Reproductive Pathologies

Reproductive Pathologies

by Tiffany Morris

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• The four functions of the reproductive system are:

  • To produce egg and sperm cells

  • To transport and sustain these cells

  • To nurture a developing fetus

  • To produce hormones

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• The primary reproductive organs are the gonads, which produce gametes (reproductive, cell containing only one set of chromosomes, or half the genetic material necessary to form a complete organism) and hormones. The secondary, or accessory, structures transport and sustain the gametes and nurture the developing offspring.

• The male reproductive system consists of the testes, duct system, accessory glands, and penis.

• The male gonads are the testes. Their location within the scrotum is necessary for the production of sperm.

• The female reproductive system includes the ovaries, uterine tubes, uterus, vagina, accessory glands, and external genital organs.

• The female gonads are the ovaries, which are located on each side of the uterus in the pelvic cavity.

• Estrogen and progesterone stimulate the development of glandular tissue and ducts in the breast. Prolactin stimulates the production of milk, and oxytocin causes the ejection of milk.

Multiple Choice

How many eggs does a female have?

During fetal life, there are about 6 million to 7 million eggs. From this time, no new eggs are produced. At birth, there are approximately 1 million eggs; and by the time of puberty, only about 300,000 remain. Of these, only __ to __ will be ovulated during a woman's reproductive lifetime. .

• 1 to 2 million

• 300 to 400

• 10,00 to 25,000

​Did You Know?

​Every uterus starts out as two small tubes called Mullerian ducts. As they begin to develop, they usually fuse together to form one uterus. According to the March of Dimes, about 3 in 100 women are born with an abnormally shaped uterus. This condition is called a Müllerian anomalies.

Females also have different pelvic shapes from each other. Putting all these factors together shows how differently the conceiving, carrying and delivering for each person can be.

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Cancer is a disease in which cells in the body grow out of control. When cancer starts in a woman’s reproductive organs, it is called gynecologic cancer. The five main types of gynecologic cancer are: cervical, ovarian, uterine, vaginal, and vulvar. 

Of all the gynecologic cancers, only one has screening tests that can find cancer early, when treatment can be most effective. Which one is it?

Multiple Choice

Of all the gynecologic cancers, only one has screening tests that can find cancer early, when treatment can be most effective. Which one is it?

• cervical

• ovarian

• vaginal

​Warning signs

​Prostate Cancer

Prostate cancer is the most common non-skin cancer in men in the U.S., and the 4th most common tumor diagnosed worldwide.

It is estimated that more than 3 million U.S. men are living with prostate cancer.

In the United States, 1 in 8 men will be diagnosed with prostate cancer in his lifetime.

As men increase in age, their risk of developing prostate cancer increases About 6 in 10 cases are found in men over the age of 65. Black men are over 75% more likely to develop prostate cancer than Caucasian men, and are more than twice as likely to die from the disease.

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Men with relatives — father, brother, son — with a history of prostate cancer may be twice as likely to develop the disease.

In 2021, almost 250,000 U.S. men were diagnosed with prostate cancer, and more than 34,000 will die from the disease. That’s one new case diagnosed every 2 minutes and another death from prostate cancer every 15 minutes.

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Prostate cancer can be silent — it’s important to get checked, even if there are no symptoms.

If detected early the survival rate is high. 99% of patients with local or regional disease live 5 years or longer after diagnosis.

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Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus. As a result, the uterus slips down into or protrudes out of the vagina.

Uterine prolapse can occur in women of any age. But it often affects postmenopausal women who've had one or more vaginal deliveries.

​ Signs and symptoms of moderate to severe uterine prolapse include:

• Sensation of heaviness or pulling in your pelvis

• Tissue protruding from your vagina

• Urinary problems, such as urine leakage

• Trouble having a bowel movement

• Feeling as if you're sitting on something

Often, symptoms are less bothersome in the morning and worsen as the day goes on.

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Polycystic Ovary Syndrome (PCOS)

PCOS is a metabolic condition which affects 1 in 10 women and means that the ovaries have an abnormally large number of follicles on them.

These follicles are not harmful, but they can cause a hormonal imbalance, often resulting in several problems, such as irregular or no periods, weight gain, difficulty getting pregnant, excessive body hair, thinning of head hair and acne or oily skin. These symptoms will usually present themselves during their teenage years.

In order for a woman to be diagnosed with PCOS, she needs to have -

• Irregular or lack of periods

• High levels of male hormones

The cause is often a hereditary trait and related to abnormal hormone levels, including high levels of insulin. Although PCOS has no known cure, the symptoms of PCOS can be treated. Medication will usually be prescribed to treat symptoms such as irregular periods, infertility and excessive hair growth. In more severe cases, a surgical procedure called laparoscopic ovarian drilling (LOD) may be required.

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Ovarian cysts and PCOS are related conditions with many of the same symptoms, meaning that women often confuse the two, or wrongly believe that they have PCOS when they do not.

The most significant difference between the two conditions is that PCOS results in a substantial hormonal imbalance, which is not generally the case with ovarian cysts. It is also possible for women to have multiple ovarian cysts without suffering from PCOS.

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Ovarian Cysts

Ovarian cysts are sacs filled with fluid which are present in or on the ovaries. They are very common with many women developing them at some point in their lifetime.

Ovarian cyst symptoms are very similar to those found in women with PCOS, such as irregular or non-existent periods, acne and weight gain. Other ovarian cyst symptoms may include pelvic pain, high blood pressure, lower back pain, abdominal pressure and nausea.

It has been found that women with ovarian cysts usually do not have much difficulty getting pregnant, whereas it is common for those with PCOS to struggle.

Ovarian cysts can be identified during an ultrasound scan. Treatment for ovarian cysts will be dependent on:

• The size and appearance of the cysts

• The symptoms

• Have been through menopause

Cysts often disappear without intervention or treatment, but in the more serious cases, such as if they are large or potentially cancerous, a procedure will be used to surgically remove the ovarian cysts.

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  • ​Pelvic inflammatory disease is an infection of the female reproductive organs. Sexually transmitted infections —gonorrhea and chlamydia—are the main causes of PID. When a woman is infected with gonorrhea or chlamydia and does not receive treatment, it can take anywhere from a few days to a few weeks before she develops symptoms. PID also can be caused by infections that are not sexually transmitted. This includes childbirth, miscarriage, abortion, or inserted birth control devices.

  • If left untreated​

    • Infertility—One in 10 women with PID becomes infertile. PID can cause scarring of the fallopian tubes.

    • Ectopic pregnancy—Scarring from PID also can prevent a fertilized egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube. The tube may rupture (break) and cause life-threatening bleeding into the abdomen and pelvis.

    • Chronic pelvic pain—PID may lead to long-lasting pelvic pain.

    • ​Blood infection

    • symptoms of pelvic inflammatory disease

      • Abnormal vaginal discharge

      • Pain in the lower abdomen (often a mild ache)

      • Abnormal menstrual bleeding

      • Fever and chills

      • Painful urination

      • Nausea and vomiting

      • Painful sexual intercourse

      • Each year, more than 1 million women in the U.S. get PID. And more than 100,000 women become infertile because of it,

      • PID is treated first with antibiotics.

    • ​Sexually active women of childbearing age are most at risk for PID. The more sex partners a woman has, the higher her risk of getting PID. Women who are 25 or younger are more likely to get PID than those older than 25.​

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Multiple Choice

Pelvic inflammatory disease doesn't affect men because it's an infection of the fallopian tubes and uterus. But, should a male partner still get checked by a doctor if YOU have PID?

• Yes, many times these bacteria are sexually transmitted

• No, it has no effect on male fertility

Ectopic Pregnancy

 Pregnancy requires a number of steps in a woman’s body. One of these steps is when a fertilized egg travels to the uterus to attach itself. In the case of an ectopic pregnancy, the fertilized egg doesn’t attach to the uterus. Instead, it may attach to the fallopian tube, abdominal cavity, or cervix.

However, because tissues outside the uterus cannot provide the necessary blood supply and support the structure containing the fetus typically ruptures after about 6 to 16 weeks, long before the fetus is able to live on its own

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Common causes for this

• inflammation and scarring of the fallopian tubes from a previous medical condition, infection, or surgery

• hormonal factors

• genetic abnormalities

• birth defects

• maternal age of 35 years or older

  • history of pelvic surgery, abdominal surgery, or multiple abortions

  • history of pelvic inflammatory disease (PID)

  • history of endometriosis

  • conception occurred despite tubal ligation or intrauterine device (IUD)

  • conception aided by fertility drugs or procedures

  • smoking

  • history of ectopic pregnancy

  • history of sexually transmitted diseases (STDs), such as gonorrhea or chlamydia

  • having structural abnormalities in the fallopian tubes that make it hard for the egg to travel

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Gestational diabetes and Preeclampsia are both conditions that only occur during or just after pregnancy. Gestational diabetes is caused by an inability to use sugar properly during pregnancy, and may result in giving birth to a large baby. One of the potential complications of gestational diabetes is the development of preeclampsia. This condition, which may also be called toxemia of pregnancy or pregnancy-induced hypertension, occurs in about 10 to 30 percent of women with gestational diabetes.

Preeclampsia is the presence of protein in urine and high blood pressure occurring after the 20th week of pregnancy. The condition affects about 5 to 8 percent of all pregnancies. In the United States, preeclampsia rarely causes the death of a mother or infant, but worldwide pregnancy-induced high blood pressure still causes 76,000 maternal deaths and 500,000 infant deaths every year.

Preeclampsia risk may happen if you have gestational diabetes, a family history of preeclampsia, are overweight, or if you had high blood pressure or kidney disease before your pregnancy. Preeclampsia is more common during your first pregnancy, if you are carrying twins, and if you are over age 40 or a teenage mother.

​The signs and symptoms of preeclampsia are caused by the sudden increase in blood pressure, retention of fluids in the body, and kidney damage that allows proteins to pass into urine.

Untreated preeclampsia can prevent a baby from getting enough blood and nourishment through the placenta in the womb. Preeclampsia can also lead to eclampsia, which is high blood pressure plus seizures, a very serious condition for both mother and baby.

​Relaxin is a hormone secreted in the ovary . When a woman is pregnant, the placenta will also release the hormone, as will the uterine lining. Men also have relaxin, which comes from the prostate gland and is found in semen, but in men it does not circulate in the blood. In preparation for childbirth, it relaxes the ligaments in the pelvis and softens and widens the cervix. Relaxin is a hormone structurally related to insulin and insulin-like growth factor. It alters the properties of cartilage and tendon by activating collagenase. This hormone is also involved in bone remodeling and healing of injured ligaments and skeletal muscle.

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Mastitis is an inflammation of breast tissue that sometimes involves an infection. The inflammation results in breast pain, swelling, warmth and redness. You might also have fever and chills. Mastitis most commonly affects women who are breast-feeding 

Antibiotics are required. Mild pain relievers can help with discomfort.

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Fibrocystic Breast Change is noncancerous changes that give a breast a lumpy or ropelike texture.

The condition is likely due to hormone changes during the menstrual cycle that affect breast tissue.

Symptoms include a change in breast texture, pain or tenderness, and lumpiness.

Most fibrocystic breast changes are normal.

Treatment consists of self care and anti-inflammatories

Multiple Choice

Can men get breast cancer?

• Yes

• No

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Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.

Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.

Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.

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12.4% of women in the United States will develop breast cancer over the course of her lifetime. This makes breast cancer the most common cancer among women, besides skin cancer.

In 2018, an estimated 266,120 new cases of invasive breast cancer were diagnosed in women in the U.S., along with 63,960 new cases of non-invasive breast cancer.

There were about 2,550 new cases of breast cancer in men in 2018.

​Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder.

This type of prostate enlargement isn't thought to be a precursor to prostate cancer.

With this condition, the urinary stream may be weak, or stop and start. In some cases, it can lead to infection, bladder stones, sexual dysfunction and reduced kidney function.

Treatments include medications that relax the bladder or shrink the prostate and surgery.

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Prostatitis is swelling and inflammation of the prostate gland.

Acute bacterial prostatitis is often caused by common strains of bacteria. The infection can start when bacteria in urine leak into the prostate

Prostatitis often causes painful or difficult urination. Other symptoms include pain in the groin, pelvic area or during sexual activity, cloudy or bloody urine, and sometimes flu-like symptoms.

Prostatitis affects men of all ages but tends to be more common in men 50 or younger. The condition has a number of causes. If prostatitis is caused by a bacterial infection, it can usually be treated with antibiotics.

Depending on the cause, prostatitis can come on gradually or suddenly. It might improve quickly, either on its own or with treatment. Some types of prostatitis last for months or keep recurring .

• Complications of prostatitis can include:

  • Bacterial infection of the blood

  • Inflammation of the coiled tube attached to the back of the testicle

  • Pus-filled cavity in the prostate

  • Semen abnormalities and infertility,

  There's no direct evidence that prostatitis can lead to prostate cancer.

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Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society’s estimates for prostate cancer in the United States for 2021 are:

• About 248,530 new cases of prostate cancer

• About 34,130 deaths from prostate cancer

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  Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen).

  Other types of cancer that can start in the prostate include:

  • Small cell carcinomas

  • Neuroendocrine tumors (other than small cell carcinomas)

  • Transitional cell carcinomas

  • Sarcomas

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  About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.

  Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40.

​Sexually transmitted bacterial infections

​Chlamydia And Gonorrhea are a common STD's that can infect both men and women. You can get sexually transmitted bacterial infections by having vaginal, anal, or oral sex with someone who has them.

The infection is carried in semen and vaginal fluids. It most often affects the urethra, rectum or throat. In females, it also can infect the cervix.

Antibiotics for the affected patient and the patient's sexual partners is the recommended treatment .

If left untreated ,it can cause serious, permanent damage to a woman’s reproductive system

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If you are pregnant and have a bacterial STD, you can pass the infection to your baby during delivery. This could cause an eye infection or pneumonia. It may also make it more likely to have an early delivery.

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Many who have these STD's don't develop symptoms, but they can still infect others through sexual contact.

Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Symptoms in women can include:

• Painful or burning sensation when peeing;

• Increased vaginal discharge

• Bleeding between periods.

Men who do have symptoms may have:

• A burning sensation when peeing;

• A white, yellow, or green discharge from the penis

• Painful or swollen testicles ( less common).

Rectal infections may either cause no symptoms or cause symptoms in both men and women that may include:

• Discharge;

• Anal itching;

• Soreness;

• Bleeding

• Painful bowel movements.

​Syphilis is another bacterial infection usually spread by sexual contact from person to person via skin or mucous membrane contact with these sores

Syphilis develops in stages, and symptoms vary with each stage.

The first stage involves a painless sore on the genitals, rectum, or mouth a week to 3 weeks after exposure.

When the initial sore heals, the second stage is characterized by a rash. It can begins on your trunk but eventually covers your entire body even the palms of your hands and the soles of your feet.

Some people also experience hair loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year.

Then, there are no symptoms until the final stage which may occur years later. This final stage can result in damage to the brain, nerves, eyes, or heart.

Syphilis is treated with penicillin. Sexual partners should also be treated as well.

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Babies born to women who have syphilis can become infected through the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash on the palms of their hands and the soles of their feet.

Later signs and symptoms may include deafness, teeth deformities and saddle nose — where the bridge of the nose collapses.

However, babies born with syphilis can also be born too early, may die in the womb before birth or can die after birth.

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​Virus sexually transmitted diseases

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Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus. Sexual contact is the primary way that the virus spreads. After the initial infection, the virus lies dormant in your body and can reactivate several times a year.

Many have no signs or symptoms of genital herpes. If infected, you can be contagious even if you have no visible sores.

There's no cure for genital herpes, but medications can ease symptoms and reduce the risk of infecting others. Condoms also can help prevent the spread of a genital herpes infection.

When present, symptoms may begin about two to 12 days after exposure to the virus.

• Pain or itching. You may experience pain and tenderness in your genital area until the infection clears.

• Small red bumps or tiny white blisters. These may appear a few days to a few weeks after infection.

• Ulcers. These may form when blisters rupture and ooze or bleed. Ulcers may make it painful to urinate.

• Scabs. Skin will crust over and form scabs as ulcers heal.

During an initial outbreak, you may have flu-like signs and symptoms such as swollen lymph nodes in your groin, headache, muscle aches and fever.

Multiple Choice

Condoms are the only way to be 100 percent protected from genital herpes.

• True

• False

​Condoms cover only the penis, but herpes sores can appear in places outside the covered area, like on thighs and buttocks. And contact with any herpes sore anywhere can lead to infection.

Cold sores are caused by certain strains of the herpes simplex virus. HSV -1 usually causes cold sores. HSV -2 is usually responsible for genital herpes. But either type can spread to the face or genitals through close contact, such as kissing or oral sex.

 So whether your partner is a man or a woman, you could still be exposed to herpes even if you don't engage in genital sex.

​Also known as the French disease or great pox, syphilis was a common sexually transmitted disease in Europe in the 1800s. In fact, 10-15% of Europeans in the 19th century were likely infected with the bacterial infection. Hence there was not a lot of social stigma, for men at least, to have the disease. Odds are high that several Western artists, especially those who regularly frequented brothels, had syphilis.

​Van Gogh was no stranger to brothels. At one point he was romantically involved with a former prostitute. Van Gogh was officially diagnosed with gonorrhea but it's widely believed that he also suffered from syphilis. Gonorrhea and syphilis both have similar symptoms but unlike gonorrhea, syphilis causes insanity in it's last stages His erratic behaviors like the most popular account of Van Gogh cutting off his ear and giving it to a prostitute as a gift. Gave him the nickname by his neighbors as the Red Headed Madman. His hallucinations caused him to spend much time in and out of mental asylums where he created some of his best known work like Starry Night. Van Gogh was discharged from hospital and moved closer to his brother Theo, but his mental health continued to decline. it was reported that he shot himself in the chest and passed away from the infection a few days later. His parting words to his brother where “the sadness will last forever”.

Six months after Van Gogh's death, his brother Theo died from, you guessed it, syphilis

​Fun with STD history!

Poll

Van Gogh as been diagnosed through the years as having many conditions that could have contributed to his mental state of mind. What's your theory?

• Syphilis

• Schizophrenia

• Temporal lobe damage from epilepsy

• Alcoholism

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Genital warts are a type of sexually transmitted disease that causes warts to form in and around the genitals mouth and rectum. Certain types of human papillomavirus (HPV) cause genital warts.

Genital warts and the virus that causes them are both highly contagious. There isn’t a cure for HPV. Once you have the virus, you’re always infectious. Even if you don’t have symptoms like genital warts, or you have the warts treated and removed, you can still infect another person .

Genital warts affect all genders. It’s most common in teenagers and young adults. Men are slightly more at risk.

Warts look like rough, skin-colored growths. Genital warts often have a bumpy cauliflower look, but some are flat. Genital warts aren’t usually painful. Occasionally, they cause:

• Mild bleeding.

• Burning sensation.

• Discomfort.

• Genital itching or irritation.

Genital warts can go away on their own. Or they may get larger or multiply.

Your healthcare provider may use one of these methods to treat genital warts:

• Electrocautery: An electric current burns away warts.

• Freezing: liquid nitrogen to freeze and destroy warts.

• Laser treatment: A laser light destroys tiny blood vessels inside warts, cutting off their blood supply.

• Loop electrosurgical excision procedure an electrically charged wire loop to remove warts. may use this method to remove warts on a woman

• Topical (skin) medicine:  The chemical causes blisters to form under the warts, stopping blood flow.

• Surgery:  surgically cut out warts that are large or don’t respond to other treatments.

Genital warts on the cervix or inside the vagina can cause cervical changes that can lead to cervical cancer. The warts cause these changes, not HPV.

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Multiple Choice

An estimated ___ people ,most of them in their late teens and twenties ,get genital warts every year.

• 50,000

• 400,000

• 1 million

​ Protozoan sexually transmitted disease

​Trichomoniasis sometimes called Trich is the most common curable STD in the United States ,treatable with a course of antibiotics. It effects 3.7 million people.

It is caused by infection with a protozoan parasite called Trichomonas vaginalis.

Infection is more common in women than in men. It it almost always a sexually transmitted disease. But rare cases of nonsexual transmission of trichomonas has occured through contaminated towels ,toilet seats and from swimming pool/spa areas

The CDC estimates that there were more than two million trichomoniasis infections in 2018. However, only about 30% develop any symptoms of trichomoniasis.

Although symptoms of the disease vary, most people who have the parasite cannot tell they are infected. A very pungent odor is one of the first noticeable signs .

Some people with symptoms get them within 5 to 28 days after being infected. Others do not develop symptoms until much later.

In women, trichomoniasis can cause:

• itching, burning, and redness in and around the vagina

• painful urination

• pain during sex

• frothy smelly yellow, green, or white discharge from the vagina

• lower abdominal pain

In men, trichomoniasis can cause:

• burning after ejaculation

• white discharge from the penis

• pain or burning during urination

• swelling and redness around the head of the penis

• pain during sex

 

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