Many women have a sensitive sense when something is wrong with their bodies. Women seek medical attention earlier than men when they have complaints. They regularly inform themselves about health and nutrition in magazines or on the Internet and can thus better communicate their wishes, fears and concerns to their doctor. Of particular importance are questions about contraception, cycle disorders, childlessness or pregnancy, menopause and cancer screening. In the following, diseases that are assigned to this category according to ICD-10 (N60-N64, N70-N77, N80-N98) are described under “Genital system of the woman incl. mamma (breast)”. The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.
Female genital system including mamma (breast)
The female genital organs (organa genitalia feminina) are divided into primary and secondary sexual characteristics. The primary sexual characteristics are used for reproduction. The secondary sexual characteristics develop during puberty. They signal sexual maturity. For the sake of completeness, the secondary sexual characteristics are also listed below, but are not discussed in further detail here. Primary sexual characteristics of the female
External sexual organs
- Vulva (pubic region)
- Mons pubis (mons pubis; “mons veneris”).
- Labia majora (outer labia) and labia minora (inner labia).
- Vaginal vestibule (vestibulum vaginae).
- Clitoris (clitoris)
- Urethral opening (meatus urethrae externus).
- Vaginal opening (Introitus vaginae)
- Vestibular glands (Bartholin glands; vaginal vestibular glands).
Internal sex organs
- Vagina (vagina)
- Uterus (womb)
- Fallopian tubes (tubes)
- Ovaries (ovaries)
Secondary sexual characteristics of the female
- Breast growth (thelarche)
- Pubic hair growth (Pubarche)
- Menstruation (menstruation)
- Female body appearance – wider hips, narrow waist, narrow shoulders.
Anatomy
Mons pubis (Mons Pubis; “mons veneris”)The mons pubis, also called the mons veneris, is a prominence located above the pubic bone. Due to estrogen, more subcutaneous fatty tissue (subcutaneous fat) is deposited at this location. Together with the labia majora, the mons pubis delimits the vulva. In the course of puberty, it is partially or completely covered with pubic or intimate hair. Labia majora pupendi, labia minora pupendi)The labia majora are two folds of skin that are padded with fatty tissue. Among other things, they contain erectile tissue. Below the labia majora, the labia minora, are the labia minora. These are two thin folds of skin that are not always covered by the major ones, but can also hang out. Vaginal vestibule (Vestibulum vaginae) The vaginal vestibule is enclosed by the labia. It includes the clitoris (clit), the urethra, which lies just below the clitoris, and the vagina, which lies further back. The clitoris is formed of erectile tissue. It is particularly sensitive to touch because many nerve endings run here.Embedded in the vaginal vestibule are also the vestibular glands (Bartholin’s glands; vaginal vestibular glands). Vagina (vagina)The vagina runs tubularly and connects the external sexual organs of the woman with the uterus (womb). It is 8-10 cm long, 2-3 cm wide and ends at the cervix (portio vaginalis). It is made of muscle fibers and is stretchable. The mucosa of the vagina secretes a secretion that keeps the vagina moist. During sexual arousal, it secretes more mucus. The vaginal environment is acidic, which serves as protection against bacteria. Uterus (womb)The uterus is a hollow muscular organ about 6-7 cm long, 4-5 cm wide and weighing 50-100 g. However, considerable variation can occur. Size and weight can increase significantly, especially after pregnancies. The uterus has the shape of an upside-down pear. It consists of the cervix uteri (cervix; this is where the cancer screening smear is taken) and the corpus uteri (body of the uterus). The surface of the cervix uteri visible in the vagina is called the portio vaginalis (cervix; transition from the cervix uteri to the vagina).From the dome, the so-called fundus (fundus uteri), the two tubes (fallopian tubes) depart. Tubes (Fallopian tubes)The tubes (singular: Latin tuba uterina, tuba fallopii; Greek salpinx) arise in pairs from the fundus of the uterus and extend with a length of 10-15 cm in the direction of the two ovaries. They are muscular tubes lined with mucosa. At the end far from the uterus there are fringe-shaped extensions (fimbrial funnels) which, at the site of ovulation of the ovary, lay over the egg ready for ovulation and guide it into the fallopian tube by sucking contractions. Ovaries (ovaries)The ovaries are about 3-5 cm long and 0.5-1 cm thick. The color is white and the shape is almond-shaped. They consist of cortex and medulla, covered by a single-layer epithelium (superficial cell boundary layer). The cortex contains the oocytes at different stages of development. The medulla consists of connective tissue and contains blood and lymphatic vessels and nerves.
Physiology
Mons pubisThe mons pubis serves as padding from impact or injury to the pubic bone during sexual intercourse. LabiaThe labia majora close the vagina to the outside and protect against the penetration of foreign bodies and pathogens, on the one hand, and against dehydration, on the other. They enclose the pubic cleft. The labia minora enclose the entrance to the vagina and the clitoris. Vaginal vestibuleThe vestibular glands moisten the vaginal vestibule. They secrete more during sexual arousal. VaginaThe vagina has the following functions:
- During menstruation, blood flows out of the body through the vagina.
- During sexual intercourse, the sperm of the man passes through the vagina to the cervix.
- At birth, the vagina is the exit channel for the baby.
- Shielding the internal female reproductive organs from ascending infections.
UterusThe uterus is the breeding chamber for pregnancy. If pregnancy does not occur after ovulation (ovulation), the endometrium (endometrium) prepared for pregnancy is shed with menstrual bleeding to rebuild in a new cycle. TubulesThe tubules serve to transport the ruptured egg (oocyte) into the uterus (womb). Tubal defects, such as those caused by inflammation, can result in tubal gravidities (ectopic pregnancies). OvariesThe ovaries are the counterpart to the male testes. The ovaries are responsible for the production of eggs (oocytes) and the production of female sex hormones (estrogens, progestins). During sexual maturity, the follicles (“egg follicles”) located in the cortex are stimulated to grow and produce hormones.
Common diseases of the female genital system including the mamma (breast)
- Adnexitis (ovarian inflammation).
- Endometriosis – occurrence of endometrium (uterine lining) extrauterine (outside the uterine cavity).
- Endometrial carcinoma (cancer of the endometrium).
- HPV infection (human papillomavirus)
- Mammary carcinoma (breast cancer)
- Mastitis (inflammation of the mammary glands)
- Mastodynia (pain in the mammary glands)
- Menopause (climacteric / menopause in women).
- Myomas of the uterus
- Premenstrual syndrome (PMS)
- Female sterility
- Vaginitis/colpitis (inflammation of the vagina)
- Vulvitis (inflammation of the external genitalia).
- Cycle disorders
The main risk factors for diseases of the female genital system including the mamma (breast)
Behavioral causes
- Diet
- High fat, lots of red meat, foods with acrylamide, vitamin D deficiency, micronutrient deficiency.
- Consumption of stimulants
- Alcohol consumption
- Tobacco consumption
- Late first gravidity (pregnancy)
- Short lactation
- Psycho-social situation
- Shift work
- Night work
- Sleep duration < 6 h and > 9 h
- Overweight
- Increased waist circumference (abdominal girth; apple type).
- Underweight
- Mechanical stress, e.g., cycling, horseback riding, etc.
- Lack of genital hygiene as well as exaggerated.
- Promiscuity (frequent change of partners)
Causes related to disease
- Ascending bacterial infections from the vagina (vagina), cervix uteri (cervix) or uterus (uterus).
- Diabetes mellitus – diabetes mellitus type 1, diabetes mellitus type 2.
- Infections (bacterial and viral)
- Metabolic syndrome
- Periodontitis
- Thyroid disease
Medication
- Antibiotics
- Calcium antagonists
- Glucocorticoids
- Hormone replacement therapy (HRT)
- Estrogen-enhanced ovulation inhibitors (contraceptives).
- Cytostatic drugs (drugs used in oncology / cancer therapy).
X-rays
- Radiotherapy in the pelvis and abdomen (abdominal cavity).
Environmental exposure – intoxications (poisonings).
- Environmental toxins (occupational substances, environmental chemicals) such as solvents, organochlorines, pesticides, herbicides.
Please note that the enumeration is only an extract of the possible risk factors. Other causes can be found under the respective disease.
The most important diagnostic measures for diseases of the female genital system including the mamma (breast)
Laboratory diagnostics
- Pregnancy test (quantitative HCG).
- Hormone diagnostics
- Tumor markers (CA 15-3, CEA, HER2/HER2 protein)
Medical device diagnostics
- Abdominal sonography (ultrasound examination of the abdominal organs).
- Mammary sonography (breast ultrasound)
- Vaginal sonography (ultrasound using an ultrasound probe inserted into the vagina/vagina).
- Mammography (X-ray examination of the breast).
- Mamma-MRI (magnetic resonance mammography (MRM; magnetic resonance imaging of the breast).
- Computed tomography (CT) of the abdomen (abdominal CT)/pelvis (pelvic CT).
- Magnetic resonance imaging of the abdomen (abdominal MRI)/pelvis (pelvic MRI).
- Laparoscopy (abdominal endoscopy)
- Hysteroscopy (uterus endoscopy)
- Punch, vacuum, sentinel node or open biopsy (tissue sample); also fine needle aspiration if necessary.
- Endometrial biopsy – sampling of the endometrium.
Which doctor will help you?
For diseases of the female genital system, including the mamma (breast), a gynecologist (gynecologist) should be consulted.
