GYNE 101 Comprehensive Gynecology Notes and Reproductive
Health Insights with Complete Solution
GYNAECOLOGY
Puberty
The menstrual cycle
Menopause
Abortion
Ectopic pregnancies
Ovarian tumors
Infertility
Benign disorders of the uterine corpus
Cancer of the cervix
Prostate cancer
REPRODUCTIVE HEALTH
A state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity in all matters related to the functions and processes
of the reproductive system.
Components of Reproductive health
Safe motherhood - Pre/Peri/Postnatal care, breast feeding and neonatal care
Family planning information and services
Prevention and management of infertility.
Prevention and management of complications of abortion
Prevention and management of reproductive tract conditions and neoplasms
Menopause - Prevention of osteoporosis, atherosclerosis
REVIEW OF ANATOMY AND PHYSIOLOGY OF THE FEMALE
REPRODUCTIVE SYSTEM
GYNAECOLOGICAL HEALTH ASSESSMENT:
HISTORY
Demographic data: Name, age, marital status, address
Obstetric history: number of children with ages and birth weight,
miscarriages, terminations of pregnancies and reasons, abnormalities of children
and pregnancies
Usual menstrual cycle
Sexual and contraceptive history,
Previous medical history
,1
,Family history
Detailed history of present complaint
Enquiry about other systems
Emotional problems
PHYSICAL ASSESSMENT
First do a quick general assessment
Concentrate on the area of concern- abdomen and reproductive system
DIAGNOSTIC ASSESSMENT
Laboratory test depends on the findings
Urine- urinalysis test
Blood—Hblevel,widal test,VDRL
Vagina and the cervix-pus swabs ,HVS, endecervic al swabs,cytological test for
cancer, cervical biopsy nfor histology
Uterus –D&c , cytological test /pap smear ,cervical biopsy
Endoscopy-culdoscopy
Laparascopy
Hysteroscopy-visualization of parts of uterine cavity RADIOLOGICAL EXAM
-plain pelvic exam
-ct-scan-
-ultrasound
-hysterosalpingogram (uterotubogram)- this is an x-ray study of the uterus and
uterine tubes after the injection of contrast media
PUBERTY
Period when the endocrine and gametogenic functions of the gonads are fully
developed so that reproduction is possible
This is characterized by
The beginning of gametogenesis
2
, Secretion of gonadal hormones
Development of secondary sexual characteristics
Factors affecting the onset of puberty
Genetic/Ethnic factors
Environmental/Geographical factors
Stages of puberty
Pre-pubertal stage (8–9 year of age)
The hypothalamic-anterior pituitary-gonadal axis is suppressed by;
Neuronal restraint pathways
Negative feedback provided by minute amounts of circulating gonadal steroids Thus
there are undetectable serum levels of;
luteinizing hormone (LH)
sex hormones (i.e., estradiol in girls, testosterone in boys)
Peri-pubertal period (1-3 year before the onset of puberty)
Pulsatile secretion of low levels of LH during sleep due to endogenous episodic
discharge of hypothalamic gonadotropin-releasing hormone (GnRH).
Nocturnal pulses of gonadotropins continue to increase as clinical puberty
approaches. This pulsatile secretion of gonadotropins is responsible for;
Enlargement and maturation of the gonads
The secretion of sex hormones
Appearance of the secondary sex characteristics
A positive-feedback mechanism develops whereby rising levels of estrogen in mid-
cycle cause a distinct increase of LH and ovulation.
Puberty in Girls (8-13year)
Thelarche (Development of Breasts) - Breast bud - 10–11 years
Pubarche (Development of axillary and pubic hair) - Appearance of pubic hair - 6–12
months later
Menarche (first menstrual period) Interval to menarche - 2–6 years after thelarche.
⋅ Mean age of menarche - 12.5 year (13.5 years in rural girls)
3
Health Insights with Complete Solution
GYNAECOLOGY
Puberty
The menstrual cycle
Menopause
Abortion
Ectopic pregnancies
Ovarian tumors
Infertility
Benign disorders of the uterine corpus
Cancer of the cervix
Prostate cancer
REPRODUCTIVE HEALTH
A state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity in all matters related to the functions and processes
of the reproductive system.
Components of Reproductive health
Safe motherhood - Pre/Peri/Postnatal care, breast feeding and neonatal care
Family planning information and services
Prevention and management of infertility.
Prevention and management of complications of abortion
Prevention and management of reproductive tract conditions and neoplasms
Menopause - Prevention of osteoporosis, atherosclerosis
REVIEW OF ANATOMY AND PHYSIOLOGY OF THE FEMALE
REPRODUCTIVE SYSTEM
GYNAECOLOGICAL HEALTH ASSESSMENT:
HISTORY
Demographic data: Name, age, marital status, address
Obstetric history: number of children with ages and birth weight,
miscarriages, terminations of pregnancies and reasons, abnormalities of children
and pregnancies
Usual menstrual cycle
Sexual and contraceptive history,
Previous medical history
,1
,Family history
Detailed history of present complaint
Enquiry about other systems
Emotional problems
PHYSICAL ASSESSMENT
First do a quick general assessment
Concentrate on the area of concern- abdomen and reproductive system
DIAGNOSTIC ASSESSMENT
Laboratory test depends on the findings
Urine- urinalysis test
Blood—Hblevel,widal test,VDRL
Vagina and the cervix-pus swabs ,HVS, endecervic al swabs,cytological test for
cancer, cervical biopsy nfor histology
Uterus –D&c , cytological test /pap smear ,cervical biopsy
Endoscopy-culdoscopy
Laparascopy
Hysteroscopy-visualization of parts of uterine cavity RADIOLOGICAL EXAM
-plain pelvic exam
-ct-scan-
-ultrasound
-hysterosalpingogram (uterotubogram)- this is an x-ray study of the uterus and
uterine tubes after the injection of contrast media
PUBERTY
Period when the endocrine and gametogenic functions of the gonads are fully
developed so that reproduction is possible
This is characterized by
The beginning of gametogenesis
2
, Secretion of gonadal hormones
Development of secondary sexual characteristics
Factors affecting the onset of puberty
Genetic/Ethnic factors
Environmental/Geographical factors
Stages of puberty
Pre-pubertal stage (8–9 year of age)
The hypothalamic-anterior pituitary-gonadal axis is suppressed by;
Neuronal restraint pathways
Negative feedback provided by minute amounts of circulating gonadal steroids Thus
there are undetectable serum levels of;
luteinizing hormone (LH)
sex hormones (i.e., estradiol in girls, testosterone in boys)
Peri-pubertal period (1-3 year before the onset of puberty)
Pulsatile secretion of low levels of LH during sleep due to endogenous episodic
discharge of hypothalamic gonadotropin-releasing hormone (GnRH).
Nocturnal pulses of gonadotropins continue to increase as clinical puberty
approaches. This pulsatile secretion of gonadotropins is responsible for;
Enlargement and maturation of the gonads
The secretion of sex hormones
Appearance of the secondary sex characteristics
A positive-feedback mechanism develops whereby rising levels of estrogen in mid-
cycle cause a distinct increase of LH and ovulation.
Puberty in Girls (8-13year)
Thelarche (Development of Breasts) - Breast bud - 10–11 years
Pubarche (Development of axillary and pubic hair) - Appearance of pubic hair - 6–12
months later
Menarche (first menstrual period) Interval to menarche - 2–6 years after thelarche.
⋅ Mean age of menarche - 12.5 year (13.5 years in rural girls)
3
