The Reproductive System - Ailments: what can go wrong with the reproductive system
Many ailments and disorders can affect the male and female reproductive systems, preventing them from functioning properly. These conditions can range from mild to moderate to severe. Some are life-threatening.
An embryo is an organism in its earliest stages of development, produced when an ovum is fertilized by a sperm. Shortly after fertilization, the ovum begins to grow and develop. It divides to form two cells, then four, then eight, and so on. The cells then combined to form structures and systems. A developing human individual is considered an embryo from the time of fertilization until the ninth week of pregnancy. At that point, it is considered a fetus.
The following is a list of changes or appearances that mark each month in the development of a fetus:
Month 3: Head is abnormally large in proportion of the body. Facial features are present in crude form. Bone development increases. Brain continues to enlarge. Sex can be readily determined from the genitals. Approximate overall size: 3 inches (7.6 centimeters).
Month 4: Head still quite large, but arms and legs lengthen. Hair appears on head. Face begins to look more human. Eyes, ears, nose, and mouth are well-formed. Body systems continue to develop. Approximate overall size: 5 to 7 inches (13 to 18 centimeters).
Month 5: Body begins to grow more rapidly than head. Body is covered with silklike hair (lanugo). Skin is covered with a grayish-white, cheese-like coating (vernix). Skeletal muscles become active. Approximate overall size: 10 to 12 inches (25 to 30 centimeters).
Month 6: Eyelashes and eyebrows form. Eyelids begin to open. Lanugo has largely disappeared. Skin is wrinkled and red. Approximate overall size: 12 to 14 inches (30 to 35 centimeters).
Month 7: Body and head approach normal proportions. Weight increases substantially. Fat deposits are laid out beneath the skin, which becomes less wrinkled. Fingernails and toenails are present. In males, testes descend into the scrotum. Approximate overall size: 14 to 17 inches (35 to 43 centimeters).
Month 8: More fat is deposited under the skin. Most body systems are fully functional. Approximate overall size: 18 inches (46 centimeters).
Month 9: Skin appears whitish pink. Nails are fully developed. Lungs are more mature. Lanugo is shed. Fetus ready to be born. Approximate overall size: 19 to 21 inches (48 to 53 centimeters).
Vaginal yeast infections, caused by a species of yeast found in virtually all normal people, are common infections in women. While not serious, they can be uncomfortable and irritating until treated. Impotence, a condition in which a man is unable to maintain an erection, may be due to some physical or psychological problem. Again, this disorder does not threaten life, but it is a cause of concern to a man (and to his spouse or partner) as it prevents him from engaging in sexual intercourse.
The organs of the male and female reproductive systems are often sites where tumors or other growths develop. Many of these growths are cancerous. The following are some of the more serious diseases and disorders that can afflict the reproductive systems in males and females.
Breast cancer develops when cells of the breast become abnormal and grow uncontrollably, forming tumors. The cancer cells can invade and destroy surrounding tissue, then spread throughout the body by way of the blood or lymph vessels. Every woman is at risk for breast cancer. Regardless of family history, a woman's risk for developing this type of cancer increases as she ages. In fact, 80 percent of all breast cancers are found in women over the age of fifty.
A woman's chance for developing breast cancer increases if her mother or sister have had breast cancer, if she has gone through menopause late in life, if she did not breastfeed her children, or if she did not have children or had them late in life. However, more than 70 percent of women who get breast cancer have none of these risk factors.
The following are all indications of possible breast cancer: a lump in the breast, changes in the nipple of the breast, dimpled or reddened skin over the breast, and change in size or shape of the breast.
More than 90 percent of all breast cancers are detected by mammography (a low-dose X ray of the breast). The American Cancer Society recommends that women between the ages of forty and forty-nine have a mammogram done every year or two; women aged fifty or over should have one every year.
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Treatment options for breast cancer include surgery, chemotherapy, and radiation. During surgery, surgeons may remove only a portion of a woman's breast, her entire breast and some underarm lymph nodes, or her entire breast along with all of the underarm lymph nodes and chest muscles. The extent of the surgery depends on the type of breast cancer, whether the disease has spread, and the woman's age and health. After the cancer has been removed, the physician may recommend the woman undergo chemotherapy (using a combination of drugs to kill any remaining cancer cells and shrink any tumors) or radiation therapy (using X rays or other high-energy rays to kill any remaining cancer cells and shrink any tumors) or a combination of both.
Breast cancer cannot be prevented, but it can be treated successfully if diagnosed from a mammogram at an early stage.
Endometriosis is a condition in which bits of tissue similar to the endometrium (lining of the uterus) grow in other parts of the body. Like the endometrium, this tissue builds up and sheds in response to monthly hormonal cycles. However, the blood discarded from these tissue implants has no natural outlet. It falls onto surrounding organs, causing swelling and inflammation. Eventually, scar tissue and adhesions develop in these areas.
The exact cause of endometriosis is unknown and there is no way to prevent the disease. It most commonly strikes women who are between the ages of twenty-five and forty. About 7 percent of the women in this age group in the United States are affected by the disorder.
The most common symptoms of endometriosis include menstrual pain beginning a day or two before the true menstrual period starts, abnormal bleeding during menstrual periods, and pain during sexual intercourse.
If endometriosis is discovered, treatment depends on a woman's symptoms, her age, and the extent of the disease. For mild cramping and menstrual pain, over-the-counter pain relievers are taken. Medications similar to hormones may be given to reduce pain and shrink or stop the spread or growth of the condition. The only permanent method to eliminate endometriosis is the surgical removal of the uterus, ovaries, and fallopian tubes. For women with minimal endometriosis, laser surgery to remove the endometrial tissue implants and ovarian cysts may be employed.
Chlamydia (kla-MI-dee-ah): Sexually transmitted disease caused by a bacterium.
Endometriosis (en-doe-mee-tree-OH-sis): Condition in which bits of tissue similar to the endometrium grow in other parts of the body.
Gonorrhea (gah-nuh-REE-ah): A highly contagious sexually transmitted disease caused by a bacteria.
Syphilis (SIF-uh-lis): Sexually transmitted disease caused by a coil-shaped bacterium
Uterine fibroids (YOU-ter-in FIE-broydz): Also called myomas, benign (nonthreatening) growths of the muscle in the uterus.
Ovarian cancer develops when cells in the ovaries become abnormal and grow uncontrollably, forming tumors. Ninety percent of all ovarian cancers develop in the cells that line the surface of the ovaries. This type of cancer is the fifth most common cancer among women in the United States. However, the death rate due to this cancer is higher than that of any other cancer among women.
Ovarian cancer can develop at any age, but more than half the cases occur in women who are sixty-five or older. It is difficult to diagnose ovarian cancer early because often there are no warning symptoms. Also, the disease spreads relatively quickly.
The actual cause of ovarian cancer is not known. However, several risk factors are known to increase a woman's chances of developing the disease. These factors include age, race (cancer is highest among white women), a high-fat diet, a family history of ovarian cancer, and having a first period at a young age, or going through menopause at a late age.
In the early stages of ovarian cancer, there may be no noticeable symptoms. Later, a woman may experience pain or swelling in the abdomen, constipation, vomiting, loss of appetite, fatigue, and unexplained weight gain.
If cancer is detected, surgery is the main treatment. The type of surgery depends on the extent of the disease. In most cases, the ovaries, uterus, and fallopian tubes are completely removed. In rare cases, only one ovary may be removed with the uterus and fallopian tubes left intact. After surgery, chemotherapy (using a combination of drugs to kill any remaining cancer cells and shrink any tumors) is usually administered.
More than 50 percent of the women who are diagnosed with ovarian cancer die within five years. If the disease is diagnosed before it has spread beyond an ovary, more than 90 percent of those women will survive five years or more. Since ovarian cancer cannot be prevented, the American Cancer Society recommends that all women over the age of forty undergo annual pelvic examinations to increase the chance of detecting the disease early.
Prostate cancer develops when cells in the prostate gland become abnormal and grow uncontrollably, forming tumors. It is the most common cancer among men in the United States, and it is the second leading cause of cancer deaths. Prostate cancer affects African American men twice as often as it does white men. In fact, African Americans have the highest rate of prostate cancer in the world.
Prostate cancer is found mainly in men over the age of fifty-five. As men grow older, the chance of developing the disease increases. Although the cause of this type of cancer is unknown, evidence suggests that age, race, a high-fat diet, and increased blood levels of testosterone may play a part in the development of the disease.
Frequently, prostate cancer has no symptoms. When the tumor is enlarged or the cancer has spread, the following symptoms may appear: weak or interrupted urine flow, frequent urination (especially at night), difficulty starting urination, inability to urinate, pain or burning sensation when urinating, blood in the urine, persistent pain in the lower back, and painful ejaculation.
If prostate cancer is detected (either through a rectal examination or blood test), surgery to remove the prostate gland completely is the most common treatment. The seminal vesicles are also removed during the procedure. If the prostate cancer is detected at an early stage, radiation therapy (using X rays or other high-energy rays to kill cancer cells and shrink any tumors) may be used instead of surgery. Chemotherapy (using a combination of drugs to kill any remaining cancer cells and shrink any tumors) is sometimes used to treat prostate cancer that has recurred after initial treatments.
Nearly 87 percent of men who are treated for prostate cancer survive. If the disease is detected early, that percentage increases. Prostate cancer cannot be prevented. To increase the chance of detecting the disease early, the American Cancer Society recommends that all men over the age of forty have an annual rectal examination (men over the age of fifty should have a blood test, in addition).
Sexually transmitted diseases
Sexually transmitted diseases (also called STDs or venereal diseases) are infections transmitted through various forms of sexual activity. More than twenty-five STDs exist, caused by many different organisms. About 12 million new STD infections occur in the United States each year. Almost 65 percent of all STD infections affect people under the age of twenty-five.
STDs can cause birth defects, blindness, brain damage, cancer, heart disease, infertility, mental retardation, and death. Symptoms of STDs vary according to the virus or bacteria causing the disease and the body system affected. In general, a woman who has an STD may bleed when she is not menstruating. She may also have an abnormal vaginal discharge. In addition, vaginal burning, itching, and odor are common. A man afflicted with an STD may have a discharge from the tip of his penis. Urinating may also cause a painful or burning sensation. Both women and men may develop skin rashes, sores, bumps, or blisters near the mouth, genitals, or anal area.
Perhaps the most deadly and frightening STD is AIDS or acquired immune deficiency syndrome. It is caused by the human immunodeficiency virus or HIV. The virus is transmitted between humans in blood, semen, and vaginal secretions. The two main ways to contract the virus are by sharing a needle with a drug user who is HIV-positive (infected with the virus) or by having unprotected sexual relations with a person who is HIV-positive. (For a more detailed discussion of HIV and AIDS, see chapter 5.)
Other common and potentially serious STDs in the United States include chlamydia, genital herpes, genital warts, gonorrhea, and syphilis.
Chlamydia is the most common STD in the United States. It is caused by a microscopic organism that lives as a parasite in human cells. It is transmitted through vaginal intercourse. A common symptom for both men and women is frequent and painful urination. The disease can be successfully treated with antibiotics.
Genital herpes is an incurable infection caused by a virus that is similar to the one responsible for cold sores. The infection is marked by the formation of fluid-filled, painful blisters in the genital area. The virus stays in the body for life. Over 25 million people in the United States are infected with the disease. It can be transmitted by oral and vaginal intercourse. Drugs are available to lessen symptoms and reduce outbreaks of the disease.
Genital warts, also called venereal warts, are caused by a virus that produces growths (warts) on the skin. In women, the growths occur on the genitals and on the walls of the vagina and cervix. In men, they develop in the urethra and on the shaft of the penis. The disease is transmitted by sexual contact. In addition to the visible warts, bleeding, pain, and odor are common symptoms. No treatment for genital warts is completely effective because it is necessary to destroy the skin infected by the virus.
Gonorrhea, commonly referred to as "the clap," is a highly contagious STD caused by a bacteria. It is transmitted through vaginal and anal intercourse. In men, the disease begins as an infection of the urethra. In women, it will most likely infect the cervix. If left untreated, the disease can travel through the reproductive tract (causing sterility) and spread to the bloodstream, infecting the brains, heart valves, and joints. Symptoms of the disease in women include bleeding between menstrual periods, painful urination, abdominal pain, and a cloudy and yellow vaginal discharge. Symptoms in men include painful and frequent urination and a thick, cloudy discharge from the penis. Gonorrhea is usually treated with a variety of antibiotics, but the bacteria that causes it is developing an increased resistance to routine medications.
Syphilis is an infectious disease caused by a coil-shaped bacterium. Spread by vaginal and anal intercourse, syphilis has been a public health problem since the sixteenth century. It currently affects an estimated 50 million people worldwide. The earliest symptom in both women and men is a chancre sore in the mouth or on the genitals. The fluid in the sore is very infectious. Lymph nodes near the chancre swell in most people afflicted with
the disease. As syphilis progresses, lymph nodes in the armpits, groin, and neck areas may also swell and skin lesions may erupt. If not treated, syphilis may cause damage years later to the heart and blood vessels, lungs, and central nervous system. The disease is usually treated with sufficiently large doses of antibiotics such as penicillin.
Testicular cancer develops when cells in the testes become abnormal and grow uncontrollably, forming tumors. Although a rare type of cancer, it often grows very quickly. It is the most common type of cancer to occur in young males under the age of thirty. The cause of testicular cancer is unknown.
This type of cancer usually shows no early symptoms. A mass in the testes usually indicates testicular cancer, but this may not be true in every case. In advanced stages of the cancer, symptoms include lower back pain, difficulty in urinating, a cough, and breathing problems. Sometimes there is pain in the testes.
William Augustus Hinton (1883–1859), the first African American professor at Harvard Medical School, earned an international reputation as a medical researcher for his work on the detection and treatment of sexually transmitted diseases. He was integral in developing two common diagnostic (identification) procedures for syphilis, the Hinton test and the Davies-Hinton test.
From the time he graduated from Harvard Medical School in 1912 until his retirement, Hinton concentrated his research on the diagnosis and treatment of syphilis. The first diagnostic test for the disease had been developed by German physician August von Wassermann in 1906. However, the test took two days to complete. In 1923, a Russian-American researcher, Reuben Leon Kahn, produced a modified syphilis test that took only a few minutes to complete. However, these blood tests for the disease often resulted in false diagnoses and consequent medical mistreatments.
In 1927, Hinton perfected a syphilis test—subsequently known as the Hinton test—that was simpler, less expensive, and more accurate than the previous procedures. As a result, the Hinton test was adopted as the standard method for diagnosing syphilis. Later, with J. A. V. Davies, Hinton developed an even more accurate diagnostic test, the Davies-Hinton test. In 1936, Hinton wrote Syphilis and Its Treatment , in which he outlined correct procedures for using laboratory tests for syphilis. Although the book at first had little support in the medical community, within twenty years it had become widely accepted and acclaimed.
If testicular cancer is discovered, surgery to remove the mass is the first line of treatment. If the cancer has spread to other parts of the body, chemotherapy (using a combination of drugs to kill any remaining cancer cells and shrink any tumors) or radiation therapy (using X rays or other high-energy rays to kill any remaining cancer cells and shrink any tumors) or a combination of both may be used following surgery.
The cure rate for testicular cancer that has not spread is 95 percent. Since the cancer cannot be prevented, it is important for men to perform regular examinations of their testes in order to detect any mass at an early stage.
Uterine cancer, also called endometrial cancer, develops when cells of the endometrium become abnormal and grow uncontrollably, forming tumors. It is a common type of cancer among women, generally occurring in those women who have gone through menopause and are forty-five years old or older.
The exact cause of uterine cancer is unknown. Medical researchers believe, however, that several factors increase a woman's chance of developing this type of cancer. Among those factors are age, obesity, diabetes, high blood pressure, irregular menstrual periods, family history of uterine cancer, and having a first period at a young age or going through menopause at a late age.
Symptoms of uterine cancer are present at an early stage in the disease. The most common symptom is unusual bleeding or discharge from the vagina. Pain and the presence of a lump or mass in the pelvic region are symptoms that occur late in the disease.
If uterine cancer is discovered, the standard treatments are surgery, radiation therapy, chemotherapy, and hormonal therapy. The type of procedure used depends on the stage of the disease. When the disease is detected early, surgery to remove the uterus is the procedure most often employed. This type of surgery is called a hysterectomy. If the cancer has spread, the ovaries and fallopian tubes are also surgically removed. Radiation therapy (using X rays or other high-energy rays to kill any cancer cells and shrink any tumors) may be used in place of or in addition to surgery. Chemotherapy (using a combination of drugs to kill any cancer cells and shrink any tumors) is usually reserved for women with advanced or recurrent uterine cancer. In hormonal therapy, drugs similar to the hormone progesterone are give to help slow the growth of endometrial cells. Again, this procedure is usually reserved for women with advanced or recurrent uterine cancer.
If uterine cancer is found and treated in its early stages, approximately 96 percent of women so treated survive five years or more. That survival rate falls to 66 percent if the cancer has spread before it is treated. Early detection is extremely important in helping to cure this disease. Controlling obesity, high blood pressure, and diabetes may also help to reduce the risk of developing uterine cancer.
Uterine fibroids, also called myomas, are benign (nonthreatening) growths of the muscle in the uterus. They are not cancerous, nor are they related to cancer. Uterine fibroids are extremely common. They usually develop in women between the ages of thirty and fifty. About 25 percent of the women in this age group have noticeable fibroids.
No one knows exactly what causes fibroids, which grow in three locations: in the uterine cavity, on the wall of the uterus, and on the outside of the uterus. Not all fibroids cause symptoms, but when they do, the symptoms include the following: heavy uterine bleeding, pelvic pressure and pain, and complications during pregnancy.
Even fibroids that do cause symptoms may not require treatment. When the fibroids grow large enough to cause serious problems, surgery may be necessary. The only real cure for fibroids is the surgical removal of the uterus,
a procedure called a hysterectomy. If only the fibroids are removed and the uterus is repaired and left in place, the surgical procedure is called a myomectomy.
Uterine fibroids cannot be prevented. Luckily, many women who have fibroids have either no symptoms or only minor symptoms. Unfortunately, fibroids tend to grow over time, and many women ultimately decide to have some form of treatment.