Reproductive System, Female Health Article

Infertility

Infertility is diagnosed when a sexually active couple is unable to get the woman pregnant (or she is unable to carry a pregnancy to a successful childbirth) after one year of attempts. There are numerous reasons why infertility may occur:

• low number or lack of sperm cells produced by the male
• lack of ovulation (no eggs released from ovaries)
• abnormal fallopian tubes
• occurrence of what would normally be the lining of the womb somewhere else than in the womb (endometriosis), such as in the fallopian tubes
• problems with thick mucus in the neck of the womb (hence, sperm are not able to enter the womb)

A number of techniques may be used to assist a couple in getting the woman pregnant. These include fertilization in a dish (in vitro fertilization, IVF; in vitro is Latin for "in glass"). Eggs are removed from the woman, placed in a culture dish, and fertilized by sperm, then inserted into the womb for implantation. An alternate technique is gamete intrafallopian transfer, or GIFT. Male and female reproductive cells are removed from the man and woman and then transferred to the fallopian tube where fertilization may take place naturally.

Cancer

Cancer (uncontrolled and abnormal new growth of cells) may occur in any of the structures of the reproductive system, male or female. Common types of cancer in women include the following:

• Cancer of the womb (uterine carcinoma). It is the most common cancer of the female reproductive system.
• Cancer of the neck of the womb (cervical carcinoma). It may be caused by the sexually transmitted human papillomavirus or HPV.
• Cancer of the ovaries (ovarian carcinoma). It has the highest death rate of all cancers of the female reproductive system.
• Cancer of the external genitals (vulvar carcinoma). It is usually a type of skin cancer.
• Cancer of the vagina (vaginal carcinoma). It may be caused by the sexually transmitted human papillomavirus (HPV).
• Cancer of the fallopian tubes. It is the rarest cancer of the female reproductive system.
• Tumors that form in the womb during or after pregnancy (hydatidiform moles).

Other

The absence or abnormal stopping of menstrual periods (amenorrhea). A number of factors may abnormally stop menstruation. They include abnormal production of LH and FSH; excessive exercise; extreme stress; and near-starvation.

Painful menstruation, that is, menstruation with severe cramps or aches (dysmenorrhea). It may be caused by excessive production of prostaglandins (the hormones that cause the womb to contract forcefully at childbirth, thus squeezing the fetus into the vagina) or by diseased genitals.

Premenstrual syndrome (PMS) occurs during the luteal phase of the menstrual cycle and is characterized by numerous symptoms. These include changes in mood and behavior, cramps, headaches, fluid retention, and fatigue. Approximately 40% of menstruating women complain of some sort of PMS.

Toxic shock syndrome (TSS) is a rare but devastating disease associated with tampon use. Although the exact cause of the disease is not known, it has been linked to infection by Staphylococcus aureus. If S. aureus

enters the vagina, it is possible that tampon use could promote the growth of these deadly bacteria. S. aureus may then secrete poisons (toxins) that enter the bloodstream and lead to TSS. Symptoms start with fever, vomiting, diarrhea, and low blood pressure, but may eventually involve multiple organ systems and result in death.

KEY TERMS

Amenorrhea—Abnormal absence or stopping of menstrual cycles.

Dysmenorrhea—Painful menstruation.

Endometrium—The inner lining of the womb.

External genitals—The greater lips (labia majora), the lesser lips (labia minora), the clitoris, and the opening of the vagina.

Follicle—A small spherical sac located in an ovary in which an oocyte develops and matures; when the follicle bursts, the mature egg (ovum) is released into the fallopian tube. Only about 300 follicles burst during a woman's lifetime.

Gamete—A one-fold (haploid, that is, having 23 instead of 46 chromosomes) cell involved in sexual reproduction; the male gamete is the sperm; the female gamete is the egg.

Internal genitals—The vagina, womb, fallopian tubes, and ovaries.

Menarche—The first menstrual cycle in a girl's life.

Menopause—The permanent stopping of menstrual cycles, traditionally marking the end of a woman's ability to reproduce.

Menstruation—The discharge of the lining of the womb (endometrium) as it sheds during the menstrual cycle when pregnancy does not take place.

Zygote—A two-fold (diploid, that is having 46 chromosomes) cell resulting from fertilization of the female egg by a sperm.

BOOKS

Fogel, Catherine I. "Common Reproductive Concerns." In Maternity and Women's Health Care, edited by Michael S. Ledbetter. St. Louis, MO: Mosby, 2000.

Hart, David M., and Jane Norman. Gynaecology Illustrated. London, UK: Harcourt Publishers, 2000.

Shephard, Bruce D., and Carroll A. Shephard. The Complete Guide to Women's Health. New York: Penguin Books, 1997.