Womens Health 8
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    Womens Health 8 Womens Health 8 Presentation Transcript

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