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Physiology of the Female Reproductive System. Liu Wei Department of Ob & Gy Ren Ji hospital. Physiological Stages. Neonatal period: birth---4 weeks Childhood: 4 weeks----12 years Puberty: 12 years---18 years Sexual maturation: 18 year---50 year

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Physiology of the Female Reproductive System


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physiology of the female reproductive system

Physiology of the Female Reproductive System

Liu Wei

Department of Ob & Gy

Ren Ji hospital

physiological stages
Physiological 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 function (40 years)----1 year postmenopause
  • Postmenopause:
menstruation
Menstruation
  • Menstruation

cyclic endometrium sheds and bleeds due to cyclic ovulation

  • Mense
  • Endometrium is sloughed (progesterone withdrawal)
  • Nonclotting menstrual blood mainly comes from artery (75%)
  • Interval: 24-35 days (28 days). duration: 2-6 days. the first day of menstrual bleeding is consideredy by day 1
  • Shedding: 30-50 ml
central reproductive hormones
Central reproductive hormones
  • Hypothalamus-Pituitary-Ovary(H-P-O axis)
central reproductive hormones5
Central reproductive hormones
  • Neuroendocrine regulation
  • Gonadotropin-releasing hormone,GnRH
  • chemical structure

(pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2

  • Synthesize and transport

nerve cells

hypothalamus

portal vein

pitutary

anterior lobe

central reproductive hormones7
Central reproductive hormones
  • Regulation of GnRH

Hypothalams

GnRH

Pituitary

FSH, LH

Ovary

E,P

central reproductive hormones8
Central reproductive hormones
  • Gonadotropins
  • Composition (glycoprotein)

Follicle stimulating hormone,FSH

Luteinizing hormone,LH

  • Synthesize and transport

ovary

Gonadotroph (pulse)

Blood circulation

central reproductive hormones9
Central reproductive hormones
  • Prolactin (PRL)

Regulated by the prolactin inhibiting factor (PIF)

the ovarian cycle
The Ovarian cycle
  • Function of ovary
  • Reproduction

development and maturation of follicle; ovulation

  • Endocrine

estrogens, progesterone, testosterone

the ovarian cycle11
The Ovarian cycle
  • Cyclic changes of ovary
  • The development and maturation of follicle
  • Primordial follicle: before meiosis
  • Preantral follicle: zona pellucida, granulosa cells (FSH receptor)
  • Antral follicle: granulosa cells (LH receptor), E↑
  • Mature follicle: E↑,P↑

Theca externa, theca interna, granulosa, follicular antrum, mound, radiate coronal

  • Follicular phase: day 1 to follicle mature (14 days)
the ovarian cycle13
The Ovarian cycle
  • Ovulation
  • First meiosis completed → collagen decomposed → oocyte ovulated
  • Regulation
  • LH/FSH peak

E2↑(mature follicle) → GnRH ↑ (hypothalamus) → LH/FSH peak (positive feedback)

  • P cooperation

LH ↑ → P ↑(follicle luteinized before ovulation) →positive feedback

the ovarian cycle14
The Ovarian cycle
  • Corpus luteum
  • follicle luteinized after ovulation: luteal cells
  • LH → VEGF → corpus hemorrhagicum
  • Regression

non fertilized → corpus albicans

  • Luteal phase

Ovulation to day 1

the ovarian cycle15
The Ovarian cycle
  • sex hormones secreted by ovary
  • Composition

Estrogen, progesterone, testosterone

  • Chemical structure

Steroid hormone

  • Synthesis

Cholesterol→pregnenolone→androstenedione→

testosterone→estradiol

Δ5 or Δ4 pathway of estrogen production

the ovarian cycle16
The Ovarian cycle
  • Metabolism: liver
  • Cyclic change of E and P in ovary
  • Estrogen
  • E↑(day 7) → E peak (pre-ovulate) → E↓ → E↑ (1 day after ovulate) →E peak (day 7-8) → E↓
  • theca interna cells (LH receptor) → testosterone
  • Granulosa (FSH receptor) → estrogen
the ovarian cycle17
The Ovarian cycle
  • Progesterone

P↑ (after ovulation) → P peak (day 7-8) → P↓

granulosa

LH

progesterone

the ovarian cycle19
The Ovarian cycle
  • H-P-O axis
  • Positive feedback

Sex hormones (E)↑ → GnRH or LH/FSH↑

E peak (≥200pg/ml) → LH/FSH peak → ovulation

  • Negative feedback

Sex hormones (E)↑ → GnRH or LH/FSH↓

Follicular phase: E↑ → FSH↓

Luteal phase: E↑P↑ → LH/FSH↓(formation)

E↓P↓→ LH/FSH↑(regression)

the endometral cycle
The endometral cycle
  • Proliferative phase
  • E↑(mitogen)→ stroma thickens and glands become elongated → proliferative endometrium
  • Duration: 2 weeks
  • Thickness: 0.5mm → 5mm
the endometral cycle21
The endometral cycle
  • Secretory phase
  • P↑(differentiation) → secretory endometrium
  • Features

stroma becomes loose and edematous

blood vessels entering the endometrium become thickened and twisted

glands become tortuous and contain secretory material within the lumina

  • Duration: 2 weeks
  • Thickness: 5-6mm
change of other genital organs
Change of Other genital organs
  • Cervix

endocervical glands (E↑)→ mucus(thin,clear, watery) → maximal (ovulation)

endocervical glands (P↑)→ mucus(thick, opaque, tenacious)

  • Vagina

Vaginal mucosa (E↑)→ thickening and secretory changes

Vaginal mucosa (P↑) → secrete↓