- painful menstruation

- due to release of prostaglandins fr. endometrium (primary) or related to pelvic pathological conditions (eg. endometriosis) and can occur anytime in cycle (secondary)

- lack of menstruation

- may be normal (pregnancy) or pathological (Turner syndrome)

- usually caused by a failure to ovulate

- includes dysfunctional uterine bleeding (DUB)

Dysfunctional uterine bleeding

(DUB)

- heavy or irregular bleeding in the absence of disease

- associated w/ anovulatory cycles

- when there's no progesterone is produced but estrogen continues to be produced

- effect is a very thick endometrium w/c produces heavy bleeding

1. endometriosis

- presence of fxning endometrial tissue outside of the uterus

- occurs primarily in the abdominal and pelvic cavities

- not sure of cause

- if blood supply is sufficient, the ectopic endometrium follows the same growth/breakdown and bleeding pattern of the endometrium in the uterus

- the bleeding then causes inflammation and pain in surrounding tissues

- the inflammation may lead to fibrosis, scarring, and adhesions

1. cervical

2. endometrial

3. ovarian

- most common cancer of women

- caused by human papillomavirus (HPV)

- slowly progressive disease

- 90% can be detected early through the use of Pap and HPV testing

- smoking

- immunosuppression

- poor nutrition

- most prevalent malignancy of female reprod. tract

- mostly occurs in post-menopausal women

- causes more deaths than any other cancer of female reprod system

- early stages very difficult to detect (20% only found in early stage)

- risk is reduced by factors that suppress ovulation

- increasing age

- family history

- breast, ovarian and colon cancers appear to share common genetic markers

- frequency of ovulation

1. benign breast disease

2. breast cancer

- noncancerous changes in breast tissue

- irregular lumps, cysts, sensitive nipples and pruritus

1. Nonproliferative

- eg. cysts, fluid filled sacs

- occur in women in 30s to early 50s

- affected by hormonal changes w/in menstrual cycle

2. Proliferative

- eg. hyperplasia of cells in the ducts (2 layers)

- characterized by growth of tissue, w/o cellular signs of malignancy

3. Proliferative w/ atypia

- eg. increased # of cells w/in the lumen of the ducts

- characterized by growth of tissue, but there's an abnormalities in the structure

- most common in American women

- leading cause of death in women 40-44 yrs (2nd killer in women after lung cancer)

1. Hormonal changes

- exposure to estrogen and progesterone have an effect

- early menarche + late menopause increases the risk

- estrogen cause increased cell proliferation

- increases the possibility of accumulating genetic damage - or break down into toxic compounds that can directly damage DNA

2. Giving birth

- less than 18yrs decreases the risk; 35 yrs increases the risk

- more births and breast feeding decreases the risk

3. Family history

- specific gene mutations (BRCA1 and BRCA2) link w/ increased risk

- w/o mother/sister w/ breast cancer increases the risk

4. Age

- risk increases w/ age

- starting in 30s, the glandular structures and connective tissue bet. the glands are replaced w/ fatty tissue

- this is known as lobular involution

- the more involution, the lower the risk of cancer

- risk factor include age w/ degree of involution

- increased risk of pregnancy after 35 yrs may be interruption and reversal of involution

- the denser the tissue, the higher the risk

- the more involuted the breast tissue, the lower the risk

- from the epithelium of the ducts (79%) but can occur in the lobules or in the stroma

- edges of lesion can invade local tissue

- w/c is followed by malignant cells scattering into the lymph nodes

- then the cancer can metastasize into other body site

- lung, liver, and bone

- first sign is a painless lump in upper outer quadrant where most of the glandular tissue of the breast is located

1. Urethritis

2. Urethral stricture

3. Crytorchidism

4. Varicocele

5. Hydrocele

6. Tortion of the testis

- tingling, itching, burning frequent urination

- inflammatory process usually caused by sexually transmitted organism

- narrowing of the urethra caused by scarring

- trauma

- long-term use of in-dwelling catheters

- infection

- group of abnormalities in w/c the testis fails to descend completely

- may remain in abdomen, or only partially descend

- abnormal dilation of the testicular vein

- most common identified scrotal abnormalities

- decreases blood flow thru the testes, interfering w/ spermatogenesis

- collection of fluid bet. outer layers of tissue surrounding testes

- asymptomatic and usually self-resolving

- when the testis rotates on its axis, interrupting its blood supply

- can occur w/ exertion or trauma

- causes ischemia - pain and swelling

- must be corrected w/ 6hrs of symptoms to preserve normal fxn

- enlargement of the prostate gland

- problematic if it interferes w/ passage of urine thru urethra

- normal enlargement that begins 40-45 yrs and continues slowly for remainder of life

- result of a complex interaction bet. sex hormones, chronic inflammation and growth factors

- if prostatic urethra is compressed, symptoms occur

- frequent urges to urinate

- delay in starting urination

- decreased force of flow

- w/ further obstruction, the bladder can't empty all of urine, and this results in

- uncontrolled overflow incontinence w/ increase in intra-abdominal pressure

- involuntary release of urine

- increased risk for infection and bladder stones

- treatments: medication/ surgery

- most common of male cancers

- increases w/ increasing age

- prostate tumours secretes PSA (prostate specific antigen)

- diet has an influence on the development of prostate cancer

- eg. increased total fat intake - increase

- eg. tomato products - decrease

- inflammation

- hormones

- genetic factors

- no symptoms until cancer is far advanced

- usually symptoms are of bladder outlet obstruction

- accompanied by rectal obstruction

- symptoms of late disease:

- bone pain at sites of bone metastasis

- enlargement of lymph nodes

- liver enlargement

- mental confusion w/ brain metastases

- prostate specific antigen

- secreted by prostate tumours

- can be used to screen for prostate cancer