Transcript effects of ageing on the reproductive system

Title: The effects of aging on the reproductive system
03 April 2017
Learning question: Why do we age and how does it affect fertility?
Homework: You have your class test next week – study!
Learning Objectives
Candidates should be able to:
(a) describe the effects of ageing on the
reproductive system;
(b) describe the changes in physiology associated
with the menopause;
What is aging?
• Aging is the deterioration over time, including:
– Increased weakness;
– Susceptibility to disease and adverse
environmental conditions;
– Loss of mobility and agility;
– Age-related physiological changes;
– Reduced reproductive capacity.
Aging and reproduction
• The impact of aging and
fertility is becoming more of
an issue as many women
are opting to have a family
later in life than previous
generations.
• 50% of infertility treatment
is because of reproductive
aging.
Aging and reproduction
• A woman’s reproductive potential decreases with age.
• The decline begins around the age of 30, despite the continuation
of the menstrual cycle until menopause.
• The reproductive potential may have been lost before menopause.
Aging and reproduction
• One third of women aged 35 and over will have problems
conceiving, while fewer than 30% of women aged 40 and over
are able to conceive naturally.
• The chances of having a miscarriage also increases with age.
This is because of several factors including:
• Quality of oocyte (declines with age) – this is the immature egg
• FSH (follicle stimulating hormone) increases with age – difficulty conceiving. If
they do, miscarriage is likely.
Menopause
• Changes in reproductive organs and genitalia
occur rapidly.
• Menstrual cycle stops and ovaries stop
producing oestrogen.
• Atrophy (thinning) of tissues in the labia minora,
clitoris, vagina and urethra occur.
• Can result in chronic dryness, irritation and
discharge from the vagina.
• Vaginal infections are more likely to develop.
Also, after menopause the uterus, fallopian
tubes and ovaries become smaller.
Male fertility
• The impact of aging is not as severe as it is for
women!
• Number, motility and percentage of sperm
decrease slightly
• If a male partner is >50 years, fertility
decreases and rate of miscarriage increases
Oldest father in the world, 96 years
“Despite the fact that
some men can become
fathers at the age of 80 or
older, couples should
consider the effects of
aging in both partners
when planning to become
parents.”
Males and reproduction
• Aging causes a gradual change in male sexual
function
– Levels of testosterone decrease
– Results in loss of libido
– Blood flow to penis decreases
– Decreased sensitivity of penis and volume of
ejaculate
Exception to the rule…
Changes in physiology associated with the
menopause
• Menopause, also known as the “change of life” – women’s
body slowly produces less progesterone and oestrogen.
• Often occurs between 45-55 years, although can happen
earlier (35) or later (60)
• There are 3 phases of menopause:
– Peri-menopausal
– Menopausal
– Post-menopausal
Peri-menopausal period
• Regular cycle of menstruation disrupted
• Menstruation becomes irregular
• Can last from 6 months to one year
• Oestrogen production decreases and
eventually stops
Menopausal and post menopausal period
• Defined as the ending of the menstrual period
• Women are described as post-menopausal
when they have gone one year without a
period.
Decrease of ovarian hormones
• Coronary heart disease (CHD) risk increases due to
elevated levels of cholesterol and LDL (low density
lipoprotein) cholesterol
• Oestrogen prevents high levels of blood cholesterol
and maintains activity of oestrogen receptors
• This helps to prevent CHD
Decrease of ovarian hormones
Ca loss increases in 5
years leading up to
menopause
Loss of bone density
Tapers off then
accelerates again at about
75 years
Older women much more likely to suffer
from osteoporosis and bone fractures
Decrease of ovarian hormones
• Body composition changes
• Increased percentage of body fat, decreased percentage of
muscle mass
• Increase in body fat is partly due to decreased physical activity
Questions
• Complete questions 1 -4 on page 263
• Read the green box on HRT to help you
answer question 4
• Use the mark scheme at the back of your book
to assess how well you have learned this topic.
Past paper question
• Do January 2011 question 2
• Use your notes to help answer this question
thoroughly!