From its site of production in the testes, the sperm must travel through the sperm tract to reach the outside of the body. As it does so, the various components that make up the seminal fluid are added to the sperm. The sperm tract, illustrated in figure 3.7, consists of a number of ducts including the epididymis, the vas deferens, the ejaculatory duct, and the urethra. In addition, a number of glands that secrete various fluids join the sperm tract through a series of small ducts.

After being produced in the seminiferous tubules, the sperm are stored in the epididymis, which is a highly coiled, interconnected network of seminiferous tubules lying in the upper part of the testes. As the sperm mature in the epididymis, they become capable of movement as the neck of each sperm becomes flexible.

The vas deferens carries the sperm from the epididymis to the ejacu-latory duct. At this point, the ducts of the seminal vesicles join the sperm tract and provide a viscous, alkaline secretion containing fructose and prostaglandins. The fructose, a sugar, is a source of energy for the sperm; the prostaglandins stimulate uterine contractions and help the sperm move to the female's fallopian tubes where fertilization takes place. The prostate gland surrounds the ejaculatory duct at the place where it becomes the urethra. It secretes a milky fluid that aids in sperm motility. The fluid contains, among other things, a large concentration of bicarbonate ions that gives the semen its alkaline pH. The alkaline nature of the seminal vesicle fluid and the prostate gland fluid reduces the acidity present in the urinary system, which is joined to the sperm tract at the urethra. This is particularly important since sperm motility is adversely affected by an acidic environment. Finally, the bulbourethral glands (Cowper's glands) secrete a mucuslike substance that provides lubrication for the urethra.

The secretions just described are called seminal fluid, and the combination of sperm and seminal fluid is called semen. Since there frequently is confusion as to the distinction between sperm and semen, it is worthwhile to point out that while sperm are under the careful hormonal control previously described, the seminal fluid is produced by the body as needed and is not affected by hormonal levels. Also important is the fact that the semen contains an antibiotic substance called seminalplasmin. Were it not for seminalplasmin, seminal bacteria would almost always infect women's vaginas, making sexual intercourse a routine health hazard.


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'My boobs get awfully painful in the week or so before my periods come,' Helen said. 'Fortunately, it seems to get a lot less as soon as the blood flow starts, but it's a real nuisance. Specially it I'm out on a social event, and my fellow starts holding me tightly! I nearly yell with the pain, and it's a bit hard to tell him to lay off my chest!" Sore breasts, tender boobs, call it what you like. Doctors mutter about 'mastodynia' or 'mastalgia', and they all mean the same. Sore, tender, swollen breasts (and frequently very tender nipples) in the 7-10 day interval preceding the start of a menstrual bleed.

Many women have rushed along to the doctor, fearing it might be cancer. Or they think they detect a lump. Very sensible these women are, for any lump (real or imagined) must receive proper medical attention, and the sooner the better.

However, a full medical check-out frequently indicates that there is no real evidence ot cancer, nor of any other sinister breast disease. Indeed, there may certainly be some deep tender areas, but these are most likely milk glands that are swollen.

Once more, this is part of the P.M.T. biz. It is of tea due to fluid retention in the breast tissues, aggravated and often caused by oestrogen and progesterone production by the corpus luteum in the second half of the menstrual cycle.

In some women, it may be aggravated by another female hormone called prolactin; this it alto produced by the pituitary gland at the base of the brain. But it can also come from ovarian-uterine sources as well. As its name implies. It is really aimed at producing and regulating milk production and secretion during lactation following childbirth. That is why it affects breast tissue so forcefully.

The methods of treating painful breasts related to periods is similar to the general principles of P.M.T. therapy. Oral diuretics (fluid pills) are often extremely effective. By reducing the body's fluid retention (especially at it applies to breast tissue) almost immediate relief is available.

Also, by inhibiting ovulation by the use of the oral contraceptive pill, the chances of recurrence are greatly reduced. Some women respond successfully to various other forms of hormonal medication taken during the second half of the cycle.

Fairly recently the development of the drug called bromocriptine has been effective in many women in whom a raised level of the hormone prolactin appears to be the chief culprit. Many

trials have been reported documenting the value and efficacy of bromocriptine. Although its primary use is for other complaints (often involving high prolactin levels), it does play a part here, if the doctor thinks fit to use it.

As with most other symptoms relating to the menstrual cycle, attending your doctor for suitable tailor-made medication is suggested. Do not go first to your pharmacist to seek these potent drugs. All must be given under proper medical supervision, and your doctor is the one to see in the first instance. Be guided by your doctor's advice.