notes13

Chapter 13

Reproductive Systems - Notes (Changes and Suggestions in blue - 3/6/06)

1. Name the five reproductive system functions that are necessary for reproduction.

     1. produce sex cells
     2. produce hormones
     3. assist in uniting sperm and egg
     4. supporting development of the new individual
     5. giving birth

2. Describe the importance of sexual activity beyond its contributions to reproduction.

- pleasure and positive biological, social, and psychological impact such as decr. stress, bonding, self-esteem

3. Explain that the hormones produced in connection with reproductive systems have other important roles and describe three of these roles for testosterone and for estrogen.

- testosterone -> sebaceous gland function, body hair, bones, muscles, incr. BMR, body contour, fluid balance, psychological effects
- estrogen -> decr. risk of atherosclerosis, sebaceous gland function, body hair, bones, body contour, fluid balance, psychological effects

4. Describe the overall age changes and age-related changes in male reproductive functioning and describe the effects from these changes.

- very variable decline in testosterone production, sperm production, production of normal sperm (incr. % of abnormal sperm) (patchy and irregular degeneration of seminiferous tubules)
- effects = no significant changes in reproductive capability (includes no significant changes in reproductive capability in functioning of glands or other structures)

5. Name specific factors other than reproductive system aging that have significant effects on male and female sexual responses.

     - factors affecting male sexual responses
          1. aging nervous system -> decr. sensitivity, decr. reflex responses
          2. aging circulatory system - decr. ability for active congestion
          3. medications such as reduce blood pressure, tranquilizers
          4. reduced sexual activity -> decr. ability
          5. psychological factors such as expectations, depression
          6. social factors such as partner availability, living situations
          7. diseases such as atherosclerosis, strokes, dementia, arthritis
     - factors affecting female sexual responses
          1. menopause -> declining estrogen
          2. diseases such as reproductive system diseases, atherosclerosis, strokes, dementia, arthritis
          3. aging nervous system -> decr. sensitivity, decr. reflex responses
          4. medications such as estrogen, tranquilizers
          5. reduced sexual activity -> decr. ability
          6. psychological factors such as expectations, depression
          7. social factors such as partner availability, living situations

6. Name and describe effects of aging on the five phases of male sexual response (p. 273), and describe the overall effects on sexual response from these individual effects.

     - highly variable degrees of change
     - excitement phase
          1. erection = reflex engorgement of penis,incr. muscle tension, nipple erection, (incr. respiration, incr. BP, incr. HR, , swelling and elevation of scrotum and testes)
          effects
              - need more stimulation
              - slower to develop
              - less firm
          other effects
               - decr. muscle tension, decr. nipple erection, (decr. scrotal swelling, decr. testes elevation and swelling)
     - plateau phase = incr. excitement phase changes plus emission from glands
          effects
              1. same reductions as in excitement phase
              2. may enter refractory phase without having ejaculation -> apparent "impotence"
              3. incr. ability to delay ejaculation -> possible incr.   pleasure
              4. decr. amount and force of seminal vesicle and prostate secretion and expulsion -> (1) decr. sensation of impending ejaculation -> decr.   pleasure or (2) sensation of impending ejaculation not followed by ejaculation ->   frustration
     - orgasmic phase = pulsatile peristalsis of urethra and other ducts, which gradually subside and cease
          effects
              1. decr. intensity of contractions -> decr.   pleasure
              2. decr. number of contractions - decr.   pleasure
     - resolution phase = loss of erection and other excitement phase changes
          effects
              1. faster loss of erection
     - refractory period = inability for erection and other response changes
          effects
              1. longer refractory period (incr. from seconds-hours to minutes-days)
     - overall effects = slower and less intense arousal, less intense reactions, faster resolution, longer refractory period, decr. intensity of physical pleasure but still able to be completely satisfactory

7. Define menopause and explain its significance with respect to the reproductive capabilities of women.

- menopause = cessation of menstrual cycles for at least one year
- significance = (cessation of ovulation and uterine functions ->) loss of reproductive capabilities

8. Explain why menstrual cycles seem to become irregular and lengthen and as menopause approaches.

- decreased hormone production by follicles -> less complete endometrial development -> decr. menstrual flow -> apparent skipping of "periods"

9. Describe the overall effects of menopause on female reproductive structures and explain the reason for these effects.

- effects = shrinkage and decreased functioning
- reason = decline in sex steroid hormones (i.e., estrogen, progesterone)

10. Describe the overall effects of menopause and estrogen replacement therapy on the vagina, external genitalia, and breasts and describe consequences from these effects.

     - vagina
           1. shrinkage, thinning, decreased elasticity -> incr. risk of pain and injury from intercourse
           2. decr. secretion during sexual arousal -> incr. pain and injury from intercourse
           3. decr. glycogen - decr. acids -> incr. risk of infection
          note: reduced by estrogen therapy and by continued frequent intercourse
     - genitalia - shrinkage -> incr. risk of bacteria entry and infection
     - breasts
           1. incr. fat -> sagging and drooping (cosmetic effects -> other effects))
           2. decr. glandular tissue ->sagging and drooping (cosmetic -> etc.), ( no milk production)
           3. stretched fibrous support - sagging and drooping (cosmetic -> etc.)
      note: reduced by estrogen therapy

11. Name and describe effects of aging on the four phases of female sexual response (p. 283), and describe the overall effects on sexual response from these individual effects.

     - highly variable degrees of changes
     - excitement phase = vaginal exudation for lubrication, nipple erection, clitoral and labial swelling, vaginal enlargement, uterine elevation, areolar and breast swelling, incr. muscle tension
          effects
               1. decr. vaginal exudation -> difficult and painful intercourse
                    - minimized by (1)frequent intercourse, (2)estrogen therapy, (3)lubricants
               2. diminishing or loss of all excitement phase changes except nipple erection
     - plateau phase = clitoral elevation, incr. excitement phase changes, (incr. respiration, incr. HR, incr. BP, thickening of vagina lining at introitus, sex flush on labia minora)
          effects
               1. diminished plateau phase changes except elevation of the clitoris
     - orgasmic phase = pulsatile vaginal contractions and uterine contractions, which gradually subside in frequency and intensity
          effects
               1. diminished vaginal contractions (less reduction with frequent intercourse)
               2. incr. incidence of painful uterine contractions (minimized by estrogen therapy)
     - resolution phase = cessation of orgasmic contractions and reversal of excitement phase changes
(note: repeated orgasms or cycling between plateau, excitement, or resolution phases and orgasmic phases may occur)
          effects
               1. more rapid return to resting conditions
     - overall effect = slower and less intense arousal, less intense reactions, faster resolution, possible decr. intensity of physical pleasure but still able to be completely satisfactory

12. Describe age-related trends in sexual activity, discuss reasons for these trends including specific examples, and name ways of reducing these trends.

     - general decrease in frequency and enjoyment
     - frequency is directly related to frequency during youth
     - factors affecting decreases
          1. higher previous frequency -> greater decrease in frequency
          2. diseases (e.g., emphysema, atherosclerosis, stroke, Alzheimer's, arthritis, cancer)
          3. medications and other treatments (e.g., surgery, radiation)
          4. changes in other systems (e.g., circulation, nervous, muscle, skeletal)
          5. menopause (vaginal changes, + and - psychological changes)
          6. social (e.g., loss of spouse), psychological (e.g., self-image), economic (e.g., living arrangement factors - institutionalization, living with children)
     preventing and minimizing decreases
          1. maintain health
          2. prevent abnormalities and disease
          3. adjust medications
          4. attitude adjustment
          5. compensations (e.g., lubricants)
          6. adjust techniques (e.g., positions)
          7. seek professional help (e.g., medical, psychological)

13. Describe benign prostatic hypertrophy including what it is, its effects, and ways to minimize its effects.

     1. description - enlargement of the prostate
     2. effects - blocks urine flow -> (p. 285) abnormal urinary functions and incontinence
     3. treatments - regular evaluation, medications, surgery

14. Describe impotence including what it is, contributing factors, its effects, and ways to prevent or minimize this condition.

     1. description - "frequent" inadequate penile erection for intercourse (primary with no erection vs secondary with loss of erection)
     2. contributing factors - (pp. 267-268)
     3. effects - biological, social, psychological
     4. treatments - identify factors, treat causes (medications, diabetes, atherosclerosis, hormone imbalance, malnutrition, alcoholism, psychological factors), surgery, prostheses

15. Describe prostate cancer including what it is, its effects, and ways to prevent or minimize this condition.

     1. description - cancer of the prostate, which metastasizes (e.g., bones, lungs, liver)
     2. effects - destroys organs
     3. treatments - early diagnosis (e.g., rectal exams, blood test), cancer therapy (radiation, surgery, hormones)

16. Describe breast cancer including what it is, its effects, and ways to prevent or minimize this condition.

     1. description - breast cancer, which infiltrates and metastasizes (e.g., bones, lungs, liver, kidneys)
     2. effects - destroys organs
     3. treatments - prevention (e.g., minimal estrogen therapy), early detection, (e.g., breast self-exams, mammography), treatment (e.g., radiation, surgery, hormones)

17. Describe endometrial cancer including what it is, its effects, and ways to prevent or minimize this condition.

     1. description - cancer of the uterine lining, which infiltrates and metastasizes
     2. effects - destroys organs
     3. treatments - prevention (e.g., minimal estrogen therapy), early detection, (e.g., unusual vaginal bleeding), treatment (e.g., surgery, hormones)

18. Describe ovarian cancer including what it is, its effects, and ways to prevent or minimize this condition.

     1. description - cancer of the ovary, which infiltrates and metastasizes
     2. effects - destroys organs
     3. treatments - prevention (e.g., avoid smoking, minimal estrogen therapy), early detection is difficult, treatment (e.g., radiation, surgery, hormones)

19. Describe cervical cancer including what it is, its effects, and ways to prevent or minimize this condition.

     1. description - cancer of the cervix
     2. effects - destroys organs
     3. treatments - prevention (Herpes, papilloma, Chlamydia, smoking, oral contraceptives, promiscuity), early detection (e.g., Pap smears), treatment (e.g., radiation, surgery, chemotherapy)

20. Describe uterine fibroids including what they are, effects, and ways to prevent or minimize this condition.

     1. description - non-cancerous growth of connective tissue and muscle in the middle layer of the uterus
     2. effects - may cause bleeding, pressure on neighboring organs (e.g., intestine, bladder)
          - usually shrink after menopause
          - may enlarge with estrogen supplementation
     3. treatments - treatment (e.g., surgery)

21. Compare sexually transmitted diseases among young adults and older adults.

- lower incidence (possibly from lower multiple partner contacts)
- no significant difference in other factors (e.g., transmission, effects)

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