Unit 19
 Drugs and Body Systems-Reproductive System

Objectives

• Name the main parts of the male and the female internal and external genitalia.
• Use correct medical terms to describe the parts, functions, and disorders of the reproductive system.
• Name the hormones produced by the male and female gonads and tell what they do.
• Describe the actions of gonadotropins, oxytocin, and prolactin.
• Recognize descriptions of the major disorders that affect the reproductive system.
• List the main uses of hormones in drug therapy.
• State the major side effects of sex hormone therapy.
• State action, side effects and names of male and female hormones used as medication.
• See Appendix. Medication Classification
• See Performance Evaluation - Drug Card - Sample
• See Appendix. Suppository - Vaginal
• See Appendix. Food Guide Pyramid

Refer to your textbook Ch 14

Female reproductive structures and functions   Refer to your textbook pg 358-360

Video on Structure and Function of the female reproductive system: Click Here

Genitalia 

• Internal
  • Two ovaries-produce ova (female sex cells) which are released from the ovary once a month-ovulation. Also produce estrogen and progesterone.
  • Two fallopian tubes: fertilization takes place in the tube, and then the fertilized egg travels to the uterus.
  • Uterus-holds the fetus as it develops into a baby-bottom portion is called the cervix.
  • Vagina-organ of sexual intercourse, and also the birth canal.
• External
  • Mon pubis-pad off at over the symphysis pubis bone.
  • Labia majora and minora-the folds of tissue covering the vaginal opening.
  • Clitoris-similar to the penis in the male. The clitoris is erectile tissue and creates the good feelings during sex. It is also responsible for producing an orgasm.
  • The true perineum is the area from the back of the vaginal opening to the anus, and the entire perineum usually refers to the area from the umbilicus in the front to the top of the gluteal fold in the back.

Male reproductive structures and functions  Refer to your textbook pg 360-361

Video on the structure and function of the male reproductive sytsem Click Here

Genitalia

• Internal
  • Testes: reproduce sperm and testosterone.
  • Several glands-prostate, seminal vesicles, and Cowper's glands. The prostate produces semen.
  • Coiled tiny tubes called the epididymis carry the sperm from the testes to the vas deferens, which carries sperm to the urethra and out of the body during ejaculation.
• External
  • Scrotum-contains the testes.
  • Penis: made of spongy tissue, becomes engorged with blood during sexual excitement.

Sex Hormones-Gonadotropins

• A few from the adrenal cortex.
• Most are produced by the gonads.
• Female-Estrogen and progesterone.
• Estrogen-responsible for female sex characteristics. Maturing of the female body and maturing and developing of the ovum every month.
• Progesterone-prepares the uterus for a fertilized ovum each month.
• If the ovum is not fertilized, then menstruation or menses occurs.
• Menopause occurs when the ovaries stop production of ova, estrogen and progesterone.
• Male-testosterone-produced in testes
• Responsible for male sex characteristics.
• Stimulates development of sperm.
• Both males and females produce the same hormones, just in different amounts.
• Sex hormones are needed for many other body processes-growth, bone formation, protein production, mineral storage, etc.
• Pituitary hormones  Refer to your textbook pg 362-363
• FSH-follicle stimulating hormone.
• LH-luteinizing hormone.
• Control ovulation and the production of estrogen and progesterone.
• Oxytocin-controls the contractions of labor-can be given to induce labor and to contract the uterus after childbirth to prevent or control bleeding. Also controls the "let-down" reflex which allows the breast milk to come down into the ducts for release.
• Prolactin-controls the production of milk by the breasts.

Disorders of the Reproductive System

Vaginal infections  Refer to your textbook pg 362-363

• Vaginitis-inflammation of the vagina.
  • Common because the vagina opens to the outside of the body.
  • Most common:
    • Trichomoniasis
    • Yeast
• May spread to other internal organs.
  • Cervicitis-inflammation of the cervix.
• Treatment examples
  • Creams
  • Vaginal suppositories
  • Monistat 7
  • Gyne-Lotrimin

Sexually transmitted diseases (STDs).   Refer to your textbook pg 363-364

Video on STD’s Click Here

• AIDS (Autoimmune Deficiency Syndrome) - treated with antiviral drugs.
• Hepatitis B and other types of hepatitis.
• Syphilis and gonorrhea-many strains are resistant to antibiotics.
• Chlamydia-the most common STD, causing pelvic inflammatory disease (PID) and infertility. Resistant to antibiotics.
• Trichomoniasis-a vaginal infection, treated with Flagyl.
• Genital herpes simplex-treated with an antiviral, like acyclovir (Zovirax).

Prostate Diseases  Refer to your textbook pg 364

• Infection of the prostate-prostatitis.
  • Symptoms: blood in the urine or cloudy urine.
  • Treatment: antibiotics, anti-inflammatory drugs.
• BPH-benign prostatic hypertrophy-enlarged prostate narrows the urethra, making urination difficult.
  • Video on BPH Click Here
• Symptoms: difficulty starting stream of urine, distended bladder, inability to urinate.
• Treatment: surgical.
• Treatment: new drug Proscar-inhibits one form of testosterone which causes the gland to grow. Prostate-specific antigen (PSA); a blood test to screen for prostate cancer.
• Prostate cancer-common in men over 60. Treat with surgery and female hormones to slow down tumor growth.  Refer to your textbook pg 364

Cancer

• Breast
• Uterus
• Prostate-80% occur in men over 65 years old
• Testicles

Use of Sex Hormones in Drug Therapy

Estrogen  Refer to your textbook pg 365-366

• Replacement therapy after menopause (Hormone Replacement Therapy-HRT)
  • Treat symptoms of menopause.
  • Prevent osteoporosis, hot flashes and vaginal thinning.
  • Prevent osteoporosis-lack of estrogen after menopause causes bones to thin.
• Vaginal inflammation in older women is due to thinning of the vaginal walls and dryness.
• Breast cancer.
• Treatment for prostate cancer. It has a feminizing effect on men.
• Side effects-minimal 
  • Nausea.
  • Breast tenderness, abnormal bleeding.
  • Increased risk of uterine cancer (endometrial) and breast cancer.
• Drug examples
  • Estradiol
  • Esterone
  • Premarin-conjugated estrogens
  • Stilbestrol (diethylstilbestrol)

Progesterone-mostly for menstrual disorders  Refer to your textbook pg 366

• Given to treat abnormal uterine bleeding
• Endometriosis
• Dysmenorrhea-painful menses
• Given with estrogen after menopause to decrease risk of uterine cancer
• Side effects-minimal
  • Nausea
  • Headache
  • Dizziness
  • Depression, apathy, edema
• Drug examples
  • Provera (medroxyprogesterone acetate)
  • Depo-Provera
  • Megace

Contraceptives-combinations of estrogen and progesterone  Refer to your textbook pg 367-369

• Prevent pregnancy in peri-menopausal nursing home residents
• Many mild side effects
  • Nausea
  • Breakthrough bleeding
  • Water retention, edema
  • Vaginal infection
  • Headache
  • Risk of developing blood clots in the legs
  • Cancer
• Drug example
  • Norgestrel (Lo Ovral)
  • Loestrin

Testosterone-action and use  Refer to your textbook pg 369

• Replacement therapy when enough testosterone is not being produced naturally.
• Given to females with breast cancer to relieve symptoms and to slow tumor growth. It has virilizing effect on women.
• Side effects
  • Retention of salt and edema controlled with diuretics
• Drug examples
  • Oreton methyl
  • Methandrostenolone (Dianabol)
  • Stanozolol (Winstrol)
  • Testosterone cypionate (Depo-Testosterone)
  • Oxymetholone (Anadrol)
  • Methyltestosterone
• Nursing care and side effects:
  • To be effective, hormones given for anabolic effect, must be accompanied by improvement of nutrition.

Pay close attention to your textbook pg 370-371 regarding Representative Drugs for the Reproductive System
Also complete the Ch. 14 review on pg 373-376.  You do not need to hand in your answer to your instructor.
Review Practice Procedure table 14.1 on inserting vaginal medication