The human reproductive system provides many functions for both the male and female person. It is involved in hormone production, and the creation of human life. The reproductive system works together with other organs in the body to help with the regulation of hormone secretion, the secondary sexual characteristics and the ability to become pregnant. Along with the normal physiological changes that occur with puberty, pregnancy and sexual maturation, the reproductive system is prone to many different types of infections. Infections such as gonorrhea, chlamydia, HIV, syphilis and many others can affect the reproductive system in a negative way and cause irreversible damage. The anatomy and physiology of the reproductive system, both male and female, will be reviewed. Also it will discuss syphilis, its pathophysiology, clinical manifestations, prevention and the nursing interventions. It will discuss how syphilis affects the reproductive system and other parts of the body if not treated. The female reproductive system consists of internal and external genitalia. The external genitalia are located at the base of the pelvis in the perineal area and include the mons pubis, labia majora, labia minora, clitoris and perineal body (Porth & Matfin, 2009). The mons pubis is a skin covered fat pad located anteriorly to the symphysis pubis. The labia majora are the outermost lips of the vulva, during puberty they are covered with hair. The labia minora are located between the labia majora and are composed of skin, fat and some erectile tissue. They unlike the labia majora are usually light pink in color and hairless. They folds meet anteriorly at the clitoris (an organ much like the male penis). The clitoris is rich in vascular and nervous supply, and becomes very sensitive during sexual arousal. The perineal body is area between the vaginal opening and anus. The internal female organs are composed of the vagina, uterus and cervix, fallopian tubes and ovaries. The vagina is made up of a fibromuscular tube. The vagina is the opening to the internal reproductive organs from the external genitalia. It is also serves as an organ of sexual fulfillment and reproduction. The uterus is a thick-walled muscular organ it is located between the bladder and the rectum. The uterus can be divided into three parts, the fundus, the cervix and the area between both known as the body of the uterus. The wall of the uterus is composed of three layers the perimetrium, myometrium and endometrium. The uterus also is where the egg is implanted into the endometrium to sustain the pregnancy. The uterus serves for reception, implantation, retention and nutrition of the fertilized egg and later of the fetus during pregnancy and for expulsion of the fetus during child birth. It is also responsible for cyclic menstruation. (Wong, Hockenberry Perry, Lowdermilk &Wilson, 2006 p. 85). The cervix is the opening from the uterus into the vagina. It is a portal for sperm to enter the uterus for possible fertilization by secreting. If fertilization occurs the cervix then produces a thick mucous plug to protect fetus from infections. The fallopian tubes are where fertilization occurs, and are a passageway for the ova and sperm. They also provide for drainage of tubal secretions into the uterus. The ovaries are located on either side of the uterus below the fallopian tubes. The ovaries, like the male testes, have a dual function: they store the female germ cells, or ova, and produce the female sex hormones, estrogen and progesterone. Through the regulation and release of the sex hormones, the ovaries influence development of secondary sexual characteristics, regulation of menstrual cycles, and maintenance of pregnancy and advent of menopause. (Porth & Matfin, 2009, p.1117). Like the female reproductive system, the male reproductive system also includes structures inside and outside of the abdominal cavity. The testes and scrotum are located outside the abdominal cavity. The scrotum, which houses the testes, aids in the regulation of temperature of the testes. The ductile system (epididymides, vas deferens, and the ejaculatory ducts) transports and stores sperm, and assists in their maturation; and the accessory glands (seminal vesicles, prostate gland, and bulbourethral glands) prepare the sperm for ejaculation. (Porth &M Matfin, 2009). The testes secrete several male hormones, including testosterone. The penis is the external genital organ through which the urethra passes. It consists of the shaft and the end called the glans. It contains many sensory nerves, making the most sensitive part of the penis. Syphilis is a sexually transmitted disease that is caused by the bacterium Treponema pallidum. Syphilis can cause long term complications and may lead to death ssyphilis. Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres occur mainly on the external genitals, vagina, anus, or in the rectum. Chancres also can occur on the lips and in the mouth. Transmission of syphilis occurs during vaginal, anal, or oral sex. Pregnant women with the disease can transmit it to their unborn child. (Lautenschlager, S., 2006). Primary stage of syphilis is characterized by a single sore (chancre), but there may be multiple sores. The sore is usually appears at the site of infection. The sore is usually firm, round, and painless. The sore may be present for 3-6 weeks and usually disappears even if the individual is untreated. However, if the infected person does not receive adequate treatment the infection progresses to the secondary stage. (www.cdc.org). In the secondary stage, skin rashes and or sores in the mouth, vagina, or anus may be present. This stage usually starts with a rash on one or more parts of the body. The rash may appear as rough, red, or reddish brown spots on the palms of the hands and soles of feet. According to Lautenschlager, rash is the presenting complaint in more than 70% of patients and can be found on exam in all but 10% of .Other symptoms of secondary syphilis include fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. Without treatment the disease will progress to the latent phase and the late stages of the disease. The latent stage occurs when primary and secondary symptoms disappear. Syphilis can remain in the infected person’s body without treatment. The latent phase can last for many years. About 15% of people who have not been treated for syphilis develop late stages syphilis, which can appear 10-3- years after infection began (www.cdc.gov). Tertiary or late syphilis is classified into gummatous syphilis, cardiovascular syphilis and neurosyphilis (Brown & Frank, 2003). Syphilis symptoms include difficulty coordination muscle movements, paralysis, numbness, blindness and dementia. The internal organs such as the liver, brain, heart, blood vessels, bones and joints are damaged by the gummas (granulomatous-like lesions). Eventually, the damage sustained by these organs can lead to death. Diagnosis of syphilis is most commonly done by a blood test. Shortly after being infected the body produces antibodies that can detected by a simple blood test. The blood tests are named venereal disease research laboratory test (VDRL) and rapid plasma reagin (RPR). Another diagnostic method that is used is examining a culture from a syphilis sore under a dark-field microscope. If the bacterium T. pallidum is present in the sore it will be visible through the microscope. The treatment guidelines from the Center for Disease Control and Prevention recommend that Penicillin G be administered parenterally for all stages of syphilis. In the primary and secondary stage a single dose of Penicillin G benzathine 2.4 million units intramuscularly is administered. If no clinical manifestations are present (latent phase) Penicillin G benzathine 2.4 million units IM is administered once for 3 weeks. Alternate methods may be warranted if the patient has a sensitivity or allergic to penicillin. Prevention of syphilis is very simple. Practicing safe sex practices such as wearing a condom during intercourse and using a dental dam during oral sex. Abstinence is the only 100% effective method in avoiding this disease. Another prevention method is education. Education of the disease process, being mature enough to ask partners about past sexual history and inspecting the partner’s genitalia, and education them on the signs and symptoms of the disease process are the first line of defense to preventing infection. Although syphilis is a curable disease, the clinical manifestations or the difficulty to see the chancre may postpone the patient from seeking treatment. As discussed before untreated syphilis can lead to more serious complications and possible even death. Education is the best method to prevent this disease. Education on abstinence, safe practices and clinical manifestations are crucial, especially with the HIV positive patients or men that have sex with men. The human reproductive system can be afflicted with many different diseases but usually STDs are the most common and cause or lead to more serious problems. Syphilis is one disease that not only affects the reproductive system but can have grave consequences if left untreated.

References
Brown, D.L. & Frank, J.E. (July 15, 2003). Diagnosis and Management of Syphilis. American Family Physician, 68(2)
Cohen, S.E., Chew, R.A., Katz, K.A., Bernstein, K. T., Samuel, M.C., Kerndt, P.R., & Bolan, G. (2012). Repeat Syphilis Among men who have sex with men in California, 2002-2006: Implications for syphilis elimination efforts. American Journal of Public Health, 102(1), el-e8. doi:10.2105/AJPH.2011.300383
Lautenschlager, S. (2006). Cutaneous Manifestations of Syphilis: Recognition and Management. American Journal of Clinical Dermatology, 7(5), 291-304.
Porth, C.M. & Matfin, G. (2009). Pathophysiology: Concepts of altered health states. China: Lippincott, Williams & Wilkins.
Wong, D.L., Hockenberry, M.J., Perry, S.E., Lowdermilk, D.L., & Wilson, D. (2006). Maternal Child Nursing Care. St. Louis, Missouri: Mosby Elvesier