Female Reproductive System

Diseases of the female reproductive system can be organized by anatomy and understood that they would be seen this way in the physical examination.

Structure and Anatomy

​Endocrine systems should be learned as feedback loops. For the female reproductive endocrinology, this requires an understanding of the menstrual cycle and the feedback loops of H > P > O > E. The best way to learn this is through an understanding of clinical testing (serum TSH and progesterone) and drugs (leuprolide, COCP, clomiphene and spironolactone).

Pathology

The first of two lectures on female reproductive system pathology covers diseases of the external genitalia. These include rashes and masses of the vulva and infections that have rashes or vaginal discharges. The second of two lectures covers the internal genitalia. It discusses the correlation of uterine bleeding pathology to reproductive age. The endometrial diseases of DUB, endometriosis and endometrial hyperplasias are reviewed. Ectopic pregnancy is discussed. In the ovary, PCOS is reviewed, together with pathophysiologic principles that underlie the management of ovarian cysts.

Neoplasia

The key principles of vulvar squamous cell carcinoma are reviewed. As HPV is the cause of >99% of cervical carcinomas, the natural history of HPV is correlated to the development of neoplasia and patient care, Vaccines are briefly reviewed.

Amenorrhea & Infertility

This lecture gives the algorithmic approach to the investigation of primary and secondary arrhythmia together with an approach to infertility. Primary amenorrhea includes Kallman, Turner, Mullerian agenesis (RKH), androgen insensitivity syndromes together with the outflow obstructions. Secondary amenorrhea includes PCOS, hypothalamus disorders, hyperprolactinemias and ovarian failure. Infertility adds in chronic PID and endometriosis.