Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

FEMALE REPRODUCTIVE SYSTEM

Menstrual Cycle • Hormones • Menopause
OB Nursing | Broward College | Lecture Study Guide

External Organs Internal Organs Menstrual Cycle Menopause

▶ SECTION 1: EXTERNAL REPRODUCTIVE ORGANS (Vulva)

All external organs collectively = VULVA (Pudenda)

Components of the Vulva

Structure Function / Key Points

Mons Pubis Fatty pad over the pubic bone; protective cushion

Labia Majora Large hair-covered skin folds; contains sweat & sebaceous glands; protects vaginal
opening; cushioning during sex; barrier against infection & trauma

Labia Minora Inner folds inside labia majora; highly vascular & sensitive; lubricates vulva;
responds to stimulation

Clitoris ONLY purpose = PLEASURE. No other function.

Urethral Opening Passage for urine

Vaginal Opening Surrounded by hymen; passage for menstrual flow & childbirth

Vestibule
• Space enclosed by the labia minora
• Contains urethral opening + vaginal opening
• Vaginal opening surrounded by the hymen
• Hymen can tear from: tampons, exercise, horseback riding — not only from intercourse
• Purpose: passage for urine, menstrual blood, and childbirth

Gland Location Function

Bartholin Glands Opening of the vagina Increase lubrication during sexual activity

Skene Glands Either side of urethral opening Lubrication + antimicrobial protection

Perineum
• Located between the vulva and the anus

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

• Gets lacerated or tears during childbirth

• Episiotomy = surgical cut to this area during delivery
• Episiotomies are NOT done routinely anymore — mostly older-school practice

⚠ EXAM TIP: Main purpose of ALL external organs: protect internal structures, provide sexual sensation,
allow passage of urine, menstrual flow, and childbirth.

▶ SECTION 2: INTERNAL REPRODUCTIVE ORGANS

Vagina
• Elastic canal connecting the cervix to the external genitalia
• Functions: receives penis during intercourse; passage for menstrual flow; birth canal during delivery
• Has an ACIDIC environment — provides antimicrobial protection

Professor Said: "The vagina is not a clean environment, but it is acidic to protect you from infections. Do NOT
douche — it disrupts the natural pH and actually causes infection."

What Disrupts Vaginal pH?

Disruptor Effect

Douching Destroys natural pH → causes infection; pushing water in can propel sperm
upward → risk of ECTOPIC PREGNANCY

Antibiotics Disrupt normal flora → pH changes → yeast infection

Sex / Semen Semen is ALKALINE; mixing with acidic vagina disrupts balance

Infection / UTI Alters normal environment

Cervix
• Lower portion / 'neck' of the uterus — opens into the vagina
• ALKALINE environment — protects sperm from the vagina's acidity; allows sperm to pass through
• Produces cervical mucus — changes consistency at ovulation to allow sperm through
• Acts as a barrier to infection
• Dilates and effaces during labor to allow baby to pass
• Nulliparous (no prior delivery) os = small and round; after vaginal delivery = slightly open/irregular

Uterus
• Inverted pear-shaped muscular organ
• ONLY purpose = support and grow a pregnancy
• A full bladder can TILT the uterus — always empty bladder before assessing uterus postpartum

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

• After pregnancy: remains larger than pre-pregnancy

• After menopause: shrinks

Part Description

Fundus TOP part of the uterus

Cervix LOWER part of the uterus

Corpus Main body of the uterus — site of implantation; houses endometrium

Layer Type Function

Endometrium Inner lining Sheds during menstruation; thickens for

implantation

Myometrium Thick smooth muscle Major portion of uterus; contracts during labor

Perimetrium Outer serous (serosa) layer Covers the body of the uterus

⚠ EXAM TIP: Conditions affecting the uterus: uterine fibroids, endometrial hyperplasia, uterine cancer.

Fallopian Tubes
• WHERE FERTILIZATION OCCURS (not in the uterus!)
• Egg is caught by FIMBRIAE (finger-like projections lined with cilia)
• Cilia sweep the egg into the tube and move it toward the uterus
• Smoking DESTROYS cilia → egg cannot be grabbed → FERTILITY ISSUES
• After fertilization: egg travels to uterus in approximately 7 days for implantation

Ovaries
• Women are BORN with ALL their eggs — no new eggs made after birth
• By the first period, many eggs have already been lost
• Multiple eggs mature each month, but only ONE becomes dominant and is ovulated
• FSH stimulates ovaries to produce a follicle (egg)

Breasts (Accessory Organs)

• Mammary glands — part of the reproductive system
• Main purpose: produce milk for the baby
• Controlled by: estrogen, progesterone, prolactin, and oxytocin
• Pitocin (given to induce labor) = synthetic oxytocin — also stimulates milk letdown

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

▶ SECTION 3: THE MENSTRUAL CYCLE

Average Length 28 days (range: 21–35 days)

28-day cycles? Only ~40% of women actually have a 28-day cycle

Day 1 First day of bleeding = Day 1 of the cycle

Hormones: Who They Are & What They Do

Hormone Made Where Main Job

GnRH Hypothalamus (brain) Pulsatile release every 90 seconds; tells pituitary to release FSH &
LH; no vessel connects hypothalamus to pituitary — it is dead
space

FSH Anterior pituitary Stimulates ovaries to mature a follicle (egg); highest in first week
of follicular phase

LH Anterior pituitary LH surge triggers OVULATION; stimulates formation of corpus

luteum

Estrogen Ovaries / follicle Builds uterine lining; surges just before ovulation; peaks at end of
proliferative phase

Progesterone Corpus luteum "Hormone of pregnancy" — P for Protect; thickens endometrium;

calms uterus (reduces contractions); dominant in second half of
cycle

WHEN DO YOU ACTUALLY OVULATE?

⚠ EXAM TIP: NOT necessarily Day 14! Ovulation = 14 days BEFORE the NEXT period. Formula: Cycle Length
minus 14 = Ovulation Day

Cycle Length Formula Ovulation Day

21-day cycle 21 - 14 = 7 Day 7

28-day cycle 28 - 14 = 14 Day 14

30-day cycle 30 - 14 = 16 Day 16

32-day cycle 32 - 14 = 18 Day 18

Egg lifespan Egg survives 24 hours after ovulation

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

Sperm lifespan Sperm can live up to 72 hours (3 days) — pregnancy possible from sex 3 days before ovulation

The Cycle Step-by-Step

Phase / Timing Hormones What Happens in the Body

Menstruation Day 1 Estrogen LOW Progesterone Uterine lining sheds; period begins; FSH starts to rise
LOW

Follicular Phase Days 1- FSH rises Estrogen rises FSH stimulates follicle to mature; estrogen builds up
14 uterine lining (endometrium thickens)

Pre-Ovulation Day 13-14 Estrogen PEAKS LH SURGES High estrogen triggers LH surge; LH damages estrogen-
producing cells in follicle → estrogen drops slightly

OVULATION Day 14* LH SURGE Follicle ruptures → egg is released; egg travels to
fallopian tube (fertilization occurs here if sperm
present)

Luteal Phase Days 15-28 Progesterone RISES Estrogen Corpus luteum forms from ruptured follicle; secretes
rises progesterone + estrogen; endometrium thickens and
becomes secretory

If No Pregnancy Day 25- Both DROP Corpus luteum degenerates; estrogen + progesterone
28 fall; uterine lining sheds → PERIOD → cycle restarts

The Feedback Loop

Hypothalamus secretes GnRH (every 90 sec, pulsatile)

↓
Anterior pituitary releases FSH + LH
↓
Follicle matures → Estrogen rises
↓
LH SURGE → OVULATION (egg released)
↓
Corpus luteum forms → Progesterone + Estrogen rise
↓
No pregnancy → Corpus luteum dies → Both hormones drop
↓
PERIOD → Cycle restarts ↺

What Can Disrupt the Cycle?

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

• Brain tumor or increased intracranial pressure → GnRH not secreted normally

• Abnormal FSH/LH ratio → no ovulation
• High androgens (testosterone) → follicular atresia (egg shrivels and dies) → can't get pregnant
• Thyroid dysfunction → disrupts entire hormonal cascade
• Stress / elevated cortisol → late or missed periods
• Cilia damage from smoking → egg cannot be swept into fallopian tube → fertility issues

★ MEMORY TRICK: Before ovulation = ESTROGEN rules (building phase). After ovulation = PROGESTERONE
rules (maintaining phase). LH SURGE = the trigger for ovulation.

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

▶ SECTION 4: MENOPAUSE & PERIMENOPAUSE

Menopause — Key Facts

Definition No menstrual period for a FULL 12 months

Average Age 52.4 years (can be earlier — genetic link; if your mother had early menopause,
you may too)

FSH in Menopause ELEVATED — brain keeps trying to stimulate ovaries that no longer respond

After Menopause Uterus and ovaries shrink; no more eggs released; pregnancy no longer possible

Professor Said: "FSH goes UP in menopause. The brain keeps trying to reach for something that isn't there
anymore — like a factory manager demanding production from workers who are retired and can't produce."

Perimenopause — Key Facts

• Up to 10 years BEFORE menopause
• Still having periods; still ovulating; FSH levels still NORMAL
• Symptoms: hot flashes, mood changes, difficulty sleeping
• No reliable lab test for perimenopause — it is a clinical diagnosis
• Caused by: altered GnRH pulse pattern (changes from every 90 seconds) → hormonal imbalance → hot flashes

Management Options

Option Notes

Birth Control Pill Regulates hormones during perimenopause; prevents ups and downs; has sex
hormone-binding components

Progesterone Good for older women; helps hot flashes; regulates without requiring a period

Hormone Replacement (HRT) Transitioned to after menopause

Exercise Significantly helps perimenopause symptoms

Contraindications to the Birth Control Pill

• Smoker over age 35
• History of blood clots or stroke
• Diabetes with vascular disease
• Migraines WITH aura
• History of any female cancer (breast, uterine, ovarian, cervical)

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

★ SECTION 5: QUICK REFERENCE — MEMORY TRICKS

What to Remember The Answer

All external organs together = VULVA (Pudenda)

Clitoris purpose = PLEASURE ONLY — no other function

Vagina environment = ACIDIC (antimicrobial protection)

Cervix environment = ALKALINE (lets sperm survive and pass through)

Fertilization occurs in = FALLOPIAN TUBE (not the uterus)

Implantation occurs in = UTERUS — approximately 7 days after fertilization

Ovulation timing = 14 days BEFORE next period (cycle length minus 14)

Egg survives = 24 hours

Sperm survives = 72 hours (3 days)

LH surge does = Triggers OVULATION

Progesterone = "P for Protect the Pregnancy" — dominant in 2nd half of

cycle

FSH in menopause = ELEVATED (ovaries not responding; brain keeps signaling)

Smoking destroys = CILIA in fallopian tubes → egg can't be grabbed →

infertility

Full bladder can = TILT the uterus — empty bladder before postpartum
assessment

Douching causes = Disrupts pH → infection; can push sperm up → ectopic

pregnancy risk

3 uterine layers = Endometrium (inner) / Myometrium (muscle) /

Perimetrium (outer)

Menopause definition = No period for 12 full months; average age 52.4

PROFESSOR'S KEY EXAM REMINDERS

1. Ovulation is 14 days BEFORE the next period — NOT always Day 14.
2. Never douche — disrupts pH, causes infection, and can cause ectopic pregnancy.
3. FSH is ELEVATED in menopause — the body is trying to stimulate ovaries that no longer respond.
4. Fertilization = fallopian tube. Implantation = uterus (7 days later).
5. Smoking kills cilia in fallopian tubes → infertility.

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Female Reproductive System & Menstrual Cycle OB Nursing — Broward College

6. Empty the bladder before postpartum uterine assessment — a full bladder tilts the uterus.

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