How reproductive systems work

The male reproductive system consists of two major parts: the testes, where sperm are
produced, and the penis, according to Merck Manuals. The penis and urethra belong to
both the urinary and reproductive systems in males. The testes are carried in an
external pouch known as the scrotum, where they normally remain slightly cooler than
body temperature to facilitate sperm production.
The external structures of the female reproductive system include the clitoris, labia
minora, labia majora and Bartholin's glands, according to the Cleveland Clinic. The
major internal organs of the female reproductive system include the vagina and uterus
— which act as the receptacle for semen — and the ovaries, which produce the
female's ova. The vagina is attached to the uterus through the cervix, while the fallopian
tubes connect the uterus to the ovaries. In response to hormonal changes, one ovum,
or egg — or more in the case of multiple births — is released and sent down the
fallopian tube during ovulation. If not fertilized, this egg is eliminated during
menstruation.

The female reproductive system.

(Image credit: National Institute of Health)
Fertilization occurs if a sperm enters the fallopian tube and burrows into the egg. While
the fertilization usually occurs in the oviducts, it can also happen in the uterus itself. The
egg then becomes implanted in the lining of the uterus, where it begins the processes of
embryogenesis (in which the embryo forms) and morphogenesis (in which the fetus
begins to take shape). When the fetus is mature enough to survive outside of the womb,
the cervix dilates, and contractions of the uterus propel it through the birth canal.

Variations in the reproductive system

Around 49.5 percent of the world's population is female, so there are slightly more men
on the planet than women, according to World Bank. A person's sex is determined by
what reproductive system the person has, but it isn't always so simple. Some humans
are born with parts of both male and female reproductive systems or incomplete
reproductive organs of one sex or the other. Those with both male and female
reproductive parts are considered intersex. Sometimes children are labeled as male or
female, depending on how complete or functional one sexual reproductive system is
over the other. Then, the other organs are removed.
Today, many parents are opting to leave both sets of reproductive organs intact with the
intent of letting the child decide to keep or remove the various parts when they are
older. A baby is born atypical genitalia in one in about 1,500 to 2,000 births, according
to Intersex Society of North America.
Females that are born without all of their reproductive system are labeled as having
Mayer Rokitansky Kuster Hauser Syndrome. This occurs in one in 5,000 female births,
according to the Center for Young Women’s Health.
Diseases of the female reproductive system
Many parts of the male and female reproductive systems can be affected by cancer. In
females, cancer can attack the uterus, ovaries, breast and cervix, among other organs,
according to the American Cancer Society.
Many experts have seen what they refer to as the "Angelina Jolie" effect, where women
are taking proactive measures by having breasts and internal reproductive organs
removed if they have a family history of cancer before there are signs of the disease.
"With better genetic testing and screening, we have seen a number of women who are
being more proactive about their reproductive health," said Dr. Shana Wingo, who
specializes on gynecologic oncology at Arizona Oncology.
Ovarian cancer tends to have a poorer outcome than other gynecological cancers,
Ross noted, because it is not typically diagnosed until it has progressed significantly.
"There is no standard screening available for ovarian cancer, so it is very difficult to
identify it early."
Tests to detect ovarian cancer, as well as cancer of the fallopian tube, and primary
peritoneal cancer are currently being studied, according to the National Cancer Institute.
There are two tests used to screen for cervical cancer. The Pap test screens for cellular
changes in the cervix called cytology, while the genital human papillomavirus (HPV) test
identifies the presence of infection with high-risk HPV, the strains that are linked to
cervical cancer, according to Dr. Charles Dubin, an OB/GYN in Santa Monica, Calif.
A recent study published by Cancer Cytopathology, found that HPV-only screening
misses more cervical cancer in women than Pap-only or co-testing, based on
approximately 8.6 million women ages 30 to 65. There is approximately a three-fold
improvement in the cancer detection rate of co-testing compared to HPV only.

Current guidelines recommend that women first start getting the Pap test alone when
they turn 21 and repeat every three years if the test is normal until age 30. A Pap-plus-
HPV test, or co-testing, is recommended for women ages 30 to 65, and if both are
negative repeated every five years, regardless of whether they have received HPV
vaccination. "However, there is compelling scientific evidence that co-testing every three
years misses less cases of cancer and pre-cancer than every five-year co-testing,"
Dubin noted.

While genital HPV is typically associated with females, it is the most common sexually
transmitted infection. The majority of sexually active people in the United States — male
and female — will have HPV at some time in their lives, but most will not experience
any symptoms. In a small portion of women, it can result in cervical cancer and genital
warts; in men, it can cause penile and anal cancer and genital warts, according to the
NIH.

Both genders can develop sexually transmitted diseases, including genital herpes,
gonorrhea and syphilis, according to the National Institutes of Health (NIH). HIV/AIDS, a
disease of the immune system, is not exclusively transmitted through sexual contact;
sexual activity is one of the ways that the HIV virus is spread.
For females, severe menstrual cramping, or dysmenorrheal, is the most common
disease of the reproductive system occurs with a woman's monthly menstrual period,
according to Dr. Sheryl Ross, OB/GYN and Women's Health Specialist at Providence
Saint John’s Health Center.
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"Severe pain before or during your period can last anywhere from one to seven days
and disrupt your normal day-to-day routines at school, work and socially," Ross noted.
Diagnosis is made by the patient's medical history and a pelvic exam. The best
treatment includes medications that block the effects of prostaglandins and include
ibuprofen and naproxen. The birth control pill also works well in treating dysmenorrhea
by decreasing the blood flow, Ross noted.

Another common disorder of the female reproductive system is a vaginal yeast

infection, which is caused by a yeast fungus in the vagina. Most can be successfully
treated with over-the-counter medications, according to WebMD.
Endometriosis is a condition where that normally lines the inside of your uterus — the
endometrium — ends up outside of uterus, most commonly in the ovaries, bowel or the
tissue lining your pelvis. The endometrial tissue becomes trapped, causing pain,
according to the Mayo Clinic.
Pelvic inflammatory disease can involve an infection of any of the female reproductive
organs, including the uterus and ovaries. Sexually transmitted diseases, such as
gonorrhea and chlamydia, are typical causes of pelvic inflammatory disease, according
to the NIH. "Any of these STIs can cause serious and potentially long term reproductive
problems that include chronic pelvic pain and infertility," Ross said.