2.

SEXUAL REPRODUCTIVE
HEALTH AND RIGHTS
Reproductive Health Anatomy
and Physiology
Musinguzi marvin
Outline

1. External female genital anatomy

2. Internal female reproductive anatomy

3. Female sexual response

4. Menstrual cycle

5. Menopause
Female anatomy and physiology
External genital anatomy
Female external genital anatomy
The external female genital area is made up of many parts, which together are called the vulva

The clitoris: is a small, sexually sensitive organ full of nerve endings and composed of erectile
tissue. It is located at the front of the vulva where the labia minora meet.
Most of the clitoris is located under the skin and is not visible. The visible part of the clitoris is
called the glans. The glans is about the size of a pearl and covered with a fold of skin called the
prepuce.

The clitoris becomes engorged with blood during sexual excitement, providing sexual
sensation
Female external genital anatomy
Clitoris
Female external genital anatomy
The lips

The labia majora (large lips) and labia minora (small lips) surround the vaginal
opening.

The labia majora are the outer lips of the vulva and protect the urethral opening and
vagina.

The labia majora are covered with pigmented skin and hair on the outer surface of
the vulva and are smooth and free from hair on the inner surface. They are made up
of fat and glands.

The labia minora are the inner lips that form a protective covering over the clitoris
and urethral opening.
Female external genital anatomy
The lips
Female external genital anatomy
The lips

The hymen is a thin membrane that sometimes partially covers the entrance

to the vagina. An intact hymen cannot be used as an indication of “virginity”;
even at birth, this is only a partial membrane, as menstrual fluid and other
secretions must be able to exit the body, regardless of penile–vaginal
intercourse.

The vaginal opening is located between the opening of the urethra and the
anus. It is flanked by outlets to the Bartholin’s glands (or greater vestibular
glands).
Female external genital anatomy
The vagina

The vaginal opening connects the female external and internal reproductive
parts. It is the middle of three openings, between the urethral opening and anus.

The vagina is a muscular canal (approximately 10 cm long) that serves as the

entrance to the reproductive tract. It also serves as the exit from the uterus
during menses and childbirth.

The outer walls of the anterior and posterior vagina are formed into longitudinal
columns, or ridges, and the superior portion of the vagina called the fornix
meets the protruding uterine cervix.
Female external genital anatomy
The vagina

The vagina is home to a normal population of microorganisms

(normal flora) Lactobacillus, that help to protect against infection by
pathogenic bacteria, yeast, or other organisms that can enter the
vagina

The urethra is the pathway urine travels through to exit the body.
The anus is the opening through which feces leave the body.
Technically, the anus is not part of the reproductive system.
Internal reproductive female anatomy
Ovaries

The ovaries are the female gonads. Paired ovals, they are each about 2 to 3 cm in
length, about the size of an almond.

The ovaries are located within the pelvic cavity, and are supported by the mesovarium,
an extension of the peritoneum that connects the ovaries to the broad ligament.

Extending from the mesovarium itself is the suspensory ligament that contains the
ovarian blood and lymph vessels. Finally, the ovary itself is attached to the uterus via
the ovarian ligament.
The uterus is the muscular organ that nourishes and supports the
growing embryo. Its average size is approximately 5 cm wide by 7
cm long (approximately 2 in by 3 in) when a female is not pregnant.
It has three sections.

The portion of the uterus superior to the opening of the uterine

tubes is called the fundus. The middle section of the uterus is called
the body of uterus (or corpus).
The cervix is the narrow inferior portion of the uterus that
projects into the vagina.

The cervix produces mucus secretions that become thin and

stringy under the influence of high systemic plasma estrogen
concentrations, and these secretions can facilitate sperm
movement through the reproductive tract.
Sexual response
The female sexual response cycle caused by sexual excitement and stimulation

includes engorgement of the clitoris, wetness on the vulva, and vaginal lubrication

and expansion.

Orgasm occurs when the tension from sexual stimulation is released in a series of

muscle spasms and the release of endorphins. During orgasm, some people ejaculate

from the vulva and some people don't, either is normal.

 Orgasm in women is thought to have an evolutionary role in conception via the

"insuck" or "upsuck" mechanism.

MENSTRAL CYCLE
MENSTRAL CYCLE

The length of the menstrual cycle varies among women, and even
in the same woman from one cycle to the next, typically from 21 to
32 days.

The timing of the menstrual cycle starts with the first day of
menses, referred to as day one of a woman’s period. Cycle length
is determined by counting the days between the onset of bleeding
in two subsequent cycles
MENSTRAL CYCLE

Menstrual cycle Is the monthly physiologic changes that take place

in the ovaries and the uterus, regulated by hormones produced by
the hypothalamus, anterior pituitary gland and ovaries.

These monthly cycles commence at puberty and occur

simultaneously and together are known as the female reproductive
cycle.
MENSTRAL CYCLE

The menstrual cycle occurs into;

Ovarian and uterine cycles

The ovarian cycle

The ovarian cycle is divided into three phases:

Follicular phase

Ovulatory phase

The luteal phase.

The ovarian cycle
Follicular phase

Mainly Oocyte development occurs.

Initial stages of follicular development are independent of hormonal stimulation.

Inadequate hormonal stimulus causes follicular development failure at the pre-antral

stage, with ensuring follicular atresia.

Development beyond the pre-antral stage is stimulated by LH and FSH

At the start of the menstrual cycle, FSH levels begin to rise as the pituitary gland
releases from the negative feedback effects of progesterone, estrogen and inhibin.
The ovarian cycle
Rising FSH levels rescue a cohort of follicles from atresia, and initiate
steroidogenesis.

FSH controls the growth and maturation of the graafian follicles.

The largest and dominant follicle secrets inhibin which further suppresses FSH.
This dominant follicle prevails and forms a bulge near the surface of the ovary
and soon becomes competent to ovulate.

The time from the growth and maturity of the graafian follicles to ovulation is
about 1 week.
The ovarian cycle
Ovulation

High estrogen levels cause a sudden surge in LH around day 12-13 of a 28-day cycle, which lasts
approximately 48 hours.

This matures the oocyte and weakens the walls of the follicle and causes ovulation to occur on day 14.

Ovulation is the process whereby the dormant graafian follicle ruptures and discharges the secondary
oocyte into the pelvic cavity.

The fimbriae guide it into the uterine tube where it awaits fertilization.

During ovulation, some women experience some degree of abdominal pain known as the
mittelschmerz, which may last several hours.
The ovarian cycle
The luteal phase

The luteal phase is the process whereby the cells of the residual ruptured follicle proliferate and form a
yellow irregular structure known as the corpus luteum.

The corpus luteum produces estrogen and progesterone and two other hormones, inhibin and relaxin to
develop the endometrium of the uterus.

The corpus luteum continues its role until the placenta is adequately developed to take over.

The corpus luteum degenerates and becomes the corpus albicans

The levels of estrogen, progesterone, inhibin and relaxin decrease, in response to this, the hypothalamus
produces GnRH. This rising levels of GnRH stimulate the anterior pituitary gland to produce FSH and the
ovarian cycle commences again
Uterine cycle

There are three phases of menstration

1. Menses phase

2. Proliferative Phase

3. Secretory phase
Uterine cycle

The menses phase of the menstrual cycle is the phase during which

the lining is shed; that is, the days that the woman menstruates.
Although it averages approximately five days, the menses phase can
last from 2 to 7 days, or longer.

 The menses phase occurs during the early days of the follicular
phase of the ovarian cycle, when progesterone, FSH, and LH levels
are low
Uterine cycle

Proliferative Phase

Once menstrual flow ceases, the endometrium begins to proliferate again,

marking the beginning of the proliferative phase of the menstrual cycle. 

It occurs when the granulosa and theca cells of the tertiary follicles begin
to produce increased amounts of estrogen.

These rising estrogen concentrations stimulate the endometrial lining to

rebuild.
Uterine cycle
The high estrogen concentrations will eventually lead to a decrease in FSH as a
result of negative feedback, resulting in atresia of all but one of the developing
tertiary follicles.

The switch to positive feedback which occurs with the elevated estrogen
production from the dominant follicle then stimulates the LH surge that will
trigger ovulation. In a typical 28-day menstrual cycle, ovulation occurs on day 14.

 Ovulation marks the end of the proliferative phase as well as the end of the
follicular phase.
Uterine cycle
Secretory Phase

In addition to prompting the LH surge, high estrogen levels increase the uterine
tube contractions that facilitate the pick-up and transfer of the ovulated oocyte.

High estrogen levels also slightly decrease the acidity of the vagina, making it
more hospitable to sperm.

In the ovary, the luteinization of the granulosa cells of the collapsed follicle forms
the progesterone producing corpus luteum, marking the beginning of the luteal
phase of the ovarian cycle.
Uterine cycle

In the uterus, progesterone from the corpus luteum begins

the secretory phase of the menstrual cycle, in which the endometrial
lining prepares for implantation. Over the next 10 to 12 days, the
endometrial glands secrete a fluid rich in glycogen.

 If fertilization has occurred, this fluid will nourish the ball of cells now
developing from the zygote. At the same time, the spiral arteries
develop to provide blood to the thickened stratum functionalis.
Uterine cycle

If no pregnancy occurs within approximately 10 to 12 days, the

corpus luteum will degrade into the corpus albicans. Levels of both
estrogen and progesterone will fall, and the endometrium will grow
thinner.

Prostaglandins will be secreted that cause constriction of the spiral

arteries, reducing oxygen supply. The endometrial tissue will die,
resulting in menses or the first day of the next cycle.
Watch this video for more information about menstruation

https://youtu.be/2_owp8kNMus
Menopause
Menopause

Female fertility (the ability to conceive) peaks when women are in

their twenties, and is slowly reduced until a women reaches 35 years
of age. After that time, fertility declines more rapidly, until it ends
completely at the end of menopause.

Menopause is the cessation of the menstrual cycle that occurs as a

result of the loss of ovarian follicles and the hormones that they
produce.
Menopause

A woman is considered to have completed menopause if she has not

menstruated in a full year. After that point, she is considered
postmenopausal.

The average age for this change is consistent worldwide at between

50 and 52 years of age, but it can normally occur in a woman’s
forties, or later in her fifties. Poor health, including smoking, can lead
to earlier loss of fertility and earlier menopause.
Menopause

As a woman reaches the age of menopause, depletion of the

number of viable follicles in the ovaries due to atresia affects the
hormonal regulation of the menstrual cycle.

During the years leading up to menopause, there is a decrease in

the levels of the hormone inhibin, which normally participates in a
negative feedback loop to the pituitary to control the production
of FSH.
Menopause
The menopausal decrease in inhibin leads to an increase in FSH. The
presence of FSH stimulates more follicles to grow and secrete estrogen.
Because small, secondary follicles also respond to increases in FSH levels,
larger numbers of follicles are stimulated to grow; however, most undergo
atresia and die.

Eventually, this process leads to the depletion of all follicles in the ovaries,
and the production of estrogen falls off dramatically. It is primarily the lack
of estrogens that leads to the symptoms of menopause.
Signs and symptoms of
Menopause
The male reproductive system

The male reproductive system is a grouping of organs that make up a

man’s reproductive and urinary systems. These organs have the following
functions within your body:

They produce, maintain and transport sperm (the male reproductive

cells) and semen (the protective fluid around the sperm).

They discharge sperm into the female reproductive tract.

They produce and secrete male sex hormones.

The end