Female Reproductive System Pathology
Terms in this set (25)
Estrogen (Estradiol, estrone, estriol)-produced in ovaries and minor amount in adrenal glands. controls menstrual cycle, etc.
Progesterone-also controls menstrual cycle and more
Androgens-Small amounts in females, precursers of estrogen, cause acne, etc.
Normal cycle of reproduction caused by hormonal body changes during which the uterus enriches the endometrium to receive fertilized ovum.
When egg released at midcycle and then does not implant, the endometrium is sloughed off, resulting in "period".
Cycle can be anywhere from 21 days to 35 days. The most common is 28 days.
Women influence each other's cycle, tending to end up with similar monthly periods.
Dysmenorhea is pain related to uterine contractions during monthly cycle.
Pain caused by myometrial contractions and constriction of endometrial vessels causing ischemia
Primary - caused by release of prostaglandins during ovulatory
Secondary - other pathology
Problem of misdiagnosis
Rule out other causes (endometriosis, et.)
Primary - no menstruation by age 14 and no secondary sex characteristics or by age 16
Anatomic abnormalities = no uterus, abnormal ovaries, mixed genes
Secondary - no menstruation for 3 or more cycles or 6 months who have menstruated in past
Pregnancy, stress, starvation, psychogenic problems, endocrine abnormalities, tumors, chemotherapy, autoimmune
Abnormal Uterine Bleeding
Concern in children related to foreign bodies, trauma, and sexual abuse
Concern: sexually transmitted disease, bleeding disorders, trauma, abuse
Dysfunctional Uterine Bleeding
Uterine bleeding that is excessive, prolonged, and unpatterned. (>8-10 days, blood loss > 80 ml)
Polymenorrhea - less 21 days between cycles
Menorrhagia - excessive flow or duration
Metrorrhagia - irregular cycle/bleeding in between
Menometrorrhagia - irregular and excessive
Thought to be caused by fluctuating hormones/serotonin
S & S = bloating, food cravings, irritability, dysphoria
Peak symptoms differ
Cessation of menstrual flow
Hormone changes - decrease in both estrogen and progesterone
Causes many changes in body, risk factors, such as osteoporosis, and heart disease
Average age is 50 years
Release of toxins produced by the presence of Staph/strep
S & S = high fever, vomiting, peeling skin, low blood pressure, diarrhea, and a rash resembling sunburn. Most of these women had one thing in common: they were all menstruating
Majority were using a new type of tampon called a super-absorbent tampon
Woman goes into shock and potentially organ failure with death. Then 15% mortality in 1980's
Polycystic Ovarian Syndrome
S & S = infertility, hirsutism, amenorrhea, acne, male-pattern baldness
Hyperinsulinemia plays a role by stimulating androgen secretion increasing testosterone
FSH low, LH high
Affects production of hormones
Follicles are stimulated to grow, but never to maturation and ovulation
Many develop DM
Yeast Vaginitis (fungus)
75% of women will experience this infection
Caused by low lactobacillus
RF = antibiotic use, stress, immune problems
58% misdiagnose self
Make sure doesn't have undiagnosed STI's
Caused by bacteria when lactobacillus low due to low estrogen=low pH.
Bad bacteria overwhelm
Not considered an STI.
Pelvic Inflammatory Disease
Inflammation from infection in uterus, ovaries or fallopian tubes; induces necrosis.
Chlamydia/gonorrhea #1 cause
S & S = none to abdominal pain, infertility, ectopic pregnancy, chronic pelvic pain, abscesses, septicemia, pelvic pain, abnormal vaginal discharge, N/V
Pelvic Floor Relaxation/Fistulas
Serious debilitating problem in places with little/no medical care
Bladder, urethra, rectum supported in pelvis by perineal muscles. Lose their strength or tone with aging or childbirth
Genital Prolapse = cystocele (bladder protrudes into the anterior wall of the vagina; S & S - stress incontinence), rectocele (rectum protrudes through the posterior wall of the vagina; S & S = difficulty with defecation)
Slight prolapse = uterus descends part way down the vagina
Moderate Prolapse = uterus descends so deep into the vagina that the cervix is located at the vaginal opening
Complete prolapse = cervix and uterus protrude beyond the vaginal opening and the vagina is inverted
S & S = feelings of fullness, heaviness
Abnormal tunnel like opening
Women who are undernourished during their development then bear children or who bear children at a young age.
Constant escape of urine, fecal material, flatus
Ostracized by spouses, family, and community
Benign Growths: Ovary
Benign ovarian cysts
Cysts normally develop during cycle
Benign Growths: Uterus
Endometrial polyps - asymptomatic or can cause intermenstrual bleeding
Leiomyomas - uterine fibroids-benign tumors of the smooth muscle.
Endometrial cells seed throughout pelvis; rupture and spread; breaks down with normal menstruation causing pain
RF = early onset of menstruation, late onset of menopause, nulliparity, metrorrhagia, low body mass index, closed hymen
S & S = dysmenorrhea, menorrhea, pelvic pain, dyschezia, pain during or after sexual intercourse, infertility
Endometrial - 6% of all cancers in women
Ovarian - 3.6%
Cervical - 2%
Dysplasia to malignancy of cells of cervix
Human Papilloma Virus
Detected with PAP smears and HPV testing
S & S = vaginal bleeding and discharge, advanced pelvic or back pain
Vagina and Vulvar Cancer
Also related to HPV
Develop cancer of the bartholin gland
Endometrial Cancer Risks
RF = Obesity, high fat diet, breast or ovarian cancer, white, prolonged used of estrogen or tamoxifen, early menarche, late menopause, infertility or never pregnant
S & S = unexplained vaginal bleeding, how large the tumor, how deeply it invades into the myometrium part of prognosis, can be found in pelvis once uterus removed, mets to lungs
Risk reduced in conditions that decrease ovulation-pregnancy, breast-feeding, and oral contraceptive use.
Associated with BRCA
5 year mortality rate of 53%
Less than 1 in 4 cases diagnosed at an early stage
Gestational Trophoblastic Disease
Pathologic proliferation of trophoblastic cells (outermost layer of embryonic cells)
Risk factors unknown
Include hydatidiform mole, invasive mole, and choriocarcinoma