2. 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:
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3. Menstruation
• Menstruation
cyclic endometrium sheds and bleeds due to
cyclic ovulation
• Mense
4. Endometrium is sloughed (progesterone
withdrawal)
5. Nonclotting menstrual blood mainly comes
from artery (75%)
6. Interval: 24-35 days (28 days). duration: 2-6
days. the first day of menstrual bleeding is
consideredy by day 1
7. Shedding: 30-50 ml
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10. The Ovarian cycle
• Function of ovary
2. Reproduction
development and maturation of follicle;
ovulation
4. Endocrine
estrogens, progesterone, testosterone
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11. The Ovarian cycle
• Cyclic changes of ovary
2. 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
8) Follicular phase: day 1 to follicle mature (14
days)
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13. The Ovarian cycle
1. Ovulation
• First meiosis completed → collagen
decomposed → oocyte ovulated
• Regulation
d) LH/FSH peak
E2↑(mature follicle) → GnRH ↑ (hypothalamus)
→ LH/FSH peak (positive feedback)
f) P cooperation
LH P (follicle luteinized before ovulation)
↑ → ↑
positive feedback
→
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14. The Ovarian cycle
1. Corpus luteum
• follicle luteinized after ovulation: luteal cells
• LH → VEGF → corpus hemorrhagicum
• Regression
non fertilized corpus albicans
→
6) Luteal phase
Ovulation to day 1
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15. The Ovarian cycle
• sex hormones secreted by ovary
2. Composition
Estrogen, progesterone, testosterone
4. Chemical structure
Steroid hormone
6. Synthesis
Cholesterol pregnenolone androstenedione
→ → →
testosterone estradiol
→
Δ5
or Δ4
pathway of estrogen production
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16. The Ovarian cycle
1. Metabolism: liver
2. Cyclic change of E and P in ovary
3) Estrogen
d) E (day 7) E peak (pre-ovulate) E E
↑ → → ↓ → ↑
(1 day after ovulate) E peak (day 7-8) E
→ → ↓
e) theca interna cells (LH receptor) →
testosterone
f) Granulosa (FSH receptor) estrogen
→
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17. The Ovarian cycle
1) Progesterone
P↑ (after ovulation) → P peak (day 7-8) → P↓
granulosa
progesterone
LH
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19. The Ovarian cycle
• H-P-O axis
2. Positive feedback
Sex hormones (E)↑ GnRH or LH/FSH
→ ↑
E peak (≥200pg/ml) LH/FSH peak ovulation
→ →
5. 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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20. The endometral cycle
• Proliferative phase
• E↑(mitogen)→ stroma thickens and glands
become elongated → proliferative
endometrium
• Duration: 2 weeks
• Thickness: 0.5mm → 5mm
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21. The endometral cycle
• Secretory phase
• P↑(differentiation) → secretory endometrium
3. 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
7. Duration: 2 weeks
8. Thickness: 5-6mm
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