Female Reproductive System: External Genitalia

Female Reproductive System: External Genitalia

• Vulva: The collectively named external female genitalia.
• Mons Pubis: A triangular mound of fatty tissue covering the pubic bone, developing pubic hair during adolescence; protects the pelvic bones.
• Labia Majora: Two rounded, fleshy folds of fat and areolar tissue extending from the mons pubis to the perineum, darker pigmentation, covered in hair and sebaceous glands, smooth and moist, protect internal structures.
• Labia Minora: Pairs of erectile tissue folds located inside the labia majora, darken and swell with arousal, more sensitive to touch than labia majora.
• Clitoris: A hooded body of erectile tissue at the apex of the labia minora, rich in blood and nerve supply, responsible for sexual pleasure and orgasm.
• Vestibule: An area enclosed by the labia minora, containing urethral opening, Skene's glands, vaginal opening (introitus), and Bartholin's glands; boat-shaped.
  • Urethral Orifice: Located 2.5 cm posterior to the clitoris, 4 cm long; Skene's ducts (0.5 cm) on either side lubricate the vestibule.
  • Vaginal Orifice (Introitus): Posterior two-thirds of the vestibule; partially closed by the hymen (a thin membrane varying in shape).
  • Bartholin's Glands: Two small glands opening on either side of the vaginal orifice, secrete clear, thick alkaline mucus to enhance sperm viability and motility.
• Perineum: Muscle and tissue between the vaginal opening and anal canal, supporting urinary and digestive tracts, sensitive to touch. Episiotomy is an incision during childbirth.

Female Reproductive System: Internal Genitalia

• Vagina: Connects the cervix to the external genitals; located between the bladder and rectum (anterior 8-9 cm, posterior 10-11 cm).
  • Functions: Passageway for menstrual flow, uterine secretions, birth canal; lubrication during intercourse.
• Cervix: Connects the uterus to the vagina, small opening acts as a precaution against foreign bodies, dilates during childbirth.
• Uterus: Pear-shaped organ about the size of a clenched fist, composed of endometrium, myometrium, and perimetrium; sheds tissue during menstrual cycle; accommodates and expels a growing fetus (7.5 cm long, 5 cm wide, 2.5 cm thick, 60 grams).
  • Divisions: Cervix, isthmus, corpus (body), cornua, fundus, cavity.
• Fallopian Tubes (Oviducts): Pathway for ovum to the uterus, site of fertilization; about 6-10 days for the fertilized egg to travel.
  • Parts: Interstitial, isthmus, ampulla, infundibulum.
• Ovaries: Female gonads, develop and expel an ovum monthly. A woman is born with approximately 400,000 immature eggs; produce progesterone and estrogen.

Menstrual Cycle

• Definition: Cyclic changes in the endometrium (uterine lining) caused by estrogen and progesterone, typically 25-32 days, with blood loss varying by woman.
• Control: Hypothalamus-pituitary-ovarian axis; GnRH stimulates pituitary to produce FSH and LH.
  • FSH: Ovum maturation and estrogen production.
  • LH: Ovum release, corpus luteum development (progesterone production). Negative feedback mechanism.
• Phases:
  • Menstrual: Days 1-5, shedding of uterine lining.
  • Proliferative: Days 6-14, repair and thickening of the endometrium under estrogen influence.
  • Secretory: Days 15-28, preparing for potential implantation (estrogen and progesterone). If fertilization occurs, HCG maintains corpus luteum; if not, the corpus luteum degenerates, causing menstruation.
  • Ischemic: Days before menses, reduced hormone levels. Shrinking of endometrium, vessel constriction and blood leakage.
• Ovulation: Release of mature ovum from Graafian follicle around day 14 of a 28-day cycle.

Ovarian Cycle

• Control: FSH and LH produce cyclic changes in ovaries
• Phases:
  • Follicular: Primordial follicles mature, one dominant Graafian follicle secretes steroids.
  • Ovulatory: Expulsion of mature ovum by a rupturing Graafian follicle.
  • Luteal: Ruptured follicle forms corpus luteum; corpus luteum secretes progesterone & estrogen to prepare uterus for implantation.

Nursing Role During Menstrual Cycle

• Hygiene: Hand washing, perineal care (front-to-back). Sanitary products (pads preferred at night). Perineal pad application and hygiene.
• Diet: Reduced caffeine, simple sugars, and salt intake; six small meals; increased fluids; avoiding alcohol.
• Nutrition: Vitamin B complex (reduce nervousness) Vitamin B6 (relieve bloating), Vitamin E (mild prostaglandin inhibitor, improves circulation), iron (prevent depletion), calcium (relief from symptoms).
• Exercise: Daily exercise, deep breathing, aerobic activity.
• Heat and Massage: Benefit from warm application and massage.

Reproductive Health

• Definition: A state of complete physical, mental, and social well-being related to the reproductive system. Choice in pregnancy, influences population growth, environmental conditions.
• Elements: Woman's employment, nutrition, adolescent care, sexual behaviors, safe motherhood, family planning, eliminating unsafe abortions, preventing unwanted pregnancy, infertility management, male involvement, cancer prevention.
• Women's Needs: Sexual health, infertility management, fertility choices, preconception care, normal labor, pregnancy, childbirth, post-natal care, menopause and postmenopause.
• Reproductive Health Rights: Freedom from discrimination, life, liberty, security, marriage and family, education, scientific progress, sexual equality, health care, women's work laws, adolescent needs.