Physiology of the Female Reproductive System
Physiology of the Female Reproductive System
Liu WeiDepartment of Ob & GyRen Ji hospital
Liu WeiDepartment of Ob & GyRen Ji hospital
Physiological StagesPhysiological Stages
• Neonatal period: birth---4 weeks• Childhood: 4 weeks----12 years• Puberty: 12 years---18 years• Sexual maturation: 18 year---50 year• Perimenopause: decline of ovarian func
tion (40 years)----1 year postmenopause
• Postmenopause:
• Neonatal period: birth---4 weeks• Childhood: 4 weeks----12 years• Puberty: 12 years---18 years• Sexual maturation: 18 year---50 year• Perimenopause: decline of ovarian func
tion (40 years)----1 year postmenopause
• Postmenopause:
MenstruationMenstruation• Menstruation cyclic endometrium sheds and bleeds due to cyclic
ovulation• Mense1. Endometrium is sloughed (progesterone withdra
wal)2. Nonclotting menstrual blood mainly comes from
artery (75%)3. Interval: 24-35 days (28 days). duration: 2-6 days.
the first day of menstrual bleeding is consideredy by day 1
4. Shedding: 30-50 ml
• Menstruation cyclic endometrium sheds and bleeds due to cyclic
ovulation• Mense1. Endometrium is sloughed (progesterone withdra
wal)2. Nonclotting menstrual blood mainly comes from
artery (75%)3. Interval: 24-35 days (28 days). duration: 2-6 days.
the first day of menstrual bleeding is consideredy by day 1
4. Shedding: 30-50 ml
Central reproductive hormones
Central reproductive hormones
• Hypothalamus-Pituitary-Ovary(H-P-O axis)
• Hypothalamus-Pituitary-Ovary(H-P-O axis)
Central reproductive hormones
Central reproductive hormones
• Neuroendocrine regulation1. Gonadotropin-releasing hormone,GnRH1) chemical structure (pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2
2) Synthesize and transport
• Neuroendocrine regulation1. Gonadotropin-releasing hormone,GnRH1) chemical structure (pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2
2) Synthesize and transport
nerve cells
hypothalamus
portal vein
pitutaryanterior
lobe
Central reproductive hormones
Central reproductive hormones
Central reproductive hormones
Central reproductive hormones
3) Regulation of GnRH3) Regulation of GnRH
Hypothalams
GnRH
Pituitary
FSH, LH
Ovary
E,P
Central reproductive hormones
Central reproductive hormones
2. Gonadotropins1) Composition (glycoprotein) Follicle stimulating hormone,FSH Luteinizing hormone,LH2) Synthesize and transport
2. Gonadotropins1) Composition (glycoprotein) Follicle stimulating hormone,FSH Luteinizing hormone,LH2) Synthesize and transport
Gonadotroph (pulse)
Blood circulatio
n
ovary
Central reproductive hormones
Central reproductive hormones
3. Prolactin (PRL)Regulated by the prolactin inhibiting factor (PIF
)
3. Prolactin (PRL)Regulated by the prolactin inhibiting factor (PIF
)
The Ovarian cycleThe Ovarian cycle
• Function of ovary1. Reproduction development and maturation of
follicle; ovulation2. Endocrine estrogens, progesterone,
testosterone
• Function of ovary1. Reproduction development and maturation of
follicle; ovulation2. Endocrine estrogens, progesterone,
testosterone
The Ovarian cycleThe Ovarian cycle• Cyclic changes of ovary1. The development and maturation of follicle1) Primordial follicle: before meiosis2) Preantral follicle: zona pellucida, granulosa cells (
FSH receptor)3) Antral follicle: granulosa cells (LH receptor), E↑ 4) Mature follicle: E↑,P↑Theca externa, theca interna, granulosa, follicular an
trum, mound, radiate coronal5) Follicular phase: day 1 to follicle mature (14 days)
• Cyclic changes of ovary1. The development and maturation of follicle1) Primordial follicle: before meiosis2) Preantral follicle: zona pellucida, granulosa cells (
FSH receptor)3) Antral follicle: granulosa cells (LH receptor), E↑ 4) Mature follicle: E↑,P↑Theca externa, theca interna, granulosa, follicular an
trum, mound, radiate coronal5) Follicular phase: day 1 to follicle mature (14 days)
The Ovarian cycleThe Ovarian cycle
The Ovarian cycleThe Ovarian cycle2. Ovulation1) First meiosis completed → collagen decompo
sed → oocyte ovulated2) Regulationa) LH/FSH peakE2↑(mature follicle) → GnRH ↑ (hypothalamus)
→ LH/FSH peak (positive feedback)b) P cooperationLH ↑ → P ↑(follicle luteinized before ovulation)
→positive feedback
2. Ovulation1) First meiosis completed → collagen decompo
sed → oocyte ovulated2) Regulationa) LH/FSH peakE2↑(mature follicle) → GnRH ↑ (hypothalamus)
→ LH/FSH peak (positive feedback)b) P cooperationLH ↑ → P ↑(follicle luteinized before ovulation)
→positive feedback
The Ovarian cycleThe Ovarian cycle
3. Corpus luteum1) follicle luteinized after ovulation: luteal cell
s2) LH → VEGF → corpus hemorrhagicum3) Regression non fertilized → corpus albicans4) Luteal phase Ovulation to day 1
3. Corpus luteum1) follicle luteinized after ovulation: luteal cell
s2) LH → VEGF → corpus hemorrhagicum3) Regression non fertilized → corpus albicans4) Luteal phase Ovulation to day 1
The Ovarian cycleThe Ovarian cycle• sex hormones secreted by ovary1. Composition Estrogen, progesterone, testosterone2. Chemical structure Steroid hormone3. SynthesisCholesterol→pregnenolone→androstenedione
→testosterone→estradiolΔ5 or Δ4 pathway of estrogen production
• sex hormones secreted by ovary1. Composition Estrogen, progesterone, testosterone2. Chemical structure Steroid hormone3. SynthesisCholesterol→pregnenolone→androstenedione
→testosterone→estradiolΔ5 or Δ4 pathway of estrogen production
The Ovarian cycleThe Ovarian cycle
4. Metabolism: liver5. Cyclic change of E and P in ovary1) Estrogena) E↑(day 7) → E peak (pre-ovulate) → E↓ → E
↑ (1 day after ovulate) →E peak (day 7-8) → E↓
b) theca interna cells (LH receptor) → testosterone
c) Granulosa (FSH receptor) → estrogen
4. Metabolism: liver5. Cyclic change of E and P in ovary1) Estrogena) E↑(day 7) → E peak (pre-ovulate) → E↓ → E
↑ (1 day after ovulate) →E peak (day 7-8) → E↓
b) theca interna cells (LH receptor) → testosterone
c) Granulosa (FSH receptor) → estrogen
The Ovarian cycleThe Ovarian cycle
2) ProgesteroneP↑ (after ovulation) → P peak (day 7-8) →
P↓
2) ProgesteroneP↑ (after ovulation) → P peak (day 7-8) →
P↓
granulosa
progesterone
LH
Ovarian responsesOvarian responses
The Ovarian cycleThe Ovarian cycle• H-P-O axis1. Positive feedbackSex hormones (E)↑ → GnRH or LH/FSH↑E peak (≥200pg/ml) → LH/FSH peak → ovulation2. Negative feedbackSex hormones (E)↑ → GnRH or LH/FSH↓Follicular phase: E↑ → FSH↓Luteal phase: E↑P↑ → LH/FSH↓(formation) E↓P↓ → LH/FSH↑(regression)
• H-P-O axis1. Positive feedbackSex hormones (E)↑ → GnRH or LH/FSH↑E peak (≥200pg/ml) → LH/FSH peak → ovulation2. Negative feedbackSex hormones (E)↑ → GnRH or LH/FSH↓Follicular phase: E↑ → FSH↓Luteal phase: E↑P↑ → LH/FSH↓(formation) E↓P↓ → LH/FSH↑(regression)
The endometral cycleThe endometral cycle• Proliferative phase1. E↑(mitogen)→ stroma thickens and glands
become elongated → proliferative endometrium
2. Duration: 2 weeks3. Thickness: 0.5mm → 5mm
• Proliferative phase1. E↑(mitogen)→ stroma thickens and glands
become elongated → proliferative endometrium
2. Duration: 2 weeks3. Thickness: 0.5mm → 5mm
The endometral cycleThe endometral cycle• Secretory phase1. P↑(differentiation) → secretory endometrium2. Featuresstroma becomes loose and edematousblood vessels entering the endometrium become
thickened and twistedglands become tortuous and contain secretory m
aterial within the lumina3. Duration: 2 weeks4. Thickness: 5-6mm
• Secretory phase1. P↑(differentiation) → secretory endometrium2. Featuresstroma becomes loose and edematousblood vessels entering the endometrium become
thickened and twistedglands become tortuous and contain secretory m
aterial within the lumina3. Duration: 2 weeks4. Thickness: 5-6mm
Change of Other genital organs
Change of Other genital organs
• Cervixendocervical glands (E↑)→ mucus(thin,clear, wa
tery) → maximal (ovulation)endocervical glands (P↑)→ mucus(thick, opaque
, tenacious)• VaginaVaginal mucosa (E↑)→ thickening and secretory
changesVaginal mucosa (P↑) → secrete↓
• Cervixendocervical glands (E↑)→ mucus(thin,clear, wa
tery) → maximal (ovulation)endocervical glands (P↑)→ mucus(thick, opaque
, tenacious)• VaginaVaginal mucosa (E↑)→ thickening and secretory
changesVaginal mucosa (P↑) → secrete↓
Physiological function of sex hormones
Physiological function of sex hormones
• Estrogen• Estrogen
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