Basic Pharmacology And Physiology Of Female Reproductive Disorders

The female reproductive system refers to all the female organs that enable a woman to conceive, nurture and deliver a baby. The activity of the female reproductive system is controlled by hormones released by both the brain and the ovaries that cause the development and release of eggs.

The incidence of ovarian, uterine and cervical cancer as of 2020 in the United Kingdom are reported to be 23.4, 27.9 and 18.4 women per 100 000 with a mortality rate of 14.6, 7.9 and 4.3 women per 100 000.

Annual well-woman visits to a healthcare provider can greatly increase the chances that reproductive cancers are identified early through regular exams and screening tests. Many times people with early stages of reproductive cancer have no symptoms. A screening test is used to find a disease before the person has any symptoms. There are several screening tests available for some reproductive Disorders.

Reproductive disorders affect the internal and external organs in the female pelvic and abdominal areas. These disorders include dysmenorrhea (pain associated with menstruation), vulvodynia (unexplained chronic discomfort or pain of the vulva), and chronic pelvic pain (a persistent and severe pain occurring primarily in the lower abdomen for at least 6 months). Some problems can affect the proper functioning of the reproductive system and may affect a woman’s ability to get pregnant. One example, polycystic ovary syndrome, occurs when immature follicles in the ovaries form together to create a large cyst, preventing mature eggs from being released. Another reproductive disorder, endometriosis, occurs when the type of tissue that lines the uterus grows elsewhere, such as on the ovaries or other abdominal organs. Uterine fibroids are non-cancerous tumors that grow in the uterine cavity, within the wall of the uterus, or on the outside of the uterus.

Reproductive cancers are cancer that is in the organs related to reproduction. The most common reproductive cancers in women are:

  • Cervical cancer: Cancer of the cervix, the lower end of the uterus that extends to the vagina.
  • Ovarian cancer: Cancer in the ovaries, the two organs that make female hormones and produce a woman’s eggs.
  • Uterine cancer: Cancer in the uterus (womb), the organ where the baby grows when a woman is pregnant.
  • Vaginal cancer: Cancer of the vagina, the hollow channel that leads from the uterus and cervix to the outside of the body.
  • Vulvar cancer: Cancer of the vulva, the area around the opening of the vagina.
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Breast cancer is sometimes considered a reproductive cancer. Breast cancer is in the tissues of the breast. It is becoming increasingly accepted that many normal reproductive processes display hallmark signs of inflammation. Such processes include ovulation, menstruation, implantation and parturition. Reproductive hormone disorders can affect fertility and may have long-term effects on metabolic, cardiovascular and bone health. The reproductive hormones include estrogen and progesterone in women and testosterone in men. They originate from the primary reproductive glands (ovaries in women and testes in men) and are regulated by hormone signals from the pituitary gland; luteinizing hormone (LH) and follicle stimulating hormone (FSH).

In the reproductive tract, the injury and tissue remodelling caused by ovulation, menstruation and parturition trigger the inflammatory cascade. This involves a carefully orchestrated autocrine/paracrine/juxtacrine series of events to facilitate repair, remodelling and the resolution of inflammation which is regulated in a cyclical manner via the sex steroids oestradiol (E2) and progesterone. Inflammation is an active process which involves the release of inflammatory cytokines, chemokines and peptide growth factors. This establishes a gradient for the recruitment of neutrophils and macrophages to the site of injury. Injury also promotes the activation of the coagulation and fibrinolysis system, which operates in tandem to control clotting and remodelling of the vasculature. This facilitates tissue regeneration and extravasation of neutrophils at the site of injury via dilatation and oedema. Tissue remodelling also involves production of local inflammatory mediators such as kinins, histamine and eicosanoids such as prostanoids (prostaglandins (PGs), prostacyclins and thromboxanes) and leukotrienes.

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