How female organs change with age. Low blow: How your vagina changes as you age
Significant changes in the postpartum period occur in the woman's reproductive system.
Involution of the uterus
In the first hours after the period, a significant tonic contraction of the uterus occurs. Against the background of increased tone, peripheral muscle contractions (contractions) occur, which contribute to a decrease in the size of the uterus. In this case, the walls of the uterus thicken, it takes on a spherical shape, slightly flattened in the front-to-back direction.
The fundus of the uterus at the beginning of the postpartum period is 13-15 cm above the pubic symphysis, the length of its cavity (from the external os of the cervical canal to the fundus) reaches 15-20 cm, the thickness of the walls in the fundus is 4-5 cm. The transverse size of the uterus immediately after birth is 12-13 cm, weight - 1000 g. The anterior and posterior walls of the uterus are adjacent to each other.
The uterus contracts in the direction from the fundus to the cervix. Contractility the lower section and cervix are much lower, so in the lower section the uterine wall is thinner. The vaginal part of the cervix hangs down into the vagina, its edges are thinned, often have lateral tears and superficial damage (tears). Due to contraction of the body of the uterus and the circular layer of the myometrium, located around the internal pharynx, the boundary between the upper and lower sections uterus. In the first days of the postpartum period, the fundus of the uterus comes into contact with the abdominal wall, and an angle open forward (antlexio uteri) is formed between the body and the cervix. This is facilitated by the relaxation of the ligamentous apparatus and the fact that the woman in labor lies on her back. In the first days after birth, the mobility of the uterus is increased, which is also explained by the stretching and insufficient tone of its ligamentous apparatus. The uterus easily moves upward, especially when the bladder is replaced.
A reduction in the size and weight of the uterus is facilitated by the contraction of its muscles and the morphological changes that occur during this process. , which contract, compress the walls of blood and lymph vessels. The lumen of the vessels narrows, many of them close and undergo obliteration. As a result, there is a sharp restriction of nutrition of myometrial cells, their fatty degeneration, decay and resorption.
The state of uterine contraction is judged by the level of its fundus. During the first 10-12 days after birth, the fundus moves approximately 1-1.5 cm daily. On the first day after birth, the fundus of the uterus is at the level of the navel (due to increased muscle tone pelvic floor), which is higher than immediately after birth. On each subsequent day, the level of the uterine fundus decreases by one transverse finger. On the second day, the uterine fundus is located above the pubic symphysis by 12-15 cm, on the fourth day by 9-11 cm, on the sixth day by 8-10 cm, on the eighth day by 7-8 cm, on the tenth day by 5-6 cm and on the twelfth-fourteenth day is in the womb. By the end of the 6-8th week after birth, the uterus is similar in size to that of non-pregnant woman(breastfeeding mothers may even have less). The weight of the uterus by the end of the first week decreases by more than half (by 500-600g), the second week to 350g, the third week to 200g, and at the end of the postpartum period 60-70g.
Involution of the uterus depends on the general condition of the woman’s body, age, number of previous births, and the characteristics of pregnancy and childbirth. At multiple pregnancy, polyhydramnios, large fetus and anomalies labor activity uterine involution is delayed (uterine subinvolution).
Healing occurs in a unique way inner surface the uterus, which, after separation of the placenta and membranes, represents an extensive wound surface, especially in the area of the placental area, since during childbirth the superficial part of the loose layer of the mucous membrane is separated. On exposures of the uterine wall, only the basal layer can be found epithelial tissue endometrium and remnants of the deep glandular layer of the membrane. A large number of small cells that appear among the remains of decidual tissue form a layer of granulation tissue - the granulation shaft. The latter is quickly covered with an epithelial layer, which is formed from the remains of glands. Epithelial proliferation leads to regeneration of the wound surface and its transformation into a typical mucous membrane. The wound surface in the placental area is completely covered with a thin layer of mucosal cells on the tenth day of the postpartum period. The restoration of a full-fledged endometrium is completed only eight weeks after birth.
Lochia
During the healing process of the inner surface of the uterus, postpartum discharge. Fragments of decidual tissue, scraps of membranes, blood clots undergo phagocytosis and active proteolysis with the formation of wound secretion - lochia. The nature of lochia changes in accordance with the processes of cleaning and healing of the inner surface of the uterus. In the first 2-3 days after birth, lochia is bloody in nature (lochia rubra), starting from the 3rd day they become bloody-serous with a predominance of leukocytes (lochia rubro-serosa), on days 7-9 after birth - serous (lochia serosa ). The total number of lochia in the first eight days reaches 500-1500g.
Lochia has a neutral or alkaline reaction and a specific musty smell. From ten days after birth, lochia acquires a serous-mucosal character (lochia alba). At 5-6 weeks there is no discharge from the uterus. Sex life permitted no earlier than the eighth week of the postpartum period.
The involution of the cervix lags behind the involution of the uterine body in intensity. Immediately after childbirth, the cervical canal freely allows the hand to pass through. 10-12 hours after birth, the canal becomes cone-shaped, the internal pharynx allows 2-3 fingers to pass through, a day after birth due to the contraction of the circular muscles surrounding internal hole the cervical canal, the internal os allows two fingers to pass through, the cervical canal is funnel-shaped. On the third day, the internal pharynx allows only one finger to pass through. By the tenth day, the cervical canal is formed. External peephole closes in the third week of the postpartum period. The cervix takes on a cylindrical shape instead of a conical shape before childbirth, and the external os becomes slit-like in the transverse direction.
The ligamentous apparatus, which was in a state of relaxation in the first days after birth, gradually acquires its usual tone and in the third week becomes the same as before pregnancy.
Changes in the ovaries
The ovaries undergo significant changes in the postpartum period. The regression of the corpus luteum ends and the maturation of the follicles begins. In the majority (55-60%) of women who, 6-8 weeks after childbirth, menstruation occurs. In the majority of breastfeeding mothers (80%), menstruation is delayed for several months or for the entire period of breastfeeding.
The first menstruation after childbirth is often “ANOVULATORY”, i.e. the follicle matures, but ovulation does not occur and the corpus luteum does not form. The follicle undergoes regression, and currently the disintegration and separation of the uterine mucosa begins, in which proliferation processes have arisen (under the influence estrogen hormones), but secretory transformation of the endometrium does not occur. Over time, the process of ovulation, and with it menstrual function completely restored.
The menopause is a transitional stage in the life of every woman when the cessation of normal function ovaries. This period begins at the age of 45-50, as evidenced by disruption of the rhythm of menstruation and the end reproductive function. The process of extinction of the ovaries begins gradually: at first the eggs stop maturing, however hormonal functions may still manifest themselves quite long time. The climacteric period lasts on average from six months to 2-3 years, the period of its onset depends on living conditions each individual woman, as well as individual characteristics the whole body.
With the advent of menopause, age-related changes in the genital organs of women occur, but you should not be afraid of this, because this phenomenon is inherent in nature itself.
Causes of early and late menopause
Early menopause is often associated with hereditary and constitutional characteristics, as well as various chronic diseases. Poor nutrition, unfavorable working and living conditions also contribute to rapid aging of the body. Premature menopause can occur as a result of a violation metabolic processes, mental and physical injuries and also previously suffered diseases of the reproductive system. Often early menopause contribute to numerous induced abortions.
Very often, early cessation of menstruation leads to early onset of menopause, which is very difficult. Numerous studies have shown that women who get their first period early enter menopause much later.
Late menopause appears as a result of the development of painful processes in the female reproductive system, for example, fibroids or uterine cancer.
How does the menopause proceed?
After menstruation has completely stopped, menopause occurs, and for some women, menstruation may stop gradually, while for others it may stop immediately. Sometimes menstruation may be absent for several months and then return again until menopause eventually occurs.
Changes in the genital organs
During menopause, a woman's genitals also undergo some changes. The ovaries become smaller and shrink, and their functions weaken. Normal follicles no longer develop and thus lose their ability to produce full-fledged eggs and corpus luteum. Sometimes during menopause, a normal egg may mature in the ovary, which explains the facts of late pregnancy and childbirth.
Major changes are observed in the pituitary gland, thyroid gland and adrenal glands. Such phenomena provoke changes not only in the reproductive system, but throughout female body. The uterus begins to decrease in size, the vagina narrows and shortens, and its mucous membrane becomes thinner and smoother, thereby reducing protective functions vaginal wall. Gradually disappears on the labia and pubis adipose tissue, resulting in hairline begins to turn gray and thin.
Appearance changes
During menopause, a woman's appearance and figure change. As a result of metabolic disorders, most women experience increased fat deposition, especially on the abdomen, thighs and mammary glands. Sometimes a woman can, on the contrary, lose weight - with the disappearance of the fat layer, her skin begins to lose elasticity.
In most cases, menopause is asymptomatic and is not accompanied by any painful sensations, which allows women to feel not only healthy, but also able to work. However, often age-related changes in women lead to disturbances in the functioning of the body and serious complications which already require medical intervention.
Age-related manifestations in women:
Vascular disorders, accompanied by hot flashes to the face, head and other parts of the body;
Fatigue, weakness and drowsiness;
Heart pain;
Unconscious fear and anxiety;
Dizziness and tinnitus;
Fluctuations in blood pressure;
Numbness of the lower extremities;
Insomnia;
Migraine;
Nervous overexcitation;
Nausea and vomiting;
Quick mood changes;
Itching of the genitals.
Age-related changes in the genital organs in women can manifest themselves in prolonged bleeding, which weakens and may indicate the presence of cancerous lesions of the reproductive system. Such symptoms should be taken seriously and immediately contact a gynecologist.
Significant disturbances during menopause also occur in the digestive organs. A woman may experience frequent constipation, colicky pain, bloating and nausea. As a rule, these symptoms disappear without a trace over time.
How to ease menopause
To ensure that the adverse effects of menopause do not bother you, it is recommended to follow some rules that will help prevent them. Should take more walks fresh air, exercise regularly and sleep sufficient quantity time. Light laxatives of natural origin, such as almond or dill water, as well as a glass of yogurt or kefir before bed will help avoid constipation.
Contrasting foot baths effectively help combat hot flashes. In addition, evening baths with sea salt or pine extract, which have a positive effect on the nerve endings and blood vessels of the skin. Correctness plays a big role healthy eating woman, which should contain everything necessary for the body substances: carbohydrates, proteins, fats, and mineral salts. During menopause, it is advisable to consume animal fats in limited quantities, as they are poorly digested and deposited in the body, leading to obesity and atherosclerosis. / website/
The hormonal activity of the placenta during pregnancy affects the entire woman’s body and, first of all, the genitals.
Genital organs during pregnancy: features of changes in a woman’s uterus
The genitals undergo significant changes during pregnancy. They are most characteristic of the uterus; throughout pregnancy it increases in size, but this happens asymmetrically, it depends to a large extent on where the fetal egg is attached. During the first weeks of pregnancy, the uterus is shaped like a pear, and already at the end of the second month the uterus increases its size by about 3 times, and becomes round shape, and remains this way throughout the second half of pregnancy.
As for the increase in the weight of the uterus, instead of 50-100 g when it is in its normal state, during pregnancy it changes weight to 1000-1200 g. This occurs due to an increase in muscle mass and stretching of the walls. In the fourth month of pregnancy, the uterus reaches the hypochondrium, extending beyond the pelvis. After 20 weeks, the rise of the uterus almost stops, and its volume increases due to stretching of the muscle fibers under the influence of the enlarging fetus. When the uterus is stretched, its walls become larger, the uterus increases in size by more than 500 times.
Features of changes in the muscular layer of the genital organs during pregnancy
It is clear that the most pronounced changes in the genitals during pregnancy occur in the uterus. In addition to its size, shape and position, its consistency and excitability to various kinds of stimuli also change. The increase in the size of the uterus is ensured by hypertrophy and hyperplasia of muscle fibers, as well as the presence of growth of newly formed muscle elements, mesh-fibrous and arginophilic “framework”. Ultimately, the weight of the uterus increases from 50 g to 1000-1500 g, and the walls of the uterus are at their greatest thickness in the middle of pregnancy - 3-4 cm.
Subsequently, the increase in muscle fibers no longer occurs, and the increase in size is associated with stretching of the fibers in length. Simultaneously with this process, the growth of loose connective tissue and an increase in the number of elastic fibers occur. The combination of these processes leads to a softening of the uterus, increasing its plasticity and elasticity. Significant changes in the genital organs during pregnancy occur in the mucous membrane of the uterus, undergoing restructuring and the so-called decidua is formed. No less significant changes in the genital organs during pregnancy are also observed in the vascular network of the uterus:
- arteries,
- veins
- and lymphatic vessels, they expand and lengthen, as well as the formation of new ones.
At the very beginning of pregnancy, the connective tissue frame of the uterus improves, which, together with bundles of muscle fibers, guarantees the required stability and elasticity of the uterine wall.
During pregnancy, there is no general synchronous interaction between bundles of smooth muscle cells. The entire uterus seems to be divided into zones, which, regardless of each other, either shrink or relax at different rates and asynchronously in time. This supports the additional adaptation of the blood supply to the organ. By 38 weeks of pregnancy, there is a gradual synchronization of decreases in the body of the uterus and simultaneous relaxation of its lower part and the neck of the uterus. During pregnancy, the lower sector of the uterus develops from the isthmus.
- If in the first trimester of pregnancy the length of the isthmus is 0.5-1 cm,
- then by the end of the third trimester it increases to 5 cm,
- Well, during the birth process up to 10-12 cm.
Due to the effects of estradiol and progesterone, the cervical tissue softens.
As the connective tissue framework develops, uterine contractions become more frequent. First, they appear repeating the appearance of individual decreases, similar to Braxton-Gix contractions. These are irregular and non-painful decreases, which subsequently appear with increasing frequency in the 2nd half of pregnancy. Periodic increase in uterine tone and irregular decreases in it individual areas guarantee withdrawal venous blood, in fact, it also improves the flow arterial blood. Stretching of the uterus during pregnancy occurs, as a rule, with the help of the anterior wall, while the posterior wall is not significantly stretched. The maximum stretching of the uterus during the normal course of pregnancy occurs at 30-35 weeks.
Considering the changes in the genital organs during pregnancy that occur in muscle layer uterus, an increase in the amount of actomyosin can be noted, mainly in the muscles of the uterus. There is also a decrease in ATP - actomyosin activity and conditions are created for carrying the pregnancy to term. In the muscular layer of the uterus, phosphorus compounds, creatine phosphate and glycogen accumulate. For pregnancy, an important point is the accumulation of biologically active substances in the uterus:
- serotonin,
- catecholamines, etc.
Their role is quite large, for example, serotonin is an analogue of progesterone and a synergist of estrogen hormones.
Examining the reactivity of the uterus to various kinds of stimuli, it can be noted that excitability decreases significantly in the first months of pregnancy and increases quite strongly towards its end. However, irregular and weak contractions of the uterus, which the woman does not feel, are observed throughout pregnancy. Their role is to improve blood circulation in the system of intervillous spaces.
Due to a significant increase in the size of the uterus, the ligamentous apparatus of the uterus also increases, which plays a huge role in maintaining the uterus in its normal position. I would like to note that the round uterine and sacrouterine ligaments undergo the greatest hypertrophy. For example, the round uterine ligaments are palpated during pregnancy through the anterior abdominal wall in the form of dense strands. The location of these ligaments depends on the placenta insertion. If it is located along the anterior wall of the uterus, then the arrangement of the round uterine ligaments is parallel or they diverge slightly downwards. If the placenta is located on the back wall, they, on the contrary, converge downwards.
Vascular changes in the uterus during pregnancy
During pregnancy, significant changes occur in both vascular system uterus. The vessels of this organ lengthen and twist in a corkscrew fashion. The walls of the vessels located under the placenta lose their own elasto-muscular layer.
All these configurations are aimed at ensuring rational blood flow to the placenta. It is very graceful in the fundus of the uterus, thickens in the body area and has extreme thickness in the neck, where it mixes with elastic and collagen fibers. This layer does not shrink; in fact, it acts as protection for the fetus during a single contraction of the uterus.
Changes in the cervix during pregnancy
The processes of hypertrophy and hyperplasia are less pronounced in the isthmus of the uterus. Nevertheless, loosening of the connective tissue and an increase in elastic fibers in this area occur. Subsequently, the isthmus becomes overstretched due to descent into it ovum(in the fourth week of pregnancy).
Analyzing changes in the cervix during pregnancy, it should be noted that the processes of hypertrophy in it are slightly expressed due to the smaller number of muscle elements in its structure. Nevertheless, an increase in elastic fibers and loosening of connective tissue occurs. Enough major changes undergoes vasculature cervix. The cervix resembles spongy (cavernous) tissue, and congestion give the cervix a bluish discoloration and swelling. The cervical canal itself during pregnancy is filled with viscous mucus. This is the so-called mucus plug, which prevents microorganisms from penetrating the fertilized egg.
Features of changes in other genital organs during pregnancy
Other genital organs also experience changes during pregnancy:
For example, the fallopian tubes thicken due to increased blood circulation in them.
The ovaries also change their location; due to the increase in the size of the uterus, they are now located outside the pelvic area. Also, it is in one of the ovaries that during the first four months the corpus luteum is located; it is responsible for maintaining pregnancy up to 16 weeks, for which it produces the hormone progesterone.
As for the external organs of the reproductive system, during pregnancy the labia are blue in color and loosen. They can also increase in size due to increased blood supply.
The mammary glands also experience significant changes, glandular cells grow, and incoming milk activates the growth of the milk ducts. In general, the mass of the mammary glands increases to 400-500 g. The blood supply to the mammary glands increases, and at the end of pregnancy colostrum, a thick, light liquid, begins to be released. Thus, the female genital organs undergo complex changes during pregnancy, but after childbirth, the body gradually returns to its previous shape, restoring the size of the changed organs.
Changes in the fallopian tubes and ovaries during pregnancy
Changes in the fallopian tubes and ovaries are minor. The fallopian tubes become somewhat thicker due to hyperemia and serous saturation of the tissues. Their location changes due to the growth of the uterine body; they move down along the lateral surfaces of the uterus. The ovaries increase in size slightly. During pregnancy, they move from the pelvis to abdominal cavity.
Particularly noteworthy is the change in color of the vagina, which acquires a bluish tint. This process is explained by increased blood supply to the vagina. Other changes in the vagina can be characterized by its lengthening, widening and greater protrusion of the folds.
Why and how do the labia change during pregnancy?
It is likely that this is considered incomprehensible to someone, although during pregnancy changes even occur in the woman’s genitals, namely the labia. How do the labia change during pregnancy? A change in the color of the labia is considered one of the first symptoms of pregnancy. Only a gynecologist will be able to see such a sign if the fairer sex herself deliberately does not carry out a check. Darkening (pallor and purplishness) of the labia is noticeable already 10-12 days after conception. Although excessively noticeable changes in the labia, which often cause discomfort, pain, even itching, occur in the middle and second half of pregnancy.
With the onset of pregnancy, under the influence of hormones, the blood supply to the pelvic organs increases significantly, which is actually intended by nature to facilitate childbirth.
The labia minora and majora increase in volume (seem to swell).
The skin in this area (and also around the nipples and along the middle stripe of the abdomen) becomes darker.
Also, to facilitate childbirth, nature provides a large flow of blood to the pelvic organs.
1Based on the analysis of data from domestic and foreign scientific literature, information on age-related changes in the female reproductive system from a morphological point of view is summarized. The available information is mainly general in nature and highlights the features of changes in the uterus, ovaries and fallopian tubes mainly from a clinical point of view, highlighting the periods of puberty, reproductive and postmenopausal. Traditionally, the importance of the condition of the arteries is noted as providing nutrition to the organs of the female reproductive system. There has been insufficient coverage of issues related to changes in the quantitative characteristics of the structural components of the female reproductive system and the arteries supplying it in ontogenesis. The dimensional characteristics of the micromorphological components of tissues and organs are not presented in publications, which determines the relevance of carrying out morphological work using micromorphometric methods in this direction.
female reproductive system
morphology
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The interest of researchers on the problem of human aging in age-related anthropology in changes in organs and tissues in ontogenesis, which determine the development of involution processes, does not decrease, both from a fundamental point of view and in applied terms. In morphological studies of this issue, we can state the completion of the stage of transition from “descriptive” studies based on the analysis of qualitative characteristics to works where the material is presented by quantitative criteria with adequate methods of mathematical processing.
Internal organs and soft fabrics, as possible objects for determining age-related variability, have been critically assessed by many researchers for a long time. However, the widespread introduction of micrometric (quantitative) techniques in morphological profile studies has made it possible to determine significant signs structural components of internal organs, expressed in digital equivalent, which objectively reflect the changes that occur with an increase in the number of years lived.
To a new level in last years mathematical software modeling comes out pathological processes on the cellular and molecular levels. This determines the need to designate interval values of the dimensional characteristics of cellular and other structural components of internal organs.
Establishing quantitative age characteristics structural components of internal organs is important for correct definition and interpretation of the concept “ age norm" when analyzing morphological criteria of pathological processes.
The publications present the results of innovative work from this point of view on the study of age-related changes in the skin, arterial system, prostate, testicles, thyroid gland, kidneys and breast. The authors of these works proved the possibility of establishing the age of an individual based on the involution of internal organs and soft tissues of a person.
Age-related morphological involution of the female genital organs, among others, according to the literature, is presented extremely poorly. The publications contain separate works concerning the anatomy of the genitourinary system, the arterial system and the parametric venous plexus of the uterus, the endocrine function of the ovaries, their morphometric and histochemical features. A number of works examine the aging processes of female genital organs from the perspective functional changes under the influence of hormones. But in the available publications there are no reports on the study of age morphological changes female reproductive system from the standpoint of quantitative analysis.
The main components of the female reproductive system are the uterus, fallopian tubes and ovaries, in the age-related restructuring of which changes in the nutrients that feed them play a significant role arterial vessels.
By the time of birth, the uterus of newborns reaches a length of up to 38 mm, and subsequently decreases somewhat due to a decrease in the level of estrogen hormones. From the moment of birth to one year of life, in parallel with the gradual decrease in the thickness of the wall of the uterine body and the size of myocytes, the area occupied by the ground substance decreases, and the relative number of fibrous structures increases. At 4-7 years and further at 12-15 years, the uterine wall thickens, the area occupied by the main substance increases, and the relative number of fibrous structures decreases. U adult woman The average length of the uterus is about 7-8 cm, width - 4 cm, thickness - 2-3 cm. The weight of the uterus is nulliparous women ranges from 40 to 50 g, and in those who give birth it increases to 80-90 g. The volume of the uterine cavity is 4-6 cm 3. In the age period of 16-47 years, the uterine stroma zones acquire a typical structure. At 48-55 years of age, the wall of the uterine body becomes thinner, and the number of elastic fibers increases in the first zone; in the second, third and fourth zones the number of elastic and collagen fibers also increases; in the fifth zone - only collagen and in the sixth zone - reticular fibers. At 75-90 years old, senile atrophy of the uterus occurs, which is accompanied by a decrease (up to 2.5%) in the area occupied by the main substance, a decrease in the number (up to 29.4%) of collagen fibers in all zones of the myometrial stroma.
Significant changes occurring in the uterus are associated with the onset of menopause, when during the first 2-5 years the intensity of atrophic processes in the myometrium is most pronounced, due to which the volume of the uterus decreases to 35%. The endometrial layer also atrophies, which does not undergo cyclic changes after menopause. As a result of involutional atrophy of the layers of the uterus, a decrease in the size of its cavity, both longitudinal and transverse, occurs. After 20 years of the postmenopausal period, the size of the uterus stops changing.
The mucous membrane (endometrium) is represented by columnar epithelium and undergoes cyclic changes. Among the cells of the mucous membrane (epithelial cells), secretory and ciliated cells are distinguished. The stratum propria contains the uterine glands (crypts). The superficial thickened layer of the mucous membrane, called functional, undergoes changes under the influence of ovarian hormones. The deeper layer contains the bottoms of the uterine glands and interstitial cells that produce heparin and other hormones.
With age, the relative content of arterial vessels in the endometrium decreases. The amount of epithelial tissue increases from adolescence to adulthood, with a subsequent decrease in this indicator in old age.
In girls who have not reached puberty, the cervix has a conical shape; the same shape can be observed in infantile women. Among women childbearing age The shape of the cervix is usually cylindrical, its canal is spindle-shaped, the length from the external pharynx to the isthmus is no more than 4 cm, the external pharynx is round or in the form of a transverse slit.
Atrophic changes in the cervix that develop with deterioration of trophism against the background of decreased microcirculation are considered as a result of age-related estrogen deficiency. 88% of patients had diffuse atrophic changes, and 12% had focal ones. In addition, atrophic changes can be combined with inflammatory reaction exocervix - atrophic nonspecific exocervicitis (70% of patients). The main difference between this process and inflammation of the cervix in women reproductive age is the absence of edema and hyperemia, uneven thinning of the mucous membrane with easily damaged vessels of the subepithelial layer.
The localization of the process of cervical dysplasia also depends on the age of women. For women young the most typical location is the vaginal part of the cervix; with age, there is a tendency to move to the endocervix. The maximum number of epithelial dysplasias against the background of ectopia is observed at the age of 36-45 years (8.5%). According to multicenter epidemiological studies, the maximum number of cervical lesions infectious nature occurs at 18-30 years of age, and the peak of dysplasia and pre-invasive cancer is at 30-39 years of age.
Age-related changes in the uterine (fallopian) tubes are manifested by thickening of their walls, decreased tortuosity, expansion of the lumen and an increase in collagen content, which accelerates after 45 years.
In the process of ontogenesis, both age-related restructuring of the ovaries themselves and their appendages (epoophoron) is observed. The ovary is a paired organ that performs an endocrine function in a woman’s body, producing sex hormones, and a reproductive function, being the source of the formation and formation of eggs. By the end embryonic period Ontogenesis, the structure of the fetal ovaries is almost similar to the structure of the ovaries of an adult woman. The formation of most of the main structural components of the ovaries occurs during embryogenesis, in particular, the formation of the number of follicles is completed by the time of birth; neofolliculogenesis does not occur in the postnatal period.
From the neonatal period to the onset of puberty, the surface of the ovaries is smooth; subsequently, during the reproductive period, their surface becomes uneven and bumpy. IN old age the convolutions on the surface of the ovaries become deep grooves.
At the beginning of puberty, the ovaries in girls become large sizes: their length is from 3 to 3.5 cm, width - from 1.5 to 2 cm, thickness - from 1 to 1.5 cm. The difference in the mass of the ovary is significant: in newborns it is 0.3-0.4 g, in girls during menarche it increases 13-20 times. At the age of over 20 years, significant changes in the size and weight of the ovaries are not observed: their length on average is 4.0-4.5 - 2.0-2.5 cm (with transverse size 1.0-2.0 cm), weight - about 6.0-7.5 g. During the reproductive period of a woman, the ovaries have a size of 4.0-2.5-1.5 cm. In old age, the functioning of the ovaries stops, and they become small again, on average 2.0 x 1.0 x 0.5 cm; their weight ranges from 1 to 2 g.
In women of reproductive age, the cortex and medulla are clearly distinguishable in the ovaries, both macroscopically and microscopically. The cortex consists of spindle-shaped cells located close together, similar to swollen fibroblasts, and a collagenous stroma containing relatively few cells. The ovarian medulla is composed of loose connective tissue. The main structural and functional unit of the ovaries, the follicles, are located in the inner zone of the cortex. Follicles are divided into primordial, primary (pre-cavitary), secondary (cavitary) and tertiary: mature, preovulatory, graafian. During the reproductive period, follicles are located in the stroma of the cortex, primordial ones are localized along the periphery, and ripening ones are located in a deeper zone. With age, starting from puberty and throughout reproductive age, there is a continuous increase in the thickness of the cortical layer; with the onset of menopause, its gradual thinning begins. The thickness changes in inverse proportion medulla: its smallest thickness is observed during the newborn period, and the greatest - in old age. U mature women The ovarian cortex contains many yellow bodies varying degrees of maturity and white bodies, which are scars at the site of involution of the yellow bodies.
After the age of 20 years, a focal proliferation of collagen fibers is noted in the ovarian cortex; by the age of 30, gradual fibrosis of the cortical stroma begins, and the formation of compensatory vascular loci is noted. At 50-60 years of age, the surface of the ovaries becomes coarsely tuberous, the tunica albuginea thickens, stromal sclerosis is noted, a small amount different forms follicles, fibrous and white bodies become numerous, coarse fibrous tissue begins to prevail in the medulla connective tissue With possible development focal hyalinosis of its stroma, vascular sclerosis of varying severity is formed. At an older age, as a result of complete atrophy, the ovaries turn into flat fibrous plates.
Throughout the entire period of ontogenesis, the diameter of the vessels of the cortical and medulla of the ovaries increases, which is accompanied by a thickening of their walls and an increase in the lumen. Arterial hyalinosis, considered the main morphological feature involution of the gonads can be observed already in reproductive age. With age, there is a decrease in the ratio of the diameters of the vessels of the cortical and medulla of the ovaries, since in old and senile age due to sclerotic changes and emptying of the lumens of blood vessels, the blood supply to the cortical substance is weakened and its thickness decreases.
In the epididymis (epophron) after birth and during ontogenesis, the specific area of the tubules decreases with a decrease in the thickness of their muscle walls and the height of the epithelium lining them. In newborns, the width of the epoophoron averages 8.25±0.68 mm, height - 7.0±0.83 mm, oblique size - 9.83±0.75 mm. In women of reproductive age, the size of the epoophoron is more than 2 times larger than the size of the ovarian appendage of newborns. The volume of epoophoron in women of fertile age is 4 times greater than in newborns. In newborns, the ratio of ovarian and epoophoron volumes is 1.19, in women of reproductive age - 20.88. According to J. Mathis, the epoophoron reaches its greatest development during puberty, its structure changes depending on the period menstrual cycle, and in old age the ovarian appendage undergoes atrophy.
In age-related morphology, and in particular in the age-related morphology of the female reproductive system, one of the most important components is changes in blood vessels, which are considered as one of the main mechanisms and manifestations of aging, leading to a deterioration in the blood supply to organs and tissues. The role of age-related changes in the development of arterio- and atherosclerosis is best known, since with age the area of atherosclerotic lesions increases.
According to the works of I.V. Gaivoronsky et al., changes in the uterine artery depend not only on age, but also on functional state of the uterus are manifested by changes in architectonics, tortuosity and lumen diameter. In most elderly women, the uterine artery atrophies, subsequently it becomes obliterated, and the blood supply to the uterus is taken over by the branches of the ovarian artery through anastomoses. In women who have given birth, the venous vessels dilate, become more tortuous, and the parametric venous plexus is more pronounced, especially in the 2nd mature and elderly ages.
Thus, despite significant amount works devoted to the study of the organs of the female reproductive system at different age periods, in our opinion, the quantitative morphological structural components of the uterus, ovaries and fallopian tubes have not been studied enough. The dimensional characteristics of the micromorphological components of tissues and organs are not presented in publications, which determines the relevance of carrying out morphological work using micromorphometric methods in this direction.
Bibliographic link
Alekseev Yu.D., Ivakhina S.A., Efimov A.A., Savenkova E.N., Raikova K.A. AGE MORPHOLOGICAL CHANGES IN THE FEMALE GENITAL SYSTEM ORGANS // Modern problems of science and education. – 2016. – No. 4.;URL: http://site/ru/article/view?id=24951 (access date: 02/27/2019).
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"...I am interested in age-related changes in the labia - color and size. They are quite long, my left lip is larger than the right. They are larger than the outer lips, and are very visible from under them. I think this is not normal. Tell me how everything should be right and why this happened?”
"...I gave birth to a child last year. Previously, my labia minora were small and my labia majora closed tightly. Now my labia majora have changed - they dangle between my legs when I stand. As a result, when they come into contact with underwear, they become irritated, a burning sensation appears, itching , dryness appears on them and this creates even more discomfort..."
"...I really want to reduce my labia minora - I have an inferiority complex! I remember how in the shower with my friends I changed into adolescence, and they looked sooo surprised))) Not only are my lips enlarged and hang down when you stand, but also there is “extra” skin near the clitoris in the form of folds. I always dream of buying white bikinis for the beach, but I just can’t, because when the underwear is tight, everything sticks out THERE and is very noticeable! I talked to the guy about this, he doesn’t see any particular problem, but he says, if you have complexes from changes in the labia, then do it..."
"...Please tell me, I have one small labia more than the other. It delivers great discomfort in sexual relations and in general, when I put on a swimsuit, in the sauna some people stare there, etc. Is it possible to fix this?” - frequent questions asked to the gynecological surgeon at our center.
Labia different women completely individual. They may have smooth or fringed edges, have a color from pale pink to dark brown, more or less pronounced length - these are normal with medical point view of the genitals. And despite the fact that there are no strict standards for “female intimate beauty,” there are few girls and women who will not pay due attention to changes in the labia and the appearance of their external genitalia in general.
Lengthening (elongation) and asymmetry of the labia minora is the most common problem in girls and women. An enlarged lip is considered to be one whose size, when extended laterally, exceeds 4-5 cm. This condition is, as a rule, congenital.
WHAT IT USUALLY LOOKS LIKE
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However, more intense stretching of the labia minora may also be a consequence of certain chronic diseases, strong traction in this area or the flow of androgens (male sex hormones). Some people think that larger genitals make a girl more sexually attractive due to the fact that the female sex hormone estrogen is responsible for their size. However, the growth and change in the length and width of the lips in a larger direction is provided by the male sex hormone testosterone. And the higher its level in the body during puberty, the more pronounced the woman’s labia eventually become. By the way, testosterone is also responsible for sexual temperament.
In addition, many changes in the female external genitalia (excessively prominent lips, increased folding of the clitoral pocket, its enlargement, additional vaginal septa, etc.) indicate improper production of female sex hormones, an increase in the amount of male androgen hormones in the body. This pathology is often combined with other diseases in a woman’s body: polycystic ovary syndrome, increased hair growth(hirsutism), infertility, etc.
On external condition female intimate organs are also strongly influenced by active methods of combating overweight, childbirth, age-related changes - sagging of the labia minora and majora occurs, increased folding of the entrance to the vagina and the edges of the lips appears, the firmness and elasticity of the skin is impaired.
Find out in more detail what types of labia there are:
| Norm | Flabby | Long |
| Hanging | Large | Stretched |
| Asymmetry | Dark | Black |
| sticking out | Enlarged | After childbirth |
DO YOU NOT LIKE THE HOW YOUR LAVADIA HAVE CHANGED?
Come for a consultation with a gynecologist - a specialist in intimate plastic surgery at our clinic, discuss the problem that concerns you, find out the most the best way her decisions. Depending on the exact problem associated with appearance genitalia brought you, we will offer one or another solution to it.
Elongation, different sizes labia minora, stretching, discoloration and wrinkled edges, the consequences of injuries can only be eliminated promptly- by labiaplasty operations. Our capabilities and extensive experience in operations to correct these changes will help you get rid of and forget about this problem!
In addition to surgical correction of the size and shape of the labia minora, non-surgical procedures can be performed contour plastic surgery anogenital area. Injections of hyaluronic acid can increase tone, change the shape and size of the labia majora, narrow the entrance and the vagina itself, and enhance sexual sensations by enlarging the G-spot and clitoris.
For those wishing to lighten the skin color of the labia, anus and perineum, we offer a set of procedures intimate whitening in the clinic.
Sharp weight loss prolonged sitting on a diet, childbirth, especially repeated ones, hormonal changes lead to a decrease subcutaneous tissue, increased pigmentation, loss of tone of the labia, sagging, sagging, the appearance of stretch marks and stretch marks on the skin of the perineum. In our time intimate cosmetology offers biorevitalization sessions, plasma lifting, mesotherapy, lightening peels, as well as procedures for preventing age-related changes.
