Chapter2 Physiology of

Reproduction in Women

Wang fuling
Contents:
 一、 Physiological Stages
 二、 The definition of menstruation
 三、 The Ovarian function and cyclical variation
 四、 Ovarian steroid hormones
 五、 Hypothalamus-Pituitary-Ovary(H-P-O axis)
 六、 The endometrial cycle
 七、 The endocervix cycle
 八、 The vagina cycle
 九、 Central reproductive hormones
 一、 Physiological Stages
 Neonatal period( 新生儿 期 ): birth---4 weeks
 Childhood （儿 童期） : 4 weeks----12 years
 Puberty （青 春期） : 12 years---18 years: in the
U.S. occuring between the ages of 8-13 in girls
 Sexual maturation （性 成熟期 ） : 18 years---50
years
 Perimenopause （围绝 经期） : decline of
ovarian function (40 years)----1 year
postmenopause
 Postmenopause （绝经 后期） :
 （一） Puberty
（ 1 ） Characteristic of puberty:
 First thelarche （乳房初发育） : the development
of breasts followed by pubarche （阴毛初现） ; the
development of axillary （腋毛） and pubic hair
 Second menarche （月经初潮） : the first

menstrual period
1)The initial periods are generally anovulatory( 无排
卵
的)
2)And regular ovulation begins about 1 year later
 Puberty
 （ 2 ） Control of the onset of puberty: A
neural mechanism is responsible for the onset of
puberty.
 In children, the gonads （性腺） can be
stimulated by gonadotropins( 促性腺激素类 ) ，
the pituitary ( 脑垂体 ) contains gonadotropins,
and the hypothalamus( 下丘脑 )contains
gonadtropin-releasing hormone(GnRH)
 In adult, GnRH is secreted in a pulsatile fashion.
 Thus, during the period from birth to puberty,a
neural mechanism is operating to prevent the
normal pulsatile release of GnRH.
 Puberty
 （ 3 ） Sexual precocity( 性早熟 ):
The precocious sexual development in
humans is caused by abnormal exposure of
immature males to androgen or females to
estrogen. （ it means males exposeure to
androgen excessively or females exposure to
estrogen abundantly may cause the sexual
prococity ）
 Puberty
 （ 4 ） Delayed or absent puberty:

Puberty cannot be considered to be pathologically

delayed until menarche has failed to occur by the

age of 17.
（二） Menopause
The human ovary gradually becomes
unresponsive to gonadotropins( 促性腺激素
类 ) with advancing age, and its function
declines, so that sexual cycles and
menstruation disappear(menopause).
 The ovaries no longer secrete progesterone

and 17β-estradiol in appreciable quantities

二、 The definition of menstruation

Menstruation ： cyclic endometrium

sheds and bleeds due to cyclic ovulation
 Endometrium is sloughed (progesterone

withdrawal)
 Nonclotting menstrual blood mainly comes

from artery (75%)

 The definition of menstruation
Features of menstruation:
 The first day of menstrual bleeding is considered
day 1 of the menstrual cycle
 The length of menstrual cycle is 28 –30 days

 The usual duration of flow is 3-5 days,but it can

flows as short as 1 day and as long as 8 days

 The volume of menstrual blood loss is 30ml-

50mL(<80mL),darkness and nonclotting.

Loss of more than 80ml is abnormal
 The definition of menstruation
 Menarche: the onset of the first menses

1.occurs about two years after the onset of

puberty
2.occurs between 13 and 15 years of age
 三、 The Ovarian function and
cyclical variation
 （一） Function of ovary
2. Reproduction
• development and maturation of follicle （卵泡
）
• ovulation
5. Endocrine
estrogen, progesterone, testosterone
 三、 The Ovarian function and
cyclical variation
 （二） Cyclic changes of ovary
Ovarian cycle is divided into four phases
1 、 The development and maturation of follicle ：
primitive follicles→ primary follicles →
secondary follicles → antrum developing
follicles → maturity follicles
2 、 Ovulation
3 、 Luteal form( 黄体形 成 ) and degeneration
4 、 corpus albican （白体 ）
 卵母
细胞

白体

黄体
 三、 The Ovarian function and
cyclical variation
 1 、 The development and maturation of follicle
2) Primordial follicle: before meiosis （减数 分裂）
3) Preantral follicle: zona pellucida, granulosa cells
(follicle stimulating hormone-FSH receptor)
4) Antral follicle: theca interna cells (luteotrophic
hormone-LH receptor), E↑
5) Mature follicle: E↑,P↑
Theca externa, theca interna,
granulosa, follicular antrum,
mound, radiate coronal （放 射冠 ）
9) Follicular phase: day 1 mound
to follicle mature (14 days)
 三、 The Ovarian function and
cyclical variation
2 、 Ovulation
2) First meiosis completed → collagen decomposed
→ oocyte ovulated
3) Regulation
d) LH/FSH peak （ luteotrophic hormone/follicle-
stimulationg hormone peak ）
E2↑(mature follicle) → GnRH ↑ (hypothalamus) →
LH/FSH peak (positive feedback)
f) P cooperation
LH ↑ → P ↑(follicle luteinized before ovulation)
→positive feedback
 三、 The Ovarian function and
cyclical variation
LH/FSH peak （ luteotrophic hormone/follicle-stimulating
hormone peak ） : E2↑(mature follicle) Hypothalams
→ GnRH ↑ (hypothalamus) →LH/FSH GnRH
peak (positive feedback)
P cooperation :LH ↑ → P ↑
Pituitary
(follicle luteinized
FSH, LH
before ovulation)
→positive feedback
Ovary
E,P
 三、 The Ovarian function and
cyclical variation
3 、 Corpus luteum
• follicle luteinized after ovulation: luteal
cells
• Regression:non fertilized → corpus albicans
about 4 days before the next menses
• Luteal phase: Ovulation to day 1 if not
pregnancy occurs
4 、 Corpus albican （白体）
 三、 The Ovarian function and
cyclical variation
Reproductive cycle devided into 3 phases:
 Menstruation: 1-4days
 the follicular phase:5-14 days
a number of follicles developing,
only one dominant follicle( 优势卵 泡 )
others become atretic （闭锁 ）
ovulation:14th, releasing oocyte （卵母 细胞）
 luteal phase: 15-28 days unless pregnancy occurs
 四、 Ovarian steroid hormones
 Sex hormones secreted by ovary
2. Composition
Estrogen, progesterone, testosterone
4. Chemical structure
Steroid hormone
6. Synthesis
cholesterol( 胆固醇 )→pregnenolone （孕烯 醇
酮）→ androstenedione （雄烯二 酮） →
testosterone （睾 酮） → estradiol （雌二 醇）
Δ5 or Δ4 pathway of estrogen production
 四、 Ovarian steroid hormones
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 ovulation) →E peak (day 7-8 after
ovulation) → E↓
e) theca interna cells (LH receptor) →
testosterone
f) Granulosa (FSH receptor) → estrogen
 四、 Ovarian steroid hormones
1) Progesterone
P↑ (after ovulation) → P peak (day 7-8 after
ovulation) → P↓
granulosa

LH

progesterone
四、 Ovarian steroid hormones
Hypothalams
Estrogen GnRH
 rise in plasma by 4th day of cycle
 from granulosa cells and theca cells
 negative feedback to FSH Pituitary
 positve feedback to LH FSH, LH

Ovary
E,P
四、 Ovarian steroid hormones
Hypothalams
 Progesterone GnRH
 from corpus luteum
 maximal production occurs 3-4 days after ovulation
and maintained for 11 days Pituitary
 negative feedback on FSH and LH FSH, LH

Ovary
E,P
四、 Ovarian steroid hormones
Physiological function of sex hormones:
1 、 Estrogen
1)Facilitate the growth of the ovarian follicles
2)Increase the motility of the uterine tubes
3)Increase the thickness of endometrium ,draw out the
uterine glands,increase the amount of uterine
muscle;
the myometrium becomes more active and excitable,
and uterus is more sensitive to oxytocin( 缩宫素 )
4) Make the mucus of uterine cervix thinner 、
alkaline 、 clear and watery
四、 Ovarian steroid hormones
5) Make the vaginal epithelium cornified
6)Cause proliferation of mammary ducts
7)Increase secretion of angiotensinogen and
thyroid-binding globulin
8)Cause some degree of salt and water retention
 四、 Ovarian steroid hormones
2 、 Progesterone
2) Decrease the myometrial cells’ excitability
,sensitive to oxytocin( 缩宫素 ) and electrial
activity, while increase their membrane potential
3) Make the uterine cervix mucus thick, tenacious,
and cellular
4) In the vagina secret the thick mucus,make the
epithelium proliferate and become infiltrated with
leukocytes
四、 Ovarian steroid hormones
4) Cause growth of lobules and alveoli
5) Responsible for the rise in basal body temperature
at the time of ovulation
 五、 Hypothalamus-Pituitary-
Ovary(H-P-O axis)
Hypothalams
 H-P-O axis GnRH
2. Positive feedback
Sex hormones (E)↑ → GnRH or LH/FSH↑
E peak (≥200pg/ml) → LH/FSH peak → ovulation
Pituitary
5. Negative feedback
FSH, LH
Sex hormones (E)↑ → GnRH or LH/FSH↓
Follicular phase: E↑ → FSH↓
Luteal phase: E↑P↑ → LH/FSH↓(formation)
E↓P↓ → LH/FSH↑(regression)
Ovary
E,P
H-P-O axis
 六、 The endometrial cycle
 Proliferative phase
2. E↑(mitogen)→ stroma thickens and glands
become elongated → proliferative
endometrium
3. Duration: 2 weeks
4. Thickness: 0.5mm → 5mm
 六、 The endometrial cycle
 Secretory phase
2. P↑(differentiation) → secretory endometrium
3. Features
stroma becomes loose and edematous （水肿）
blood vessels entering the endometrium become
thickened and twisted
glands become tortuous （弯曲） and contain
secretory material within the lumina （腔）
7. Duration: 2 weeks
8. Thickness: 5-6mm
 六、 The endometrial cycle
Menstrual phase:
 The first day of menstrual bleeding is considered
day 1 of the menstrual cycle
 The length of menstrual cycle is 28 –30 days
 The usual duration of flow is 3-5 days,but it can
flows as short as 1 day and as long as 8 days
 The volume of menstrual blood loss is 30ml-
50mL(<80mL),darkness and nonclotting.
六、 The endometrial cycle
 七、 The endocervix cycle
Cervix also changes in response to the
reproductive cycle
Cervical gland secrete mucus,its features
：
1 ） thin,clear,watery mucus in follicular phase
2 ） maximal in ovulation
3 ） mucus （粘液） becomes thick,opaque(
不透明的 ),tenacious （粘的） in corpus
luteum phase
 七、 The endocervix cycle
Endocervical glands (E↑)→ mucus(thin,clear,
watery) → maximal (ovulation)
Endocervical glands (P↑)→ mucus(thick,
opaque, tenacious)
 八、 The vagina cycle
 Thickening and maturation of the surface
epithelial cells response to E2 in follicular phase
 thickening and secretory changes of vaginal

epithelium in corpus luteum phase

Vaginal mucosa (E↑)→ thickening and secretory
changes
Vaginal mucosa (P↑) → secrete↓
 九、 Central reproductive
hormones
 Hypothalamus-Pituitary-Ovary(H-P-O
axis)
 九、 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 portal vein anterior lobe
hypothalamus pituitary
 九、 Central reproductive
hormones
1) Regulation of GnRH
Hypothalams
GnRH

Pituitary
FSH, LH

Ovary
E,P
 九、 Central reproductive
hormones
1. Gonadotropins
2) Composition (glycoprotein)
Follicle stimulating hormone,FSH
Luteinizing hormone,LH
5) Synthesize and transport
Gonadotroph Blood ovary
(pulse) circulation
 九、 Central reproductive
hormones
1. Prolactin (PRL)
Regulated by the prolactin inhibiting factor
(PIF)
 Prolactin is another anterior pituitary

hormone that has important functions in

reproduction and pregnancy
 Its secreted by the endometrium and the

placenta.
 Questions
 What did physiological stages include ？
 What is the definition of menopause?
 What is the definition of menstruation?
 What did the features of menstruation?
 What is the definition of menarche?
 What is the definition of sexual precocity?
 What is physiological function of estrogen and
progesterone respectively?
 What is the features of the endometrial cycle?