Shier, Butler, and Lewis:  Hole’s Human Anatomy and Physiology, 12th ed.                                            

Chapter 22:  Reproductive Systems

I.  Introduction and

II.  Organs of the Male Reproductive System 

A.  The functions of the organs of the male reproductive system are to produce and maintain the male sex cells, to transport sex cells to the female reproductive tract, and to secrete male sex hormones.
B.  The primary organs of the male reproductive system are testes in which sperm cells and male sex hormones are produced.
C.  The accessory organs of the male reproductive system are all reproductive organs that are not the testes.
D.  Introduction
1.  The testes are ovoid structures.
2.  The testes are suspended by spermatic cords.
3.  The testes are contained within the scrotum.
E.  Descent of the Testes
1.  In a male fetus, the testes originate from masses of tissue posterior to the parietal peritoneum, near the developing kidneys.
2.  Usually before birth, the testes descend to the lower abdominal cavity and pass through the abdominal wall into the scrotum.
3.  The hormone testosterone stimulates the testes to descend.
4.  The gubernaculum is a fibromuscular cord that functions to help the testes descend.
5.  The inguinal canal is a canal through which a testis descends into the scrotum.
6.  During descent, each testis carries a developing vas deferens, blood vessels, and nerves.
7.  Cryptorchidism is the condition in which a testis does not descend and leads to infertility if untreated.
F.  Structure of the Testes
1.  The tunica albuginea is a tough, white, fibrous capsule that encloses a testis.
2.  The mediastinum testis is a thickening of the tunica albuginea that extends into a testis.
3.  The septa divide a testis into lobules.
4.  Seminiferous tubules are highly coiled, convoluted tubules located in the testes.
5.  The rete testis is the union of seminiferous tubules and is located within the mediastinum testis.
6.  The epididymis is formed from several ducts of the rete testis.
7.  The seminiferous tubules are lined with specialized stratified epithelium, which includes the spermatogenic cells that give rise to sperm cells.
8.  Interstitial cells are located in spaces between seminiferous tubules and produce male sex hormones.
G.  Formation of Sperm Cells
1.  The lining of the seminiferous tubules consists of supporting cells and spermatogenic cells.
2.  The functions of the sustentacular cells are to support, nourish, and regulate spermatogenic cells.
3.  Spermatogenic cells give rise to sperm cells.
4.  Spermatogonia are undifferentiated spermatogenic cells and contain 46 chromosomes.
5.  During embryonic development, spermatogonia give rise to more spermatogonia and some become primary spermatocytes.
6.  Primary spermatocytes are enlarged cells derived from spermatogonia.
7.  At puberty, testosterone secretion rises and primary spermatocytes undergo meiosis.
8.  The two divisions of meiosis are first and second meiotic divisions.
9.  Meiosis I separates homologous chromosome pairs.
10.  Before meiosis I, each homologous chromosome is replicated so it consists of two complete DNA strands called chromatids.
11.  Chromatids are two complete DNA strands that are attached together.
12.  Centromeres are regions that attach the chromatids of replicated chromosomes.
13.  Each cell that undergoes meiosis II emerges with one member of each homologous pair.
14.  Haploid is having one set of chromosomes.
15.  After meiosis II, each chromatid becomes independent chromosomes.
16.  The events of prophase I are:  individual chromosomes appear, nucleoli disappear, nuclear membrane disassembles, spindle appears, and synapsis occurs.
17.  Synapsis is the pairing and intertwining of homologous chromosomes.
18.  Crossover is an exchange of genetic material between homologous chromosomes.
19.  The events of metaphase I are when chromosome pairs line up midway between the poles of the developing spindle and attachment of chromosomes to spindle fibers.
20.  The events of anaphase I are the separation of homologous chromosomes and movement of each half toward one end of the spindle.
21.  The events of telophase I are the division of the cell in two, formation of nuclear membranes around chromosomes, appearance of nucleoli, and disassembly of spindle fibers.
22.  Meiosis II is similar to a mitotic division.
23.  The events of prophase II are when the chromosomes condense and reappear and move into positions midway between the poles of the developing spindle.
24.  The events of metaphase II are the attachment of chromosomes to spindle fibers.
25.  The events of anaphase II are the separation of centromeres and movement of chromatids to opposite poles of the spindles.
26.  The events of telophase II are the divisions into two cells.
27.  Each cell undergoing meiosis has the potential to produce 4 gametes.
28.  In males, gametes mature into four sperm cells.
29.  In females, three of the products are cast aside as polar bodies and one cell becomes the egg.
30.  During spermatogenesis, primary spermatocytes divide to become two secondary spermatocytes.
31.  Each secondary spermatocyte divides to form spermatids.
32.  Spermatids mature into sperm cells.
33.  Each primary spermatocyte that undergoes meiosis produces four sperm cells with 23 chromosomes each.
34.  Fertilization is the joining of an egg and sperm.
35.  Spermatogonia are located near the base of the germinal epithelium of seminiferous tubules.
36.  As spermatogenesis occurs, cells in more advanced stages are pushed along the sides of sustentacular cells toward the lumen of the seminiferous tubules.
37.  Occluding junctions are the fusions of adjacent sustentacular cells and they divide the tissue into two layers.
38.  The membranous complex of the occluding junctions helps maintain a favorable environment for development of sperm cells by preventing certain large molecules from moving from the interstitial fluid of the basal epithelium into the region of the differentiating cells.
39.  Spermatogenesis occurs continually in a male, starting at puberty.
40.  The resulting sperm cells collect in the lumen of each seminiferous tubule then pass through the rete testis to the epididymis, where they accumulate and mature.
H.  Structure of a Sperm Cell
1.  A mature sperm cell consists of a flattened head, a cylindrical midpiece body, and an elongate tail.
2.  The head of a sperm cell is composed of a nucleus with highly compacted chromatin consisting of 23 chromosomes.
3.  An acrosome is a small protrusion that contains enzymes at the head of a sperm that functions to aid the sperm cell in penetrating the egg.
4.  The midpiece of a sperm is composed of a central, filamentous core and many mitochondria organized in a spiral.
5.  The tail of a sperm cell is a flagellum, which provides motility for the sperm.
I.  Introduction
1.  The male internal accessory organs include the epididymides, vasa deferentia, ejaculatory ducts, urethra, seminal vesicles, prostate gland, and bulbourethral glands.
J.  Epididymis
1.  Each epididymis is a tightly coiled, threadlike tube and is connected to ducts within a testis.
2.  An epididymis is located on the posterior and superior surface of a testis.
3.  The inner lining of the epididymis is composed of pseudostratified columnar cells that secrete glycogen and other substances that support stored sperm cells and promote their maturation.
4.  When immature sperm cells reach the epididymis, they are nonmotile.
K.  Vas Deferens
1.  Each vas deferens is a muscular tube that is lined with pseudostratified columnar epithelium.
2.  Each vas deferens is located at the lower end of the epididymis and passes upward along the medial side of a testis, through the inguinal canal, into the abdominal cavity outside the parietal peritoneum, and over the pelvic brim.
3.  Each vas deferens ends behind the urinary bladder.
4.  The ampulla of a vas deferens is a dilation at the terminal end of a vas deferens.
5.  The ejaculatory duct is formed by the union of a vas deferens and the duct of a seminal vesicle.
6.  The ejaculatory duct passes through the prostate gland and empties into the urethra.
L.  Seminal Vesicle
1.  A seminal vesicle is a convoluted, saclike structure attached to the vas deferens near the base of the urinary bladder.
2.  The secretions of the seminal vesicle are slightly alkaline and contain fructose and prostaglandins.
3.  The functions of the secretions of the seminal vesicle are to help regulate the pH of the tubular contents as sperm cells travel the outside, to provide energy to sperm cells, and to stimulate muscular contractions within the female reproductive organs, aiding the movement of sperm.
4.  As sperm move through the vas deferens into the ejaculatory duct the contents of the seminal vesicles empty into the ejaculatory ducts.
M.  Prostate Gland
1.  The prostate gland is a chestnut shaped structure that surrounds the proximal portion of the urethra.
2.  The prostate gland is composed of many branched tubular glands enclosed in connective tissue.
3.  The ducts of the prostate gland open into the urethra.
4.  The secretions of the prostate gland include a thin, milky, alkaline fluid.
5.  The functions of the secretions of the prostate gland are to neutralize sperm cell-containing fluid, to enhance motility of sperm, and to neutralize the acidic environment of the vagina.
N.  Bulbourethral Glands
1.  The bulbourethral glands are two small structures that are located inferior to the prostate gland lateral to the membranous urethra.
2.  The bulbourethral glands are composed of many tubes.
3.  The bulbourethral glands secrete a mucous like fluid which functions to lubricate the end of the penis in preparation for sexual intercourse.
O.  Semen
1.  Semen is the fluid the urethra conveys to the outside during ejaculation and consists of sperm cells and secretions from seminal vesicles, the prostate gland, and bulbourethral glands.
2.  The average number of sperm cells in semen is about 120 million per milliliter.
3.  Sperm cells cannot fertilize an egg cell until they enter the female reproductive tract.
4.  Capacitation is weakening of acrosomal membranes that give the sperm the ability to release acrosomal enzymes.
5.  Sperm cells live up to three days in the female reproductive tract.
P.  Introduction
1.  The male external reproductive organs are the penis and scrotum.
2.  The urethra passes through the penis.
Q.  Scrotum
1.  The scrotum consists of skin, subcutaneous tissue, and smooth muscle fibers and is located outside the abdominal wall posterior to the penis.
2.  The function of the dartos muscle is to wrinkle the skin of the scrotum during cold conditions.
3.  The scrotum is divided into two chambers.
4.  Each chamber of the scrotum is lined with a serous membrane, which functions to help the testes move freely within the scrotum.
R.  Penis
1.  The functions of the penis are to convey urine and semen through the urethra to the outside.
2.  Erection is the enlarging and stiffening of the penis and enables it to be inserted into the vagina during sexual intercourse.
3.  The body of the penis is composed of three columns of erectile tissue, connective tissue, and skin.
4.  Corpora cavernosa is a paired column of erectile tissue dorsally located.
5.  Corpus spongiosum is a single column of erectile tissue ventrally located.
6.  A tunica albuginea is tough capsule that surrounds each column of erectile tissue.
7.  The glans penis is the enlargement of the corpus spongiosum at its distal end.
8.  The external urethral orifice is the urethral opening.
9.  The prepuce is a loose fold of skin just posterior to the glans and extends anteriorly to cover its sheath.
10.  Circumcision is removal of the prepuce.
11.  The crura of the penis are the lateral diverging of corpora cavernosa that is attached to the pubic arch.
12.  The bulb of the penis is the enlargement of the corpus spongiosum between the crura.
S.  Erection, Orgasm, and Ejaculation
1.  An erection is produced by parasympathetic nerve impulses that cause the dilation of arteries leading to the penis.  At the same time veins of the penis are compressed and blood accumulates in erectile tissue and the penis swells and elongates.
2.  Orgasm is the culmination of sexual stimulation and in the male is accompanied by emission and ejaculation.
3.  Emission is the movement of sperm cells from the testes and secretions from the prostate gland and seminal vesicles into the urethra.
4.  Emission occurs in response to sympathetic nerve impulses that stimulate peristaltic contractions in smooth muscles within the walls of the testicular ducts, epididymides, vasa deferentia, and ejaculatory ducts.
5.  Ejaculation is the forcing of semen through the urethra to the outside.
6.  The sequence of events during emission and ejaculation are release of fluid from the bulbourethral glands first, then the release of fluids from the prostate, passage of sperm cells, and finally ejection from seminal vesicles.
7.  The penis returns to a flaccid state due to the flow of blood out of the penis through veins.

III.  Hormonal Control of Male Reproductive Functions

A.  Introduction
1.  Hormones secreted by the hypothalamus, anterior pituitary, and testes control male reproductive functions.
2.  Hormones from these glands initiate and maintain sperm cell production and oversee the development and maintenance of male sex characteristics.
B.  Hypothalamic and Pituitary Hormones
1.  The hypothalamus secretes GnRH, which causes the anterior pituitary to release Gonadotropins (LH and FSH).
2.  LH promotes development of interstitial cells.
3.  FSH stimulates the sustentacular cells of the seminiferous tubules to proliferate, grow, mature, and respond to the effects of testosterone.
4.  The presence of FSH and testosterone causes the spermatogenic cells to undergo spermatogenesis.
5.  Inhibin is secreted by sustentacular cells and functions to inhibit the anterior pituitary.
C.  Male Sex Hormones
1.  Androgens are male sex hormones and are produced by interstitial cells.
2.  The most important androgen is testosterone.
3.  Dihydrotestosterone is another androgen and stimulates the cells of the prostate gland, seminal vesicles, and male external accessory organs.
4.  Testosterone secretion begins during fetal development then ceases during childhood.
5.  Puberty is the phase in development when an individual becomes reproductively functional.
6.  After puberty, testosterone secretion continues throughout life.
D.  Actions of Testosterone
1.  During embryonic development testosterone stimulates the formation of the male reproductive organs.
2.  During puberty testosterone stimulates enlargement of the testes and accessory organs of the reproductive system, as well as development of male secondary sex characteristics.
3.  Secondary sex characteristics include increased growth of body hair, enlargement of larynx, thickening of vocal folds, thickening of skin, increased muscular growth, broadening shoulders, narrowing of the waist, and thickening and strengthening of bones.
4.  Testosterone increases the rate of cellular metabolism and production of red blood cells by stimulating release of erythropoietin.
5.  Testosterone stimulates sexual activity by affecting certain portions of the brain.
E.  Regulation of Male Sex Hormones
1.  The extent to which male secondary sex characteristics develop is directly related to the amount of testosterone that the interstitial cells secrete.
2.  The hypothalamus regulates testosterone output through negative feedback.
3.  As the concentration of testosterone in the blood, the hypothalamus becomes inhibited, decreasing its stimulation of the anterior pituitary gland.
4.  As LH secretion falls, the amount of testosterone decreases.
5.  When the blood concentration of testosterone drops, the hypothalamus becomes less inhibited, and it once again stimulates the anterior pituitary to release LH.
6.  Male climacteric is a decline in sexual function that occurs with age.

IV.  Organs of the Female Reproductive System

A.  The functions of the organs of the female reproductive are to produce and maintain female sex cells, to transport eggs to the site of fertilization, to provide a favorable environment for a developing offspring, to move the offspring to the outside, and to produce female sex hormones.
B.  The primary sex organs of the female reproductive system are the ovaries.
C.  The accessory organs of the female reproductive system are internal reproductive organs (except the ovaries) and external reproductive organs.
D.  Introduction
1.  Ovaries are solid, ovoid structures.
2.  Ovaries are located in shallow depressions on each side in the lateral wall of the pelvic cavity.
E.  Ovary Attachments
1.  Ligaments help hold each ovary in place.
2.  The broad ligament is attached to the uterine tubes and the uterus.
3.  The suspensory ligament is a ligament that holds ovarian blood vessels and nerves.
4.  The ovarian ligament is  a cordlike ovary that anchors an ovary to the uterus.
F.  Ovary Descent
1.  The ovaries of the female originate from masses of tissue posterior to the parietal peritoneum.
2.  During development, ovaries descend to locations just inferior to the pelvic brim, where they remain attached to the lateral pelvic wall.
G.  Ovary Structure
1.  The medulla of an ovary is the inner region.
2.  The cortex of an ovary is the outer region.
3.  The ovarian medulla is composed of loose connective tissue and contains many blood vessels, lymphatic vessels, and nerve fibers.
4.  The ovarian cortex consists of more compact tissue and has a granular appearance due to tiny masses of cells called ovarian follicles.
5.  The germinal epithelium of an ovary is a layer of cuboidal epithelial cells that covers the free surface of the ovary.
6.  The tunica albuginea is a layer of dense connective tissue just beneath the germinal epithelium.
H.  Primordial Follicle
1.  Primordial follicles form during prenatal development.
2.  A primordial follicle consists of a primary oocyte surrounded by a layer of flattened epithelial cells called follicular cells.
3.  Early in development, the primary oocytes begin to undergo meiosis, but the process halts until the individual reaches puberty.
4.  Of the million or so primordial follicles present at birth, only about 400,000 are left by the time of puberty.
I.  Oogenesis
1.  At puberty, some primary oocytes are stimulated to continue meiosis.
2.  Oogenesis is the process of egg cell formation.
3.  The division of a primary oocyte results in a secondary oocyte and a polar body.
4.  A large secondary oocyte represents a future egg cell.
5.  If the secondary oocyte becomes fertilized, it will divide into a large fertilized egg and a tiny second polar body.
6.  A zygote develops into an embryo.
7.  The formation of polar bodies function to allow for production of an egg cell that has the massive amounts of cytoplasm and abundant organelles required to carry a zygote through the first few cell divisions, yet the right number of chromosomes.
J.  Follicle Maturation
1.  At puberty, the anterior pituitary secretes increased amounts of FSH, and the ovaries enlarge.
2.  When primordial follicles mature, oocytes within them enlarge, and the surrounding follicular cells divide mitotically.
3.  Granulosa cells are stratified epithelial cells derived from follicular cells.
4.  The zona pellucida is a layer of glycoproteins that separates the primary oocyte from granulosa cells.
5.  A primary follicle consists of a primary oocyte surrounded by granulosa cells.
6.  The inner vascular layer is composed of steroid secreting cells, loose connective tissue, and blood vessels.
7.  The outer fibrous layer consists of tightly packed connective tissue cells.
8.  An antrum is a space within a secondary follicle.
9.  A secondary follicle consists of an antrum, a primary oocyte, and granulosa cells.
10.  A mature follicle consists of a large fluid filled antrum that bulges outward on the surface of the ovary, a secondary oocyte, and granulosa cells.
11.  As many as 20 primary follicles may begin to mature at the same time.
12.  The dominant follicle is the follicle that outgrows the other follicles.
K.  Ovulation
1.  Ovulation releases a secondary oocyte.
2.  Ovulation is triggered by LH.
3.  After ovulation, the secondary oocyte and some follicular cells are propelled to the opening of a nearby uterine tube.
4.  If the secondary oocyte is not fertilized, it will degenerate.
L.  Introduction
1.  The internal accessory organs of the female reproductive system are a pair of uterine tubes, a uterus, and a vagina.
M.  Uterine Tubes
1.  Uterine tubes are suspended by portions of the broad ligament.
2.  Uterine tubes are located between ovaries and the uterus.
3.  The infundibulum of a uterine tube is an expansion of a uterine tube near the ovary.
4.  Fimbriae are branched extensions on the margins of an infundibulum.
5.  The walls of uterine tubes are composed of an inner mucosal layer, a middle muscular layer, and an outer covering of peritoneum.
6.  The cilia of the uterine tubes function to transport an egg down uterine tubes.
7.  The egg moves down a uterine tube due to ciliary action and peristaltic contractions of the uterine tube’s muscular layer.
N.  Uterus
1.  The functions of the uterus are to receive the embryo and sustain its development.
2.  The broad ligament is a structure that attaches to the ovaries and uterine tubes, and extends from the lateral walls of the uterus to the pelvic walls and floor, creating a drape across the top of the pelvic wall.
3.  The round ligament is a flattened band of tissue within the broad ligament that connects the upper end of the uterus to the anterior pelvic wall.
4.  The uterus is located medially within the anterior portion of the pelvic cavity, superior to the vagina, and is usually bent forward over the urinary bladder.
5.  In the nonpregnant state, the size of the uterus is about 7 cm long and 5 cm wide.
6.  The body of the uterus is the upper two-thirds of the uterus.
7.  The fundus of the uterus is the dome shaped top of the uterus.
8.  The cervix is the lower one-third of the uterus.
9.  The three layers of the wall of the uterus are the inner endometrium, middle myometrium, and the outer perimetrium.
10.  The endometrium is the inner mucosal layer lining the uterine cavity.
11.  The myometrium is a very thick, muscular layer, largely composed of bundles of smooth muscle fibers in longitudinal, circular, and spiral patterns and is interlaced with connective tissues.
12.  The perimetrium is an outer serosal layer of the uterus.
O.  Vagina
1.  The vagina is located inferior to the uterus, posterior to the urinary bladder, and anterior to the rectum.
2.  The functions of the vagina are to convey uterine contractions, to receive the erect penis during sexual intercourse, and to provide an open channel for the offspring during birth.
3.  Fornices of the vagina are the recesses between the vaginal wall and the cervix.
4.  The hymen of the vagina is a thin membrane that partially covers the vaginal orifice.
5.  The three layers of the vaginal wall are mucosal layer, muscular layer, and fibrous layer.
6.  The mucosal layer is the inner vaginal lining composed of stratified squamous epithelium.
7.  The muscular layer is the middle vaginal layer composed of smooth muscle fibers.
8.  The fibrous layer is the outer vaginal layer composed of dense connective tissue interlaced with elastic fibers.
P.  Introduction
1.  The external accessory organs of the female reproductive system are the labia majora, labia minora, clitoris, and vestibular glands.
2.  The vulva is the structures that surround the openings of the urethra and vagina.
Q.  Labia Majora
1.  The labia majora enclose the other external reproductive organs.
2.  The labia majora are composed of rounded folds of adipose tissue and a thin layer of smooth muscle, covered by skin.
3.  The skin of the labia majora contains hairs, sweat glands, and sebaceous glands.
4.  The pudendal cleft is the cleft that separates the labia majora and includes the urethral and vaginal openings.
5.  The mons pubis is a rounded elevation of adipose tissue that overlies the symphysis pubis.
R.  Labia Minora
1.  Labia minora are flattened longitudinal folds between the labia majora.
2.  Labia minora are composed of connective tissue richly supplied with blood vessels and stratified squamous epithelium.
S.  Clitoris
1.  The clitoris is a small projection and is located at the anterior end of the vulva between the labia minora.
2.  The clitoris is composed of two columns of erectile tissue and dense connective tissue.
3.  The crura of the clitoris are where the corpora cavernosa diverge and attach to the pubic arch.
4.  The glans of the clitoris is the anterior end of the clitoris that contains erectile tissue and is richly supplied with sensory nerve fibers.
T.  Vestibule
1.  The vestibule contains the vaginal opening, urethral opening, and the openings vestibular glands.
2.  Vestibular glands are located on either side of the vaginal opening and function to produce a mucous-like fluid for lubrication of the vaginal orifice during sexual intercourse.
3.  Vestibular bulbs are masses of erectile tissue beneath the mucosa of the vestibule on either side.
U.  Erection, Lubrication, and Orgasm
1.  Erection of the clitoris occurs due to parasympathetic nerve stimulation and the subsequent dilation of arteries in erectile tissue that allows the erectile tissue to swell with blood.
2.  The parasympathetic nervous system stimulates vestibular glands to secrete mucus into the vestibule.
3.  Orgasm is the culmination of sexual stimulation.

V.  Hormonal Control of Female Reproductive Functions

A.  Introduction
1.  The glands that regulate the functions of the female reproductive system are the hypothalamus, anterior pituitary gland, and ovaries.
B.  Female Sex Hormones
1.  In a female, the hypothalamus begins to secrete GnRH around puberty, which in turn causes development and maintenance of female secondary sex characteristics, maturation of female sex cells, and changes that occur during monthly reproductive cycles.
2.  FSH and LH function to control female sex cell maturations and the production of female sex hormones.
3.  Ovaries, adrenal cortices, and the placenta (during pregnancy) secrete estrogens and progesterone.
4.  Estrogens stimulate enlargement of accessory organs, stimulates the endometrium to thicken, and control the development of female secondary sex characteristics.
5.  Female secondary sex characteristics are development of breasts and mammary glands, increased deposition of adipose tissue in breasts, thighs, and buttocks, and increased vascularization of the skin.
6.  The actions of progesterone are to promote changes in the uterus during female reproductive cycles, to affect the mammary glands, and to help regulate secretions of Gonadotropins from the anterior pituitary gland.
7.  The functions of androgens in the female are to promote growth of pubic and axillary hair.
C.  Female Reproductive Cycle
1.  The anterior pituitary gland secretes FSH and LH.
2.  FSH stimulates the maturation of a follicle.
3.  Estrogens and some progesterone are secreted by granulosa cells of the follicle.
4.  Estrogens function to maintain secondary sex characteristics and to increase the thickness of the uterine lining.
5.  The anterior pituitary releases a surge of LH.
6.  An LH surge stimulates ovulation.
7.  The corpus luteum develops from follicular and thecal cells and produces estrogens and progesterone.
8.  Estrogens continue to stimulate endometrium development.
9.  Progesterone stimulates the endometrium to become more glandular and vascular.
10.  Estrogens and progesterone inhibit secretion of FSH and LH from the anterior pituitary gland.
11.  If the secondary oocyte is not fertilized, the corpus luteum degenerates and no longer secretes estrogens and progesterone.
12.  As estrogens and progesterone levels decline, blood vessels in the endometrium constrict.
13.  The endometrium disintegrates and sloughs off, producing a menstrual flow.
14.  The reproductive cycle then repeats.
D.  Menopause
1.  Menopause is the period of life when menstrual cycles cease.
2.  Menopause is caused by aging of the ovaries.
3.  Changes that result from a decrease of estrogens and progesterone are changing of female secondary sex characteristics, shrinkage of breasts, vagina, uterus, and uterine tubes, loss of pubic and axillary hair, thinning of linings of urinary and reproductive organs, thinning of skin, and loss of bone mass.

VI.  Mammary Glands

A.  Location of the Glands
1.  The mammary glands are located in the subcutaneous tissue of the anterior thorax within breasts.
2.  Breasts are hemispherical elevations.
3.  The breasts overlie the pectoralis major muscles and extend from the second to the sixth ribs and from the sternum to the axillae.
4.  A nipple is a projection located near the tip of each breast.
5.  The areola is a circular area of pigmented skin that surrounds a nipple.
B.  Structure of the Glands
1.  A mammary gland is composed of fifteen to twenty irregularly shaped lobules.
2.  Each lobule of a mammary gland contains glands drained by alveolar ducts which drain into a nipple.
3.  Suspensory ligaments are dense strands of connective tissue that extend inward from the dermis of the breast to help support the breast.
C.  Development of the Breasts
1.  Ovarian hormones stimulate development of breasts in the female.
2.  As a result of ovarian hormones, alveolar glands and ducts enlarge, and fat is deposited so that each breast becomes surrounded by adipose tissue.

VII.  Birth Control

A.  Introduction
1.  Birth control is the voluntary regulation of the number of offspring produced and the time they are conceived.
2. Contraception is designed to avoid fertilization of an egg cell.
B.  Coitus Interruptus
1.  Coitus interruptus is the practice of withdrawing the penis from the vagina before ejaculation.
2.  Coitus interruptus may result in pregnancy because a male may find it difficult to withdraw just prior to ejaculation.
C.  Rhythm Method
1.  The rhythm method requires abstinence from sexual intercourse two days before and one day after ovulation.
2.  The rhythm method results in a relatively high rate of pregnancies because accurately identifying infertile times to have intercourse is difficult.
D.  Mechanical Barriers
1.  Mechanical barriers prevent sperm cells from entering the female reproductive tract.
2.  Examples of mechanical barriers are male and female condoms, diaphragms, and cervical caps.
3.  A male condom is a thin membrane worn over the penis during sexual intercourse.
4.  A female condom is a small plastic bag that is inserted into the vagina prior to intercourse.
5.  A diaphragm is a cup-shaped structure that covers the cervix.
6.  A cervical cap is similar to a diaphragm but adheres to the cervix by suction.
E.  Chemical Barriers
1.  Chemical barrier contraceptives include spermicidal creams, foams, and jellies.
2.  Chemical barrier contraceptives are easy to use but have a high failure rate when used alone.
3.  Chemical barrier contraceptives are more effective when used with a condom or diaphragm.
F.  Combined Hormone Contraceptives
1.  Combined hormone contraceptives deliver estrogen and progestin in combination to prevent pregnancy.
2.  An oral contraceptive contains synthetic estrogen-like and progesterone-like substances.
3.  When a woman takes the pill daily, the drugs disrupt the normal pattern of gonadotropin secretion and prevent the LH surge that triggers ovulation.
4.  Side effect of oral contraceptives includes nausea, retention of body fluids, increased pigmentation of skin, and breast tenderness.
G.  Injectable Contraception
1.  An example of an injectable contraceptive is Depo-Provera.
2.  The actions of Depo-Provera are to prevent maturation and release of secondary oocytes and to alter the uterine lining.
3.  One injection of Depo-Provera lasts three months.
H.  Intrauterine Devices
1.  An intrauterine device is a small, solid object that is placed in the uterine cavity.
2.  An IUD interferes with implantation.
I.  Surgical Methods
1.  A vasectomy is a surgical procedure in which a small section of each vas deferens is removed and the cut ends of the ducts are tied.
2.  A tubal ligation is a surgical procedure in which uterine tubes are cut and tied so that sperm cells cannot reach an egg cell.
VIII.  Sexually Transmitted Diseases
A.  Sexually transmitted diseases are often called “silent” because the early stages may not produce symptoms, especially in males.
B.  Signs and symptoms of sexually transmitted diseases are burning sensation during urination, pain in the lower abdomen, fever or swollen glands in the neck, discharge from the vagina or penis, pain, itch or inflammation in the genital or anal area, pain during intercourse, sores, blisters, bumps, or a rash anywhere on the body, and itchy, runny eyes.
C.  Pelvic inflammatory disease is a disease in which bacteria spread throughout reproductive organs and can lead to infertility.
D.  Acquired immune deficiency syndrome is a steady deterioration of the body’s immune system.