Disorders of the Reproductive Systems

Male Disorders

Prostatitis is acute or chronic inflammation of the prostate gland and is often associated with tenderness and enlargement of the prostate. It is usually caused by bacteria in connection with urinary tract infections or sexually transmitted diseases. It also occurs without a known cause.

Benign prostatic hyperplasia (BPH) is the enlargement of the prostate gland without inflammation, resulting from an increase in the number of glandular cells. It occurs in about 33% of males over 60 years of age and is usually detected by a rectal examination. In some cases, it may restrict the flow of urine and prevent the control of micturition. It could lead to urinary retention and urinary infections, but does not lead to prostate cancer. The cause of BPH is unknown, although it may be related to the changes in the ratio of androgens to estrogens associated with aging. Surgical correction usually is by transurethral resection, a procedure in which an instrument is inserted into the urethra to remove portions of the prostate gland compressing the urethra.

Prostate cancer is the most common cancer and the second leading cause of death from cancer in American males. The cause is unknown, although it is probably related to genetic and hormonal factors. It usually grows slowly and shows no symptoms at its early stage. Males over 40 years of age should have annual prostate examinations.

Testicular cancer is the most common male cancer between 15 and 35 years of age, although it is not generally a common form of cancer. The cause is unknown, although it may be related to cryptorchidism, physical damage, or environmental pollutants. It is one of the most easily detected cancers and has one of the highest cure rates of all the cancers. Monthly testicular self-exams are recommended for men over age 14.

Erectile dysfunction (ED) is the inability to attain and maintain an erection long enough for sexual intercourse. It may result from organic or psychological factors. Treatment is available in most cases.

Infertility is the inability of a male to produce and deposit in the vagina sufficient numbers of viable sperm to bring about fertilization of a secondary oocyte. A low sperm count is a common cause.

Female Disorders

Amenorrhea is the absence of menstruation. Primary amenorrhea is the failure of a woman to begin menstruation, and it is caused by endocrine disorders or abnormal reproductive development. Secondary amenorrhea is the absence of one or more menstrual periods without pregnancy. This may result from excessive physical exertion or excessive weight loss.

Dysmenorrhea refers to painful menstruation that prevents a woman from doing her normal activities for one or more days during the menstruation. Uterine contractions are thought to be responsible for the pain.

Premenstrual syndrome is characterized by severe physical or emotional distress after ovulation and prior to menstruation. The cause is unknown, although it is probably related to ovarian hormone production.

Toxic shock syndrome is characterized by high fever, fatigue, headache, sore throat, vaginal irritation, vomiting, and diarrhea. It results from a toxin produced by a strain of bacteria (Staphylococcus aureus) whose growth is apparently enhanced by the use of highly absorbent tampons.

Endometriosis is the growth of endometrial tissue external to the uterus. The tissue migrates through the uterine tubes into the pelvic cavity. It may cause premenstrual or menstrual pain due to its breakdown during menstruation. Infertility may result from tubal obstruction.

Infertility in females is the inability to conceive. It may be caused by tubal obstruction, hypothalamus, pituitary gland or ovarian diseases, or a lack of maintenance of the endometrium.

Pelvic inflammatory disease (PID) is a collective term referring to any infection of the female reproductive organs and/or other pelvic tissues. The most common pathogens are those of sexually transmitted diseases that migrate into the pelvic cavity via the uterine tubes.

Cancer of the female reproductive system most often occurs as breast cancer or cervical cancer. Breast cancer is the most common cancer and the second leading cause of death from cancer in American females. Although the precise cause is unknown, it is strongly related to genetic factors and estrogens. It rarely occurs before age 30 and is more prevalent after menopause. Monthly breast self-exams over age 20 and yearly mammography screens over age 40 are recommended. Any lump in a breast should be brought to a physician’s attention immediately because breast cancer has a high fatality rate unless it is treated early. Cervical cancer is a rather slow-growing cancer and most of the cases are caused by human papilloma viruses (HPV). Two newly developed vaccines, Cervarix and Gardasil, are available for preventing the types of HPV that cause most of the cervical cancer. These vaccines are recommended for females and males at ages 11 to 26 and ages 11 to 21, respectively. Annual Pap smear exams, the common test for detecting early cervical cancer, are recommended for females over age 21.

Sexually Transmitted Diseases (Stds)

Acquired immunodeficiency syndrome (AIDS) results from infection with the human immunodeficiency virus (HIV), which attacks a group of lymphocytes known as helper T (T_H) cells. HIV is transmitted via sexual intercourse and by blood transfer, including through infected needles shared by drug users. Also, it may be passed from an infected mother to her developing fetus. It is not transmitted by casual contact.

Gonorrhea is caused by the bacterium Neisseria gonorrhoeae. In males, it infects the urethra, causing painful urethritis. In females, it infects the vagina and may spread to the urethra, uterus, uterine tubes, and pelvic cavity. Females may not experience symptoms until advanced stages. Gonorrhea is a major cause of female sterility due to damage to the uterine tubes, and it can cause blindness in newborn babies. Antibiotics usually provide effective treatment. Most newborn infants born in hospitals receive eyedrops of antibiotics at birth to protect against possible gonorrhea infection.

Syphilis is caused by the bacterium Treponema pallidum. Without treatment, syphilis progresses through several recognizable stages. The first stage is characterized by an open sore, a chancre (shang’-ker), at the site of entrance by the bacterium. It may not be readily noticed, especially in females. The chancre heals within one to five weeks.

Several weeks later, the second stage appears as muscle and joint pain, fever, and skin rash; it persists from four to eight weeks. Then, the disease enters a latent period of variable length. When the bacterium begins to destroy organs, such as the brain and liver, the third stage is recognized. Treatment with antibiotics is effective prior to the third stage.

Chlamydia (klah-mid’-e-ah) is caused by the bacterium Chlamydia trachomatis, and it infects nearly 5 million people each year. In males, it causes painful urethritis. In females, it may spread throughout the reproductive tract, causing damage to uterine tubes that can lead to sterility. Chlamydia may also be transmitted from an infected mother to her infant during childbirth when the bacterium enters the infant’s eyes. Antibiotics are an effective treatment.

Genital herpes is caused by the herpes simplex virus type 2. This disorder is characterized by painful blisters on the reproductive organs and may be accompanied by fever or flulike symptoms. It may be transmitted from an infected mother to her infant during delivery. In the newborn, it may cause only mild discomfort, serious neural damage, or death. Treatment with the drug acyclovir inhibits viral replication but does not eliminate the virus. The virus remains in the body and intermittently produces the genital blisters.

Genital warts are caused by HPV. About 1 million new cases occur each year. Patients with genital warts may have an increased risk of certain cancers of the reproductive organs. Although there is no treatment that eliminates the virus, the warts can be removed by electrocautery (burning), cryosurgery (freezing), or laser surgery. Two newly developed vaccines, Cervarix and Gardasil, are available for preventing the types of HPV that cause most of the genital warts.