Understanding the Reproductive System

we're going to talk about the reproductive system today and we will start with the female reproductive system on however going to tell you that in the people stage of development private to about nine weeks of pregnancy or what we call nice of cetacean if you were to look at the fetus you cannot tell on the outside whether it was a boy or girl so there is no external genitalia at all after about the nine steps of the guidance be the external genitalia begin to form and that is completely dependent on the protocol so talk about this before you know for a female the top of some selections excellent form a ensemble oh okay yeah okay pusher away okay clearances the NICU my brother will go subscribe your unloaded sure Shula problems look like an X and a wife or a male now and a male during this gestational period around the 10th week of pregnancy that baby start to secrete testosterone and testosterone is responsible for making this external genitalia growth so if you look at for instance the clitoris of the female so if you look at this external genitalia of the female and you look at the clitoris of the females the clitoris and all of the tissues surrounding it if it is exposed to colostrum will then form into a penis the lobby of my Nora and the lobby of majora here uh if it's exposed to testosterone will end form into the particular sacs and by the way the urethral opening here along with the clitoris after us pointed out all becomes the penis area and then of course there's no vaginal opening that closed up so what that means is for the male his external genitalia forms because his doctor arm is causing the change in those for the female there's no normal of necessary for her external genital Wepa penis which means that let's say you have this male fetus who has something wrong and cannot secrete in the estas drum when that male baby is born his external genitalia will live Latino because there wasn't enough testosterone to turn that into the male external genitalia and a lot of times the parents don't even know that internally their female child is actually male has X Y chromosomes and have internal genitalia like growing testes things like that externally they think that they have a female there are no true from Africa in humans so this is as close to of an acrid I as a human gift so the external genitalia looks female the internal Jen is males the only problem is although the internal genitalia grows it doesn't fully complete growth and so they don't have any working intelligent eyes so we don't have a true functioning come advertising use so by the time their child gets to puberty where you think this little girl is supposed to start growing breasts and have a menstrual cycle it doesn't happen and many times this is when the parents finally know that hormonal e genetically the child is actually really male and believe it or not the majority of parents and children will ought to go through surgery so via external genitalia matches with the chromosomes match because here's another thing depending on our chromosomes is also tells us how to wire the brain and I think you probably have noticed by now play male think is a female figure not quite the same they behave and think and act a little bit differently from each other and so in these children usually the brain is wired to be more male than Cena even though they've been racism they feel more like they're male because that is really the way the brain is wired so many of them ought to how their estrogen is how you change to male now what you can do and very interesting a students who give me certain things like at the end of the semester and one semester a gentleman who's in my class I do it also been in the Navy decided that he would gift me with a movie and it was his adventures in Thailand so part of his adventures was in new prostitute district as part of that movie was the females who have been exposed to testosterone later on in life and so what they did is as adults they gave themselves a few injections of system into the clitoris and if you do that you can barbecue now if you do it too much in life the penis will only get to be maybe about 3 inches long for these children who have external genitalia that look quite female if you do that that puberty they can actually normally naturally with testosterone grow a fully functioning penis all that has to happen after that is they have to have the vaginal opening closed up because it is not functioning at that point okay unfortunately for them they also do not have a functioning testes because of the fact that they do not grow up completely but all you have to do is give injections of testosterone different have to do any type of massive surgery in order to be able to give them a functioning penis which is very nice for the child one other thing I want to point out to you is this section right here it's called premium maybe it is either in a female between the vaginal opening a novena or in the mail it's between the underside of this particular stack and in this program iam really doesn't do much not really very important throughout our lives and stuff if you are working with burn patients okay so individuals who are hot inspires and their bodies begin to burn one of the things that we the natural stress reaction is they go into a fetal position which means that that bringing their arms together they're bringing their legs up and they're bringing their butt in got a lot of pucker power going on there and for them that's actually very important is because there is a really high chance that if the person survived this small area may about the size of a quarter of skin also for us so you may have the patient who had burned over 99 percent of their body but that wonderful area of skin is still intact and since our skin is an organ we may have to have like an organ transplant if we lose our skin and we can reject certain types of skin that we might get as a transplant so we can grow our own skin when you lose it it is so much better course because then we would have rejected so in this patient you've got a couple problems out because they don't have any skin you're going to put pigskin over top of them in the meantime and you're going to put them into medically induced coma because it's really painful the reason you put a pigskin on them is one so they don't lose all their water and dehydrating dust and two because the bugs can't get in so you wrap them head to toe in the pigskin and then you take a really interesting instrument it's electric as almost like a shaver and you shave off that one piece of perineum skin and put it into like a cookie sheet okay and you put medium in there and you oxygenate it and you let that sucker grow and you grow it in a full sheet of skin and you'll grow after that multiple sheets of skin in order to graphic now around your patient hopefully if you can keep them alive long enough to get all that skin to grow specialist they've lost a lot of their skin if you ever have an opportunity to do a rotation at arrow tests see if you can go to their burn ward it's absolutely fantastic they have one of the top for our Lord in all of Southern California and they grow their own skin there and it's just an awesome experience and it's just really really nice and so a lot of people their skin and comes in from the perineal region because it's the only fit back essentially be left up it's usually a few weeks oh for one sheet or less usually about a week from the line so you get that premium to grow you take a piece off and put it in another sheet and grow it so it within a couple of weeks you've got enough skin for the whole body yeah now you may have to do multiple transplants over time to stumble they lock you get is more there's all kinds of different things that you have to do over time but it usually took initially wrapped up is about two weeks we shave all the scales of emperium okay so you mention that you know handling organs and I know a symptom extent Delta name or a hardener where you guys can do they are doing that now yet but you for the long time like it if I have skin to grow it will be faster than if I be simple so best to hope for a little bit of skin less for them to be able to growth not by the way on the clitoris okay because it also turns into the penis tells you that it the same and neurological and blood supply as the penis looks so that means that is also connected in the same area in the female brain as in the male brain so basically the clitoris is like for the male organ of orgasm and then underneath that you have your referral opening so that urination can occur and then you have a vaginal opening which leads up eventually to the uterus then there are these little Bland's right here these are called the Bruner's gland and Bruner's lands secrete a mucus II substance that keeps this entire area noise and this area officially is what we call the vulva okay and so the brooder glands become infected they'll cross over and there's not enough mucus secretion and the vulva region can become very dry and cracked and even begin to bleed poets is not fun experience now if you proceed up through the vaginal canal up to the bat-vault excusal then you'll enter into the basketball town so this is the pelvic bone here here we have the clitoris this is the opening to do your redress and moving left into the black and we have the vaginal canal leading up into Z or the vaginal opening season again leading up into the vaginal canal and then the uterus and right here are our Bruner's lamb and then the rectal region now the vaginal canal is very stretchy however it's lined with skeletal muscle okay and it has multiple different jobs of course this is where the storm is planted in order to fertilize an egg and have a baby it's also going to have to stretch open because this is the birth canal where that baby is going to be able to come out but another really important thing about the vaginal it's like a really strong column that hold the uterus in place the uterus sits on top of the vaginal canal now in the arms pregnant female the uterus is about the size of like a walnut okay not very large but of course the pregnant females depending on how big that baby get it can really stretch out now also the skeletal muscle of the vaginal canal can really stretch out when that baby is born so let's say you have a woman who have had three four or five children the vaginal canal can stretch quite substantially and the problem is that eventually the uterus kind of stretches out to becomes a little bit heavier the connective tissue can't hold as well commercial canal is too big and the uterus falled up socialism Argo about Herman she sees this purplish thing hanging out the vaginal canal and interviewers so once that happened okay what we called for a lot cuter as' and it happened quite frequently actually she's going to have to have a hysterectomy and have a uterus removed so it's not a real positive thing for the woman and so wanted to think that you need to suggest for her is that she needs to after every pregnancy after a little bit of recovery do some exercises to strengthen the muscles because their skeletal muscle again she's gotten to a little bit of that vaginal canal because by strengthening the muscle the canal shrinks in size and then can hold that uterus up so this type of muscle exercise was first talked about by dr. table so they called the Kegel muscle exercises and you know obviously doesn't II don't have a vaginal canal I don't think no and I saw it's a little bit hard for you to understand but in order to instruct your patient you can kind of tell them it's sort of like you know when you have some about room and just can't go yet and so you know you're squeezing it and holding it it's that same kind of response so you're going to squeeze those muscles in that vaginal area and of course you know do like you know 30 repetitions a couple times a day I mean you could be doing it is me all across right now we never know is related to somebody come on what is that I come on squeeze those muscles firmly several times a day or you could also buy we're called Benoit balls and these are stainless steel balls becoming a little case and you come in go ahead and slide the hooklink and they start out very large and go down to the size of a pea and the idea is you're supposed to be able to insert those into the vaginal canal and hold them while walking around now please please please you dr. Harvey a really big favor please do not walk around with these in public okay it's really really embarrassing when dr. Harvey is like in target picking something up really fast and in the same aisle with a woman who all of a sudden this little stainless steel ball goes oh just came coming right now and she goes chasing it down the aisle and picks it off and pop in our pocket and it's just we're in the privacy of your home and 90 target because I can read over time see and okay please please don't do that okay always reminds me of a story true story cuz I was there and a half we're on Highland Avenue in San Bernardino going down Street in a police car and this guy's on the side the road waving us down and he holds a cop over book it out she's like you see that homie right again she just ran up to me question is on prosecuted of officer called her over okay what happened I did not rob him I keep paying me for a job okay I'm a city paid ten bucks and he got a better [ __ ] Christmas and last year does look to the gentleman he says look I'm sorry no you have to take this the civil court this is not a crime okay and there's nothing I can do for you here's my last $10 and I'm hungry and she's robbing me though but I was just kind of listening in on like whatever adding up to the girl came out you know what give him the ten bucks back hi so she lifts her leg and sticks it on to the bumper of the officers car takes their hands this is up inside her vaginal canal and pulled off this dripping $10 bills tries to slap it into the officer cams and screams and jump back so she slaps it in the guy's hand he grabs it sticks in his pocket this thank you and walked on the streets Taco Bell to fight is do your mom tell you that money is dirty the chickens money is dirty okay so you will be real careful handling money okay fabulous okay cuz you never know where it actually came from so do not tell your baby says this is a good person okay I can tell you other stories where I met a woman who actually had a six-pack of beer I don't know we all sit back and what was worse she was caught on video I made there's a watch just amazing you have to put them in one at a time well he's especially now I told you it stretching it I'm gonna get it right time her three-year-old favor both in the liquor store with the same time and I'm going how did she walk out with that actually not break one she got drunk one people now for the video that I saw I witnessed women who have really practice their cable lock electrified and these women were shooting dark out of the vessel guess what and Gimbel watch two watches course it helps in coding okay by how well did to de Kegel exercises letting you know just to go off when you know Oh laughs it takes all this to OG uterus hear that sizzle top the battle canal and notice how it's tilted forward and it's tilted over top of that bladder there so now imagine in one she gets pregnant and she has this seven eight count baby inside there and it's pressing down on that latter it pops that Baker open and this is why she number one Jill the choice of a bathroom all the time and have to be really careful of not being your pimp because there's so much pressure on top as well now one other thing I want you to know about the vessel canal is like many other areas in the human body there are log bacteria and even some parasites in there and they're there for a good reason it keeps other things out okay so one of the things you want to be real careful of with your patient is tell the man that douching is a no-no it is not a good idea the different bacteria that's in there helps to keep the vaginal canal highly acidic and that acid environment keeps everything now so in my experience women who bouche have gingers so you know working at low London emergency room you get certain women that come in and there's certain you know experiences you have like pulling giant blonde cockroaches out of a woman - yes sure that did you say 15 fire ants no I she was asking how come and I said well because the the environment is so no longer is acidic food cetera they unlit up and live in fungus so you have to go very very different areas it probably [ __ ] every problem about using scripts so not in the cabin and then you might make both of them but anyway see there are other things to besides you know stuff that you can buy at the store that people douche with or interest for instance the industry of my favorite stories one is a student showed me some x-rays of a patient of hers at one of the local hospitals and the patient had come in complaining originally of upper right abdominal pain okay that was the original complaint very very painful and then ran all kinds of tests on the liver the ultrasounds I mean they just put her through a battery of tests now keep in mind one of the things that happened with your patients is that they don't always tell you everything number one maybe they don't have the ability to because they're sick or maybe they're not growing that intelligence or maybe they'll think of certain things to tell you which is what this patients total dr. farthing I never thought of telling you and so then he decided that they were going to do abdominal exploratory surgery on her and when they did they found swimming very interesting they found a route embedded in her liver and it was growing leaves so they follow his bruise all the way back through fallopian tube into the uterus down into the vaginal canal because in her vaginal canal this patient has douche with a small tell me people would start all kind of interesting things about this I've seen people have been inserted eggs up there and have to go and flush all the shells out does it Brooke they're going to be that make sure parvo okay you put a potato up there now twice are warm moist environment ruler well that's what a half so start to grow it grow it through right through her abdomen and implanted on her liver which is why she had that rise of abdominal pain so they had to dig that root out and remove our potatoes okay after that okay back off my merit story that we've all time favorite story all those women who came into Louisville Linda and a lot of women are very embarrassed you know when they talked about their Volvo region and so they have a tendency to you know they down there which I always love to look at their toes at that point but she gave me a complaining that down there was very in Chi spell the nurses took her into the back and one of the nurses came out just dying from laughter and you have got to come see this which means you're going to do it right and so they have our completely undress and you can see in this vulgar region she is actually having the belly button all the way down across her thighs all the way to the bun she is covered in maggots Oh discovered this little mystery community in your life everything about Russian Ahmad may be taking a shower or not okay so you're going to show you them interesting people come into your er and so I of course have to know is how to disappearance because that's just the way I have the story that she told me that two weeks prior her boyfriend was coming over there good and she knew that he liked great chili so she packed her vaginal canal with Big Joe and then she never took shower I told you to be some interesting people especially be worked up with no live near never-ending which is very long-winded okay and luckily for her kind of fly yes Epis may come from as well as all their propagates lie which is a flushing why another worldwide that bites you you know you believe it out okay that kind of flies that the magnet program those flies only left to eat dead decaying flesh so as they started to grow and move around on her they actually debride it her and the other reason that she lived and you used all kind of maggots in hospital a lot of times is a brief bit and so she actually survived they hostel enter for a while your cream antibiotics make sure she was okay but she survives and then they instructed her don't accurate jelly out there I hope they had served in Iran like peanut butter kids it's not was probably bad all right frost about your canal you have the uterus now the mouth of the uterus is what we call this perfect I'll deserve it okay when is shown there it looks like there's this massive opening in the cervix right here that is not the case this opening right here is actually microscopic okay because when that giant flying cockroach gets into somebody's vaginal canal you don't want to be able to get up through this uterus through the fallopian tubes and then it's attracting that fat potato actually ruptures the surgical area to get through there and alpha silicon tubes so there was some damage to her cervix so this is very very small microsoft and then on top of it there's a really really thick layer of mucus here what they actually call like a mucous plug right before a baby's going to be born that need to close will fall out so it tells you you're on very much time okay just letting you this blood fall down and it is really quite thick mucus now let me just back up for a second and tell you that the function of a reproductive system is to reproduce it's not to have fun people get that so confused okay oh and what'd I tell you this is because no matter let them try to do support this research system people still have a be okay be there to this time they take birth control pills and the human race is still increasing okay condoms I care what it is that sperm and that egg they're tricky okay and they want to come together and they want to farm baby and you would think by having the good mucus plug here that does not keep the sperm out and you know you just have this little teeny tiny microscopic opening here in this muscle area it will keep the sperm out but it doesn't that microscopic opening is just big enough for those little sperm to get to and this mucus plug if you look at it under a microscope what you see is something very interesting this mucus plot also have like will burn free ways through it delegates they're a tricky devil so that is just big enough for a single sperm at a time to be able to get through and so it does not stop the firm where it myself just want approach but that's Burke still have the ability to get through that service and then into the uterus and then off to fulfill use now talking about the uterus if you remember from analogous three layers to the uterus the innermost layer is all we're really going to care about today is called the endometrium and then the middle layer is all muscle this is a myometrium and then it's outer layers apparently trim is like a connective tissue layer on the top now just add frontal tiny bit about the mind metrium that layer is not really super important in a woman's life until she's ready to deliver or what we call her tuition and so when she's ready to deliver that muscle needs to be able to contract and have to contract an affair in particular we want the muscle that Miami trim to contract from the top or the fundus of the uterus down and then contract from the top down and continue to contract in this pattern because what it's doing is pushing a little parasite out okay squeeze that little thing out like a pebble now no time in the woman's life can that uterus contract in that pattern and so Romney ninth month of pregnancy because during the ninth month of pregnancy all the muscle cells in her myometrium start forming gap junctions between each other and as soon as our cells start forming gap junctions they're able to talk to each other and to tell each other to contract now she'll start to feel those little contractions like little switches during that nice month as more and more gap junctions form and eventually when all the gap junctions form they'll know to contract in this downward pattern now before all the gap junctions form before labor begins what do we call all that twitching of the Merkel bracket and hit abstract that's the name of the two doctors that figured this out so that's where she starts syllable twitches and pains in the uterus and then when you get that synchrony of attraction we know that labor has started now we're really going to focus today on the endometrium because this is the layer that once a month build up and then if she doesn't get pregnant died like okay so we're going talk about how build up how it dies off but off of the uterus are the fallopian tubes and right underneath but not attached to just kind of right underneath the fallopian tubes is the ovary now the fallopian tubes they're only about four inches long and they're only about a quarter of an inch in diameter their lines with cilia and then at the end of them to have those little finger like projections your they call them sittin brain so about the fimbriae are we moving in a pattern kinda like this okay and it's sort of a [ __ ] pattern and it's sucking in water that's on the outside of the user now one an egg popped out or ovulates out of the ovary okay it's going to suck that egg in and all the cilia it's lining the fallopian tube or the oviducts in all beading in one direction towards the uterus so the bat rule egg starts to move the four inches into the uterus now the sperm and egg will typically meet right here at a little bend what they call the ambulance so if there's an as present and a firm present fertilization usually occurs right here and then the egg continues on its y-axis been fertilized into the uterus now just so you can keep this in mind since we're going to talk about this a little bit later it actually makes seven days for this Kerrville egg to go four inches so the really slow journey for the egg to get into the years now sometimes for some women and this especially happens especially transmitted diseases are involved these cilia your girl's done and if the cilia die then there's nothing to move that egg into the uterus and if it gets fertilized here it ends up staying in the fallopian tube and on day seven that FERC watch egg will implant wherever it's at so if it's in the fallopian tube it plants there if it's in the uterus it plants there so if it's in the fallopian tube and it starts to grow since all the quarter inch in diameter it can't grow very much before it starts a strain on that too and there's a lot of pain that the woman feels when she has what we call it too little pregnancy because it's crying too if it grows too much fat people explode it will rupture and the weapon is she was lead to death before she ever got to a hospital so there is no ability at least at this point for a baby that's growing in the tube to actually be removed and then transplanted into the uterus so what the doctor is going to do is cut this piece off because number one it's defective that's why the eggs planted in there in the first place even if they scrape the egg out it would happen again one now she's got another tube and just because one of defective does not mean the other one has to be so she could still you know get pregnant through the other two but that's what she still want but that flowed into any questions so far so we're going to talk about what happens in the ovaries and the monthly changes that occur in the ovaries and then we'll go in and talk about the monthly changes that occur in the uterus and a hormonal issues okay so the ovaries just like a lot of other organs and the cortex around the outside and then I'm going to do luck in the middle in the middle where the medulla is is where all the blood that will come in and the nurse the cortex is where the eggs grow now up until about two years ago one of the things that I need to tell you is that a little girl was born with all the eggs she's ever going to have we now know that's not true just like a little boy little girl her eggs start to grow later in life and now we know that they come from so when the baby is born she does have some stem-cell in the ovaries but they don't look like anything we might think of as a eventually these stem cells will start to form this role in the Chur looking egg which is what's referred to as a follicle okay and then those volleyball just kind of sit there until puberty just like a word for hope okay Phyllis the hypothalamus obviously talked about it a lot in class so far very important area of the brain and the other interesting thing about it though is it is actually the last part of the brain to totally mature so you could say it's the slowest maturing part of the brain and doesn't completely mature until around the time of puberty and so we know that the hypothalamus is finally totally mature when it first starts making GnRH or gonadotropin-releasing hormone this hormone GnRH once it's secreted and then make its way to the anterior pituitary and cause the anterior pituitary to secrete two different hormones so the anterior pituitary's that are released to different hormones one is also stimulated Carla the other is luteinizing hormones these come from the same cells and and your juicer so you know that we have these immature follicles and so although stimulating hormone is going to be possible to mature or we could also say cause these follicles to go through meiosis it and so I want to go through my outfit you get a mature egg or you get a mature oppa blues rising for month causes an increase in estrogen okay so again we're going to test between luteinizing hormone and oxygen production and this is most position here this is our OVA or our own site are we gonna call it surrounded by our granulosa cells and our biggest seller they are being stimulated by follicle stimulating hormone to go through mitosis the thing yourself have receptors for luteinizing hormones so our luteinizing hormone is going to bind to these receptors on the Saiga cell and cause the snake itself to increase production of a certain hormone that hormone instance Ostrow so I'm good but like a big t in here we're going to make dr. ohn in the biggest up now success is das droids made by Sega cell it's going to simply diffuse into the granulosa cells and all the granulosa cells contain a special enzyme there's only two types of cells in the human body that contains this end gun it's the granulosa cells which of course on the females down but also fat cells and that would be in both males and females and then enzyme in the granulosa cells is called a roll the tape a relative is going to take testosterone and convert it into estrogen so when we say that one eivin's hormone increases estrogen production get out the other several steps to actually get the test version production to dilla we may now watch this when estrogen production increases this estrogen actually feeds back on to the hypothalamus and on to the hands your pituitary and eventually we're going to see a rise in with men and women and then of course when women come on Rises will have greater estrogen production that estrogen will feed back again on to the anterior pituitary and cause the luteinizing hormone to rise again which then causes estrogen to rise which will feed back and cause dependence on to rise again and estrogen will rise again and what kind of feedback so we have positive this is a positive feedback and you know again that was a positive feedback there has to be a shutoff switch I'm going to have to talk about what that shows which is in just a second let's go out and check my musicians meet you and it will have user kind of she could probably get something off the phone hey no there is actually a disease that runs in her line and it's called it's actually called Lou Gehrig's disease amyotrophic lateral sclerosis and it's a neurological disorder and so while she cannot have puppies because we don't want to continue reading her line at all she luckily has no problems from it but this neurological disorder eventually when they get to a certain age it actually causes them to become completely hairless I was very basket over budget actually from France and we didn't know that she had this disorder until her dad died from it okay so now we have blue Magnus come on Friday and follicle stimulating hormone rise rqz and estrogen levels rise until LH and estrogen LH and estrogen they just keep going up and our moms now the question is why why we have this okay so look here again on the overhead you have follicle which has become a mature egg okay and around it are the thicket and granulosa cells here in pink and over time as estrogen levels go up you start to see this fluid being built up around the eggs eventually you get a ton of fluid built up around this egg and notice how all this fluid here is actually pushing out on the outside of the ovaries this fluid starts to build up so much that it actually creates a pressure on the wall the ovary to the point where the wall of the ovary explodes and what that does is the fluid pushes out and the egg gets pushed out in that fluid and now no population so in order for the egg to actually leave the ovary you have to build up all of this what we would call follicular fluid and estrogen is responsible for this fluid production so the more estrogen that goes up the more follicular fluid is made and you keep going up and up and up and those kind of like an oath exist on the side of the wall there's so much pressure it explodes and then we have ovulation of this egg okay be thinking regular so make that with it but it's under the influence of custody and the estrogen levels are going to rise and create a pressure on the wall of the ovary until that wall ruptures and ovulation can occur now as soon and ovulation occurs take a look again at the overhead at the Seca and granulosa cells here as this egg ovulate they're already starting to change colors and within just a few seconds they start to kind of look a little puffy and the circular yellow and then within just about a minute the second grain will fulfill a totally different they look very swollen and they're a ripe yellow coat and these bacon granulosa cells are now renamed the corpus luteum our purpose in body lucia means yellow so right after ovulation taken in grandma's now are going to change into what we would call the corpus luteum [Music] [Music] as we taking granulosa cells change and become the focus with TM these cells also start to secrete a different hormone this hormone is progesterone but no longer are we producing estrogen now we're going to produce progesterone progesterone job is to feedback on the hypothalamus and the anterior pituitary to turn off GnRH LH and FSH so we're going to turn off there's a positive feedback but we're going to turn off all the hormone secretion so this is a negative feedback so we just turned off all those hormones are just producing so our GnRH no more FSH LH no more estrogen all stop concerned look for Becca and then they never saw [Music] okay so why would you want progesterone levels to go up at all during the reproductive cycle in the female so that we turn off gnrh LH FSH estrogen why would you want that to ever occur the difference yeah it prevents pregnancy so after ovulation she may get pregnant and so then right after ovulation you wouldn't want her to be able to get pregnant again you have to stop ovulation from occurring so we have inflation occur and then we're going to suppress all these hormones so ovulation can occur just in case she's pregnant because could you imagine if she's an autumn late after she was pregnant that means she could get pregnant after she's already pregnant soon after how long is it before her due while I'm doing nine months I do six months and I'm doing two weeks there won't be any children born after that and someone will just stop having babies after that you have to get pregnant after you're pregnant and would not be a little bit so we have this ovulation occurring here and then the purpose buti'm come long to make progesterone and we want to keep oscillation from occurring now of course what if she doesn't get pregnant okay if she doesn't get pregnant you don't want to keep suppressing all these hormones you want ovulation to be able to occur again so if she's not pregnant then the corpus luteum needs to go away for just your own needs to go away okay so the corpus luteum it potentially can last for a long time so if she's pregnant she doesn't modulate or the corpus luteum potentially can go away from Swift if she's not pregnant I'm going to talk about what happens to the corpus luteum if she is pregnant and if she isn't pregnant yeah okay so we know if she is pregnant we don't want our nation to occur so we don't want for just Iran to go away we want to keep it there so it's suppresses gnrh lhf image okay if she's not pregnant who want the corpus luteum to goldwave we don't want any progesterone anymore so let's talk about if she's not pregnant first and we'll talk about if she is pregnant you so corpus luteum if there is no pregnancy we'll go through any pops toastin 7 days after ovulation what is apoptosis okay so this is pre-programmed Suns or suicide literally the cell have instructions to kill itself so there's no pregnancy 7 days after ovulation occurred all these corpus luteum cells will destroy themselves their form progesterone levels drop and then we can get ovulation again but if she is pregnant that means there's a fertilized egg now we need to stop apoptosis before our date 7 occurred okay so that little fertilized egg it's going to start dividing and dividing and dividing over the next 7 days and it's going to becomes what we call an embryo there's going to be several hundred cells and you have an embryo that embryo will secrete a very important hormone that prevents the corpus luteum from committing suicide so on day seven this embryo is secreting HCG and HCG stands for human chorionic gonadotropin it's this HCG that prevents a populace of the corpus luteum cells Oh so HCG is going to prevent apoptosis of the corpus luteum which also means progesterone levels are going to stay up throughout pregnancy and there's not going to be any more ovulation again grandiose little grandiose echo don't repeat projections elevators that's right now just for your information on purpose luteum is the main source of producing estrogen during pregnancy and so maybe about the fourth month of pregnancy during the fourth month of pregnancy that's when the placenta is really fully formed and it will take over making most of the progesterone so the corpus luteum is pretty much on a back burner now because the placenta is making a ton of progesterone any questions so far no pedestrianism not at all now it is goddess of good it doesn't so this progesterone is the prepping GnRH LH FSH so remember in this step we'll look magical anacs estrogen testosterone is produced here to make that action okay but in the fetus this isn't affecting the fetus is affecting for long so it doesn't and obviously in a male he's making his doctor own mainly as a fetus in adrenal glands so there's not a lot of testosterone production ineffective at any location that is not going to actually occur well there's two times this is sovereign production in a male goes up and the first time is on a day of birth because in the unborn baby boy yet these are active forms right well mill but okay they're not in this particular set 24 on that very first day if you measure testosterone levels in little baby boy who was just born they will be as high as an adult males level of testosterone and those super high levels of testosterone actually caused the taxi to descend from the abdominal cavity into the scrotal sac and after about day three those levels go down until you go through puberty and then the world around so during the fetal stage of development social levels are fairly low so higher than in a female fetus but they're way lower than in a child or adult any questions so far if so it's a woman hat assistant a few dozen soon okay you can have a partial or a total hysterectomy is typically just the uterus so and blue oophorectomy is removing the ovaries so when we say it's a total hysterectomy is usually close we're talking about so if she still has her ovaries all of this is still occurring none of this has anything to do with the uterus at least at this point there's nothing and so all these hormones are still being produced and ovulation can still occur of course there's no uterus so the baby doesn't have ability to grow we're really confused where do they attach the tube to okay so if we remove the uterus okay it's not that they have to choose because it seems off okay but these ovaries are cut from here but they remain attached to their blood supplies so there's connective tissue around them and so the ovaries stay in the public cavity but this uses gone and photophobia yes it's called an instantaneous Network his menopause is nothing but the fact that she runs out of tempo she doesn't have the ability to go through the whole title anymore and then there's also changes in the hypothalamus where she also doesn't sakru's GnRH LH and FSH at the same level those hormones go down dramatically and so you don't have any more samples we don't have any more stem cells in ovaries and don't have the same level of hormones everything these creases dramatically but just have a partial nope doesn't affect anything everything to me to explain that no backpaki go through after but it happens any other questions okay so we are also going to affect the uterus we need to talk about the endometrial lining inside the uterus the lining that changes each month okay now we're going to talk about in fact that the endometrial lining has two layers to it it has what we call a basal layer and now we also have a functional layer and the functional layer is really what goes through changes the basal layer just kind of sits there going to do a whole bunch so the functional layer can change now the female reproductive cycle is based off of a 28-day cycle so you have day one you have days twenty-eight and so during this 28-day cycle we're going to say that day one is first day that she sees red blood and the thirty day one of our cycle and on day one all the hormones pretty much that we've been talking about are starting to go up gnrh driving FSH LH even a certain level there all right and you know that when estrogen goes up LH goes up as Jin goes up LH goes up so these levels are going to rise even more in GnRH for emphasis there going to be a tremendous rise in estrogen and in LH and they continue to rise until ovulation which is about day fourteen because we also know that on day 14 this is the day that we form the corpus luteum so we're going to see another hormone rising here and that hormone is going to be progesterone and we know that on day seven which will be day 21 after ovulation one of these things is going to occur you can progesterone continues or progesterone is gone so if we have pregnancy or just run local state if we don't have Tripathi on day 21 across the can go through apoptosis and we see progesterone levels falling so this is going to affect our LH FFA GnRH levels so we know when the metro goes up all these levels are going to go down on a planet armed a flowing lines and progesterone levels are up all those levels are going to go down now what will happen to GnRH LH and FSH if she's pregnant if she's pregnant what happens to gr h LH FFA estrogen stay down no modulation but if she's not pregnant they're all going to start coming back up again so we'll see these stay down until somewhere around day one again and then they'll all start rising again if there's no pregnancy everything is going to start coming back up if there is a pregnancy they all stay down for the next timeline and we don't want her to OB late again so now we know between day 1 and day 14 estrogen levels are rising and one of the things about estrogen is that throughout our entire body estrogen can stimulate mitosis so between day 1 and day 14 we see mitosis of the functional layer in the uterus so estrogen levels between days 1 to 14 are rising and they are stimulating mitosis of the functional layers now first and 14 is ovulation so in case you get pregnant we want a really nice thick functional layer from embryo to embed it's open a second thing that estrogen is doing is that in this basal layer we have very specialized arteries that kind of look like little offs through screws here these are called spiral arteries and ultra Jen also affects those spiral arteries and kind of causes them to unwind and as these layers get thicker the spiral arteries are much further away if they stay in the basal layer so as we get more cells we're going to lose the spiral arteries out into the functional layer so we can see these cells but also if an embryo enters in here these spiral arteries will also be able to see damn real so remember ovulation is going to occur on day 14 and then it hit only 24 hours for fertilization to occur so there's got to be a sperm hanging around between day 14 and day 15 because after day 15 the egg died so we say basically fertilization occurs on day 14 when ovulation and makes seven days for this fertilized egg to move down the fallopian tubes and so on gate 21 it enters into the uterus we also know on day 21 the corpus luteum may or may not stay alive and one if she is or isn't present so let's talk about what happens if she isn't pregnant so if there means no embryo okay on day 21 there's no embryo that means the corpus luteum is going to go through apoptosis and what happens to progesterone levels fizzle came out we haven't talked about progesterone in any of them so far can the homeand open do anything to any of this why ovulation occurs and progesterone levels go up all progesterone does is kind of maintain the scene keeps everything just like it is doesn't let anything change it's kind of a maintenance hormone okay and a lot of times younger people call progesterone the hormone of pregnancy because it's really the only hormone that stays up during all the pregnancy so when progesterone is on day 14 it's only maintaining all the work that estrogen has done so if for just role model drop because she's not pregnant then we're not going to maintain all this so the first thing that's going to happen is all these spiral arteries will start kind of twisting up again and they'll start pulling themselves back into the basal layer so it's progesterone levels go down on day 21 you'll start to see all these spiral arteries fully maxed so the spiral arteries between day 21 and 28 start pulling back into the functional layer so the spiral arteries are cork screwing up again and they're pulling back into the bagel place out of production level part now notice we onl have a lot of blood supply for all these functional way ourselves anymore and so these cells are going to die so what you see is during this time these cells start to die so we say that the cells of a functional layer are going to slough off that means not only do they die but they fall off the inside of the uterus they don't attach anymore so during day 21 to 28 she made any kind of a brownish discharge those are the dead cells from the functional layer on day one again these cells have died off so much it actually exposes a little bit of these spiral arteries and red blood can be synced and so for Menzies asserts that last long has all the functional layer cells from day one as estrogen levels are going up they start to grow and so there'll be a little bit of bleeding for maybe three or five days if there is pregnancy everything is maintained for the whole pregnancy leaders of the prepreg a genetic 51 one yeah one to say three or one is a five if it's occurring more than that usually is it a much younger girl that all four hormonal levels are quite regulated yet by the way the youngest person again a female in your household will cause everyone else to cycle with her because all of these hormones come out in her sweat and then you know ladies inhale it and it changes your entire cycle here's something else that's really interesting workers did you know that men in their quest also secrete testosterone and somehow in this whole cycle it is actually controlled by his guttural they did a really interesting study where they took this College that wasn't still live it's an all-girls College on the East Coast it's called goals in the college and they asked all these ladies at the college for one you know I'm sorry for two months please do not have anything to do with any guy don't leave the campus is a huge college wide experiment and by basically the second month most of the women on the campus word pretty irregular already then what they did is they brought a guy in that nobody knew and they didn't have him talk to anybody all he did was walk through every dorm or and they asked all the ladies of the dormitory please stand in front of your door don't say anything to him don't touch him nothing just he's going to walk but after he walked by everybody noticed the next month everybody was pretty regular again so that it appears that the testosterone levels that a male's decree through his quest into the air when she breathes it in helps to actually regulate her cycle and a household of all women typically have a very irregular cycle so when you ask what is he good for there you don't and that is what you will that be like all the big paycheck they're going to be a whole package they don't have regular tuition and they are feel like not married yet after that life is like having a baby in the tradition that's all the wiring memory makes a big change and how brains work so why is it that one female is pregnant you hear sometimes that persistence well okay so all of these hormones are airborne we're all plugging them out so she now has lots of progesterone and guess what he's inhaling it and now he's feeling no system because he has never had high levels of progesterone this is actually pretty banged up on him because he awoke on the weird system he's never had before like his breasts start to hurt and he gives morning sickness and get it yes this is what you know he's not making it up trust me he's feeling the same thing you are you can make the difference what must you have like maybe less like not lean is heavy maybe less and yet where she's with us how those women yes heavier period not painted look yes women if let's say you are a female and all you have a brother okay and there's no other female in the house does that change how heavy the cycle is and the answer is yes in comparison to living in a house bulking up if you live in an earth email you live in a house of all males will 0-2 females in your house you will not have a penny of the cycle because your suction levels are so high it suppresses a lot of departments if you're living in a house of all female now all these hormone levels are higher than you would normally make them because you're getting theirs to my friends okay I have a very good friend who we work together at San Diego State University and he was doing research on how estrogen affects certain females and he has to actually mix these concoctions up that have your high levels of estrogen so he wore gloves and he wore you know gown and everything that he never thought about we're in the math and so over the years he was actually inhaling all this airborne estrogens and over time he actually had to have a double mastectomy because he had such high estrogen level that is mitosis level went so high he ended up a breast cancer and it nearly killed him so these hormones float in the air and they effective and they change personality and they change how hard your cycle is or not and they can do all kinds of different things like here's another one cortisol will inhibit blood nagging hormone secretion which means estrogen won't go up which means follicular fluid won't go up which means she won't oddly so the more stressed out you are the less likely you are to get regnant people running women athletes nervous because they don't have enough fat and remember I told you the other cells that make the Roma takes its back though so they have such little amount of fat on their body that they actually don't make as high a advanced Regine level so they also don't popular any questions we have you're breaking into more formal letters yes yes and by the way during pregnancy some women globally and this means that their progesterone levels are high enough they're not maintaining and the social layers will be not now look at what the problem is if there's an embryo in here or there's a fetus growing in here and the functional layers left off it could fall out so bleeding during pregnancy is a very bad thing it is one of the major cause however seventy-five percent of all pregnancies and in miscarriages of the woman doesn't even know she has because the majority of those embryos are equal and so they just naturally miss her and she never emotions to happen so early on in a crisis so instead upon you feel free to do so normal girl right yeah so identified what's happening is the uterus is stopping forgetting everything and those estrogen and progesterone level will control the astrocytes in the brain and how the synapses gate so the estrogen progesterone levels all those astrocytes what synapses fall apart to learn is it's like much out there trying to figure out how do I push back together and what do I do how do I get done snaps there's a lot of rewiring that's going on so like a short circuit for a little bit and it comes back together short circuit because it's nothing to drop all at once it's like everything else goes down and all up and then down the clock them yeah and we don't really officially call it menopause until all that crap stop I think you can have nothing in a one-year-old yes so everybody going to be like Pharma and the new casino yes and you cannot have it for two years and it can come back to why do the necklace looks like up there move swings like we that that's what we're talking about right there because what happens is as the hormones are dropping and then sometimes you'll make some more and then they drop the men sometimes make smart it will changes in apses in the brain so that you synapses kind of short circuits and eventually won the caramel level drop all the way those synapses figure out how it comes back without the use of estrogen and progesterone drops okay so thank you and here's the cycle can t force until event including me like an abundance and there may be people that you may not remember we're talking about steroid hormones so I was even a fat in my diet how do I produce enough of these steroid hormones because I've gotta have that fat as a precursor to make cholesterol which make these steroid hormones intersect so I won't have any estrogen progesterone testosterone changes because those are all made from fat so if I'm eating a low-fat diet I may not be able to make enough of these hormones to even have a cycle so I have this amenorrhea where I don't have any mental cycle at all or maybe I have mental cycle once every 18 months so that's why sitting on this fat diet so under high populations all your daughter's very irregular commuted so to put into practice or a fad years of share this exam lol it should help you and especially women who can't get pregnant most of the time it's due to low fat macgyver multi-way but most of the time birth control birth control is basically high levels of progesterone that inhibit gnrh FSH LH so the ovulation can offer I'm still curious you still have a period but it is enough to inhibit ovulation so the functional layer can still grow but then on birth control it doesn't grow as much you don't believe as much okay so usually the period can be as little as a single drop a blood - maybe just a couple of days of bleeding occurring so it lowers all of those hormone levels especially low enough so there's no ovulation are there harmful effects of being on birth control because it changes the levels are those many women have been on birth control for the last all 60 years and they haven't seen any long-term problems with that the only problem come once you get older like into your forties or so you increase your risk of blood loss especially if you're in your 40s and you're smoking then you do not let the on birth control cause blood clot risk and stroganoff goes really high yeah so when you come in at regular mesh the type of either the doctors tell you to be on birth control room regulated because okay so you have so much stuff so many days of these pills right so those days all have different amounts of hormones in them so they're mimicking what this cycle is supposed to be doing and so it should help you to become more regular because the person is not regular isn't producing the right amount of hormones at your step that's why they tell you to do it's not going to help in the long term it helps in the short term but the reason you're a regular is typically because your diets bad the exercise too much or you're under too much stress or your hypothalamus up in total to mature yet because you're still young there's a whole host of reasons what you may not be regulated I thought it was Marvin the boycott start consuming pretty starts to break down around them and think they'll work right so the mechanism to form blood boxes to become more sensitive to level to progesterone and though you're much more likely to department and then of course if somebody's smoking cigarette they're already more likely to form blood clots and so you just add all the back together and it would be a disaster I prefer for that like personal health to like flexing and children saliva absolutely for being no idea because nobody knows what causes cracking nobody has a clue that's why there is no civil or market to solve it there's nobody figured out what causes it your scans and while we start an indeterminate urgency does not really because the expansion is so slow over time they're already lined up if you have a moment alone birth control pills or any type of birth control that kept them from having periods does that affect menopause really depends on the birth control pills some of the thoughts are if it's a strong enough tail in a lengthened menopause symptoms there's really no good studies out there those to say the best what you need will they not go through it or will be delayed it longer no idea I've never seen a study on that I've had that question a million times and I'm never been able to find a study to answer that question so the answer could be yes or no I don't really know to be honest it makes sense but I don't kind of own them and the other question okay so let's talk about the nail okay so during puberty gymnastics GnRH from the hypothalamus and that caused the anterior pituitary's made FSH and LH now obviously she doesn't have a follicle and you doesn't have a corpus luteum but the reason that we use these same names and her nail is because they found these problems in the female first and they already named them and then it down oh shoot men have the same exact hormone so you're stuck with the female name now after page increases from out Genesis LH increases to stop them yes

we're going to talk about the reproductive system today and we will start with the female reproductive system on however going to tell you that in the people stage of development private to about nine weeks of pregnancy or what we call nice of cetacean if you were to look at the fetus you cannot tell on the outside whether it was a boy or girl so there is no external genitalia at all after about the nine steps of the guidance be the external genitalia begin to form and that is completely dependent on the protocol so talk about this before you know for a female the top of some selections excellent form a ensemble oh okay yeah okay pusher away okay clearances the NICU my brother will go subscribe your unloaded sure Shula problems look like an X and a wife or a male now and a male during this gestational period around the 10th week of pregnancy that baby start to secrete testosterone and testosterone is responsible for making this external genitalia growth so if you look at for instance the clitoris of the female so if you look at this external genitalia of the female and you look at the clitoris of the females the clitoris and all of the tissues surrounding it if it is exposed to colostrum will then form into a penis the lobby of my Nora and the lobby of majora here uh if it's exposed to testosterone will end form into the particular sacs and by the way the urethral opening here along with the clitoris after us pointed out all becomes the penis area and then of course there's no vaginal opening that closed up so what that means is for the male his external genitalia forms because his doctor arm is causing the change in those for the female there's no normal of necessary for her external genital Wepa penis which means that let's say you have this male fetus who has something wrong and cannot secrete in the estas drum when that male baby is born his external genitalia will live Latino because there wasn't enough testosterone to turn that into the male external genitalia and a lot of times the parents don't even know that internally their female child is actually male has X Y chromosomes and have internal genitalia like growing testes things like that externally they think that they have a female there are no true from Africa in humans so this is as close to of an acrid I as a human gift so the external genitalia looks female the internal Jen is males the only problem is although the internal genitalia grows it doesn't fully complete growth and so they don't have any working intelligent eyes so we don't have a true functioning come advertising use so by the time their child gets to puberty where you think this little girl is supposed to start growing breasts and have a menstrual cycle it doesn't happen and many times this is when the parents finally know that hormonal e genetically the child is actually really male and believe it or not the majority of parents and children will ought to go through surgery so via external genitalia matches with the chromosomes match because here's another thing depending on our chromosomes is also tells us how to wire the brain and I think you probably have noticed by now play male think is a female figure not quite the same they behave and think and act a little bit differently from each other and so in these children usually the brain is wired to be more male than Cena even though they've been racism they feel more like they're male because that is really the way the brain is wired so many of them ought to how their estrogen is how you change to male now what you can do and very interesting a students who give me certain things like at the end of the semester and one semester a gentleman who's in my class I do it also been in the Navy decided that he would gift me with a movie and it was his adventures in Thailand so part of his adventures was in new prostitute district as part of that movie was the females who have been exposed to testosterone later on in life and so what they did is as adults they gave themselves a few injections of system into the clitoris and if you do that you can barbecue now if you do it too much in life the penis will only get to be maybe about 3 inches long for these children who have external genitalia that look quite female if you do that that puberty they can actually normally naturally with testosterone grow a fully functioning penis all that has to happen after that is they have to have the vaginal opening closed up because it is not functioning at that point okay unfortunately for them they also do not have a functioning testes because of the fact that they do not grow up completely but all you have to do is give injections of testosterone different have to do any type of massive surgery in order to be able to give them a functioning penis which is very nice for the child one other thing I want to point out to you is this section right here it's called premium maybe it is either in a female between the vaginal opening a novena or in the mail it's between the underside of this particular stack and in this program iam really doesn't do much not really very important throughout our lives and stuff if you are working with burn patients okay so individuals who are hot inspires and their bodies begin to burn one of the things that we the natural stress reaction is they go into a fetal position which means that that bringing their arms together they're bringing their legs up and they're bringing their butt in got a lot of pucker power going on there and for them that's actually very important is because there is a really high chance that if the person survived this small area may about the size of a quarter of skin also for us so you may have the patient who had burned over 99 percent of their body but that wonderful area of skin is still intact and since our skin is an organ we may have to have like an organ transplant if we lose our skin and we can reject certain types of skin that we might get as a transplant so we can grow our own skin when you lose it it is so much better course because then we would have rejected so in this patient you've got a couple problems out because they don't have any skin you're going to put pigskin over top of them in the meantime and you're going to put them into medically induced coma because it's really painful the reason you put a pigskin on them is one so they don't lose all their water and dehydrating dust and two because the bugs can't get in so you wrap them head to toe in the pigskin and then you take a really interesting instrument it's electric as almost like a shaver and you shave off that one piece of perineum skin and put it into like a cookie sheet okay and you put medium in there and you oxygenate it and you let that sucker grow and you grow it in a full sheet of skin and you'll grow after that multiple sheets of skin in order to graphic now around your patient hopefully if you can keep them alive long enough to get all that skin to grow specialist they've lost a lot of their skin if you ever have an opportunity to do a rotation at arrow tests see if you can go to their burn ward it's absolutely fantastic they have one of the top for our Lord in all of Southern California and they grow their own skin there and it's just an awesome experience and it's just really really nice and so a lot of people their skin and comes in from the perineal region because it's the only fit back essentially be left up it's usually a few weeks oh for one sheet or less usually about a week from the line so you get that premium to grow you take a piece off and put it in another sheet and grow it so it within a couple of weeks you've got enough skin for the whole body yeah now you may have to do multiple transplants over time to stumble they lock you get is more there's all kinds of different things that you have to do over time but it usually took initially wrapped up is about two weeks we shave all the scales of emperium okay so you mention that you know handling organs and I know a symptom extent Delta name or a hardener where you guys can do they are doing that now yet but you for the long time like it if I have skin to grow it will be faster than if I be simple so best to hope for a little bit of skin less for them to be able to growth not by the way on the clitoris okay because it also turns into the penis tells you that it the same and neurological and blood supply as the penis looks so that means that is also connected in the same area in the female brain as in the male brain so basically the clitoris is like for the male organ of orgasm and then underneath that you have your referral opening so that urination can occur and then you have a vaginal opening which leads up eventually to the uterus then there are these little Bland's right here these are called the Bruner's gland and Bruner's lands secrete a mucus II substance that keeps this entire area noise and this area officially is what we call the vulva okay and so the brooder glands become infected they'll cross over and there's not enough mucus secretion and the vulva region can become very dry and cracked and even begin to bleed poets is not fun experience now if you proceed up through the vaginal canal up to the bat-vault excusal then you'll enter into the basketball town so this is the pelvic bone here here we have the clitoris this is the opening to do your redress and moving left into the black and we have the vaginal canal leading up into Z or the vaginal opening season again leading up into the vaginal canal and then the uterus and right here are our Bruner's lamb and then the rectal region now the vaginal canal is very stretchy however it's lined with skeletal muscle okay and it has multiple different jobs of course this is where the storm is planted in order to fertilize an egg and have a baby it's also going to have to stretch open because this is the birth canal where that baby is going to be able to come out but another really important thing about the vaginal it's like a really strong column that hold the uterus in place the uterus sits on top of the vaginal canal now in the arms pregnant female the uterus is about the size of like a walnut okay not very large but of course the pregnant females depending on how big that baby get it can really stretch out now also the skeletal muscle of the vaginal canal can really stretch out when that baby is born so let's say you have a woman who have had three four or five children the vaginal canal can stretch quite substantially and the problem is that eventually the uterus kind of stretches out to becomes a little bit heavier the connective tissue can't hold as well commercial canal is too big and the uterus falled up socialism Argo about Herman she sees this purplish thing hanging out the vaginal canal and interviewers so once that happened okay what we called for a lot cuter as' and it happened quite frequently actually she's going to have to have a hysterectomy and have a uterus removed so it's not a real positive thing for the woman and so wanted to think that you need to suggest for her is that she needs to after every pregnancy after a little bit of recovery do some exercises to strengthen the muscles because their skeletal muscle again she's gotten to a little bit of that vaginal canal because by strengthening the muscle the canal shrinks in size and then can hold that uterus up so this type of muscle exercise was first talked about by dr. table so they called the Kegel muscle exercises and you know obviously doesn't II don't have a vaginal canal I don't think no and I saw it's a little bit hard for you to understand but in order to instruct your patient you can kind of tell them it's sort of like you know when you have some about room and just can't go yet and so you know you're squeezing it and holding it it's that same kind of response so you're going to squeeze those muscles in that vaginal area and of course you know do like you know 30 repetitions a couple times a day I mean you could be doing it is me all across right now we never know is related to somebody come on what is that I come on squeeze those muscles firmly several times a day or you could also buy we're called Benoit balls and these are stainless steel balls becoming a little case and you come in go ahead and slide the hooklink and they start out very large and go down to the size of a pea and the idea is you're supposed to be able to insert those into the vaginal canal and hold them while walking around now please please please you dr. Harvey a really big favor please do not walk around with these in public okay it's really really embarrassing when dr. Harvey is like in target picking something up really fast and in the same aisle with a woman who all of a sudden this little stainless steel ball goes oh just came coming right now and she goes chasing it down the aisle and picks it off and pop in our pocket and it's just we're in the privacy of your home and 90 target because I can read over time see and okay please please don't do that okay always reminds me of a story true story cuz I was there and a half we're on Highland Avenue in San Bernardino going down Street in a police car and this guy's on the side the road waving us down and he holds a cop over book it out she's like you see that homie right again she just ran up to me question is on prosecuted of officer called her over okay what happened I did not rob him I keep paying me for a job okay I'm a city paid ten bucks and he got a better [ __ ] Christmas and last year does look to the gentleman he says look I'm sorry no you have to take this the civil court this is not a crime okay and there's nothing I can do for you here's my last $10 and I'm hungry and she's robbing me though but I was just kind of listening in on like whatever adding up to the girl came out you know what give him the ten bucks back hi so she lifts her leg and sticks it on to the bumper of the officers car takes their hands this is up inside her vaginal canal and pulled off this dripping $10 bills tries to slap it into the officer cams and screams and jump back so she slaps it in the guy's hand he grabs it sticks in his pocket this thank you and walked on the streets Taco Bell to fight is do your mom tell you that money is dirty the chickens money is dirty okay so you will be real careful handling money okay fabulous okay cuz you never know where it actually came from so do not tell your baby says this is a good person okay I can tell you other stories where I met a woman who actually had a six-pack of beer I don't know we all sit back and what was worse she was caught on video I made there's a watch just amazing you have to put them in one at a time well he's especially now I told you it stretching it I'm gonna get it right time her three-year-old favor both in the liquor store with the same time and I'm going how did she walk out with that actually not break one she got drunk one people now for the video that I saw I witnessed women who have really practice their cable lock electrified and these women were shooting dark out of the vessel guess what and Gimbel watch two watches course it helps in coding okay by how well did to de Kegel exercises letting you know just to go off when you know Oh laughs it takes all this to OG uterus hear that sizzle top the battle canal and notice how it's tilted forward and it's tilted over top of that bladder there so now imagine in one she gets pregnant and she has this seven eight count baby inside there and it's pressing down on that latter it pops that Baker open and this is why she number one Jill the choice of a bathroom all the time and have to be really careful of not being your pimp because there's so much pressure on top as well now one other thing I want you to know about the vessel canal is like many other areas in the human body there are log bacteria and even some parasites in there and they're there for a good reason it keeps other things out okay so one of the things you want to be real careful of with your patient is tell the man that douching is a no-no it is not a good idea the different bacteria that's in there helps to keep the vaginal canal highly acidic and that acid environment keeps everything now so in my experience women who bouche have gingers so you know working at low London emergency room you get certain women that come in and there's certain you know experiences you have like pulling giant blonde cockroaches out of a woman - yes sure that did you say 15 fire ants no I she was asking how come and I said well because the the environment is so no longer is acidic food cetera they unlit up and live in fungus so you have to go very very different areas it probably [ __ ] every problem about using scripts so not in the cabin and then you might make both of them but anyway see there are other things to besides you know stuff that you can buy at the store that people douche with or interest for instance the industry of my favorite stories one is a student showed me some x-rays of a patient of hers at one of the local hospitals and the patient had come in complaining originally of upper right abdominal pain okay that was the original complaint very very painful and then ran all kinds of tests on the liver the ultrasounds I mean they just put her through a battery of tests now keep in mind one of the things that happened with your patients is that they don't always tell you everything number one maybe they don't have the ability to because they're sick or maybe they're not growing that intelligence or maybe they'll think of certain things to tell you which is what this patients total dr. farthing I never thought of telling you and so then he decided that they were going to do abdominal exploratory surgery on her and when they did they found swimming very interesting they found a route embedded in her liver and it was growing leaves so they follow his bruise all the way back through fallopian tube into the uterus down into the vaginal canal because in her vaginal canal this patient has douche with a small tell me people would start all kind of interesting things about this I've seen people have been inserted eggs up there and have to go and flush all the shells out does it Brooke they're going to be that make sure parvo okay you put a potato up there now twice are warm moist environment ruler well that's what a half so start to grow it grow it through right through her abdomen and implanted on her liver which is why she had that rise of abdominal pain so they had to dig that root out and remove our potatoes okay after that okay back off my merit story that we've all time favorite story all those women who came into Louisville Linda and a lot of women are very embarrassed you know when they talked about their Volvo region and so they have a tendency to you know they down there which I always love to look at their toes at that point but she gave me a complaining that down there was very in Chi spell the nurses took her into the back and one of the nurses came out just dying from laughter and you have got to come see this which means you're going to do it right and so they have our completely undress and you can see in this vulgar region she is actually having the belly button all the way down across her thighs all the way to the bun she is covered in maggots Oh discovered this little mystery community in your life everything about Russian Ahmad may be taking a shower or not okay so you're going to show you them interesting people come into your er and so I of course have to know is how to disappearance because that's just the way I have the story that she told me that two weeks prior her boyfriend was coming over there good and she knew that he liked great chili so she packed her vaginal canal with Big Joe and then she never took shower I told you to be some interesting people especially be worked up with no live near never-ending which is very long-winded okay and luckily for her kind of fly yes Epis may come from as well as all their propagates lie which is a flushing why another worldwide that bites you you know you believe it out okay that kind of flies that the magnet program those flies only left to eat dead decaying flesh so as they started to grow and move around on her they actually debride it her and the other reason that she lived and you used all kind of maggots in hospital a lot of times is a brief bit and so she actually survived they hostel enter for a while your cream antibiotics make sure she was okay but she survives and then they instructed her don't accurate jelly out there I hope they had served in Iran like peanut butter kids it's not was probably bad all right frost about your canal you have the uterus now the mouth of the uterus is what we call this perfect I'll deserve it okay when is shown there it looks like there's this massive opening in the cervix right here that is not the case this opening right here is actually microscopic okay because when that giant flying cockroach gets into somebody's vaginal canal you don't want to be able to get up through this uterus through the fallopian tubes and then it's attracting that fat potato actually ruptures the surgical area to get through there and alpha silicon tubes so there was some damage to her cervix so this is very very small microsoft and then on top of it there's a really really thick layer of mucus here what they actually call like a mucous plug right before a baby's going to be born that need to close will fall out so it tells you you're on very much time okay just letting you this blood fall down and it is really quite thick mucus now let me just back up for a second and tell you that the function of a reproductive system is to reproduce it's not to have fun people get that so confused okay oh and what'd I tell you this is because no matter let them try to do support this research system people still have a be okay be there to this time they take birth control pills and the human race is still increasing okay condoms I care what it is that sperm and that egg they're tricky okay and they want to come together and they want to farm baby and you would think by having the good mucus plug here that does not keep the sperm out and you know you just have this little teeny tiny microscopic opening here in this muscle area it will keep the sperm out but it doesn't that microscopic opening is just big enough for those little sperm to get to and this mucus plug if you look at it under a microscope what you see is something very interesting this mucus plot also have like will burn free ways through it delegates they're a tricky devil so that is just big enough for a single sperm at a time to be able to get through and so it does not stop the firm where it myself just want approach but that's Burke still have the ability to get through that service and then into the uterus and then off to fulfill use now talking about the uterus if you remember from analogous three layers to the uterus the innermost layer is all we're really going to care about today is called the endometrium and then the middle layer is all muscle this is a myometrium and then it's outer layers apparently trim is like a connective tissue layer on the top now just add frontal tiny bit about the mind metrium that layer is not really super important in a woman's life until she's ready to deliver or what we call her tuition and so when she's ready to deliver that muscle needs to be able to contract and have to contract an affair in particular we want the muscle that Miami trim to contract from the top or the fundus of the uterus down and then contract from the top down and continue to contract in this pattern because what it's doing is pushing a little parasite out okay squeeze that little thing out like a pebble now no time in the woman's life can that uterus contract in that pattern and so Romney ninth month of pregnancy because during the ninth month of pregnancy all the muscle cells in her myometrium start forming gap junctions between each other and as soon as our cells start forming gap junctions they're able to talk to each other and to tell each other to contract now she'll start to feel those little contractions like little switches during that nice month as more and more gap junctions form and eventually when all the gap junctions form they'll know to contract in this downward pattern now before all the gap junctions form before labor begins what do we call all that twitching of the Merkel bracket and hit abstract that's the name of the two doctors that figured this out so that's where she starts syllable twitches and pains in the uterus and then when you get that synchrony of attraction we know that labor has started now we're really going to focus today on the endometrium because this is the layer that once a month build up and then if she doesn't get pregnant died like okay so we're going talk about how build up how it dies off but off of the uterus are the fallopian tubes and right underneath but not attached to just kind of right underneath the fallopian tubes is the ovary now the fallopian tubes they're only about four inches long and they're only about a quarter of an inch in diameter their lines with cilia and then at the end of them to have those little finger like projections your they call them sittin brain so about the fimbriae are we moving in a pattern kinda like this okay and it's sort of a [ __ ] pattern and it's sucking in water that's on the outside of the user now one an egg popped out or ovulates out of the ovary okay it's going to suck that egg in and all the cilia it's lining the fallopian tube or the oviducts in all beading in one direction towards the uterus so the bat rule egg starts to move the four inches into the uterus now the sperm and egg will typically meet right here at a little bend what they call the ambulance so if there's an as present and a firm present fertilization usually occurs right here and then the egg continues on its y-axis been fertilized into the uterus now just so you can keep this in mind since we're going to talk about this a little bit later it actually makes seven days for this Kerrville egg to go four inches so the really slow journey for the egg to get into the years now sometimes for some women and this especially happens especially transmitted diseases are involved these cilia your girl's done and if the cilia die then there's nothing to move that egg into the uterus and if it gets fertilized here it ends up staying in the fallopian tube and on day seven that FERC watch egg will implant wherever it's at so if it's in the fallopian tube it plants there if it's in the uterus it plants there so if it's in the fallopian tube and it starts to grow since all the quarter inch in diameter it can't grow very much before it starts a strain on that too and there's a lot of pain that the woman feels when she has what we call it too little pregnancy because it's crying too if it grows too much fat people explode it will rupture and the weapon is she was lead to death before she ever got to a hospital so there is no ability at least at this point for a baby that's growing in the tube to actually be removed and then transplanted into the uterus so what the doctor is going to do is cut this piece off because number one it's defective that's why the eggs planted in there in the first place even if they scrape the egg out it would happen again one now she's got another tube and just because one of defective does not mean the other one has to be so she could still you know get pregnant through the other two but that's what she still want but that flowed into any questions so far so we're going to talk about what happens in the ovaries and the monthly changes that occur in the ovaries and then we'll go in and talk about the monthly changes that occur in the uterus and a hormonal issues okay so the ovaries just like a lot of other organs and the cortex around the outside and then I'm going to do luck in the middle in the middle where the medulla is is where all the blood that will come in and the nurse the cortex is where the eggs grow now up until about two years ago one of the things that I need to tell you is that a little girl was born with all the eggs she's ever going to have we now know that's not true just like a little boy little girl her eggs start to grow later in life and now we know that they come from so when the baby is born she does have some stem-cell in the ovaries but they don't look like anything we might think of as a eventually these stem cells will start to form this role in the Chur looking egg which is what's referred to as a follicle okay and then those volleyball just kind of sit there until puberty just like a word for hope okay Phyllis the hypothalamus obviously talked about it a lot in class so far very important area of the brain and the other interesting thing about it though is it is actually the last part of the brain to totally mature so you could say it's the slowest maturing part of the brain and doesn't completely mature until around the time of puberty and so we know that the hypothalamus is finally totally mature when it first starts making GnRH or gonadotropin-releasing hormone this hormone GnRH once it's secreted and then make its way to the anterior pituitary and cause the anterior pituitary to secrete two different hormones so the anterior pituitary's that are released to different hormones one is also stimulated Carla the other is luteinizing hormones these come from the same cells and and your juicer so you know that we have these immature follicles and so although stimulating hormone is going to be possible to mature or we could also say cause these follicles to go through meiosis it and so I want to go through my outfit you get a mature egg or you get a mature oppa blues rising for month causes an increase in estrogen okay so again we're going to test between luteinizing hormone and oxygen production and this is most position here this is our OVA or our own site are we gonna call it surrounded by our granulosa cells and our biggest seller they are being stimulated by follicle stimulating hormone to go through mitosis the thing yourself have receptors for luteinizing hormones so our luteinizing hormone is going to bind to these receptors on the Saiga cell and cause the snake itself to increase production of a certain hormone that hormone instance Ostrow so I'm good but like a big t in here we're going to make dr. ohn in the biggest up now success is das droids made by Sega cell it's going to simply diffuse into the granulosa cells and all the granulosa cells contain a special enzyme there's only two types of cells in the human body that contains this end gun it's the granulosa cells which of course on the females down but also fat cells and that would be in both males and females and then enzyme in the granulosa cells is called a roll the tape a relative is going to take testosterone and convert it into estrogen so when we say that one eivin's hormone increases estrogen production get out the other several steps to actually get the test version production to dilla we may now watch this when estrogen production increases this estrogen actually feeds back on to the hypothalamus and on to the hands your pituitary and eventually we're going to see a rise in with men and women and then of course when women come on Rises will have greater estrogen production that estrogen will feed back again on to the anterior pituitary and cause the luteinizing hormone to rise again which then causes estrogen to rise which will feed back and cause dependence on to rise again and estrogen will rise again and what kind of feedback so we have positive this is a positive feedback and you know again that was a positive feedback there has to be a shutoff switch I'm going to have to talk about what that shows which is in just a second let's go out and check my musicians meet you and it will have user kind of she could probably get something off the phone hey no there is actually a disease that runs in her line and it's called it's actually called Lou Gehrig's disease amyotrophic lateral sclerosis and it's a neurological disorder and so while she cannot have puppies because we don't want to continue reading her line at all she luckily has no problems from it but this neurological disorder eventually when they get to a certain age it actually causes them to become completely hairless I was very basket over budget actually from France and we didn't know that she had this disorder until her dad died from it okay so now we have blue Magnus come on Friday and follicle stimulating hormone rise rqz and estrogen levels rise until LH and estrogen LH and estrogen they just keep going up and our moms now the question is why why we have this okay so look here again on the overhead you have follicle which has become a mature egg okay and around it are the thicket and granulosa cells here in pink and over time as estrogen levels go up you start to see this fluid being built up around the eggs eventually you get a ton of fluid built up around this egg and notice how all this fluid here is actually pushing out on the outside of the ovaries this fluid starts to build up so much that it actually creates a pressure on the wall the ovary to the point where the wall of the ovary explodes and what that does is the fluid pushes out and the egg gets pushed out in that fluid and now no population so in order for the egg to actually leave the ovary you have to build up all of this what we would call follicular fluid and estrogen is responsible for this fluid production so the more estrogen that goes up the more follicular fluid is made and you keep going up and up and up and those kind of like an oath exist on the side of the wall there's so much pressure it explodes and then we have ovulation of this egg okay be thinking regular so make that with it but it's under the influence of custody and the estrogen levels are going to rise and create a pressure on the wall of the ovary until that wall ruptures and ovulation can occur now as soon and ovulation occurs take a look again at the overhead at the Seca and granulosa cells here as this egg ovulate they're already starting to change colors and within just a few seconds they start to kind of look a little puffy and the circular yellow and then within just about a minute the second grain will fulfill a totally different they look very swollen and they're a ripe yellow coat and these bacon granulosa cells are now renamed the corpus luteum our purpose in body lucia means yellow so right after ovulation taken in grandma's now are going to change into what we would call the corpus luteum [Music] [Music] as we taking granulosa cells change and become the focus with TM these cells also start to secrete a different hormone this hormone is progesterone but no longer are we producing estrogen now we're going to produce progesterone progesterone job is to feedback on the hypothalamus and the anterior pituitary to turn off GnRH LH and FSH so we're going to turn off there's a positive feedback but we're going to turn off all the hormone secretion so this is a negative feedback so we just turned off all those hormones are just producing so our GnRH no more FSH LH no more estrogen all stop concerned look for Becca and then they never saw [Music] okay so why would you want progesterone levels to go up at all during the reproductive cycle in the female so that we turn off gnrh LH FSH estrogen why would you want that to ever occur the difference yeah it prevents pregnancy so after ovulation she may get pregnant and so then right after ovulation you wouldn't want her to be able to get pregnant again you have to stop ovulation from occurring so we have inflation occur and then we're going to suppress all these hormones so ovulation can occur just in case she's pregnant because could you imagine if she's an autumn late after she was pregnant that means she could get pregnant after she's already pregnant soon after how long is it before her due while I'm doing nine months I do six months and I'm doing two weeks there won't be any children born after that and someone will just stop having babies after that you have to get pregnant after you're pregnant and would not be a little bit so we have this ovulation occurring here and then the purpose buti'm come long to make progesterone and we want to keep oscillation from occurring now of course what if she doesn't get pregnant okay if she doesn't get pregnant you don't want to keep suppressing all these hormones you want ovulation to be able to occur again so if she's not pregnant then the corpus luteum needs to go away for just your own needs to go away okay so the corpus luteum it potentially can last for a long time so if she's pregnant she doesn't modulate or the corpus luteum potentially can go away from Swift if she's not pregnant I'm going to talk about what happens to the corpus luteum if she is pregnant and if she isn't pregnant yeah okay so we know if she is pregnant we don't want our nation to occur so we don't want for just Iran to go away we want to keep it there so it's suppresses gnrh lhf image okay if she's not pregnant who want the corpus luteum to goldwave we don't want any progesterone anymore so let's talk about if she's not pregnant first and we'll talk about if she is pregnant you so corpus luteum if there is no pregnancy we'll go through any pops toastin 7 days after ovulation what is apoptosis okay so this is pre-programmed Suns or suicide literally the cell have instructions to kill itself so there's no pregnancy 7 days after ovulation occurred all these corpus luteum cells will destroy themselves their form progesterone levels drop and then we can get ovulation again but if she is pregnant that means there's a fertilized egg now we need to stop apoptosis before our date 7 occurred okay so that little fertilized egg it's going to start dividing and dividing and dividing over the next 7 days and it's going to becomes what we call an embryo there's going to be several hundred cells and you have an embryo that embryo will secrete a very important hormone that prevents the corpus luteum from committing suicide so on day seven this embryo is secreting HCG and HCG stands for human chorionic gonadotropin it's this HCG that prevents a populace of the corpus luteum cells Oh so HCG is going to prevent apoptosis of the corpus luteum which also means progesterone levels are going to stay up throughout pregnancy and there's not going to be any more ovulation again grandiose little grandiose echo don't repeat projections elevators that's right now just for your information on purpose luteum is the main source of producing estrogen during pregnancy and so maybe about the fourth month of pregnancy during the fourth month of pregnancy that's when the placenta is really fully formed and it will take over making most of the progesterone so the corpus luteum is pretty much on a back burner now because the placenta is making a ton of progesterone any questions so far no pedestrianism not at all now it is goddess of good it doesn't so this progesterone is the prepping GnRH LH FSH so remember in this step we'll look magical anacs estrogen testosterone is produced here to make that action okay but in the fetus this isn't affecting the fetus is affecting for long so it doesn't and obviously in a male he's making his doctor own mainly as a fetus in adrenal glands so there's not a lot of testosterone production ineffective at any location that is not going to actually occur well there's two times this is sovereign production in a male goes up and the first time is on a day of birth because in the unborn baby boy yet these are active forms right well mill but okay they're not in this particular set 24 on that very first day if you measure testosterone levels in little baby boy who was just born they will be as high as an adult males level of testosterone and those super high levels of testosterone actually caused the taxi to descend from the abdominal cavity into the scrotal sac and after about day three those levels go down until you go through puberty and then the world around so during the fetal stage of development social levels are fairly low so higher than in a female fetus but they're way lower than in a child or adult any questions so far if so it's a woman hat assistant a few dozen soon okay you can have a partial or a total hysterectomy is typically just the uterus so and blue oophorectomy is removing the ovaries so when we say it's a total hysterectomy is usually close we're talking about so if she still has her ovaries all of this is still occurring none of this has anything to do with the uterus at least at this point there's nothing and so all these hormones are still being produced and ovulation can still occur of course there's no uterus so the baby doesn't have ability to grow we're really confused where do they attach the tube to okay so if we remove the uterus okay it's not that they have to choose because it seems off okay but these ovaries are cut from here but they remain attached to their blood supplies so there's connective tissue around them and so the ovaries stay in the public cavity but this uses gone and photophobia yes it's called an instantaneous Network his menopause is nothing but the fact that she runs out of tempo she doesn't have the ability to go through the whole title anymore and then there's also changes in the hypothalamus where she also doesn't sakru's GnRH LH and FSH at the same level those hormones go down dramatically and so you don't have any more samples we don't have any more stem cells in ovaries and don't have the same level of hormones everything these creases dramatically but just have a partial nope doesn't affect anything everything to me to explain that no backpaki go through after but it happens any other questions okay so we are also going to affect the uterus we need to talk about the endometrial lining inside the uterus the lining that changes each month okay now we're going to talk about in fact that the endometrial lining has two layers to it it has what we call a basal layer and now we also have a functional layer and the functional layer is really what goes through changes the basal layer just kind of sits there going to do a whole bunch so the functional layer can change now the female reproductive cycle is based off of a 28-day cycle so you have day one you have days twenty-eight and so during this 28-day cycle we're going to say that day one is first day that she sees red blood and the thirty day one of our cycle and on day one all the hormones pretty much that we've been talking about are starting to go up gnrh driving FSH LH even a certain level there all right and you know that when estrogen goes up LH goes up as Jin goes up LH goes up so these levels are going to rise even more in GnRH for emphasis there going to be a tremendous rise in estrogen and in LH and they continue to rise until ovulation which is about day fourteen because we also know that on day 14 this is the day that we form the corpus luteum so we're going to see another hormone rising here and that hormone is going to be progesterone and we know that on day seven which will be day 21 after ovulation one of these things is going to occur you can progesterone continues or progesterone is gone so if we have pregnancy or just run local state if we don't have Tripathi on day 21 across the can go through apoptosis and we see progesterone levels falling so this is going to affect our LH FFA GnRH levels so we know when the metro goes up all these levels are going to go down on a planet armed a flowing lines and progesterone levels are up all those levels are going to go down now what will happen to GnRH LH and FSH if she's pregnant if she's pregnant what happens to gr h LH FFA estrogen stay down no modulation but if she's not pregnant they're all going to start coming back up again so we'll see these stay down until somewhere around day one again and then they'll all start rising again if there's no pregnancy everything is going to start coming back up if there is a pregnancy they all stay down for the next timeline and we don't want her to OB late again so now we know between day 1 and day 14 estrogen levels are rising and one of the things about estrogen is that throughout our entire body estrogen can stimulate mitosis so between day 1 and day 14 we see mitosis of the functional layer in the uterus so estrogen levels between days 1 to 14 are rising and they are stimulating mitosis of the functional layers now first and 14 is ovulation so in case you get pregnant we want a really nice thick functional layer from embryo to embed it's open a second thing that estrogen is doing is that in this basal layer we have very specialized arteries that kind of look like little offs through screws here these are called spiral arteries and ultra Jen also affects those spiral arteries and kind of causes them to unwind and as these layers get thicker the spiral arteries are much further away if they stay in the basal layer so as we get more cells we're going to lose the spiral arteries out into the functional layer so we can see these cells but also if an embryo enters in here these spiral arteries will also be able to see damn real so remember ovulation is going to occur on day 14 and then it hit only 24 hours for fertilization to occur so there's got to be a sperm hanging around between day 14 and day 15 because after day 15 the egg died so we say basically fertilization occurs on day 14 when ovulation and makes seven days for this fertilized egg to move down the fallopian tubes and so on gate 21 it enters into the uterus we also know on day 21 the corpus luteum may or may not stay alive and one if she is or isn't present so let's talk about what happens if she isn't pregnant so if there means no embryo okay on day 21 there's no embryo that means the corpus luteum is going to go through apoptosis and what happens to progesterone levels fizzle came out we haven't talked about progesterone in any of them so far can the homeand open do anything to any of this why ovulation occurs and progesterone levels go up all progesterone does is kind of maintain the scene keeps everything just like it is doesn't let anything change it's kind of a maintenance hormone okay and a lot of times younger people call progesterone the hormone of pregnancy because it's really the only hormone that stays up during all the pregnancy so when progesterone is on day 14 it's only maintaining all the work that estrogen has done so if for just role model drop because she's not pregnant then we're not going to maintain all this so the first thing that's going to happen is all these spiral arteries will start kind of twisting up again and they'll start pulling themselves back into the basal layer so it's progesterone levels go down on day 21 you'll start to see all these spiral arteries fully maxed so the spiral arteries between day 21 and 28 start pulling back into the functional layer so the spiral arteries are cork screwing up again and they're pulling back into the bagel place out of production level part now notice we onl have a lot of blood supply for all these functional way ourselves anymore and so these cells are going to die so what you see is during this time these cells start to die so we say that the cells of a functional layer are going to slough off that means not only do they die but they fall off the inside of the uterus they don't attach anymore so during day 21 to 28 she made any kind of a brownish discharge those are the dead cells from the functional layer on day one again these cells have died off so much it actually exposes a little bit of these spiral arteries and red blood can be synced and so for Menzies asserts that last long has all the functional layer cells from day one as estrogen levels are going up they start to grow and so there'll be a little bit of bleeding for maybe three or five days if there is pregnancy everything is maintained for the whole pregnancy leaders of the prepreg a genetic 51 one yeah one to say three or one is a five if it's occurring more than that usually is it a much younger girl that all four hormonal levels are quite regulated yet by the way the youngest person again a female in your household will cause everyone else to cycle with her because all of these hormones come out in her sweat and then you know ladies inhale it and it changes your entire cycle here's something else that's really interesting workers did you know that men in their quest also secrete testosterone and somehow in this whole cycle it is actually controlled by his guttural they did a really interesting study where they took this College that wasn't still live it's an all-girls College on the East Coast it's called goals in the college and they asked all these ladies at the college for one you know I'm sorry for two months please do not have anything to do with any guy don't leave the campus is a huge college wide experiment and by basically the second month most of the women on the campus word pretty irregular already then what they did is they brought a guy in that nobody knew and they didn't have him talk to anybody all he did was walk through every dorm or and they asked all the ladies of the dormitory please stand in front of your door don't say anything to him don't touch him nothing just he's going to walk but after he walked by everybody noticed the next month everybody was pretty regular again so that it appears that the testosterone levels that a male's decree through his quest into the air when she breathes it in helps to actually regulate her cycle and a household of all women typically have a very irregular cycle so when you ask what is he good for there you don't and that is what you will that be like all the big paycheck they're going to be a whole package they don't have regular tuition and they are feel like not married yet after that life is like having a baby in the tradition that's all the wiring memory makes a big change and how brains work so why is it that one female is pregnant you hear sometimes that persistence well okay so all of these hormones are airborne we're all plugging them out so she now has lots of progesterone and guess what he's inhaling it and now he's feeling no system because he has never had high levels of progesterone this is actually pretty banged up on him because he awoke on the weird system he's never had before like his breasts start to hurt and he gives morning sickness and get it yes this is what you know he's not making it up trust me he's feeling the same thing you are you can make the difference what must you have like maybe less like not lean is heavy maybe less and yet where she's with us how those women yes heavier period not painted look yes women if let's say you are a female and all you have a brother okay and there's no other female in the house does that change how heavy the cycle is and the answer is yes in comparison to living in a house bulking up if you live in an earth email you live in a house of all males will 0-2 females in your house you will not have a penny of the cycle because your suction levels are so high it suppresses a lot of departments if you're living in a house of all female now all these hormone levels are higher than you would normally make them because you're getting theirs to my friends okay I have a very good friend who we work together at San Diego State University and he was doing research on how estrogen affects certain females and he has to actually mix these concoctions up that have your high levels of estrogen so he wore gloves and he wore you know gown and everything that he never thought about we're in the math and so over the years he was actually inhaling all this airborne estrogens and over time he actually had to have a double mastectomy because he had such high estrogen level that is mitosis level went so high he ended up a breast cancer and it nearly killed him so these hormones float in the air and they effective and they change personality and they change how hard your cycle is or not and they can do all kinds of different things like here's another one cortisol will inhibit blood nagging hormone secretion which means estrogen won't go up which means follicular fluid won't go up which means she won't oddly so the more stressed out you are the less likely you are to get regnant people running women athletes nervous because they don't have enough fat and remember I told you the other cells that make the Roma takes its back though so they have such little amount of fat on their body that they actually don't make as high a advanced Regine level so they also don't popular any questions we have you're breaking into more formal letters yes yes and by the way during pregnancy some women globally and this means that their progesterone levels are high enough they're not maintaining and the social layers will be not now look at what the problem is if there's an embryo in here or there's a fetus growing in here and the functional layers left off it could fall out so bleeding during pregnancy is a very bad thing it is one of the major cause however seventy-five percent of all pregnancies and in miscarriages of the woman doesn't even know she has because the majority of those embryos are equal and so they just naturally miss her and she never emotions to happen so early on in a crisis so instead upon you feel free to do so normal girl right yeah so identified what's happening is the uterus is stopping forgetting everything and those estrogen and progesterone level will control the astrocytes in the brain and how the synapses gate so the estrogen progesterone levels all those astrocytes what synapses fall apart to learn is it's like much out there trying to figure out how do I push back together and what do I do how do I get done snaps there's a lot of rewiring that's going on so like a short circuit for a little bit and it comes back together short circuit because it's nothing to drop all at once it's like everything else goes down and all up and then down the clock them yeah and we don't really officially call it menopause until all that crap stop I think you can have nothing in a one-year-old yes so everybody going to be like Pharma and the new casino yes and you cannot have it for two years and it can come back to why do the necklace looks like up there move swings like we that that's what we're talking about right there because what happens is as the hormones are dropping and then sometimes you'll make some more and then they drop the men sometimes make smart it will changes in apses in the brain so that you synapses kind of short circuits and eventually won the caramel level drop all the way those synapses figure out how it comes back without the use of estrogen and progesterone drops okay so thank you and here's the cycle can t force until event including me like an abundance and there may be people that you may not remember we're talking about steroid hormones so I was even a fat in my diet how do I produce enough of these steroid hormones because I've gotta have that fat as a precursor to make cholesterol which make these steroid hormones intersect so I won't have any estrogen progesterone testosterone changes because those are all made from fat so if I'm eating a low-fat diet I may not be able to make enough of these hormones to even have a cycle so I have this amenorrhea where I don't have any mental cycle at all or maybe I have mental cycle once every 18 months so that's why sitting on this fat diet so under high populations all your daughter's very irregular commuted so to put into practice or a fad years of share this exam lol it should help you and especially women who can't get pregnant most of the time it's due to low fat macgyver multi-way but most of the time birth control birth control is basically high levels of progesterone that inhibit gnrh FSH LH so the ovulation can offer I'm still curious you still have a period but it is enough to inhibit ovulation so the functional layer can still grow but then on birth control it doesn't grow as much you don't believe as much okay so usually the period can be as little as a single drop a blood - maybe just a couple of days of bleeding occurring so it lowers all of those hormone levels especially low enough so there's no ovulation are there harmful effects of being on birth control because it changes the levels are those many women have been on birth control for the last all 60 years and they haven't seen any long-term problems with that the only problem come once you get older like into your forties or so you increase your risk of blood loss especially if you're in your 40s and you're smoking then you do not let the on birth control cause blood clot risk and stroganoff goes really high yeah so when you come in at regular mesh the type of either the doctors tell you to be on birth control room regulated because okay so you have so much stuff so many days of these pills right so those days all have different amounts of hormones in them so they're mimicking what this cycle is supposed to be doing and so it should help you to become more regular because the person is not regular isn't producing the right amount of hormones at your step that's why they tell you to do it's not going to help in the long term it helps in the short term but the reason you're a regular is typically because your diets bad the exercise too much or you're under too much stress or your hypothalamus up in total to mature yet because you're still young there's a whole host of reasons what you may not be regulated I thought it was Marvin the boycott start consuming pretty starts to break down around them and think they'll work right so the mechanism to form blood boxes to become more sensitive to level to progesterone and though you're much more likely to department and then of course if somebody's smoking cigarette they're already more likely to form blood clots and so you just add all the back together and it would be a disaster I prefer for that like personal health to like flexing and children saliva absolutely for being no idea because nobody knows what causes cracking nobody has a clue that's why there is no civil or market to solve it there's nobody figured out what causes it your scans and while we start an indeterminate urgency does not really because the expansion is so slow over time they're already lined up if you have a moment alone birth control pills or any type of birth control that kept them from having periods does that affect menopause really depends on the birth control pills some of the thoughts are if it's a strong enough tail in a lengthened menopause symptoms there's really no good studies out there those to say the best what you need will they not go through it or will be delayed it longer no idea I've never seen a study on that I've had that question a million times and I'm never been able to find a study to answer that question so the answer could be yes or no I don't really know to be honest it makes sense but I don't kind of own them and the other question okay so let's talk about the nail okay so during puberty gymnastics GnRH from the hypothalamus and that caused the anterior pituitary's made FSH and LH now obviously she doesn't have a follicle and you doesn't have a corpus luteum but the reason that we use these same names and her nail is because they found these problems in the female first and they already named them and then it down oh shoot men have the same exact hormone so you're stuck with the female name now after page increases from out Genesis LH increases to stop them yes

Transcript for:Understanding the Reproductive System

Transcript for:
Understanding the Reproductive System