anatomy and physiology of female reproductive system

1. FEMALE REPRODUCTIVE SYSTEM
BY
SONI KUMARI SHAH

2. Female Reproductive System
The female reproductive system
functions to produce gametes and
reproductive hormones, just like the
male reproductive system; however, it
also has the additional task of
supporting the developing fetus and
delivering it to the outside world.

3. Organs Of Female Reproductive System
External Genitalia
Or Vulva
Mons pubis
Labia majora
Labia minora
Clitoris
Hymen
Vestibular gland
Perineum
Internal Genitalia
Vagina
Uterus
Uterine tube
Ovary

4. Functions Of The Female Reproductive System
Formation of ova
Reception of spermatozoa
Provision of suitable environments for fertilization and fetal development
Parturition (childbirth)
Lactation, the production of breast milk, which provides complete
nourishment for the baby in its early life.

5. External Genitalia (Vulva)
The external genitalia are known
collectively as the vulva, and
consist of the labia majora and
labia minora, the clitoris, the
vaginal orifice, the vestibule, the
hymen and the vestibular glands
(Bartholin’s glands).

6. Mons Pubis
The mons pubis is a rounded cushion
of fatty and connective tissue
covered by skin and coarse, curly hair
in a triangular pattern over the
symphysis pubis (the joint formed by
the union of the pubic bones
anteriorly).

7. Labia Majora
These are the two large folds forming the
boundary of the vulva.
They are composed of skin, fibrous tissue and
fat and contain large numbers of sebaceous
and eccrine sweat glands.
Anteriorly the folds join in front of the
symphysis pubis, and posteriorly they merge
with the skin of the perineum.
At puberty, hair grows on the mons pubis and
on the lateral surfaces of the labia majora.

8. Labia Minora
These are two smaller folds of skin between the
labia majora, containing numerous sebaceous
and eccrine sweat glands.
The cleft between the labia minora is the
vestibule.
The vagina, urethra and ducts of the greater
vestibular glands open into the vestibule.
Clitoris
The clitoris corresponds to the penis in the male and
contains sensory nerve endings and erectile tissue.

9. Vestibular Glands
The vestibular glands (Bartholin’s glands) are situated
one on each side near the vaginal opening.
They are about the size of a small pea and their ducts
open into the vestibule immediately lateral to the
attachment of the hymen.
The urethral meatus is the slit like opening below the
clitoris through which urine leaves the body.
In the center of the vestibule is the vaginal orifice. It may
be completely or partially covered by the hymen, a tissue
membrane.
They secrete mucus that keeps the vulva moist.

10. Hymen
The hymen is a thin layer of mucous
membrane that partially occludes the
opening of the vagina.
It is normally incomplete to allow for
passage of menstrual flow and is stretched
or completely torn away by sexual
intercourse, insertion of a tampon or
childbirth

11. Blood Supply, Lymph Drainage And Nerve Supply
Arterial Supply
This is by branches from the internal pudendal arteries that branch from the
internal iliac arteries and by external pudendal arteries that branch from the
femoral arteries.
Venous Drainage
This forms a large plexus which eventually drains into the internal iliac veins.
Lymph Drainage
This is through the superficial inguinal nodes.
Nerve Supply
This is by branches from pudendal nerves.

12. Perineum
The perineum is a roughly triangular
area extending from the base of the
labia minora to the anal canal.
It consists of connective tissue,
muscle and fat.
It gives attachment to the muscles of
the pelvic floor.

13. Internal Genitalia
The internal organs of the
female reproductive system
lie in the pelvic cavity and
consist of the vagina, uterus,
two uterine tubes and two
ovaries.

14. Vagina
The vagina is a fibromuscular tube lined with
stratified squamous epithelium opening into the
vestibule at its distal end, and with the uterine
cervix protruding into its proximal end.
It runs obliquely upwards and backwards at an
angle of about 45° between the bladder in front
and rectum and anus behind.
In the adult, the anterior wall is about 7.5 cm long
and the posterior wall about 9 cm long. The
difference is due to the angle of insertion of the
cervix through the anterior wall.

15. Structure Of The Vagina
The vaginal wall has three layers: an outer covering of areolar tissue, a middle
layer of smooth muscle and an inner lining of stratified squamous epithelium
that forms ridges or rugae.
It has no secretory glands but the surface is kept moist by cervical secretions.
Between puberty and the menopause, Lactobacillus acidophilus, bacteria that
secrete lactic acid, are normally present maintaining the pH between 4.9 and
3.5.
The acidity inhibits the growth of most other micro-organisms that may enter
the vagina from the perineum or during sexual intercourse.

16. Blood Supply
Arterial Supply
An arterial plexus is formed round the vagina, derived from the
uterine and vaginal arteries, which are branches of the internal iliac
arteries.
Venous Drainage
A venous plexus, situated in the muscular wall, drains into the
internal iliac veins.

17. Lymph Drainage And Nerve Supply
Lymph Drainage
This is through the deep and superficial iliac nodes.
Nerve Supply
This consists of parasympathetic fibers from the sacral outflow,
sympathetic fibers from the lumbar outflow and somatic sensory fibers
from the pudendal nerves.

18. Functions Of The Vagina
The vagina acts as the receptacle for the penis during sexual intercourse
(coitus).
It provides an elastic passageway through which the baby passes during
childbirth.
It provides pathway for removal of menstrual flow.

19. Uterus
The uterus is a small, firm, pear-shaped,
muscular organ that’s situated between the
bladder and rectum.
It typically lies at nearly a 90-degree angle to
the vagina. It is about 7.5 cm long, 5 cm wide
and its walls are about 2.5 cm thick.
It weighs between 30 and 40 grams.
The parts of the uterus are the fundus, body
and cervix

20. Parts of Uterus
Fundus
This is the dome-shaped part of the uterus above
the openings of the uterine tubes.
Body
This is the main part. It is narrowest inferiorly at the
internal os where it is continuous with the cervix.
Cervix (‘neck’ of the uterus)
This protrudes through the anterior wall of the
vagina, opening into it at the external os.

21. Cervix
The cervix projects into the upper portion of the vagina. The
lower cervical opening is the external os; the upper opening
is the internal os.
The upper two-thirds of the cervical canal is lined with this
mucous membrane. Lower down, however, the mucosa
changes, becoming stratified squamous epithelium, which is
continuous with the lining of the vagina itself.
Childbirth permanently alters the cervix. In a female who
hasn’t delivered a child, the external os is a round opening
about 3 mm in diameter; after the first childbirth, it
becomes a small transverse slit with irregular edges.

22. Uterus
During pregnancy, the elastic, upper portion of the uterus, called the
fundus, accommodates most of the growing fetus until term.
The uterine neck joins the fundus to the cervix, the part of the uterus
that extends into the vagina.
The fundus and neck make up the corpus, the main uterine body.

23. Structure Of Uterus
The walls of the uterus are composed of three
layers of tissue: perimetrium, myometrium and
endometrium
Perimetrium
This is peritoneum, which is distributed differently
on the various surfaces of the uterus.
Myometrium
The muscular layer of the uterus is called the
myometrium This is the thickest layer of tissue in
the uterine wall. It is a mass of smooth muscle
fibers interlaced with areolar tissue, blood vessels
and nerves.

24. Endometrium
The mucous membrane lining of the uterus is called the endometrium.
This consists of columnar epithelium covering a layer of connective
tissue containing a large number of mucus-secreting tubular glands.
It is richly supplied with blood by spiral arteries, branches of the
uterine artery.
It is divided functionally into two layers:
The functional layer is the upper layer and it thickens and becomes
rich in blood vessels in the first half of the menstrual cycle. If the
ovum is not fertilized and does not implant, this layer is shed during
menstruation.
The basal layer lies next to the myometrium, and is not lost during
menstruation. It is the layer from which the fresh functional layer is
regenerated during each cycle.

25. Blood Supply
Arterial Supply
This is by the uterine arteries, branches of the internal iliac arteries. They
pass up the lateral aspects of the uterus between the two layers of the broad
ligaments. They supply the uterus and uterine tubes and join with the
ovarian arteries to supply the ovaries.
Venous Drainage
The veins follow the same route as the arteries and eventually drain into the
internal iliac veins.

26. Lymph Drainage And Nerve Supply
Lymph Drainage
Deep and superficial lymph vessels drain lymph from the uterus and the
uterine tubes to the aortic lymph nodes and groups of nodes associated
with the iliac blood vessels.
Nerve Supply
The nerves supplying the uterus and the uterine tubes consist of
parasympathetic fibers from the sacral outflow and sympathetic fibers
from the lumbar outflow.

27. Function Of Uterus
Provide site for implantation of embryo
Provide space for growth of fetus
Provide nutrition to the fetus.
Passage way for sperm to reach to the fallopian tube for fertilization
Passage way For menstruation
Periodic contraction and relaxation during labor to expel the fetus.

28. Supports Of Uterus
The uterus is supported in the pelvic cavity by surrounding organs, muscles of
the pelvic floor and ligaments that suspend it from the walls of the pelvis
Pelvic floor
Muscles of pelvic floor
Broad ligament
Round ligament
Uterosacral ligament
Transverse cervical ligament
Pubocervical ligament
Pubocervical fascia
Peritoneum
Connective tissue

29. Supports Of Uterus

30. Uterine Tubes
The uterine (Fallopian) tubes are about 10 cm long
and extend from the sides of the uterus between
the body and the fundus.
They lie in the upper free border of the broad
ligament and their trumpet-shaped lateral ends
penetrate the posterior wall, opening into the
peritoneal cavity close to the ovaries.
The end of each tube has fingerlike projections
called fimbriae. The longest of these is the ovarian
fimbria, which is in close association with the ovary.

31. Structure
The uterine tubes are covered with
peritoneum (broad ligament), have a middle
layer of smooth muscle and are lined with
ciliated epithelium. Blood and nerve supply
and lymphatic drainage are as for the uterus.

32. Functions
The uterine tubes propel the ovum from the ovary to the uterus by
peristalsis and ciliary movement.
The secretions of the uterine tube nourish both ovum and
spermatozoa.
Fertilization of the ovum usually takes place in the uterine tube, and
the zygote is propelled into the uterus for implantation.

33. Ovaries
The ovaries are the female gonads (glands producing
sex hormones and the ova), and they lie in a shallow
fossa on the lateral walls of the pelvis.
They are 2.5–3.5 cm long, 2 cm wide and 1 cm thick.
Each is attached to the upper part of the uterus by the
ovarian ligament and to the back of the broad ligament
by a broad band of tissue, the mesovarium.
Blood vessels and nerves pass to the ovary through the
mesovarium

34. Ovaries
The ovaries’ main function is to produce ova.
At birth, each ovary contains approximately 500,000 graafian follicles.
During the childbearing years, one graafian follicle produces an ovum
during the first half of each menstrual cycle.
The follicle releases the mature ovum (called ovulation). If the ovum
isn’t fertilized by sperm within about 1 day from ovulation, it will die.
If it’s fertilized, it will travel down a fallopian tube to the uterus. The
ovaries also produce estrogen, progesterone, and a small amount of
androgens.

35. Structure of Ovaries

36. Blood Supply
Arterial Supply
This is by the ovarian arteries, which branch from the abdominal aorta just
below the renal arteries.
Venous Drainage
This is into a plexus of veins behind the uterus from which the ovarian
veins arise. The right ovarian vein opens into the inferior vena cava and the
left into the left renal vein.

37. Lymph Drainage And Nerve Supply
Lymph Drainage
This is to the lateral aortic and preaortic lymph nodes. The lymph
vessels follow the same route as the arteries.
Nerve Supply
The ovaries are supplied by parasympathetic nerves from the sacral
outflow and sympathetic nerves from the lumbar outflow.

38. Functions
To develop and mature ova.
To discharge mature ovum at each mense.
To produce sex hormones: estrogen and progesterone.

39. The Breasts
The breasts are located on either side of the
anterior chest wall over the greater pectoral
and the anterior serratus muscles.
Within the areola, the pigmented area in the
center of the breast, lies the nipple.
Erectile tissue in the nipple responds to cold,
friction, and sexual stimulation.

40. The Breasts
Each breast is composed of glandular, fibrous, and adipose tissue.
Glandular tissue contains 15 to 20 lobes made up of clustered acini, tiny
saclike duct terminals that secrete milk. Fibrous Cooper’s ligaments
support the breasts; adipose tissue surrounds each breast.
Acini draw the ingredients needed to produce milk from the blood in
surrounding capillaries. Sebaceous glands on the areolar surface, called
Montgomery’s tubercles, produce sebum, which lubricates the areolae and
nipples during breast-feeding.

41. Mammary Glands
The mammary glands, which are located in the breasts, are
specialized accessory glands that secrete milk.
Although present in both sexes, they typically function only in the
female.

42. Lobes, Ducts, And Drainage
Each mammary gland contains 15 to 25 lobes
separated by fibrous connective tissue and fat.
Within the lobes are clustered acini—tiny, saclike
duct terminals that secrete milk during lactation.
The ducts draining the lobules converge to form
excretory (lactiferous) ducts and sinuses
(ampullae), which store milk during lactation.
These ducts drain onto the nipple surface
through 15 to 20 openings.

43. Hormonal Function And The Menstrual Cycle
Like the male body, the female body changes with age in response to
hormonal control.
When a female reaches the age of menstruation, the hypothalamus,
ovaries, and pituitary gland secrete hormones—estrogen, progesterone,
FSH, and LH—that affect the buildup and shedding of the endometrium
during the menstrual cycle.

44. The female reproductive cycle usually lasts 28 days. During this cycle, three
major types of changes occur simultaneously: ovulatory, hormonal, and
endometrial (involving the lining [endometrium] of the uterus).
Ovulatory Changes
Ovulatory changes begin on the 1st day of the menstrual cycle.
As the cycle begins, low estrogen and progesterone levels in the
bloodstream stimulate the hypothalamus to secrete gonadotropin-
stimulating hormone (Gn-RH). In turn, Gn-RH stimulates the anterior
pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing
hormone (LH).

45. Ovulatory Changes continued…
Follicle development within the ovary (in the follicular phase) is spurred by
increased levels of FSH and, to a lesser extent, LH.
When the follicle matures, a spike in the LH level occurs, causing the follicle
to rupture and release the ovum, thus initiating ovulation.
After ovulation (in the luteal phase), the collapsed follicle forms the corpus
luteum, which (if fertilization doesn’t occur) degenerates

46. Hormonal Changes
During the follicular phase of the ovarian cycle, the increasing FSH and LH levels
that stimulate follicle growth also stimulate increased secretion of estrogen.
Estrogen secretion peaks just before ovulation. This peak sets in motion the spike
in LH levels, which causes ovulation.
After ovulation, estrogen levels decline rapidly. In the luteal phase of the ovarian
cycle, the corpus luteum is formed and beings to release progesterone and
estrogen.
As the corpus luteum degenerates, levels of both of these ovarian hormones
decline.

47. Endometrial Changes
The endometrium is receptive to implantation of an embryo for only a short
time in the reproductive cycle. Thus, it’s no accident that the endometrium
is most receptive about 7 days after the initiation of ovulation—just in time
to receive a fertilized ovum.
In the first 5 days of the reproductive cycle, th endometrium sheds its
functional layer, leaving the basal layer (the deepest layer) intact. Menstrual
flow consists of this detached layer and accompanying blood from the
detachment process.

48. Endometrial Changes continued….
The endometrium begins regenerating its functional layer at about day 6 (the
proliferative phase), spurred by rising estrogen levels.
After ovulation (about day 14), increased progesterone secretion stimulates
conversion of the functional layer into a secretory mucosa (secretory phase),
which is more receptive to implantation of the fertilized ovum.
If implantation doesn’t occur, the corpus luteum degenerates, progesterone
levels drop, and the endometrium again sheds its functional layer.

49. Endometrial Changes continued….
During adolescence, the release of hormones causes a rapid increase in physical
growth and spurs the development of secondary sex characteristics.
This growth spurt begins at approximately age 11 and continues until early
adolescence, or about 3 years later.
Menarche, the onset of menstruation, generally occurs after this growth spurt,
usually between ages 11 and 14.
Irregularity of the menstrual cycle is common during this time because of failure to
ovulate.
With menarche, the uterine body flexes on the cervix and the ovaries are situated in
the pelvic cavity.

50. The Reproductive Cycle
This is a series of events, occurring regularly in females every 26 to 30 days
throughout the childbearing period between menarche and menopause.
The cycle consists of a series of changes taking place concurrently in the
ovaries and uterine lining, stimulated by changes in blood concentrations
of hormones.
Hormones secreted during the cycle are regulated by negative feedback
mechanisms.

51. Negative Feedback Mechanisms
The hypothalamus secretes Gonadotropin releasing hormone (Gn-RH),
which stimulates the anterior pituitary to secrete:
Follicle Stimulating Hormone (FSH), which promotes the maturation of
ovarian follicles and the secretion of oestrogen, leading to ovulation. FSH is
therefore predominantly active in the first half of the cycle. Its secretion is
suppressed once ovulation has taken place, to prevent other follicles
maturing during the current cycle
Luteinising Hormone (LH), which triggers ovulation, stimulates the
development of the corpus luteum and the secretion of progesterone.

52. Negative Feedback Mechanisms continued..
The hypothalamus responds to changes in the blood levels of oestrogen
and progesterone.
It is stimulated by high levels of oestrogen alone (as happens in the first
half of the cycle) but suppressed by oestrogen and progesterone together
(as happens in the second half of the cycle).

53. Menstrual Cycle
The average length of the cycle is about
28 days.
By convention the days of the cycle are
numbered from the beginning of the
menstrual phase, which usually lasts
about 4 days. This is followed by the
proliferative phase (approximately 10
days), then by the secretory phase
(about 14 days).

54. Menstrual phase
When the ovum is not fertilized, the corpus luteum starts to degenerate. (In
the event of pregnancy, the corpus luteum is supported by human chorionic
gonadotrophin [HCG] secreted by the developing embryo.)
Progesterone and oestrogen levels therefore fall, and the functional layer of
the endometrium, which is dependent on high levels of these ovarian
hormones, is shed in menstruation.
The menstrual flow consists of the secretions from endometrial glands,
endometrial cells, blood from the degenerating capillaries and the unfertilized
ovum.

55. Menstrual phase continued
During the menstrual phase, levels of oestrogen and progesterone are
very low because the corpus luteum that had been active during the
second half of the previous cycle has degenerated.
This means the hypothalamus and anterior pituitary can resume their
cyclical activity, and levels of FSH begin to rise, initiating a new cycle.

56. Proliferative phase
At this stage an ovarian follicle, stimulated by FSH, is growing towards maturity
and is producing oestrogen, which stimulates proliferation of the functional layer
of the endometrium in preparation for the reception of a fertilized ovum.
The endometrium thickens, becoming very vascular and rich in mucus-secreting
glands. Rising levels of oestrogen are responsible for triggering a surge of LH
approximately mid-cycle.
This LH surge triggers ovulation, marking the end of the proliferative phase.

57. Secretory phase
After ovulation, LH from the anterior pituitary stimulates development of the
corpus luteum from the ruptured follicle, which produces progesterone, some
oestrogen, and inhibin.
Under the influence of progesterone, the endometrium becomes edematous
and the secretory glands produce increased amounts of watery mucus.
This assists the passage of the spermatozoa through the uterus to the uterine
tubes where the ovum is usually fertilized.
There is a similar increase in secretion of watery mucus by the glands of the
uterine tubes and by cervical glands that lubricate the vagina.

58. Secretory phase continued….
The ovum may survive in a fertilizable form for a very short time after ovulation,
probably as little as 8 hours.
The spermatozoa, deposited in the vagina during intercourse, may be capable of
fertilising the ovum for only about 24 hours although they can survive for several
days.
This means that the period in each cycle during which fertilisation can occur is
relatively short.
Observable changes in the woman’s body occur around the time of ovulation.

59. Secretory phase continued….
Cervical mucus, normally thick and dry, becomes thin, elastic and watery,
and body temperature rises by about 1°C immediately following ovulation.
Some women experience abdominal discomfort in the middle of the cycle,
thought to correspond to rupture of the follicle and release of its contents
into the abdominal cavity.
After ovulation, the combination of progesterone, oestrogen and inhibin
from the corpus luteum suppresses the hypothalamus and anterior
pituitary, so FSH and LH levels fall.

60. Secretory phase continued….
Low FSH levels in the second half of the cycle prevent further follicular
development in case a pregnancy results from the current cycle.
If the ovum is not fertilised, falling LH levels leads to degeneration and
death of the corpus luteum, which is dependent on LH for survival.
The resultant steady decline in circulating oestrogen, progesterone and
inhibin leads to degeneration of the uterine lining and menstruation, with
the initiation of a new cycle

61. If the ovum is fertilized there is no breakdown of the endometrium and no
menstruation.
The fertilized ovum (zygote) travels through the uterine tube to the uterus
where it becomes embedded in the wall and produces human chorionic
gonadotrophin (hCG), which is similar to anterior pituitary luteinizing
hormone.
This hormone keeps the corpus luteum intact, enabling it to continue
secreting progesterone and oestrogen for the first 3–4 months of the
pregnancy, inhibiting the maturation of further ovarian follicles. During that
time the placenta develops and produces oestrogen, progesterone and
gonadotrophins

62. Stages Of Development Of The Ovum And The Associated Hormones.

63. Reproductive Functions Of Oestrogen And Progesterone
Oestrogen
Development of secondary sexual characteristics at puberty
Stimulates and supports thickening of uterine lining during proliferative phase
Triggers LH surge mid-cycle, stimulating ovulation
Stimulates anterior pituitary secretion of FSH and LH in first half of cycle
Progesterone
Stimulates and supports thickening and increased glandular development of
uterine lining during secretory phase
With oestrogen, inhibits secretion of FSH and LH from the anterior pituitary in
second half of cycle

64. Puberty In The Female
Puberty is the age at which the internal reproductive organs reach maturity,
usually between the ages of 12 and 14.
This is called the menarche, and marks the beginning of the childbearing period.
The ovaries are stimulated by the gonadotrophins from the anterior pituitary:
follicle stimulating hormone and luteinising hormone.

65. Puberty In The Female
A number of physical and psychological changes take place at puberty:
The uterus, the uterine tubes and the ovaries reach maturity.
The menstrual cycle and ovulation begin (menarche).
The breasts develop and enlarge.
Pubic and axillary hair begins to grow.
Increase in height and widening of the pelvis.
Increased fat deposited in the subcutaneous tissue, especially at the hips
and breasts.

66. Menopause
The menopause (climacteric) usually occurs between the ages of 45 and
55 years, marking the end of the childbearing period.
It may occur suddenly or over a period of years, sometimes as long as 10
years, and is caused by a progressive reduction in oestrogen levels, as the
number of functional follicles in the ovaries declines with age.
The ovaries gradually become less responsive to FSH and LH, and
ovulation and the menstrual cycle become irregular, eventually ceasing.

67. Cessation of menses usually occurs between ages 40 and 55. Although the
pituitary gland still releases FSH and LH, the body has exhausted the supply
of ovarian follicles that respond to these hormones, and menstruation no
longer occurs.
A farewell to menses
A woman is considered to have reached menopause after menses are
absent for 1 year. Before menopause, a woman experiences several
transitional years (called the climacteric years), during which several
physiologic changes that lead to menopause occur.

68. Menopause
Several other phenomena may occur at the same time, including:
short-term unpredictable vasodilation with flushing, sweating and palpitations, causing
discomfort and disturbance of the normal sleep pattern shrinkage of the breasts
axillary and pubic hair become sparse
atrophy of the sex organs
episodes of uncharacteristic behaviour, e.g. irritability, mood changes
gradual thinning of the skin
loss of bone mass predisposing to osteoporosis
 slow increase in blood cholesterol levels that increase the risk of cardiovascular disease
in postmenopausal women to that in males of the same age.
Similar changes occur after bilateral irradiation or surgical removal of the ovaries.

69. Female Reproductive Changes
Declining estrogen and progesterone levels cause numerous physical changes in
aging women.
Because women’s breasts and internal and external reproductive structures are
estrogen-dependent, aging takes a more conspicuous toll on women than on
men.
As estrogen levels decrease and menopause approaches, usually at about age
50, changes affect most parts of the female reproductive system.
Significant emotional changes also take place during the transition from
childbearing years to infertility.

70. Ovaries
Ovulation usually stops 1 to 2 years before menopause.
As the ovaries reach the end of their productive cycle, they become
unresponsive to gonadotropic stimulation.
With aging, the ovaries atrophy and become thicker and smaller.

71. Vulva
The vulva also atrophies with age.
Vulval tissue shrinks, exposing the sensitive area around the urethra and
vagina to abrasions and irritations—from undergarments.
The introitus also constricts, tissues lose their elasticity, and the epidermis
thins from 20 layers to about 5.
Other changes include pubic hair loss and flattening of the labia majora.

72. Vagina
Atrophy causes the vagina to shorten and the mucous lining to become
thin, dry, less elastic, and pale from decreased vascularity.
In this state, the vaginal mucosa is highly susceptible to abrasion.
In addition, the pH of vaginal secretions increases, making the vaginal
environment more alkaline.
The type of flora in it also changes, increasing older women’s risk of
vaginal infections.

73. Uterus
After menopause, the uterus shrinks rapidly to half its premenstrual
weight.
It continues to shrink until the organ reaches approximately one-fourth
its premenstrual size.
The cervix atrophies and no longer produces mucus for lubrication, and
the endometrium and myometrium become thinner.

74. Pelvic Support Structures
Relaxation of the pelvic support commonly occurs in post reproductive women.
Initial relaxation usually occurs during labor and delivery, but clinical effects
commonly go unnoticed until the process accelerates with menopausal
estrogen depletion and loss of connective tissue elasticity and tone.
Signs and symptoms include pressure and pulling sensations in the area above
the inguinal ligaments, lower backaches, a feeling of pelvic heaviness, and
difficulty in rising from a sitting position.
Urinary stress incontinence may also become a problem if urethrovesical
ligaments weaken.

75. Breasts
In the breasts, glandular, supporting, and fatty tissues atrophy.
As Cooper’s ligaments lose their elasticity, the breasts become pendulous.
The nipples decrease in size and become flat, and the inframammary
ridges become more pronounced.

76. Oogenesis
Oogenesis is the process by which oogonium is developed into mature ovum.
Process Of Oogenesis:
The process begins with the ovarian stem cells, or oogonia. Oogonia are
formed during fetal development, and divide via mitosis.
Oogonia form primary oocytes in the fetal ovary prior to birth. These primary
oocytes are then arrested in this stage of meiosis I, only to resume it years
later, beginning at puberty and continuing until the woman is near
menopause (the cessation of a woman’s reproductive functions).
The number of primary oocytes present in the ovaries declines from one to
two million in an infant, to approximately 400,000 at puberty, to zero by the
end of menopause.

77. Oogenesis
Just prior to ovulation, a surge of luteinizing hormone triggers the resumption of
meiosis in a primary oocyte. This initiates the transition from primary to
secondary oocyte.
However, this cell division does not result in two identical cells. Instead, the
cytoplasm is divided unequally, and one daughter cell is much larger than the
other. This larger cell, the secondary oocyte, eventually leaves the ovary during
ovulation. The smaller cell, called the first polar body, may or may not complete
meiosis and produce second polar bodies; in either case, it eventually
disintegrates.
Therefore, even though oogenesis produces up to four cells, only one survives.
Meiosis of a secondary oocyte is completed only if a sperm succeeds in
penetrating its barriers. Meiosis II then resumes, producing one haploid ovum
that, at the instant of fertilization by a (haploid) sperm, becomes the first diploid
cell of the new offspring (a zygote).

78. Oogenesis

80. Ovulation
Ovulation is the process by which graffian follicle in the ovary ruptures and
the ovum is released in the abdominal cavity.
Time of ovulation: it occurs 14±1 days after the onset of menstruation.

81. Process Of Ovulation
Movement of graffian follicle to periphery of ovary
LH progesterone
Formation of new blood vessels in ovary
Protrusion of blood vessel into follicular wall
Prostaglandin from granulosa cells
Increased blood flow to the follicle
Leakage of plasma into follicle
Swelling of follicle
Protrusion of follicle against ovarian capsule
Formation of stigma in ovarian capsule
Activation of proteolytic enzyme by progesterone
Weakening and rupture of follicular capsule degeneration of stigma
Oozing of follicular fluid
Release of ovum

82. Fertilization
Male gonad(testes) Female gonad(ovary)
spermatogenesis Oogenesis
Sperm Ovum(egg)
Zygote

83. Process Of Sex Determination
When sperm enters the ovum 23 chromosomes from ovum and 23
chromosomes from sperm join together to form 23 pairs or 46 chromosomes
in the fertilized ovum. Now, sex determination occurs.
Ovum contains the X chromosomes. Sperm has either X chromosome or Y
chromosome.
If the ovum is fertilized by a sperm with X chromosome, the child will be
female with XX chromosomes.
If the ovum is fertilized by a sperm with Y chromosome, the sex of the child
will be male with XY chromosome.
So, the sex of the child depends upon the male partner.

85. Secondary Sexual Characteristics In Female
Enlargement of breast
Change in voice
Growth of axillary hair and pubic hair
Enlargement of pelvis
Development of sex organs
Start of menstruation
Attraction of opposite sex

86. Female Contraceptives

87. The main function of the ovaries is to:
A. secrete hormones that affect the buildup and shedding of the endometrium during
the menstrual cycle.
B. accommodate a growing fetus during pregnancy.
C. produce ova.
D. serve as the site of fertilization.
The corpus luteum forms and degenerates in which phase of the female reproductive
cycle?
A. Luteal
B. Follicular
C. Proliferative
D. Secretory
Four hormones involved in the menstrual cycle are:
A. LH, progesterone, estrogen, and testosterone.
B. estrogen, FSH, LH, and androgens.
C. estrogen, progesterone, LH, and FSH.
D. gonadotropin-stimulating hormone, estrogen, progesterone, and testosterone.

88. Where does fertilization of the ovum normally occur?
A. in the cervical canal
B. in the ovary
C. in the uterus
D. in the Fallopian tube
What hormone is released by the corpus luteum in the greatest quantity?
A. progesterone
B. estrogens
C. luteinizing hormone
D. follicle stimulating hormone
Which cells produce the majority of estrogens?
A. the cells of the corpus luteum
B. the cells of anterior pituitary
C. endometrial cells
D. granulosa cells of the follicle

89. What is the function of progesterone?
A. to stimulate the development of follicles
B. to maintain the corpus luteum
C. prepare and maintain the uterus for pregnancy
D. to stimulate ovulation
Which one of the following is true about the secretory phase of the menstrual cycle?
A. It occurs as the uterine epithelium regrows under the stimulation of estrogens.
B. It begins at ovulation and continues while the corpus luteum is intact.
C. It refers to the release of progesterone by the corpus luteum.
D. During this phase the follicle develops prior to ovulation.
What is the name given to a young woman’s first menstrual period?
A. Menarche.
B. Menses.
C. Eclampsia
D. Amenorrhea.