Reproductive System

1. Reproductive System Diseases

2. General Information • The function of sexuality – reproduction and enhancement of caring and pleasure

9. World Health Organization Components of Sexual Health • The enjoyment and control of sexual and reproductive behavior according to personal and social ethics • Freedom from fear, shame, guilt and psychological factors that impair sexual relationships • Freedom from organic disorders, diseases and deficiencies that may interfere with either sexual or reproductive functions

10. Stages of sexual response cycle • Arousal - psychological • Plateau - psycho and physiological • Orgasm - psycho and physiological • Resolution - psycho and physiological • Also includes vasoconstriction and myotonia which may arise if some physical or mental condition arises

11. Sexual Dysfunction • An important consideration in the treatment of sexual dysfunction is a sensitivity to open communication about the problem • Physicians need to include detailed sexual history as part of medical history • Total health care must include human sexual response and its function or dysfunction

15. Dyspareunia(Painful Intercourse) • Dysparneunia is the occurrence of pain in women during sexual intercourse

16. Etiology • Anatomic – deformities of lesions in vagina, an intact hymen, or retroversion of uterus • Pathological – Scar tissue, genitourinary tract infections, pelvic inflammatory disease, abnormal growths, endometriosis, or allergic reactions to contraceptive material • Psychosomatic – Fear of pain, feelings of guilt or shame, lack of arousal, fear of pregnancy

17. Signs and Symptoms • Mild to severe discomfort during or after intercourse • Vaginal itching or burning

18. Diagnostic Procedures • Physical examination • Detailed sexual history

19. Treatment • Creams or water-soluble jellies for lubrication prior to intercourse • Excision of scars • Genital stretching • Education

20. Prognosis • Good with adequate treatment, proper education and sensitivity from partner

21. Prevention • Prompt treatment of any infections

22. Erectile Dysfunction • Erectile dysfunction is the inability of the man to achieve or sustain an erection sufficient to complete sexual intercourse

23. Etiology • Psychological causes include anxiety, depression or feelings of inadequacy • Physiological causes include pharmological agents, drug and alcohol abuse, diabetes mellitus, surgical complications, spinal cord and disk injuries, and neurological, endocrine, or urologic disorders

24. Signs and Symptoms • Partial – unable to achieve full • Intermittent – sometimes potent • Selective – only with certain women

25. Diagnostic Procedures • Differentiate between psychological and physiological causes of impotence • Physical examination • Medical history review • Detailed sexual history

26. Treatment • Therapy • Counseling • Surgical implantation of prosthesis • Drug sildenafil (Viagra) – enhances the effects of nitric oxide, which is released into penis during sexual arousal, allowing increased blood flow

27. Prognosis • Variable – depends on duration and severity • Viagra should only be taken while in physician’s care

28. Arousal and Orgasmic Dysfunction in Women • Orgasmic dysfunction is the inability to achieve orgasm • Arousal dysfunction is the lack of desire for sexual activity and arousal

29. Etiology • Diseases that produce nerve damage, such as diabetes mellitus or multiple sclerosis • Drug reactions, pelvic infections, and vascular diseases • Anxiety, depression, stress and fatigue, inadequate or ineffective stimulation, or early traumatic experiences

30. Signs and Symptoms • Loss of sexual desire or slow sexual arousal • Lack of vaginal lubrication or vasocongestive response • Inability to achieve orgasm totally or under certain circumstances

31. Diagnostic Procedures • Physical examination • Medical history • Detailed sexual history

32. Treatment • Sex therapy • Eliminate involuntary inhibitions of orgasmic reflex • Experimental therapy • Psychoanalysis • Behavior modication

33. Prognosis • Good is no nerve damage • Psychological causes may require lengthy treatment

34. Premature Ejaculation • Premature ejaculation is the expulsion of seminal fluid prior to complete erection of the penis or immediately following the beginning of sexual intercourse

35. Etiology • Anxiety • Guilt • Negative sexual relationships • Pathological factors are rare, but may be linked to degenerative neurological disorders, urethritis, prostatis

36. Signs and Symptoms • Ejaculation during foreplay • Prior to complete erection • As soon as intromission

37. Diagnostic Procedures • Physical examination • Laboratory tests • Detailed sexual history

38. Treatment • Sex therapy • Partners learning techniques to prevent premature ejaculation • Understand condition is reversible

39. Prognosis • Excellent with proper treatment and understanding from both partners • Positive self image

40. Prevention • No prevention is known

41. Male and Female Infertility • Infertility is diagnosed as failure to become pregnant after 1 year of regular, unprotected intercourse • 10 percent of couples are infertile • Female fertility peaks at 24 and diminishes at 30, pregnancy is rare after 50 • Most fertile within 24 hours of ovulation • Male fetility peaks at 24 and declines at 40 • Greatest fertility occurs with sex 4 times per week

42. Etiology • Women – hormonal, nutritional deficiencies, infections, tumors, anomalies • Men – sperm deficiencies, congenital abnormalities, endocrine imbalance, chronic inflammation of testes, epididymis, vas deferens

43. Signs and Symptoms • Typically no sexual dysfunction • Inability to conceive

44. Diagnostic Procedures • Women – complete medical, surgical and gynecologic history and examination • Serology test for syphilis • Hysterosalpingography • Analysis of cervical mucus after coitus – Huhner test • Men – sexual abstinence for 4 days and then complete ejaculation and sperm count • Testicular biopsy if azoospermia or oliospermia is determined

45. Treatment • Women – salpingostomy, Removal of ovarian abnormalities, alleviation of cervicitis, hormone therapy • Men – correction of testicular hypofunction secondary to hypothyroidism, Surgical correction of varicocele or hydrocele, hormone therapy

46. Prognosis • About 50 percent of couples who are treated for infertility achieve pregnancy • Rest are untreatable and complicated

47. Prevention • Avoid causative factors such as infections, drugs and alcohol, trauma, and environmental agents • Need emotional support and information

48. Gonorrhea • Gonorrhea is a contagious bacterial infection of the epithelial surfaces of the genitourinary tract for men and women. • Currently one of the most prevalent sexually transmitted (venereal) diseases in the U.S.

49. Etiology • Caused by the bacterium Neisseria gonorrhoeae • Infants born of infected mothers can get gonorrhea during vaginal delivery and may infect the conjunctivae, respiratory tract, or anal canal

50. Signs and Symptoms • Many cases, especially women, are asymptomatic or produce only symptoms so slight that they are ignored • Infected men show signs of acute urethritis, purulent urethral discharge, dysuria, and urinary frequency. • Discharge from pharynx or rectum with pain among homosexuals