul><li>26% increase in breast cancer </li></ul></ul></ul><ul><li>Given the recent findings, women are exploring more natural strategies such as: </li></ul><ul><ul><ul><li>Exercise </li></ul></ul></ul><ul><ul><ul><li>Nutritional products </li></ul></ul></ul><ul><ul><ul><li>Reducing stress </li></ul></ul></ul><ul><ul><ul><li>Wearing comfortable clothing </li></ul></ul></ul>
  18. 18. Human Sexual Response Cycle <ul><li>Masters and Johnson determined that the Human Sexual Response Cycle includes 4 predictable phases: </li></ul><ul><ul><ul><li>Excitement </li></ul></ul></ul><ul><ul><ul><li>Plateau </li></ul></ul></ul><ul><ul><ul><li>Orgasm </li></ul></ul></ul><ul><ul><ul><li>Resolution </li></ul></ul></ul>See Figure 8.4
  19. 19. External Genitals and Sexual Response
  20. 20. Vaginal and Uterus Response
  21. 21. Breast Response
  22. 22. Where is the “G-Spot”?
  23. 23. Orgasm <ul><li>Rhythmic contractions (3-15) of uterine walls, the first 3-6 are most intense </li></ul><ul><li>Most anorgasmic experiences have psychological and sociological roots or can be caused by a lack of proper technique </li></ul><ul><li>Most women need continuous clitoral stimulation to experience an orgasm </li></ul><ul><li>Orgasm can be achieved with adequate stimulation, whether through masturbation or intercourse </li></ul>
  24. 24. Aging and Sexual Response <ul><li>Physiologically, the excitement phase takes longer for the vagina to lubricate </li></ul><ul><li>The orgasmic phase is shorter in duration and contractions may be less intense </li></ul><ul><li>The resolution phase has been found to take longer </li></ul><ul><li>While sexual desires continue throughout the lifespan, a woman’s perceptions of relationship qualities provide a strong indicator of the level of sexual desire she attains during the aging process </li></ul>
  25. 25. Chapter Eight Examining Gynecological Issues