Study Notes for Reproductive System

STRUCTURES AND FUNCTIONS

 The primary roles of male reproductive system are production and transportation of sperm, deposition of
sperm in female reproductive tract, and secretion of hormones.
o The primary male reproductive organs are the testes.

 The primary roles of female reproductive system are production of ova, secretion of hormones, and
protection and facilitation of the development of the fetus in a pregnant female.
o The primary female reproductive organs are the ovaries.

 The hypothalamus, pituitary gland, and gonads secrete numerous hormones that regulate the processes
of ovulation, spermatogenesis, fertilization, and formation and function of secondary sex characteristics.

 In women, follicle-stimulating hormone (FSH) production by anterior pituitary stimulates growth and
maturity of ovarian follicles.
o Mature follicle produces estrogen, which in turn suppresses the release of FSH. In men, FSH
stimulates seminiferous tubules to produce sperm.

 Estrogen and progesterone are produced by the ovaries.

o Estrogen is essential to development and maintenance of secondary sex characteristics,
proliferative phase of menstrual cycle immediately after menstruation, and pregnancy uterine
changes.
o Progesterone is also involved in body changes of pregnancy.

 The major gonadal hormone of men is testosterone, which is produced by the testes. Testosterone is
responsible for development and maintenance of secondary sex characteristics and spermatogenesis.

 Menarche is the first episode of menstrual bleeding, indicating that a female has reached puberty.
o This usually occurs at 12 to 13 years of age.
o The length of the menstrual cycle generally ranges from 20 to 40 days.

 The major functions of ovaries are ovulation and secretion of hormones. These functions are
accomplished during the menstrual cycle.

 If fertilization occurs, high levels of estrogen and progesterone continue to be secreted due to continued
activity of corpus luteum from stimulation by human chorionic gonadotropin (hCG).
o If fertilization does not take place, menstruation occurs because of a decrease in estrogen
production and progesterone.

 Menopause is the physiologic cessation of menses associated with declining ovarian function. It is
usually considered complete after 1 year of amenorrhea.

 The sexual response is a complex interplay of psychologic and physiologic phenomena influenced by a
number of variables, including daily stress, illness, and crisis.
o Changes that occur during sexual excitement are similar for men and women.
o Sexual response can be described in terms of the excitement, plateau, orgasmic, and
resolution phases.

Gerontologic Considerations
  In women, many changes relate to the altered estrogen production of menopause.

 A reduction in circulating estrogen along with an increase in androgens in postmenopausal women is

associated with breast and genital atrophy, reduction in bone mass, and increased rate of atherosclerosis.

 Changes in aging men include an increase in prostate size, decreased testosterone level and sperm
production, decreased scrotum muscle tone and size and firmness of the testicles. Erectile dysfunction
and sexual dysfunction can occur as result of these changes.

ASSESSMENT
 Nurses have an important role in providing accurate and unbiased information about sexuality and age.
Nurses should emphasize normalcy of sexual activity in older adults.

 Reproduction and sexual issues are often considered extremely personal and private.
o A professional demeanor is important when taking a reproductive or sexual history.
o The nurse needs to be sensitive, ask gender-neutral questions, and maintain awareness of
patient’s culture and beliefs.
o It is helpful if the nurse begins with least sensitive information (e.g., menstrual history)
before asking questions about more sensitive issues such as sexual practices or sexually
transmitted diseases.

 Women should have a complete menstrual and gynecologic history taken, including oral contraceptive
use.
o The nurse should question the patient regarding current health status and presence of any
acute or chronic health problems as problems in other body systems often relate to problems
with reproductive system.

 Physical examination:
o Male external genitalia: inspection and palpation of pubis, penis, scrotum and testes,
inguinal region and spermatic cord, anus and prostate.
o Female: begins with inspection and palpation of breasts and then proceeds to abdomen and
external genitalia including mons pubis, labia majora, labia minora, perineum, and anal
region.
o Pelvic and bimanual examinations are considered advanced skills.

DIAGNOSTIC STUDIES
 Serum hormone test, hCG, is used to identify pregnancy.

 Prolactin assay is used for patient with amenorrhea.

 Serum progesterone and estradiol can also help in ovarian function assessment, particularly for
amenorrhea.

 Hormonal blood studies are essential for a fertility workup.