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Physiology of the Female Reproductive System
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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: 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:
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Menstruation cyclic endometrium sheds and bleeds due to cyclic ovulation Mense 1.Endometrium is sloughed (progesterone withdrawal) 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 Mense 1.Endometrium is sloughed (progesterone withdrawal) 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
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Central reproductive hormones Hypothalamus-Pituitary-Ovary(H-P-O axis)
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Central reproductive hormones Neuroendocrine regulation 1.Gonadotropin-releasing hormone,GnRH 1)chemical structure (pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH 2 2)Synthesize and transport Neuroendocrine regulation 1.Gonadotropin-releasing hormone,GnRH 1)chemical structure (pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH 2 2)Synthesize and transport nerve cells hypothalamus portal vein pitutary anterior lobe
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Central reproductive hormones
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3)Regulation of GnRH Hypothalams GnRH Pituitary FSH, LH Ovary E,P
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Central reproductive hormones 2.Gonadotropins 1)Composition (glycoprotein) Follicle stimulating hormone,FSH Luteinizing hormone,LH 2)Synthesize and transport 2.Gonadotropins 1)Composition (glycoprotein) Follicle stimulating hormone,FSH Luteinizing hormone,LH 2)Synthesize and transport Gonadotroph (pulse) Blood circulation ovary
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Central reproductive hormones 3.Prolactin (PRL) Regulated by the prolactin inhibiting factor (PIF) 3.Prolactin (PRL) Regulated by the prolactin inhibiting factor (PIF)
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The Ovarian cycle Function of ovary 1.Reproduction development and maturation of follicle; ovulation 2.Endocrine estrogens, progesterone, testosterone Function of ovary 1.Reproduction development and maturation of follicle; ovulation 2.Endocrine estrogens, progesterone, testosterone
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The Ovarian cycle Cyclic changes of ovary 1.The development and maturation of follicle 1)Primordial follicle: before meiosis 2)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 antrum, mound, radiate coronal 5)Follicular phase: day 1 to follicle mature (14 days) Cyclic changes of ovary 1.The development and maturation of follicle 1)Primordial follicle: before meiosis 2)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 antrum, mound, radiate coronal 5)Follicular phase: day 1 to follicle mature (14 days)
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The Ovarian cycle
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2.Ovulation 1)First meiosis completed → collagen decomposed → oocyte ovulated 2)Regulation a)LH/FSH peak E 2 ↑( mature follicle ) → GnRH ↑ (hypothalamus) → LH/FSH peak (positive feedback) b)P cooperation LH ↑ → P ↑ (follicle luteinized before ovulation) → positive feedback 2.Ovulation 1)First meiosis completed → collagen decomposed → oocyte ovulated 2)Regulation a)LH/FSH peak E 2 ↑( mature follicle ) → GnRH ↑ (hypothalamus) → LH/FSH peak (positive feedback) b)P cooperation LH ↑ → P ↑ (follicle luteinized before ovulation) → positive feedback
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The Ovarian cycle 3.Corpus luteum 1)follicle luteinized after ovulation: luteal cells 2)LH → VEGF → corpus hemorrhagicum 3)Regression non fertilized → corpus albicans 4)Luteal phase Ovulation to day 1 3.Corpus luteum 1)follicle luteinized after ovulation: luteal cells 2)LH → VEGF → corpus hemorrhagicum 3)Regression non fertilized → corpus albicans 4)Luteal phase Ovulation to day 1
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The Ovarian cycle sex hormones secreted by ovary 1.Composition Estrogen, progesterone, testosterone 2.Chemical structure Steroid hormone 3.Synthesis Cholesterol → pregnenolone → androstenedione → testosterone → estradiol Δ 5 or Δ 4 pathway of estrogen production sex hormones secreted by ovary 1.Composition Estrogen, progesterone, testosterone 2.Chemical structure Steroid hormone 3.Synthesis Cholesterol → pregnenolone → androstenedione → testosterone → estradiol Δ 5 or Δ 4 pathway of estrogen production
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The Ovarian cycle 4.Metabolism: liver 5.Cyclic change of E and P in ovary 1)Estrogen a)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: liver 5.Cyclic change of E and P in ovary 1)Estrogen a)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
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The Ovarian cycle 2)Progesterone P ↑ (after ovulation) → P peak (day 7-8) → P ↓ 2)Progesterone P ↑ (after ovulation) → P peak (day 7-8) → P ↓ granulosa progesterone LH
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Ovarian responses
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The Ovarian cycle H-P-O axis 1.Positive feedback Sex hormones (E) ↑ → GnRH or LH/FSH ↑ E peak ( ≥200pg/ml ) → LH/FSH peak → ovulation 2.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) H-P-O axis 1.Positive feedback Sex hormones (E) ↑ → GnRH or LH/FSH ↑ E peak ( ≥200pg/ml ) → LH/FSH peak → ovulation 2.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)
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The endometral cycle Proliferative phase 1.E ↑ (mitogen) → stroma thickens and glands become elongated → proliferative endometrium 2.Duration: 2 weeks 3.Thickness: 0.5mm → 5mm Proliferative phase 1.E ↑ (mitogen) → stroma thickens and glands become elongated → proliferative endometrium 2.Duration: 2 weeks 3.Thickness: 0.5mm → 5mm
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The endometral cycle Secretory phase 1.P ↑ (differentiation) → secretory endometrium 2.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 3.Duration: 2 weeks 4.Thickness: 5-6mm Secretory phase 1.P ↑ (differentiation) → secretory endometrium 2.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 3.Duration: 2 weeks 4.Thickness: 5-6mm
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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 ↓ 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 ↓
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Physiological function of sex hormones Estrogen
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