The document discusses the physiology of the female reproductive system. It covers the stages of development from birth through menopause. It describes the menstrual cycle and how it is regulated by hormones like estrogen and progesterone produced by the ovaries and hypothalamus-pituitary-ovarian axis. The ovarian cycle and changes in the endometrium across the proliferative and secretory phases are also summarized.

1. Physiology of the
Female Reproductive
System

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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4. Central reproductive hormones
• Hypothalamus-Pituitary-Ovary(H-P-O axis)
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5. Central reproductive hormones
• Neuroendocrine regulation
2. Gonadotropin-releasing hormone,GnRH
3) chemical structure
(pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2
5) Synthesize and transport
nerve cells
hypothalamus
portal vein
pitutary
anterior lobe
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6. Central reproductive hormones
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7. Central reproductive hormones
1) Regulation of GnRH
Hypothalams
GnRH
Pituitary
FSH, LH
Ovary
E,P
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8. Central reproductive hormones
1. Gonadotropins
2) Composition (glycoprotein)
Follicle stimulating hormone,FSH
Luteinizing hormone,LH
5) Synthesize and transport
Gonadotroph
(pulse)
Blood
circulation
ovary
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9. Central reproductive hormones
1. Prolactin (PRL)
Regulated by the prolactin inhibiting factor (PIF)
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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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12. The Ovarian cycle
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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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18. Ovarian responses
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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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22. 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
→ ↓
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