Moternal& ChildHeolth Nursing:

CEU-Makati Reprodudiveand SexuolHeolth

Nursing

v.esdirecl personol core to mqternil

Invdlv.es moternity
clientsond lhqir newborn infqnls or lo relqled
ociivilies on thei)nQeholfduring the vqrious
'Rgview of the
phosesof ihe childbegringexperience. Anotorhy.$ Physiology
of'rhg
Objeclive ol Mcilernlly t'tuninq Reproductivd'system
\\\\\.
To ensurethot every expeclcint,nursing
mother moinlqinsgood heolth,leoms-thech
normol delivery,qnd beors
ccrre,hcrs.cr
children.

wtqleReproductive
System \
MdQExternolStructures
1. Penis \1
- the orgoirgf copulotion;o cylindricolshoftconsisling
nt.

o. Two loterol'betumnsof erectiletissue{corporo

covernoso, ):.-
Sffii.pubb
/--
b. A column of ereclite..fissueon the undersideof me
penis/corpusspongio\m/ ihot encosesihe
.- &r&! cawnogh
urelhro. t"
&pa.F^gb5u6
-_f
c. the glonspenis,o cone-shcilqd exponsionof ihe
corpusspongiosumthol ishighllqensitiveio sexuol
stimulus. \r //
d. the prepuce or fore skin.o skinflop
the glonspenisin uncircumcisedmole.

2. Scrolum
- o pouch honging below the
penisthol contoinslhe tesles,
\ epididymis,ond the lower
\ poriion of the spermoiic
the mediol seotum
ihe scrotuminto two
socs,eobh of which conloins
o lestis.
Mete InternolStructures
.a.___
l. Tesfis 't..
- two solidovdN,orgons4-5cm long, divided into
lobes. Eoch festlsQcomposed of o number of
lobules,eoch conicjini,nginterstifiotceils{Leydig's
cells)ond o seminiferorRtubule.
- functionsof ihe lestistherdfqreinclude hormone
production (tesiosferone)ondrqermotogenesis.
 Maternol & ChildHeolth Nursing:
CEU-Makati Reproductiveond SexuolHeolth

2. EpidldyniK..
- o tubulorsbqlocoied
next to eoch feqtisthot
servesos reservohfer
spermsloroge ond \

- ii h opproximotely20 ft, 4. EjoculoloryDucl

ond it tokes l2-20 doys '..
- ihe conol formed by the union\lhe vos deferens
for the sperm1olrovel
ond the excreloryducl of the sem)nglvesicle,which
the lengfh of epididymis.
enten the urethrool the Orortot" n'ohd,,,.,rr

Accessory
Orgons
l. SemindLVesicles
5. Urelhro - ore two\sonvoluted
- lhe possogewoyfor pouches lh)r{ lie olono *
bolh urineond semen, lhe tower pori)bq of tnie E
, extendingftom the posteriorsurfoceiX,ttre j!
.'. blodder to the urethrol blodder ond empty irrtq S
\\.. meolus. the urelhro by woy of \ fl ' '
:rit isopproximotely8 in the ejoculoforyducls.
(l&2Ocml lono. - theseglondssecrele o
viscousportion of the
\ semen,which hos c
high content of o bosic
sugor,protein ond
prosloglondinsond is
olkoline.

4. Semehor Semlnol fluid

- is o thi\/hifish ftuid ejocutoted by lhe mote during
orgosm. cbqloins spermolozoo ond fruciose-rich
nutrients.
-t
- semenisderived'fro.1n the prostoteglond (60%),ihe
seminolvesicles(30%),.iheepididymis(S%),ond the
bulbourethrolglonds {5x1,
- lhe normolvolume of semd\s 2 to 5 ml, eoch ml
conioining obout l@ millionspegmcells. A sperm
count below 20 millionisconsideibdobnormot_
- the semen (spermcells)con livewiih'leihe femole
g e n i t o l t r o c t f o r o b o u i 2 4 l7
o 2 h o u r s . '. . \ , r /

/\-
,/
/\
 Motemal & Childtteslth Nursing:
CEU-Makati Reproductiveand SexuolHeolth
'*
\
lh
FeqnoleRepro'ductive
System
The
Vulva

:-0t'lsbr
- ii is covered by curly hoir, lrdlhdrd- i-lwtF
:- Y{ir
(hokpotterniscolled Y--
ercuicheon), ofler
puberty. Thehoir potlern
in femole istriongulor
with bose uo, ond in
mole, diomond-shooed.
I
tir

2. LoblolAojoro
- longitudinolfoldsof -'r. Cliloris
pigmented skin l. olons i'Fe{s
extendingfrom the mons - erectiletislue locoted ol
pubisto the perineum. the upper endqf lobio
- contoinsthe Boriholin's mtnoro. -.t'
\ glond thot secreleso - it isthe primorysiteoF..
\. yellowishmucusthot ocls sexuolorousol. '.'.
bqo lubricontduring - the clilorisisusedos o
sexboloctivity. guide in femole
.-.{m cotheterizotion.
i 3. l.obio
- sofi longiiudihql skin
between the
mojoro.

h.Jrefhroll eolus
:\oll opening befween
The
Vulva 5. Voginol Veslibule thbqlitorisond voginol
orifice$o,rthe purpose of The
VulYa
- o norow spoce seen
when lobio minoroore urinotion.\. lh6lFrill
8. Voglnol ortffcb'/.i4toiius/
seporoted. lt contoinslhe
voginol introitus,Bortholin' opening \' r,i#::
ond Skene'sglond,ond - extemol opening ol*!e liH$!'- *,n*
. vogino thot conloinsihe, ;';{#-ffi
ogitro. *.-1i3,-1:-6**
-rr., urethrolmeotus. -
hymen. \. . oi*m-
trfid"dild---3#"f- hslF
6. fos\ttoviculoris 9. Hymen Fdtdde . -
- o membronoustissue -l-E--n!n
- refers'*gthe spoce lstlafi l:1, ,'
ringingthe voginol
ond vogir
usuollyob
childbirth.
fourchetle
tus. inlroitus.
l0.Pefineum
- tissuebeiween lhe onus
r
lr
ond vogino. Thesile of il; \..
episiolomy. ,/

Marlon Bernardo,RN
 Maternot & chitd Heolth Nursing:
CEU-Makati Reproductiveond SexualHeolth

Skene'sGlond! (PorcurelhrotGlonds)
Skene'sglondsore locoted just loterol to the
meotus,one on eoch side,
12,Borfholin'sElgnds(VulvovoglnolGtonds)
- locoted justlot)rol to lhe voginol opening on bolh
t'l
sides.
* Secrefionsfrom bolh \fhe5eglondshetp
to lubdcale
fhe exfernorgenitolio durinqcoifus. Ihe otkofinepH
of fheiisecrefion helps fo irnprqve spermsuwivol in
the vogino. "\
I 3. Fourchelle
- isthe ridge of tissueformed by the
of the two lobio minoroond ihe lobio moioro.tr(is is
somelimescut during childbirth. ,r' \
.:. Yqe exlernolgeniiolio'sblood supplyismoinV
from ihe pudendal aiqy ond o portiori of
the infedorrecfur orlery. Relurnis through pudendol
vein whictrlvhen
whicllwhen impeded
imDeded bybv the pressure
oressrrreof the
fha
fetol heod dixing childbirfh,con produce
voricosities.On\e otherhond, thisrich blood supply
isodvontogeousfo)-tfe fosterheoling of lesions
coused by troumo during childbirihl
* Nervesupplyof lhe onterior comes moinly
from the lllo-inguinol ond genllo
leve[, while the pudendo, aerves{S3'teyel}moinly
supplythe posteriorportion. Thisisthe rd'cqonwhy
one type of onesthesioused for childbirthii
pudendorblock

IntemolStructures &frhq.*.r.rbtLix{$b

lnternal
Sexual
I Heproductive
2. Uterus
l. Vqginol 0tgans{F) - o hollowpeor-shoped
- 3.4in
3.4in long)Qllotobte
I
muscurororgon.
conol betwee\he - size:3 in. long. 2 in. wide,
blodderond thelectum. ond I in. ihick
- conloinsrugoe thoi\
permilsshetchingwithcii*tr \. - weigth: 50 gms in non-
teoring. \. pregnonl
:'qorts:fundus,corpus,ond
- funclionsinclude: cdrv.t
possogewoyfor
- positioR;.onteverled
menslruoldischorges, - loyers:pdriqretrium,
receivespenisduring mvometrium','.ond
intercourse,ond serves
endomelrium
os ihe birih conol.

Itsbq!'dinolfunciion isos on orgon of reproduction.

- Orgohqf menslruotion Loyers'btrfheuferus:
- Ulerinecbqtroction - io expel the felus during lobor o. perimeiltqm- the outermostserosolloyerottoched
ond to seol tom blood vesselsofter deliveryof to the brooflligoments
plocento.
\ b. illyomefrium- inq mUOtemusculorloyerresponsible
Theporfs of the cervx ole1 for ulerinecontroiliqns during lobor.
a. lnfernolos - opens io corilup c. Endomehlum- lhe innbrryrost cilioled mucosotloyer
contoiningnumerousuterihqglondsfhot secreleso
b.Cervlcolconol-ospindle -\ ihin olkolinefluid to keep theb grine coviliy moisl.
shoped
shdoed oreo
ored which
which is
i< ocftiolly
anllrnllrr \.
\
Thisloyer undergo chonges in reipgnse to the
oconiinuotionofthe \ /ft'H hormoneof voriousphosesof menslftr-ol
trionguloruterinecovity cycle ond
during pregnoncy.
locoted between the internol
ond exlernolos.
c. Exlernolos - opens lo vogino

Marlon Bernardo,RN
 Moternzl & ChildHeolth Nursing:
CEU-Makati Reproductiveond SexuolHeolth

Ugomenis:
onsvetse-ceMcot/Mockenrodf ligomenf s
- ihe portion of the brood ligomenis. lt is the d. AnLiorligoments
morn of lhe uterus. Domoge io this - providqssupportto ihe uterusin connection Wlh
the bloddgr. Over slretchingof thisligomentwill
ligomeni to ligoment prolopse. leod to hentie{ionof lhe blodder to ihe vogino.
o condition colfqd cystocere.
Ligomenls , \..
- originolesfrom the the corpus ond extends e. Posleriorllgomenls'\-
to fhe loierol pelvic wolls, ihe sides of lhe - thisligomentsformsthe cDt-Qe-socof Dougtos.
uterusond ossists in holding tn Domoge to ihisligomenlswihtAodto herniolion
onteversion. of rectum to the vogino, o cond*ion colled
recfocele. \
c. Roundligomenls
- connecis uterusto the lobio mojoro. Gives*Sb'flfi
io ihe uterus. /,t'\,

2. FollopionTubeslOvlducls '\..
- 4 incheslong from eoch 3. ovodes ta.
sidesof lhe fundus.
- femole sexghnds
- Funcfions:tronsport locoted on eoch'siQeof
ovum from ovory to the the uterus. \r.
\, uteru,ihe siteof - functionsinclude '...
'..fertilizotion.ond provides oogenesis,ovulotion,
n'ou,rishment io lhe ovum ond hormone
durin'g(lsjoumey. production.
- Porfs:islhgrus,ompullo,
ondinfun\m ,

Structures
b. Sbqum -wedge-shoped, forinsthe bock port
The Pelvis-'\- of fhq pelvis;consistsof 5 fused vertebroe.
- iso bonyhqg locoted in lowerportion of the c. Coccyx\owest porl of the spine;mode up of
lrunk. \. 4 rudimedtqryvertebreoe.
\r
Sfrucfures: \,
Atticulotion:pelvic bonbs ore held iogether by 4
o. 2 innominote bones vlhich rbmode up of: joints:
lleum- upper extendedlqrt; curve upper o. syrnohyslb oubis- joinsih'b,{ pubistogether
border is the ilioc crest;on-leiorsuperiorilioc b. 2 socroilioc joinfs - join the ibc.rum ond the ilio
spinesore importont \\\.
c. socrococcvoeo/jorirf- joinsthi'socrum ond
,schium- under port; when siiiingihq bone \\\
thecoccyx.
reslson ihe ischioliuberosilies;ischicil-spines
ore imporiont. \_
Pubr3- front porl

Marlon Bernardo,RN
 Moternol & ChildHealth Nursing:
CEU-Makati Reproductiveond SexualHealth

Exlemo/S*{uclures:
o. Nipole o)r\4ommoryPoo,rloe- locoted ol the center of
{rrnudn lhe onteridn{urfoceof och breost. lt hos 15-20
IltiI
opening condegted lo locliferousducts ond in which
uiI milkflowsout. \.
b. Areoro- the pigmentdq.skinlhol sunoundsthe nipple.
Bothnipple ond oreolohqve pigmenled ond
wrinkledskin.
muscles,between the c. MontaomeNt ubercles-glonds'h\theoreolo thot
second hond ond sixth secreteon oilysubsionceihot keeBsthe oreolo ond
ribs. nipple lubricoted. -\\\
O Thebreoslore supported
by ihe Cowper's '
ligoments.

lnfernoiS*ruclures:
o. lobes -'fs.lo 20 lobesore found in eoch breostthot Hormoneslhol/nfluencethe Mommary Glonds
ore divideb.inloseverollobules. o. Fslrooen- i"tiqrulolesdevelopmenl of the ductile
b. Lobures- compoqed of clustersof ocini cells structuresof\e breost
c. Acini ce/ls- milksebr€iingcellsthol isstimulotedby b. Progresferone - stiixlloies the developmenl of the
proloclin \
d. Locfiferousducfs - ducls\i serveos possogewoyof - promolesbreosl
milk -.r developmenl during
e. Loclferoussinus- diloted porticihpf the ducts locoied
behind the nipple thot serveos res\>r of milk.
\r-
,/t
\ .,"

ond FemoleReproductive

Neuro\docrinology of
*.0,"{:1""

MarlonBernardo,
RN
 Maternol & ChildHeolth Nursing:
CEU-Makati Reproductiveand SexuolHeslth

*.*r.-1r::]ffi
,rrr. +f_*,***
*o"ol I
L_bc-**'
Howj'i\ *,"*-"1
ta
a-
spermotozoJ-.. _L6

. ..!

produced? <1.-._ rhF!(5

'il(enstruotion
Considerotions
\\\\\
o Eoch contoins 300,000+ 400,000
- Monlhtydischor.qeof immolure ihol were formed during
blood from the utbqs the first5 of intrauierinelife,
occuning from pubeily,. however, mony degenerotesond
to menopousewherein - by 7 yeon of oge;
obout3G60cc of
holf remoinsin eoch
blood, epitheliotcelts ovory. By oge 22, only third cqn be
ond mucusore being found. Only 300-400 moture during
dischorged. the enfire reproduclive cycle o womon.

o li isinitiotedby menorche qnd ends

menopouse.

period lostgfrom 3- 5 dovs.

structures
involved:
-\''*qo,
o Mensfiwl cycle loslsfrom 2335 doys. hypothoJomus, onlerior
Averoge:"?gdoy cycle.
gilyjtqry0le1d.ovories.
,g
"a, ond ulerus. \\\\\\.
o Associoted lerm\.,.
Amenonhea - morkb-elydiminished
menslruolflow .,., o Hormonesinvolved;-'\..
follicle stimuloling "',..@
Menorrhoqio- excessiveb'le.edinodurino
regulormenstruqtion -
". \
Polvmenanhea - frequentmensti
occuning of inlervolsof lesslhon 3
Dysmenonheo- poinful

MarlonBernardo,
RN
 Maternal & ChildHealth Nursing:
CEU-Makati Reproductiveand SexuolHealth

Eshqgen Ef\fsof Eslrogen:

\ o Inhibiilollicle sllmuloiing hormone.
- Theso c\led "Hormoneof Women",which o Stimuldlet deposition of fot in subcutoneous
isproduced.QyGrqofionlollicle. tissuestho{lives o femole shoDe ond
developmenlo(secondory sexuolchorocleristics
\ in femole (breost'dqvelopmenl. foi deposiiion
- lt is metqbotized bxthe liver ond excreled thol gives o womon\eody femole shopel
in lhe urine. \" o Stimulotesgrowth of vog'ing ond uterus,ond lhe
lhickening of lhe endometrii_x{r.
o Cousesmucus to be thin, lronsd'or.ent,
- Thereore lhree kindsof esliogen: estrone stretchoble.
ond highly
(El), eslrodiol(E2).ond esrriot(EBl.
o Slimuloteslhe grovylhof ductile slructuiesof the
breosls, "r....
o Menorcheond menstruolion. ...
o Premenslruolwolerrefention.

),bqr,"ron'
fs of Progeslerone..
o Thehnogenic effecl.
- Theso-c\s{ed o Reloxealjerinemuscles
"Hormoneis{ o Promotesglqryth of the ocini cellsof lhe breosls.
Mother". '\
o Cousesfluid retbniionthot resullin weight goin.
\ o lslhrough to be the"eguseof premensiruol
- Producedby corpus\.. Syndrome(PMS).
luleum. \.
o Cousessecreiorychonges")n.lheendomelriumin
preporolion for implontciion.-.1
o Couseslinglingsensotionond fee}ng of fullnessin
the breostbefore menslruotion. -\\\

lirtenorche
\
o Menorbtl,srsfers lo the very firstmenslruolion,
on event ihgt signifiesthe end of puberty ond
the beginninilqf the reproductiveyeorsof o
womon, \ hypotholomus lolqduce follictestimutoting
o Theoveroge oge oiV6icn menorche occurs
is 12to 13yeon, but the\set of menstruotion
moy occur onytime betwei}q.9to I Z yeorsold
depending on nutrition,heredhyoroceond
climole.
o Thefirslmenstruolcyclesore usuolly
onovulotory,poinlessond inegulor.
MenstruolCycle
l. On the thkd'<{oyof ihe mensiruolcycle, serum
esirogenlevelllqt loweslwhich stimulolesthe
hormone releosingfo-etor(FSHRF).
2. FSHRF isresponsibleforslimu'totingthe onterior
piiuiforyglond (ApG)io produle foilictestimutoting
hormone (FSH)which will oct on
oocyle insideo primordiolfollicle,stimblQting
its
growth.

MarlonBernardo,
RN

I

CEU-Makati
3. lh{ew of the FSH,eslrogen is now going to be
in on increosingomount insidethe follicle.
which is\und in the ovory. Once eslrogenis
presenl, thb.Brimordiol follicle is now termed
GroofionfotlblsJcFr. TheGFisthe structure
thereforethoicohteins high omountsof estrogen.
4. Estrogenin the GFwill cbtrseihe cellsin lhe uteruslo
proliferote(grow ropidly),in'creosingitsthicknessto
obout eight fold. Thisiscolled ihg protiferotivel
Folliculorphose '\
8. O\ce ovulofionhos token ploce, the GFwhich
conloinsincreosedomount of progesleronewill tum
to CORP{SIUTEUM, which isyeilowin oppeoronce.
9. Progesteronebquses the glond of lhe ulerine
endolheliumlo bbqome corkscrewortwisted in
oppeoronce. Thisislhe formone of pregnoncy
becouse it preventsuleifirgcontrociions. Once ihe
fertilizedovum develdped hnger{ikeprojections
OROPHOBTAST) oround the bl*locyst, lhese
trophoblosisore the onesihot wilDrqplonthigh on
lhe onterioror posleriorsurfoceof
IITIPtANTATION olsocotted NtDAT'ON,
ploce obout o week ofler fertllizotion.
,. Phosesof MenstruolCycle
-ir'trir-;i
*,*l
R:ii..*rl
nr'wPbdi.
thnrcfii!(:
Flr*
35*
MarlonBernardo,
RN
Msternol& ChildHealth Nursing:
Reprodudiveond SexuolHeolth
S. bn.fne l3rhdoy of the menstruolcycte, ihere isnow
o vely_lowlevel ot progesleronein the blood. This
stimuloQhe hypotholomusto produce Luleinilng
Hormoneri\sing foctor (LHRF).
6. LHRFisresponsibldfgrstimulotingthe onteriorpituitory
glond to produce Luteipilng Hormone{LH).
.\
7. TheLHin turn,isresponsiblefogstimulotingthe ovory
to produce progesterone.Thdingreosedomountsof
both esirogenond progesteroneilqsh lhe new
molure ovum io ihe surfoceof the oiory untilthe
followingdoy (l4rh),the GFrupturesond\eoses
moture ovum.
.\\
\.
rMPelqANr:
> Despitri:'the
voriobilityof o womon's cycle (2325
doys),ovul'dtionoccurs exocfly 2 weeksbefore lhe
next menslruolion.ThefirstI 4 doys of lhe cycle is
vorioble.Thus,ov\otion occun not on the l4h doy
of the cycle, but I 4 doys priorto the firstdoy of the
next menslruolcycle, un\s o pregnoncy occurs.
F Firstdoy of the cycle isthe finilqy of menstruotion,
ond one menstruolcycle isfrom the.Jirsidoy of the
menstruolperioduntilthe firstdoy of ihqnext cycle.
-\/
t-,.
,t"
t$tgrineCycle:
l. Prqliferotive
Phose
- lmmedid{glyoflero menstruolflow(first4 orS doys of
the cycle),-fte endomentriumisvery lhin. As ihe'
ovory beginstbproduce estrogen,the endometrium
beginsto prolifercitq.Thisincreosesihe thicknessof
lhe endomelriumoplrgximoiely eighlfotd.
Ihis holf of the menslruotcltq (opproximotelydoy $
I4) istermed interchongeoblylhe esirogenic,
folliculor,or postmenstruolphqse.
Underlhe influenceof estrogen.the geniioJtroci
prepored forsperm migrolion:cervicol
becomes obundoni, ihin ond wotery to foc.fildte.lhe
joumeyofspermotozootoiheuterus.,r/ t
.
10
 Maternal & ChildHeslth Nursing:
CEU-Makati Reproductiveqnd SexuolHealth

2. SegretoryPhose 3.'.lschemic
Phose
- tf feihfiaotiondoes not occur. ihe corpusluteum in the
After oiUlgfion, lhe formofionof progesteronein the
ovory bdgi5rslo regressofier 8 to l0 doys. As it
couseslhe glondsof the uterine regresses, thqproduction of estrogenond
progesteronedagreoses.
\
- Withthe withdrowoloTprogesleronestimulofion,ihe
omounl untilthe lining
endometriumof the uterts,beginsio degenerote
rich,spongyvelvet. (opproximolelydoy 24 or 29ie(the cycle. The
copillcriesrupture,wilh minvte hqmonhoges,gnd the
endomelriumsloughsoff. \.

Progesteronewithdrowqlresultsin formolionond
releoseof prostoglondinsond possiblyof enlogrSin-
I which cousesorteriorolsposmsond contrgCiidrr.of i
myometrium.

4)v\4enstruol
FlowPhose \orion
''.., Cycle: ;:_ii ::::
#lli;::! x..#lni1*."_
- Themehs(uol flow or mensesinclude blood from ihe r Folici,Nh:::_ lw l'"'""
rupturedcdpillories;mucin from the glonds;
frogmenlsof eihQomelrioltissue;ond the
- PrimohdPrimor- $::;f
microscopic,otro\ed, ond unfertilizedovum. diolFotticte. r*-m
diolFottibq, **--4fr Ii .mrqro'
- Growing Follie[e :ii'---W |
- Mensfruolflowcontoinsfuy opproximoiely3G80cc - c,.oqrro"n
n;iiilrb.firX.- 1;1*ffi,"
of blood. -..r \ffTm I
ovulotion ,r{iffi#
- A womon lossesopproximotelyI l-fng of iron during
thisphose. w
I
I
\.- LuteolPhose l- '
- Corpus Luleum l .-lT:l,ilT,*
rh__:_drt/
-r\

eqoofionFo/Ible
N{olliculor Phose
- The\m groofion follicleisderived from the nome of
Regnerdq Groof, the Dufch onolomisiwho first
describedit iQ1672.
Primordiol ore the irnmolurefolliclesinsioe \
the ovory thot Itoin immotureovo. - Atler puberty,sele(ol folliclesbegin to develop under
fhe influenceof FSH.\
\. \
- Everymensfruolcycle, of thesefollicles
develop under the of FSH. - Fromthe numerousfolliclei"t\ot showsignsof
development,only one will be\osen tb reoch fult
GrowingFolllrcte -t motudly ond releoselhg ovum.
r
\.
- Sfillunder the influene of FSH,the - Thegroofion fotlicleisdescribedos o bliiler like
fo grow, opproximotelyon doys 5-6 of the slructureborely visibleto the noked eye.
menstruolcycle. . develops,it produce lorge omountsof

CEU-Makati
2. lotion
- Al midpoin(of ihe cycle. lhe very high estrogentevel
orrd very low irqrgesieronelevel triggersthe releoseof
luieinizinghormohq(LH).
- LHislhe hormonethoilromoies ovulotion. The
exposedareo of the Grooftonfolliclewhich protrudes
ol the ovorionsurfocegroducillathins,coupled by
pressureof lhe folliculorfluidwithhr;..the
Groofionfollicle
finollyrupturesreleosingthe ovum, tir)a_tolliculor
fluid
ond o considergblenumber of gronuloib.e..ells.
lrrqeosed bosol body temperoture- the surgeof
prouEsleroneofter ovulotionresultsin increosed
restingbedy temperolure. Thisisso becouse
progesterbnghos thermogeniceffect.
Peokblood level\luteinizing hormone- there ore
urinetestsnow thotbOuld determinethe level of LH
ond thuspredicl when\yv-omon isovuloting.
- Thefirstholf ot tne cycte extehUsfrom lhe fiat doy of
menstruotionuntilovulotion,il cciVqnthe proliferotive
phose. '\..
- Thesecond holf exlendsfrom ovulolion
ovulotionto\hg
to\l-re doy
aav .-
,r/
before menstruolion,covgring the secretoryphope-
ond ischemicphoses. ,.-\
teol Phose
- TheGroo'fio5r Follicleconlinue lo proliferoteond
enlorgeuntifi{becomes o dense mossof cellsobout
'lto
3 mm in dioineter lhot produce o yellowishfluid
colled lutein. Luteih.fi.lls
ihe spoce thotwos once
occupied by the ovur\iving it o yellowishcolorotion.
Thisiswhy the follicleistefu1edCorpusLuteumofier
ovulotion,which meonsyellci\body.
- *rer :tr:fitrtr rcrge ornount of prc!;esterone ond
lOrre esi:r.Dger-
Marlon Bemardo, RN
Moternal & Child Heolth Nursing:
Reproductive ond Sexual Heolth
- Chqngesoccuring in o womon's body in relolionto
her tnerslruolcycle:
-'\
Mittelschmbrq-the lower obdominol poin felt ot the
sideof the ovo'ty\thotreleosedthe ovum.
\
Spinnborkheit- signo'b.thotthe womon isneoring
ovulolion or isovuloting.)sqtdoes not indicote the
exoci time of ovulolion. '\...
- Thissignischorbc.terizedby cervicol
mucoso thoi isihin, wolery or lron$greni, obundont
ond highlystretchoble. \,
- Whendried ond viewed\nder lhe
microscope,the mucusreveolso fern potteirL.The
pollem isdue io the elevoted levelsof sodiumb.lft
- Thefirs'itolf iso vorioble period while ihe second holf is
o fixed pdriod becouse I 4 doys ofter ovulolion,
menstruoiior}\ill occur. In prolonged cycles,if is
olwoysihe prollffsrotiveor the firstholf of the cycle thol
isexiended.
"a
- Tocompule for the dote df.gvulotion,count bock l4
doys from the firstdoy of merisi(uoiionor subtroct l4
from the totol number of doys thbt compose o
menstruolcycle. '....
thq.corpusluteumhos o tifesponof Z io I doys.
lf feXi(zoiiondo not toke ploce withinihisperiod. it
willotrdp[yin i0- l2 doysond stopproducing
progester\
- Complete regreiir:o{rof the corpustuieum occur
before mensiruqtion,\.lqteriiWll be seenos o whiie
fibrouslissue,colled co'ipqsolbiconsond corpus
olbicontio. '-\r.
- lt fertilizoiiontokesploce, the hurir\spchorionic
gonodolropin produced by the troph)eblostcellsof
the lygote will prolonglhe life of ihe cobvs luleum for
ii lo continue producing progesieroneunfillueh time,
when the plocenio is moture enough to ioke d!94h
function of producing progeslerone. ,z'
".,.
 Mqternol & Child Heolth Nursing:
CEU-Makati . Reprodudive ond Sexuol Heolth

truolProblems b.-.t€condory d)6meno.rheo - hos on undslying dlFose condilion

inflommotory dismse {PlD}
ii. Fnqomefrlcis - prolifsotion of endomelriollisues oulside
l. Dysmenorihqo - poinlul mensiruotion. the Oierus such os the ovories, inieslines ond ligomenls.
o. fnmoy ay\nonheq - no known or idenlified couse iii. Ademyc}rs - ulerine mcs
l. Dbcomfort bbgins I - 2 doys befoe onset of menses iv. Uierineprolfupe
ihen sub6ldesbhhe second doy. v. Utsine myomos'oodpolyps
ii. Oiher symploms inihsqe: noueo. vomiting, dionheo, tnteNentioft Primory mondgrqmenl is lo treol lhe couse.
'\
syncope, leg poin
Inferuenlions: 2. Amenffhe - obsence of meros).f$oy be due lo pregnancy,
loctotion, obnmolity of the endociiqe syslem, ropid welght
- lmmediole eliet's by sdotives bnQ norcotic: lo$, onorexio nervoF d slrenous <i6tvilies, Trtrfment is
ibuprcfen {Mofrin), mefenomic ocid'fp.onsion), occtrding lothe couse. \
noproxensodium
(Anofiox). 3. Oligomentrheo- deseosed menlruolflow. '..''
-a,, \/\./

4. Mqntrhogio - h6vy ond prolonged mens. Mqy be due to

endq{ne imbolonc, infectbn ond utsine fumoB. Mqnopouse
5. MeAoarhogib\ d€ding in between menses, Frequenlly cou€d \
by on underlyiigtdiffise proces. - Refersto ilibt time in o womon's life when she
undergoeso lrbesilionfrom ihe reproduclivesioge
6. Polymenonheo - bledlnq ot frequenl infwols. Frequenfly due to the non-reprodUqtivestoge.
lo o direose process. '..
\.-\\ \
- lt generollyoccun betwbqn the oges of 45 lo 55 or o
\ lime eorlierin somewomen.\t thistime fertility
'" decreosesond menstruotionb'6qomesinegulor,
\\,\\\\\ coused by very few folliclesleft in ihe ovory os most
of lhem ore olreody spentin fhe prev'ibusmeniruol
cycleS.

:deoch how fo monoge hof flushes:

Sigqrs
ond Sympfomsof Menopouse..

o. Hot\hes > Drbslin the loyerlook,remove ouler clothing during

ottoc\
b. Lossof brebel.mossond firmness,cnd olrophy of .
reproductivedrgons. F Avoid hot eirvironment.
\..
\ > Avoid getiing exci{bQ.ond emotionolslress.
c. Dysporeuniodue todqcrecsed voginol lubricolion.
\
d. Musculoskeleiol
symptom)'1 F Avoid foods thot could tri(1gerhot flushes:spicy
foods, coffee, teo ond olcohbL\
e. Mood instobility,lossof sexuoldeile. depression
ond onxietydue io fluctuoling hormdnq.levels. F Usbcooling lechniques:fons,showbrs,icecubes

> Keep o diory to monitorhol flusheso""ufuqO fry

ovoid precipitotingsituotionin the fulure.

F Supplementsof vitomin B ond E. ,r' '-'

MarlonBernardo,
RN r.3
 Moternal & ChildHeolth Nursing:
CEU-Makati Reprodudiveand SexuolHeolth

Fncourogelhe women to engoge in regulor

exprciseregimenlo mointginmuscletone but ovoid
iodmqch weight lifiingto preveni ftoctures.
! Emhosizelhq.importonceof odequole intoke of
colcuim ond \4{ominD to preveni osleoporosis- rich
in milk. 'a...
> lnslructon proper usehqoler solublevoginol
lubriconifor poinfvl interco\
) ProvideemotionglsuBporfond
understonding
}' Referfor counsellingos lhe need orise.
-'
> lnstructtoovoid smokingond olcohol. ,/
FlueonSexuolity
Sexuotit)'iqomullidimensionolphenomenonthot
includelfgelings,ottitudes,ond octions. lt hqs
both biolodiKrd cullurol compgnents.
EiologrbGender* denbtes chromesomolsexuql
development. '\!.
\\\
GenderAexuotldentity- the innbr.sense
o personhos
of being mole or femole, which'rRoy be the some
os or differentfrom biologic
Gender Role - the behovlor o oenon
being mole or femole, which moy or moy
'. the some os biologic gender or gender

ituqnonSexuolResponse ypesof SexuolOrientotion

FourDiscfete Sloges of lhe Sexuo,ResponseCycrej \.
Heferosexuo)rfy--
findssexuolfulfitlmeniwith the
l. Excitemenf\curs with physicolond psychologicol opposile gender-
slimulotion. \ \
\_ Homosexuality- finds i\uot futfillmentwith o member
2. Ploteau- reoched jusitbqforeorgqsm. of hisor her own sex. '.,
\ .,.
3. Orgosm- stimulotionpro"eddr,throrgh ihe ploleou - people who ochievilsgxuol sotisfoction
Bisexuolily
sfoge to o point ot which the bo-dgsuddenly from both sexer. -'\.
dischorgesoccumuloted sexuoltenlie!.
Ironssexuolify- on individuol who feels os hhe or she
4. Resolufirn-the exiernolond intemol shouldbe of the opposite gender.
returnlo on unorousedsiote.

of SexuolExpression
Dis'oqders
of SexuolFunctioning
i. cdio)\. \
"a
PrimorySexudfDysf unction
ii. Mosturbotion\.. o. EreclileDlMgrnclion
\. b. PremotureEjdsploiion
iii. EroticStimulolion \ c. Foilure1oAchievbQrgosmor DecreosedSexuol
Desire '...
iv. Fefishism d. Voginismus- involuntorlgonlroction of the
musclesot lhe oullet of the.vogino when
v. Tronsvestism -'\.
coitusisoliempted.
e. Dysporeunio tr,
vi. Voyeurism f. InhibitedSexuolDesire ,/
vii. Sodomosochism SecondorysexuotDysfunciion
,.)>(,, _

MarlonBernardo,
RN ttl.

CEU-Makati
Re.productive
ond
SbriuolHeolth
\'..
t'...
frfor|onArngrOo,
Centro Bcolor
Fhllosophyof Moternolond
Chil{Heoth Nursing
\ oll fomifyqnembers,
o lt isfornily:Centered.
s lt iscommunityr,ceniered os the heolthof
the fomiliesdepdndson ond influences
the heollh of commbeiiies.
o lt isreseorch-oriented oi'rqseorch
increosescrilicolknowledg'b1.
o Nursingtheoryond evidenc
proctice provide o foundoiion for hqr5ir
core. r'4.
o'R()gnoncyor childhoodillness con be
skdls{ulond con olier fomilylifein both
subtle'o4dextensivewoys.
-\\
o Personol,cultulcf ond religiousolfitudes
ond beliefsinfluerleEr
the meoningof
illness
ond ih impoct'onthe fomily.
o Motemolondchild heolthniXlng iso
chollengingrolefor fhe nurseon)d,[s
o
mojorfoctor in promotinghighJeve\"
''..
wellnessin fomilies.
MarlonBernardo,
RN
Moternal & ChildHeotthNursing:
Reprodudiveond SexuolHeolth
Brleflntroductionto Moternol
ond'QhildHeolthNursing
\
'\\
PrlmoryGool
It con be stoted shnplyos the promofion
ond moinlenonce of optimol fomilyheollh fo
ensurecyclesof optimol childbqoringond
, '\..\.
childreoring.
o A'.moternolond child heolthnurseserves
os an{dvocole to protect the rightsof
includingthe felus.
o lt useso high dbgree of independent
nursingfunctionsdbqouseleoching ond
counselingore so freQuqntlyrequired.
'\
o Promoiingheolthison importbn{nursing
role becouse thisprolects the heb(h of
the next generotion. X.
\.
Obslefrics
t'....
\.
Primorilycoie-emed with the phenomenon
ond the monogemeiht.ofpregnoncy.lobor ond
puerperiumbolh underhermql ond qbnormol
circumstonces.lt isderived'frpmthe Lotinword
Obsfefrixwhich meons midwifb:.
,r"'