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The female reproductive system consists of the paired ovaries and uterine tubes (or oviducts/fallopian tubes), the uterus, the vagina, and the external genitalia (Figure 22–1). This system produces the female gametes (oocytes), provides the environment for fertilization, and holds the embryo during its complete development through the fetal stage until birth. As with male gonads, the ovaries produce steroidal sex hormones that control development and function of the reproductive organs and influence other tissues. Beginning at menarche, when the first menses occurs, the reproductive system undergoes monthly changes in structure and function, under the control of neurohormonal mechanisms. Menopause represents a variably timed period during which the cyclic changes become irregular and eventually disappear. In the postmenopausal period the reproductive organs slowly involute. Although the mammary glands do not belong to the genital system, they are included here because they undergo changes directly connected to the functional state of the reproductive organs.
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Ovaries are almond-shaped bodies approximately 3-cm long, 1.5-cm wide, and 1-cm thick. Each ovary is covered by a simple cuboidal epithelium, the surface (or germinal) epithelium, continuous with the mesothelium and overlying a capsule of dense connective tissue, the tunica albuginea, like that of the testis. Most of the ovary consists of the cortex, a region of highly cellular connective tissue stroma containing many ovarian follicles that vary greatly in size after menarche (Figure 22–1). The most internal part of the ovary, the medulla, encompasses loose connective tissue and blood vessels entering the organ through the hilum from the mesenteries suspending the ovary (Figures 22–1 and 22–2). No distinct border delineates the ovarian cortex and medulla.
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