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Pharmacology · chapter 36 · Reproductive Health Drugs

Review of the Female Reproductive System

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Internal reproductive organs

    The internal organs are the vagina, cervix, uterus, fallopian tubes, and ovaries (Hoare Kahn, 2022; Netter, 2022).

  2. The uterus and menstruation

    The uterus, or womb, is where a fertilized egg implants to develop into the fetus. If an egg is not fertilized and implanted, the uterus sheds its inner lining in the process usually known as menstruation or a period.

  3. The hormone chain from brain to ovary

    The anterior pituitary is stimulated by GnRH to secrete two hormones: Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH). Finally, the ovaries (gonads) themselves secrete estrogen and progesterone (gonadotropins) in response to FSH and LH released by the anterior pituitary.

  4. GnRH as the central regulator

    GnRH is a critical hormone in the hypothalamic-pituitary-gonadal axis, acting as the central regulator. It is responsible for regulating the start of puberty, onset of menstrual cycle, development of sex characteristics, and ovulation.

  5. What FSH and LH do

    FSH and LH stimulate the development of ovarian follicles and the release of mature ova (eggs) from mature follicles. Additionally, FSH and LH prepare the body for pregnancy and support pregnancy until the time of delivery.

  6. Roles of progesterone

    Progesterone performs many of the same functions as estrogen does, to promote maturation of sex organs, prepare the body for pregnancy, and maintain a healthy uterine environment for development of the fetus.

  7. Androgen effect after menopause

    In menopause, androgen has more of a masculinization effect on females because the ovaries secrete less estrogen (Nassar, 2023).

  8. Day 1 of the cycle

    Each menstrual cycle begins with the first day of bleeding from the uterus.

  9. When ovulation happens

    Approximately 14 days after the first day of the cycle, ovulation occurs. The ovary releases an egg, and it travels through the fallopian tubes to the uterus to be fertilized and implanted.

  10. Progesterone peaks after ovulation

    Progesterone secretion, in contrast, is low until just before ovulation and then increases sharply, reaching a peak on about day 20.

  11. LH and FSH surge before ovulation

    Both LH and FSH secretion rise slightly at the start of the menstrual cycle, decrease, and then sharply increase immediately before day 14, or ovulation.

  12. When menopause is diagnosed

    Menopause is diagnosed once a client has not had any monthly cycles for 12 consecutive months (Peacock Ketvertis, 2022; Mayo Clinic, 2023b; North American Menopause Society (NAMS) 2022 Hormone Therapy Position Statement Advisory Panel, 2022).

  13. Common menopause symptoms

    Vaginal dryness, hot flashes, night sweats, mood changes, weight gain, trouble sleeping, and thinning hair are what most clients experience during menopause.

  14. Bone loss after menopause

    One primary concern of menopause is the loss of bone mass, which can lead to fractures.

Terms to know

Menstrual cycle
Menstrual Cycle The menstrual cycle refers to the monthly changes in hormones and reproductive organs that usually occurs on a 28-day cycle.
Menarche
The first menstrual cycle is known as menarche and generally begins around age 12, with some clients starting earlier and some not starting until their mid-teens.
Perimenopause
Menopause Once a client has passed the age when they have regular monthly cycles, they have entered perimenopause.
Surgical menopause
Surgical menopause happens when the ovaries are surgically removed.
Early menopause
Clients who experience menopause younger than age 40 are considered to have early menopause, usually the result of a genetic or chromosomal problem.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

The graded version needs JavaScript. Every question is below anyway, with the answer and why.

Every question here, with the answer

  1. A 49-year-old client says her last period was 8 months ago and asks if she is now in menopause. What is the nurse's best response?

    1. "Yes, menopause starts when periods stop for 6 months."
    2. "Menopause is diagnosed after 12 months in a row without a period."
    3. "You cannot reach menopause before age 55."
    4. "Menopause is diagnosed by a single blood test only."

    Answer: "Menopause is diagnosed after 12 months in a row without a period."

    Menopause is diagnosed once a client has had no monthly cycles for 12 consecutive months. Menopause can occur from the 30s to the mid-50s, so the age statement is wrong.

  2. A client with a regular 28-day cycle asks when she is most likely to ovulate. The nurse answers that ovulation occurs about how many days after the first day of bleeding?

    1. 5 days
    2. 28 days
    3. 14 days
    4. 20 days

    Answer: 14 days

    Ovulation occurs approximately 14 days after the first day of the cycle. Bleeding lasts about 5 days, and progesterone peaks around day 20.

  3. A client in menopause asks what symptoms are common. Which symptoms should the nurse include? Select all that apply.

    1. Trouble sleeping
    2. Night sweats
    3. Increased bone mass
    4. Vaginal dryness
    5. Hot flashes

    Answer: Trouble sleeping, Night sweats, Vaginal dryness, Hot flashes

    Most clients experience vaginal dryness, hot flashes, night sweats, mood changes, weight gain, trouble sleeping and thinning hair. Menopause causes loss, not gain, of bone mass.

  4. A client who has just gone through menopause asks why her provider is concerned about her bones. What should the nurse explain?

    1. Bone changes occur only before age 40.
    2. Menopause causes loss of bone mass, which can lead to fractures.
    3. Menopause increases calcium in the bones.
    4. Bones are affected only after surgical menopause.

    Answer: Menopause causes loss of bone mass, which can lead to fractures.

    A primary concern of menopause is loss of bone mass, which can lead to fractures. The signs and symptoms are the same whatever the cause of menopause.

  5. Which statements about hormones of the female reproductive system are accurate? Select all that apply.

    1. GnRH stimulates the anterior pituitary to secrete FSH and LH.
    2. LH and FSH rise sharply just before ovulation.
    3. Progesterone peaks at about day 20.
    4. The ovaries secrete estrogen and progesterone in response to FSH and LH.
    5. Estrogen is secreted only by the adrenal cortex.

    Answer: GnRH stimulates the anterior pituitary to secrete FSH and LH., LH and FSH rise sharply just before ovulation., Progesterone peaks at about day 20., The ovaries secrete estrogen and progesterone in response to FSH and LH.

    GnRH from the hypothalamus stimulates FSH and LH, which make the ovaries secrete estrogen and progesterone; LH and FSH surge before day 14 and progesterone peaks around day 20. The ovaries, not only the adrenal cortex, produce estrogen.

  6. A client had both ovaries removed during surgery. The nurse recognises this as which type of menopause?

    1. Perimenopause
    2. Induced menopause from radiation
    3. Surgical menopause
    4. Early menopause from a chromosomal problem

    Answer: Surgical menopause

    Surgical menopause happens when the ovaries are surgically removed. Early menopause is usually genetic, and induced menopause results from medications or radiation.

Where every quote comes from

Section 36.1 Review of the Female Reproductive System of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.