Endocrine Reproductive System NRSB 311 Review Anatomy and

Endocrine & Reproductive System NRSB 311

Review Anatomy and physiology of the male and female reproductive system Handheld physical assessment book (Barbarito) (pgs 196 -231) Module 4. 4 on Canvas

Endocrine system Hypothalamus Pituitary is divided into the Anterior lobe and Posterior lobe

Endocrine system Anterior Pituitary Hormones (Sustains life) ACTH – adrenocorticotropic hormone FSH – follicle stimulating hormone GH – growth hormone LH – luteinizing hormone PH or PCL – prolactin TSH – thyroid stimulating hormone MSH – melanocyte stimulating hormone –

Endocrine system Posterior Pituitary Hormones ADH (vasopressin)– antidiuretic hormone Promotes Water absorption Oxytocin : Uterine contractions

Female hormones Female reproductive system is driven, controlled and regulated by the pituitary hormones : (FSH ) Follicle stimulating hormone (LH) Luteinizing hormones and Female sex steroid Estrogen and progestin

Female Hormones Estrogens: Responsible for stimulating the development of secondary female sex characteristics – produced by the ovary, regulate the release of FSH +LH for the pituitary gland via negative feedback loop Progesterone : Produced by the corpus luteum, help create optimal conditions for pregnancy or promote the start of menses, inhibit uterine contractions, stimulate growth of alveolar glands in breast. Both play critical role in the fertilization process

Female Hormones What are some hormonal issues and concerns that are specific to females § Fertility § Menopause S/S § Labor induction § Contraception § Uterine bleeding § Osteoporosis

Factors affecting reproductive system BMI – Can affect menstruation (either low or high BMI) (lifestyle questions) Full psychosocial assessment Alcohol, tobacco, or drug use can affect sexual activity (low libido) (higher risk behavior) (also if trying to get pregnant will need to avoid) Fatigue and low libido may be related to poor diet and / or anemia Family history of reproductive problems Occupation can have an impact of teratogenic exposures (ones that may cause birth defect)

Assessment (Female) Menstruation details and include menarche (age menstruation started) Sexual activity Pregnancy (if trying to get pregnant – vitamins such as folic acid) Vaginal discharge, itching, odor, lesions Dysparenia (painful intercourse) or pain in abdomen Breast drainage or masses STI (sexually transmitted infection) exposure BSE

Male Hormones Male reproductive system is driven, controlled and regulated by the pituitary hormones : (FSH ) Follicle stimulating hormone (LH) Luteinizing hormones Male sex steroid testosterone

Male Hormone Androgens (Testosterone) – produced in the testes. Responsible for both primary and secondary sex characteristics: seminal vesicles, penis, scrotum, male hair distribution, laryngeal enlargement and thickening of the vocal cords, body musculature and fat distribution, bone development advanced development of the prostate.

Testosterone Anabolic Activity of testosterone Stimulate muscle tissue and bone growth Inhibit protein breakdown and aide in the retention of nitrogen, phosphorus, potassium and sodium. Stimulate production of red blood cells Anabolic Steroids are synthetic drugs that closely resemble natural testosterone but more potent.

Male Hormones What are some hormonal issues and concerns that are specific to male? BPH Erectile dysfunction Hypogonadism Prostate cancer

Assessment (Male) Circumcision Penile discharge or lesions Sexual activity Exposure to STI’s Pain with urination Pain, swelling or nodules in testicles / scrotum TSE

Physical exam includes external visualization of genitalia looking for nodules, redness, lesions, hair distribution Testes are examined for any nodules or masses that may indicate testicular cancer, hernias, or varicoceles Females may get a pelvic exam by physician or nurse practitioner Rectal exam may be included in exam Abdominal exam important as well

Tests STI testing (urine, blood, or cultures with swabs) Pap test (female pelvic exam for cancer cells) Mammogram Ultrasound of abdomen, testicles or breasts X-ray of the abdomen Colposcopy (biopsy of cells on cervix) Breast biopsy of mass to determine if cancerous Needle aspiration of the male prostate gland Blood tests for hormone levels (progesterone, testosterone, FSH, LH…)

Common problems Masses in breast, reproductive organs, testicles STI’s Pain Prostate cancer Hormonal imbalance Abnormal cervical cells from pap test Missed period (pregnancy or other reasons related to hormones) Menses is 20 -40 days (from 1 st day of period to the next 1 st day of period) Anything out of this range is considered abnormal Hernia’s (male – inguinal hernia would appear as swelling in scrotum)

Common meds – Refer to Lilley book Pages 519 (common terms) Pages 520 -527 (estrogen, progesterone, and contraceptive drugs – specific names not necessary, just a general overview of uses) Pages 540 -543 (just an overview of men’s reproductive health issues / meds)

Nursing interventions Education: STI prevention / signs of infection, TSE / BSE, puberty Assessment to include whole person assessment (see specific focused interview questions in physical assessment book) Pregnancy prevention (oral contraceptives, condoms…) Assess for abuse