It is customary to distinguish several stages that successively replace each other: the intrauterine, or embryonic, period, childhood, puberty, or puberty, the reproductive period, or puberty, the menopausal period and the period of old age.

Prenatal period

At this stage of development, the formation of all fetal systems occurs, including the female genital organs. In the embryonic rudiments of the ovaries, primary follicles are laid, from which eggs will subsequently develop.

Childhood

This period lasts from the birth of a girl until she is 8-9 years old. Immediately after birth, under the influence of hormones released from the placenta, engorgement of the mammary glands and bloody discharge from the vagina are possible. In the future, the hormonal background remains quite stable, the body and organs of the reproductive system grow.

Puberty

Puberty falls between the ages of 9-10 and 17-18 years. At this stage, restructuring begins hormonal system. Secondary sexual characteristics are formed: hair growth occurs in the pubic and axillary areas, development mammary glands, pelvic bones, distribution of subcutaneous fat according to the female type.

This period ends with the onset of monthly menstruation. After the first menstruation (menarche), menstruation is most often irregular for some time, and anovulatory cycles are possible. After 1-2 years, menstrual cycles stabilize and the woman enters next period of its development.

Puberty period

This is the longest stage in a woman’s life. Cyclic hormonal changes in the body during this period occur regularly, which leads to the monthly maturation of follicles in the ovaries and the release of eggs from them (ovulation).

During each cycle, a woman’s body creates all necessary conditions For possible pregnancy. If fertilization of the egg does not occur, the monthly cycle ends with the onset of menstruation. On average menstrual cycle lasts 28 days.

Menopause

The timing of menopause depends on many factors and is largely determined by heredity. Normally, this period begins at the age of 45-50 years.

Changes during perimenopause hormonal levels cause menstruation to become irregular. Then comes menopause - complete cessation of ovarian function and cessation of menstruation.

Postmenopause is the period from a woman reaching menopause (1 year after last menstrual period) up to 65-69 years.

The synthesis of female sex hormones decreases during menopause. At normal course During menopause, this happens gradually, so the woman’s body has time to adapt to the changes. If there are any disturbances during this process, climacteric syndrome occurs, which is manifested by neuropsychic, endocrine, and vegetative-vascular disorders.

Vegetative-vascular disorders lead to hot flashes, chills, headaches, and sweating. Psycho-emotional disorders are manifested by irritability, sleep disturbances, depression, and anxiety disorders.

Metabolic disorders are characterized by fluctuations in body weight, instability blood pressure, the risk of developing osteoporosis increases.

Old age period

Lasts from 70 years until the end of a woman’s life. During this period, the synthesis of female sex hormones remains consistently low, atrophy of the genital organs and general aging of the female body occur.

2. Age periods of a woman’s life

Having become familiar with the anatomical and physiological characteristics of the female genital organs at different age periods, it will be easier for you to understand many biological processes, occurring in a woman’s body.

Age, functional features The reproductive system of a woman is closely dependent on a number of factors. Great value have primarily periods of a woman's life. It is customary to distinguish:

1) period of intrauterine development;

2) the period of childhood (from birth to 9-10 years);

3) period of puberty (from 9-10 years to 13-14 years);

4) adolescence (from 14 to 18 years);

5) period of puberty, or childbearing (reproductive), age from 18 to 40 years; transition period, or premenopause (from 41 to 50 years);

6) the period of aging, or postmenopause (from the moment of permanent cessation of menstrual function).

During the prenatal period the formation, development and maturation of all organs and systems of the fetus, including the reproductive system, occurs. During this period, the formation and embryonic development of the ovaries occur, which are one of the most important links in the regulation of the function of the reproductive system of the female body after birth.

During the prenatal period, various factors (intoxication, acute and chronic infections, ionizing radiation, medications etc.) can have a damaging effect on the embryo or fetus. These factors can cause developmental defects various organs and systems, including the genitals. Such congenital abnormalities in the development of the genital organs can lead to disruption of the functions characteristic of the female body. Intrauterine developmental defects that arise under the influence of the factors listed above may be accompanied by damage to various parts of the regulation of the menstrual cycle. As a result, girls may experience various disorders menstrual, and subsequently reproductive function.

During childhood There is relative rest of the reproductive system. Only during the first few days after the birth of a girl can she experience the so-called sexual crisis (bloody discharge from the vagina, engorgement of the mammary glands). This occurs under the influence of the cessation of the action of placental hormones, which occurs after childbirth. In childhood, the organs of the reproductive system gradually grow, but the features typical for this age are preserved: the predominance of the size of the cervix over the size of the uterine body, convoluted fallopian tubes, the absence of mature follicles in the ovaries, etc. During childhood, there are no secondary sexual characteristics.

Puberty characterized by relatively rapid growth of the organs of the reproductive system and primarily the uterus (mainly its body). In a girl of this age, secondary sexual characteristics appear and develop: a skeleton is formed female type(especially the pelvis), fat deposition occurs according to the female type, hair growth is noted first on the pubis, and then in the armpits. Most a clear sign The period of puberty is the onset of the first menstruation. For girls living in middle lane, the first menstruation appears at the age of 11-13 years. Then, for about a year, menstruation may be irregular, and many periods occur without ovulation (the appearance of an egg). The onset and formation of menstrual function occurs under the influence of cyclic changes in the nervous system and glands internal secretion, namely the ovaries. Ovarian hormones have a corresponding effect on the uterine mucosa, causing characteristic cyclic changes in it, i.e. the menstrual cycle. Adolescence also known as transitional, since at this time there is a transition to the onset of puberty - the flourishing of the function of the organs of the female reproductive system.

Puberty period is the longest in a woman's life. Due to the regular maturation of follicles in the ovaries and ovulation (the release of an egg), as well as the subsequent development corpus luteum All the necessary conditions for pregnancy are created in the female body. Regular cyclical changes occurring in the central nervous system, ovaries and uterus, which externally manifests itself in the form of regular menstruation, is the main indicator of the health of a woman of childbearing age.

Premenopausal period characterized by the transition from the state of puberty to the cessation of menstrual function and the onset of old age. During this period, women often develop various disorders of menstrual function, the cause of which may be age-related disorders central mechanisms regulating the function of the genital organs.

Aging period characterized by a complete cessation of menstruation and general aging of the female body.

The frequency of diseases of the genital organs in women is closely related to the age periods of their life. Thus, during childhood, it is relatively common to experience inflammatory diseases external genitalia and vagina. During puberty, uterine bleeding and other menstrual dysfunction are common. During puberty, inflammatory diseases of the genital organs, as well as menstrual irregularities, are most common. of various origins, genital cysts, infertility. At the end of the childbearing period, the frequency of benign and malignant tumors of the genital organs increases. Less common during premenopause inflammatory processes genital organs, but the frequency increases significantly tumor processes and menstrual dysfunction (menopausal bleeding). During the postmenopausal period, prolapse and prolapse of the genital organs occur more often than before, as well as malignant tumors. The age specificity of diseases of the female genital organs is mainly determined by the anatomical and physiological characteristics of the female body in individual periods life.

← + Ctrl + →
Women's hygiene during menstruation3. Protective barriers female body

A woman’s life can be divided into several periods, which are characterized by age-related anatomical and physiological characteristics.

Intrauterine period - the formation of the reproductive system begins from the 18th week of pregnancy. At this time, the ovaries of the female fetus already have primordial follicles that begin to function, but hormonal function the fetal ovaries are still poorly developed and are especially sensitive to adverse factors external environment.

The neonatal period is the 1st month of life after childbirth. During this period, the level of estrogen decreases and in the first days after birth, the girl may show signs of a sexual crisis: engorgement of the mammary glands, bloody discharge from the genital tract.

Neutral period - childhood; lasts up to 8 years. The functions of the ovaries do not appear, although estrogens are synthesized. The uterus is small. The cervix is ​​longer and thicker than the size of the uterus; fallopian tubes are thin and tortuous, with a narrow lumen; the vagina is narrow, short, the vaginal mucosa is thin up to 7 years, the epithelium is represented by basal and parabasal cells. The vaginal contents have a neutral or slightly alkaline reaction.

The period of puberty (puberty) lasts from 8 to 17-18 years. During this period, the reproductive system matures and the physical development of the female body ends. Uterine enlargement begins at age 8. By the age of 12-13 years, an angle appears between the body and the cervix, open anteriorly, and the uterus takes a physiological position in the pelvis, deviating anteriorly from the wire axis of the pelvis. The ratio of body length to cervix becomes 3:1. Puberty is characterized by activation of the gonads, further development genital organs, the formation of secondary sexual characteristics (enlarged mammary glands, pubic and armpit hair), the appearance of the first menstruation and the formation of menstrual function. During puberty, two phases are conventionally distinguished: prepubertal and pubertal. The boundary between these phases is considered to be the first menstruation (menarche). By the end of puberty, the girl’s body is anatomically and functionally ready for procreation. The girl’s appearance changes, which is manifested by the formation of the pelvis and the deposition of subcutaneous fat tissue according to the female type. The puberty of a girl is ensured by the function of the ovaries, which, in turn, is formed under the influence of the activity of the hypothalamus and pituitary gland. The period of puberty is a very important period, critical period women's development. The woman’s future health depends on how correctly it proceeds.

During this period, the girl’s body is especially sensitive to the effects various factors external environment (malnutrition, injuries, infections, intoxications), physical and mental fatigue, which can have adverse influence on the development and specific functions of the female body. Considering this, for the proper formation of a woman’s body in this period, especially important have recreational activities, hardening the body, physical education and sports, proper nutrition, reasonable alternation of work and rest. During puberty special meaning has the implementation of hygiene measures. During menstruation, girls often feel physically weaker than at other times and get tired faster even when doing normal work. They may decrease and mental performance. Consequently, girls have a higher need for additional rest at this time. During menstruation, you should stop playing sports, especially those associated with large physical stress(running, skating, skiing, etc.). Swimming in open water and baths is prohibited. The hygienic regime during menstruation boils down to thorough washing. warm water with soap on the external genital organs and adjacent areas of the body at least 2 times a day (morning and evening). During menstruation, you need to use special pads that easily absorb blood, which change depending on the degree of bleeding, but at least 5 times a day.

The period of puberty (reproductive period) lasts from 17 to 45 years. The function of the reproductive system is aimed at regulating the ovulatory menstrual cycle and childbirth. Often during this period a woman experiences various diseases genital organs, for the prevention of which strict adherence to hygiene measures is of no small importance, especially during menstruation. At this time all kinds gynecological treatment(douching, enemas, electro- and mud therapy), as well as sex life must be stopped. Failure to comply with these rules can lead to infection entering the genitals and the occurrence of severe inflammatory diseases.

With marriage, a girl begins to have sex life. By law, marriage is permitted from the age of 18, since by this age the female body is prepared to ensure the physiological course of pregnancy and childbirth. Young women getting married should contact antenatal clinic for advice, where they will be explained the rules of sexual hygiene and methods of preventing pregnancy. Sexual activity during menstruation is strictly prohibited due to the risk of infection and increased bleeding. Sexual activity is also prohibited in the first two and last month pregnancy, and also for 6-8 weeks after birth.

The climacteric period according to the modern classification includes premenopause, menopause and postmenopause. This period begins at 40-45 years and lasts 8-10 or more years. The name of this period comes from the word klimax - ladder, which seems to indicate that its steps lead from the flourishing of all the specific functions of the female body to their extinction. In the ovaries, eggs gradually stop maturing, the process of ovulation and follicle development stops, and intrasecretory activity fades away. A woman loses her ability to reproduce. The rhythm, duration of the menstrual cycle, and the amount of lost menstrual blood, which ends with the complete cessation of menstruation - menopause. For most women, the menopause proceeds physiologically, without pathological manifestations. During the pathological menopause, women develop various dysfunctions of the nervous, cardiovascular and endocrine systems. Sometimes a violation normal life the body leads to loss of ability to work. Question about hygiene menopause deserves special attention, and every woman should be well aware of this for the purpose of prevention pathological course menopause and the occurrence of a number of gynecological diseases. Many signs similar to those observed during menopause may be symptoms of certain diseases, in particular those of a tumor nature. A woman in this period, as before, should see a doctor at least 2 times a year, even if she considers herself completely healthy. A woman’s condition during this period is particularly positively influenced by physical culture, long stay in the fresh air, hygienic gymnastics, water treatments, proper nutrition. Maintaining hygiene is reliable prevention pathological course of the menopause.

Old age occurs after the end of the menopause and is characterized by complete physiological rest of the female reproductive system, cessation of ovarian activity and age-related atrophy of the genital organs, which reaches great severity. Currently, in this period of life, women distinguish old age, while old age is considered only recent years this period (from 75 years and later).

In old age and old age, the ovaries do not produce hormones, but a small amount is produced by the adrenal glands.

Hygiene requirements for the elderly and old age do not differ significantly from the hygiene requirements of previous periods of a woman’s life. Sometimes at this age, women again experience bleeding from the genital tract after a more or less prolonged absence of menstruation. A woman should know that it is a mistake to regard these discharge as a sign of rejuvenation of the body and in these cases you should immediately consult a gynecologist, since similar symptom may be a sign of the development of a malignant tumor.

The functional state of a woman’s reproductive system is largely determined by periods of life, among which it is customary to distinguish the following:

Antenatal (intrauterine) period;
- neonatal period (up to 10 days after birth);
- childhood period (up to 8 years);
- period of puberty, or puberty (from 8 to 16 years);
- period of puberty, or reproductive (from 17 to 40 years);
- premenopausal period (from 41 years to the onset of menopause);
- postmenopausal period (from the moment of permanent cessation of menstruation).

Antenatal period.Ovaries. During embryonic development, the gonads are the first to develop (starting from 3-4 weeks of intrauterine life). By 6-7 weeks of embryo development, the indifferent stage of gonad formation ends. From the 10th week, female gonads are formed. At week 20, primordial follicles form in the fetal ovaries, which represent an oocyte surrounded by compacted epithelial cells. At week 25, the tunica albuginea of ​​the ovary appears. At 31-32 weeks, granular cells of the inner lining of the follicle differentiate. From 37-38 weeks the number of cavity and maturing follicles increases. By the time of birth, the ovaries are morphologically formed.

Internal genital organs. Fallopian tubes, uterus and upper third vaginas originate from the paramesonephric ducts. From 5-6 weeks of embryo development, development begins fallopian tubes. At 13-14 weeks, the uterus is formed by the fusion of the distal sections of the parameso-nephric ducts: initially the uterus is bicornuate, but later acquires a saddle-shaped configuration, which is often preserved at the time of birth. At 16-20 weeks, the cervix differentiates. From the 17th week, the labia develop. By 24-25 weeks, the hymen is clearly visible.

Hypothalamic-pituitary system. From 8-9 weeks of the antenatal period, the secretory activity of the adenohypophysis is activated: FSH and LH are determined in the pituitary gland, fetal blood and in small quantities in amniotic fluid; during the same period, GnRH is identified. At 10-13 weeks, neurotransmitters are detected. From the 19th week, the secretion of prolactin by adenocytes begins.

Newborn period. At the end of intrauterine development of the fetus high level maternal estrogens inhibit the secretion of gonadotropins from the fetal pituitary gland; sharp decline The content of maternal estrogen in the newborn’s body stimulates the release of FSH and LH by the girl’s adenohypophysis, which provides a short-term increase in the function of her ovaries. By the 10th day of a newborn’s life, manifestations of estrogenic effects are eliminated.

Childhood period. Characterized by low functional activity reproductive system: the secretion of estradiol is insignificant, the maturation of follicles to the antral occurs rarely and unsystematically, the release of GnRH is inconsistent; receptor connections between subsystems are not developed, the secretion of neurotransmitters is poor.

Puberty period. During this period (from 8 to 16 years), not only does the reproductive system mature, but it also completes physical development female body: body growth in length, ossification of growth zones tubular bones, the physique and distribution of fat and muscle tissue according to the female type are formed.

Currently, in accordance with the degree of maturity of the hypothalamic structures, three periods of maturation of the hypothalamic-pituitary-ovarian system are distinguished.

First period- prepubertal (8-9 years) - characterized by increased secretion of gonadotropins in the form of individual acyclic emissions; estrogen synthesis is low. A “jump” in body length growth is noted, the first signs of feminization of the physique appear: the hips are rounded due to an increase in the amount and redistribution of adipose tissue, the formation of the female pelvis begins, the number of epithelial layers in the vagina increases with the appearance of intermediate-type cells.

Second period- first phase puberty(10-13 years) - characterized by the formation of daily cyclicity and increased secretion of GnRH, FSH and LH, under the influence of which the synthesis of ovarian hormones increases. The mammary glands begin to enlarge, pubic hair begins to grow, the vaginal flora changes - lactobacilli appear. This period ends with the appearance of the first menstruation - menarche, which coincides in time with the end of rapid growth body length.

Third period- the second phase of the pubertal period (14-16 years) - is characterized by the establishment of a stable rhythm of GnRH secretion, a high (ovulatory) release of FSH and LH against the background of their basal monotonic secretion. The development of mammary glands and sexual hair is completed, body growth in length is finally formed female pelvis; the menstrual cycle becomes ovulatory.

First ovulation represents the culmination of puberty, but does not mean puberty, which occurs by the age of 16-17 years. Puberty is understood as the completion of the formation of not only the reproductive system, but also the entire woman’s body, prepared for conception, pregnancy, childbirth and feeding a newborn.

Period of puberty. Age from 17 to 40 years. The features of this period are manifested in specific morphofunctional transformations of the reproductive system (Section H.1.1.).

Premenopausal period. The premenopausal period lasts from 41 years to the onset of menopause - the last menstruation in a woman's life, which on average occurs at the age of 50 years. Declining activity of the gonads. Distinctive feature this period - a change in the rhythm and duration of menstruation, as well as the volume of menstrual blood loss: menstruation becomes less abundant (hypomenorrhea), their duration is shortened (oligomenorrhea), and the intervals between them increase (opsomenorrhea).

The following phases are conventionally distinguished premenopausal period:

Hypolutein - clinical symptoms absent, there is a slight decrease in the secretion of lutropin by the adenohypophysis and progesterone by the ovaries;
- hyperestrogenic - characterized by the absence of ovulation (anovulatory menstrual cycle), cyclical secretion of FSH and LH, an increase in estrogen content, which leads to a delay of menstruation for 2-3 months, often with subsequent bleeding; the concentration of gestagens is minimal;
- hypoestrogenic - amenorrhea is observed, a significant decrease in estrogen levels - the follicle does not mature and atrophies early;
- ahormonal - the functional activity of the ovaries stops, estrogens are synthesized in small quantities only by the adrenal cortex (compensatory hypertrophy of the cortex), the production of gonadotropins increases; clinically characterized by persistent amenorrhea.

Postmenopause. The ahormonal phase coincides with the beginning of the postmenopausal period. Postmenopause is characterized by atrophy of the internal genital organs (the mass of the uterus decreases, its muscular elements are replaced by connective tissue, the vaginal epithelium becomes thinner due to a decrease in its layering), urethra, bladder, muscles pelvic floor. In postmenopause, metabolism is disrupted, and pathological conditions cardiovascular, skeletal and other systems.