Reproductive System

Diseases

Male & Female Infertility

Failure to become pregnant after 1
year of regular, unprotected
intercourse (despite previous
pregnancies)
Peak fertility:

Females: 24 YOA
Most fertile within 24 hrs. of ovulation

Males: 25 YOA
Greatest fertility: intercourse 4 times/wk

Infertility

Etiologies:
Female: hormonal or nutritional,
infections, neoplasms, anomalies of
reproductive tract, age
Males: sperm deficiencies, congenital
anomalies, endocrine disorders,
infections of testes, epididymis or vas,
age, surgery (vasectomy, etc)

Infertility
Etiology: unknown in 10%
Treatment:

Surgical, hormonal treatment, etc

Sexually Transmitted
Diseases (STDs)

Gonorrhea
Infection with Neisseria gonorrhoeae
S/S: purulent discharge

Often more symptoms in males than in

infected females

Gonorrheal ophthalmia neonatorum

Treatment: antibiotics

STDs

Genital Herpes
Infection with herpes simplex virus
Mostly HSV-2
S/S: painful, irritated genital vesicular
lesions

First outbreak often has systemic signs

Aches, fevers, HA, malaise, etc

Treatment: antiviral medicines

STDs

Genital warts
Infection with papillomavirus (HPV)
Incubation period: 1-6 months
Treatment: topical meds, laser
treatment, cryosurgery, electrocautery

STDs

Syphilis
Infection with Treponema pallidum
Three clinical stages:

Primary: chancre appears, contagious

Secondary: systemic, rashes, etc.
Tertiary: CNS, aortic, musculoskeletal

Testing: multiple serum tests

Treatment: antibiotics (PCN)

STDs

Trichomoniasis
Protozoal infection with trichomonas
vaginalis
10-25% females asymptomatic
Treatment: Flagyl

STDs

Chlamydial infection
Infection with chlamydia trachomatis
S/S: often mild
Treatment: antibiotics

Male Reproductive Diseases

Benign Prostatic Hyperplasia

Also called benign prostate hypertrophy
(BPH)
Overgrowth of prostate cells, causing
prostate enlargement
Etiology: unknown, associated with
aging
Males over 50 YOA, increasing with age

BPH
Clinically: tends to obstruct urine
outflow by obstructing bladder
outflow or changing bladder shape
S/S: weak stream, hesitancy,
dribbling of urine, nocturia,
frequency
Treatment: often surgical (TURP)

Prostatitis
Inflammation of prostate gland
Usually infection (bacterial)
Acute or chronic
Treatment:

Antibiotics, regular ejaculation, possibly

surgery depending on type & severity

Epididymitis
Common infection & inflammation of
the epididymis
Typically unilateral
Usually bacterial etiology
Treatment:

Antibiotics, scrotal support

Prostate Cancer
Adenocarcinoma
In males: 3rd leading cause of
cancer death (lung & colon)
Usually males over 50 YOA
Mets to spine or pelvis early
Treatment:

Surgical resection of variable degrees,

hormonal therapies, radiation & chemo

Prostate Cancer

Risk factors associated with this:

Family or racial predisposition
Environmental exposure
Coexisting STDs
Endogenous hormone influence
High animal fat diet implicated

Testicular Cancer
Usually young and middle-aged
males, rare over 40 YOA
Risk factors:

Cryptorchidism, African-Americans,
maternal use of diethylstilbestrol

S/S: smooth, painless mass

Treatment:

orchidectomy, radiation, chemotherapy

Female Reproductive
Diseases

Premenstrual Syndrome (PMS)

Group of physical & psychological
symptoms occurring regularly 3-14
days prior to menses
Relieved by menses
Females in 30-40s

30%-40% females experience some degree

Etiology: unknown

PMS

S/S:

Irritability, anxiety, insomnia

Fatigue, depression, headaches
Vertigo, syncope, arthralgias
Abdominal bloating, palpitations
Acne, breast tenderness, appetite changes

Treatment: no single effective treatment

Amenorrhea

Absence of menarche

Primary-no menses until over 16 YOA

Hereditary, body build, environmental

Secondary-6 months without menses in

a female previously menstruating
Stress, pregnancy

Etiology: hormonal imbalances that

prevent ovulation

Dysmenorrhea

Pain associated with menstruation

Etiology:

Hormonal imbalances, PGs, endometriosis,

polycystic ovaries, tumors

Diagnosis: D & C (also theraputic)

Treatment:

Pain relief, surgical (D & C, fibroid removal)

Ovarian Cysts & Tumors

Cysts
Corpus luteum cyst
Endometrioma
Polycystic ovarian syndrome (endocrine
disorder: hirsuitism, obesity, menstrual
& ovulation irregularities, insulin
resistence) (PCOS)

Ovarian Cysts & Tumors

Tumors

Teratoma (dermoid)
Benign growth, combination of different
types of tissues

Endometriosis
Presence of functional ectopic
endometrial tissue
3-5 million in US
S/S: usually pain in site of ectopic
tissue
Treatment: hormonal therapy, BCP,
laparoscopic surgery if needed

Uterine Leiomyomas
(Fibroids)
Benign uterine tumors of the smooth
muscle layer
Most common tumor in females

Calcify after menopause

S/S: often asymptomatic

Sometimes palpable mass, increased
menstrual bleeding or dysmenorrhea
Treatment: none, surgical

Pelvic Inflammatory Disease

Infection of uterus, fallopian tubes,

ovaries

Etiologies: bacterial infection

Acute, subacute, chronic, recurrent

After surgical procedures, parturition, or due
to STDs

S/S: pain, purulent discharge, abnormal

uterine bleeding (metrorrhea)

PID

Treatment:
Antibiotics (oral or IV), hospitalization
often, some need for surgical drainage
of abscesses, pain relief
Complications: sepsis, infertility

Menopause
Cessation of menses and ovarian
function, causing decreased
estrogen levels
S/S: hot flashes, tachycardia, skin
inelasticity, decrease in breast size &
firmness, genitalia atrophy, decrease
in Bartholin secretions, depression,
poor memory & libido

Menopause

Treatment:

None or HRT (hormone replacement

therapy)
Combination vs. estrogen only
Risks tend to outweigh benefits
Risks: CAD, CVA, thromboemboli, invasive
breast CA, endocmetrial CA
Use: menopausal symptoms &
osteoporosis treatment

Ovarian Cancer

6th most common cancer in US females

1/57 females in US

Decreased risk for use of BCP for at least 5

years (by 60%)

silent killer

Asymptomatic for a long time so poor

prognosis
More deaths than endometrial & cervical
cancers combined

Ovarian Cancer

Treatment:
Usually surgery & chemotherapy
Sometimes radiation

Breast Diseases

Fibrocystic disease
Palpable masses (cysts), vary with
cycle, often tenderness or feeling of
fullness in breasts
Aged 30-55

Benign fibroadenoma
Tumor of fibrous & glandular elements
Usually 20 years post puberty

Carcinoma of the Breast

Variety of malignant neoplasms
Etiology/Risk factors:

Hereditary (FH in maternal relatives),

age, atypical hyperplasia, long
menstrual hx, obesity after menopause,
nulliparous, or no children until 30 YOA

S/S:

A mass, nipple discharge

Carcinoma of the Breast

Diagnosis

Mammography, biopsy

Treatment
Various surgeries
Chemotherapy
Radiation
Hormone therapies

Disorders of Pregnancy and

Parturition

Spontaneous Abortion
Miscarriage, most common in 1st
pregnancy
Expulsion of fetus & amniotic sac before
viability is possible
Etiology: placental or implantation
problems, hormone imbalance, trauma,
chromosomal abnormalities (most
common)

Spontaneous Abortion
S/S: cramping pain, bleeding
Usually during 1st trimester
Treatment:

No prevention is possible

Ectopic Pregnancy
Implantation & growth of fertilized
ovum outside of the uterus
Most commonly in fallopian tubes

Etiology:

Other: abdominal cavity, ovary

Scarring of fallopian tubes

S/S: unilateral lower abd pain,

abnormal menses or no menses

Ectopic Pregnancy

Diagnosis:

Verification of pregnancy by urine &

serum tests, ultrasound

Treatment:
Surgical resection
Complications: shock, exsanguination

Pregnancy-induced
Hypertension
HTN developing during 3rd trimester
=preeclampsia

Peripheral edema, HTN, proteinuria

Eclampsia
Seizures & coma develop
Emergency condition

Intracranial bleeding or edema common

Placental Diseases

Placenta Previa
Low uterine implantation of placenta so
that it blocks the cervical opening
Treatment: C-section

Abruptio Placentae
Premature separation of placenta from
uterine wall
S/S: variable bleeding, cramping,
shock

Premature Rupture of
Membranes
Early rupture of amniotic sac
Amniotic fluid discharge from vagina
Increased risk of uterine infection
and premature labor

Labor prior to fetal maturity

Treatment:

Rest, labor induction or C-section when

viability is certain