16 Focused Assessment: Reproductive Assessment
Learning Objectives
At the end of this chapter, the learner will:
- Obtain the health history related to the male and female reproductive systems, practices, and problems.
- Educate the patient on what to expect during the performance of the physical assessment of the male and female internal and external genitalia.
- Discuss the ethical-legal aspects of the reproductive assessment.
- Act as a patient advocate by being present during the female gynecology (GYN) exam
- Document the assessment findings discussed with the patient, the patient’s response to information shared, and the need for follow-up
I. Overview of the male and female male reproductive Systems
Adolescence is a period that begins with puberty and ends with the transition to adulthood (approximately ages 10–20). Physical changes associated with puberty are triggered by hormones. Cognitive changes include improvements in complex and abstract thought, as well as the development that happens at different rates in distinct parts of the brain and increases adolescents’ propensity for risky behavior because increases in sensation-seeking and reward motivation precede increases in cognitive control.
Sexual Development
Initially, there is a growth spurt, followed by the first part of sexual maturity where primary sexual characteristics develop and changes to the internal reproductive organs occur.
- For males, there is growth to the testes, penis, scrotum, and spermarche or the first ejaculation of semen occurs. This occurs between 11 and 15 years of age.
- For females, the uterus grows and menarche or the first menstrual period occurs. The female gametes, which are stored in the ovaries, are present at birth but are immature. Beginning at puberty, one ovum ripens and is released about every 28 days during the menstrual cycle. Stress and a higher percentage of body fat can bring menstruation at younger ages.
These are physical changes not directly linked to reproduction, but signal sexual maturity.
- For males, this includes broader shoulders and a lower voice as the larynx grows. Hair becomes coarser and darker, and hair growth occurs in the pubic area, under the arms, and on the face.
- For females breast development occurs around age 10, although full development takes several years. Hips broaden and pubic and underarm hair develops and also becomes darker and coarser.
Cultural differences are noted with African American girls enter puberty the earliest, followed by Hispanic girls, then European-American, and lastly Asian-American girls. Although African- American girls are typically the first to develop, they are less likely to experience negative consequences of early puberty when compared to European-American girls (Weir, 2016).
Tanner Scale of secondary sex organs by age for males and females
The Tanner staging scale is also known as the Sexual Maturity Rating (SMR) chart. This is an objective classification system used by Pediatricians