1-19 FEMALE REPRODUCTIVE SYSTEM

LEARNING OBJECTIVE: Recall the parts of the female reproductive system and their function(s).

The organs of the female reproductive system are specialized to produce and maintain the female sex cells, or egg cells; to transport these cells to the site of fertilization; to provide an environment for a developing offspring; to move the offspring outside; and to produce female sex hormones. The primary female reproductive organs are the ovaries. The other structures of the female reproductive system are considered accessory reproductive organs. The accessory organs include both internal and external reproductive organs (fig. 1-61).

Figure 1-61.—The female reproductive system.

OVARIES

The ovaries, as stated earlier, are the primary female reproductive organs, producing the female sex cells and sex hormones (fig. 1-61).

Structure

The ovaries, or female gonads, are two almond-shaped glands suspended by ligaments in the upper pelvic cavity. There is one ovary on each side of the uterus. The ligaments that suspend the ovaries contain ovarian blood vessels and nerves.

The tissues of an ovary are divided into two regions, an inner medulla and an outer cortex. The ovarian medulla is largely composed of loose connective tissue, numerous blood vessels, lymph vessels, and nerves. The ovarian cortex is composed of compact tissue containing tiny masses of cells called ovarian (primordial) follicles. The follicles contain the female sex cells or ova. The external surface of the ovary is covered by a layer of cuboidal epithelium cells. Beneath the epithelium is a layer of dense connective tissue.

Primordial Follicle

In the outer region of the ovarian cortex, microscopic groups of cells are referred to as primordial follicles. The primordial follicles consist of a single large cell, called an oocyte, which is surrounded by a layer of flattened epithelial cells called follicular cells. The oocyte is an immature eggcell. Follicular cells surround a developing egg cell and secrete female sex hormones. There are approximately 400,000 primordial follicles at puberty. Of these, probably fewer than 500 will be released from the ovary during the reproductive life of a female.

At puberty, the anterior pituitary gland secretes increased amounts of FSH (follicle-stimulating hormone). In response, the ovaries enlarge and many of the primordial follicles begin to mature. During this maturation process, the oocyte enlarges and the follicle cells multiply until there are 6 to 12 layers. Fluid-filled spaces begin to appear among the follicle cells. These spaces join to form a single cavity called the antrum. Ten to fourteen days after this process begins, the primordial follicle reaches maturity. The mature primordial follicle (preovulatory or graafian follicle) and its fluid-filled cavity bulges outward on the surface of the ovary, like a blister.

Ovulation

Ovulation is the process by which the mature oocyte is released from the primordial follicle (fig. 1-62). Ovulation is stimulated by hormones from the anterior pituitary gland. These hormones cause the mature follicle to swell rapidly and its walls to weaken. Eventually the wall ruptures, permitting the oocyte and 1 or 2 layers of follicle cells to be released from the ovary's surface.

Figure 1-62.—Ovulation process.

After ovulation, the oocyte is usually propelled to the opening of a nearby fallopian tube. If the oocyte is not fertilized by a sperm cell within a relatively short time, it will degenerate.

This process of ovulation occurs once a month. Each ovary normally releases an ovum every 56 days. The right and left ovary alternately discharge an ovum approximately every 28 days. The menstrual cycle in most women is therefore approximately 28 days.

Female Sex Hormones

Female sex hormones are produced by the ovaries and various other tissues, such as the adrenal glands, pituitary gland, and placenta (during pregnancy). These female sex hormones are estrogen and progesterone.

The primary source for estrogen is the ovaries. At puberty, estrogen stimulates enlargement of various accessory organs, which include the vagina, uterus, fallopian tubes, and external structures. Estrogen is also responsible for the development and maintenance of female secondary sexual characteristics. See section titled “Endocrine System” for listing of secondary female sexual characteristics.

The ovaries are also the primary source of progesterone (in a non-pregnant female). This hormone promotes changes that occur in the uterus during the female reproductive cycle. In addition, progesterone stimulates the enlargement of mammary glands and ducts, and increases fat deposits in female breasts during puberty.

INTERNAL ACCESSORY ORGANS

The internal accessory organs of the female reproductive system include a pair of fallopian tubes, the uterus, and the vagina (fig. 1-61).

Fallopian Tubes

The fallopian tubes, also known as uterine tubes, serve as ducts for the ovaries, providing a passageway to the uterus. The fallopian tubes are composed of three tissue layers. These tissue layers include an inner mucosal layer, a middle muscular layer, and an outer serous layer, and they are continuous with the layers of the uterus. The fallopian tubes are in contact with the ovaries but are not continuous with them. Their funnel-shaped openings, called free openings, are fringed with fingerlike processes that pick up an ovum and draw it into the fallopian tubes. Once the ovum enters the fallopian tubes, it is transported to the uterusby peristalsis and gravity. Fertilization of an ovum normally takes place in the fallopian tubes.

Uterus

The function of the uterus is to receive the embryo that results from the fertilization of an egg cell, and to sustain its life during development. The uterus, or womb, is a hollow, pear-shaped organ with thick, muscular walls. The uterus is divided into two main regions, the body and cervix (fig. 1-61). The body of the uterus consists of the upper two-thirds of the uterus. The cervix is the lower one-third portion of the uterus that projects into the upper part of the vagina. The cervical opening into the vagina is called the external os.

The uterine wall is composed of three layers: the endometrium, the myometrium, and the perimetrium. The inner lining consists of specialized epithelium, called endometrium, which undergoes partial destruction approximately every 28 days in the nonpregnant female. The middle layer, the myometrium, consists of bundles of interlaced muscular fibers. The muscular layer produces powerful rhythmic contractions that are important in the expulsion of the fetus at birth. The perimetrium consists of an outer serosal layer that covers the body of the uterus and part of the cervix. The uterus also has three openings: superiorly and laterally, two openings connect the fallopian tubes to the uterus, and inferiorly, an opening leading to the vagina.

Vagina

The vagina is the organ that receives the male sperm during intercourse. It also forms the lower portion of the birth canal, stretching widely during delivery. In addition, it serves as an excretory duct for uterine secretions and menstrual flow.

The vagina is a fibromuscular tube capable ofgreat distention. The canal is approximately 9 cm long and extends from the uterus to the outside. The vaginal orifice is partially closed by a thin membrane of tissue called the hymen. The wall of the vagina consists of three layers. The inner mucosal layer does not have mucous glands; the mucous found in the vagina comes from the glands of the cervix. The middle muscular layer consists mainly of smooth muscles fibers. At the lower end of the vagina is a thin band of smooth muscle that helps close the vaginal opening. The outer fibrous layer consists of dense fibrous connective tissue interlaced with elastic fibers. These fibers attach the vagina to the surrounding organs.

EXTERNAL ACCESSORY ORGANS

Many of the external accessory organs of the female reproductive system are referred to collectively as the vulva. The vulva includes the labia majora, the labia minora, the clitoris, and the vestibular glands (fig. 1-63). The mammary glands are also considered an accessory organ of the female reproductive system.

Figure 1-63.—External reproductive organs.

Labia Majora

The function of the labia maj ora is to enclose and protect the other external reproductive organs. The labia majora are composed of two round folds of fat tissue and a thin layer of smooth muscle, covered by skin. On the outer portion of the labia majora, the skin has numerous hairs, sweat glands, and sebaceous glands. The inner portion of skin is thin and hairless. The labia majora extend from the mons pubis anteriorly to the perineum (the region between the vaginal orifice and the anus). The mons pubis is the pad of fatty tissue beneath the skin, which overlies the symphysis pubis.

Labia Minora

Within the labia majora folds are two smaller folds, called the labia minora. The labia minora extend from the clitoris to either side of the vaginal orifice.

Clitoris

The clitoris is a small projectile at the anterior end of the vulva between the labia minora. It is richly endowed with sensory nerves that are associated with the feeling of pleasure during sexual stimulation.

Vestibule

The vestibule is the area enclosed by the labia minora that includes that vaginal and urethral openings. The vestibule contains a pair of vestibular glands, more commonly known as the Bartholin's glands. The Bartholin's glands lay on each side of the vaginal opening. The ducts of these glands secrete fluid that moistens and lubricates the vestibule.

Mammary Glands

The mammary glands, or breasts, are accessory organs of the female reproductive system. They develop during puberty under the influence of the hormones estrogen and progesterone. The breasts are responsible for the secretion ofmilk (lactation) for the nourishment of newborn infants.

Structurally, the breasts resemble sweat glands. At the center is a nipple containing 15 to 20 depressions into which ducts from the lobes of the gland empty. During pregnancy, placental estrogen and progesterone stimulate further development of the mammary glands in preparation for lactation. After childbirth, hormones secreted by the anterior lobe of the pituitary gland stimulate production for 6 to 9 months.

FEMALE REPRODUCTIVE CYCLE

Females around age 11 begin to experience the female reproductive cycle and continue into middle age, after which it ceases. The female reproductive cycle, or menstrual cycle, is characterized by regular, recurring changes in the uterine lining, resulting in menstrual bleeding (menses). The first phase of the recurring reproductive cycle is menstrual bleeding. Menstrual bleeding begins when the endometrial lining starts to slough off from the walls of the uterus, and it is characterized by bleeding from the vagina. This is day 1 of the cycle, and this phase usually lasts through day 5. The time between the last day of the menses and ovulation is known as the postmenstrual phase. It lasts from day 6 through day 13 or 14 and is characterized by proliferation of endometrial cells in the uterus, which develop under the influence of the hormone estrogen. Ovulation, as discussed earlier in this section, is the rupture of a primordial follicle with the release of a mature ovum into the fallopian tubes. It usually occurs on day 14 or 15 of the cycle. The postovulatory (premenstrual) phase is the time between ovulation and the onset of the menstrual bleeding and normally lasts 14 days. During this phase the ovum travels through the fallopian tubes to the uterus. If the ovum becomes fertilized during this passage, it will become implanted in and nurtured by the newly developed endometrial lining. However, if fertilization does not take place, the lining deteriorates and eventually sloughs off, marking day 1 of the next cycle.