Female Physiology Part I 2013

Introduction
The only purpose of your uterus is to carry the products of T A K E N O T E
conception. It has been a running joke among obstetricians that if the monthly
When youre in 3rd
year, you will discuss the topic, Ectopic
chance is not achieved, the uterus cries in the form of menstrual blood.
Pregnancy which is pregnancy outside the uterus and the most
common site of ectopic pregnancy is the ampullary area.
Anatomy
Another thing to emphasize is the fimbrial end of the tube.
External Female Genitalia They are composed of finger-like structures and these structures are
the one guiding the ovum through the fallopian tube.

If these structures are missing, stenotic or fused, where

will the ovum go? Sometimes, it will go in the abdominal cavity. Thats
why we have abdominal pregnancies.

c. Ovary
It is composed of follicles different stages of maturation.
The midpoint of this cycle is exemplified by the ovulation of a
follicle which is then called an ovum and the remaining follicles
inside the ovary become the corpus luteum.

All structures seen from the mons pubis to the perineal body
compose the external female genitalia. Interestingly, even if you cant see your
vagina, it is still part of the external female genitalia.

Internal Female Genitalia

The ovaries progress in different stages from primordial

to primary to pre anthral to mature graffian (follicle thats bound to
Internally, you only have 3 organs: the uterus, the fallopian tubes ovulate/ dominant follicle). As the follicle matures, the number of
and the ovaries. cells increases. So as the number of cells increases, the ovum
becomes large. The cells that increase in number are the granulosa
a. Uterus cells and the theca cells. The granulosa cells, as they mature, they
Anatomically, the uterus is divided into 3 parts: the secrete an anthral fluid in the anthrum (very rich in estrogen)
fundus, the corpus (body) and the cervix.
A follicle that is bound to rupture is called a pre-
ovulatory follicle. The ovum is contained in the zona pelucida and
T A K E N O T E the group of cells surrounding the zona pellucida is called the
cumulus oophorus. When the follicle ovulates, all these structures
The cervix is part of the uterus. It is not a separate structure. are extruded along the fallopian tube.

The uterus also has 3 layers: the serosa layer is from the
perimetrium, the myometrium (muscular layer), and the T A K E N O T E
endometrium (inner layer). The endometrium is very important There are only 4 stages of mitosis namely prophase,
because this is the layer involved in the menstrual cycle. metaphase, anaphase and telophase.

b. Fallopian Tube Please remember that interphase is not part of mitosis. It is

Both fallopian tubes have 4 parts: only a preparation for mitosis wherein you ready the centrioles and
the chromosomes.
1. The one embedded in the uterus or the
interstitial portion is called the isthmic;
the narrowest portion So mitosis produces 2 daughter cells. The only
2. Ampullary area difference between mitosis and meiosis is that in meiosis, the
3. Infundibular area mechanism by which diploid organisms reduce their chromosome
4. Fimbria number to haploid so they can combine again during fertilization to
become diploid organisms.

Just like mitosis, meiosis is also composed of the

different sub stages of prophase, metaphase, anaphase and
telophase.

1 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r
 Female Physiology Part I 2013

T A K E N O T E T A K E N O T E
2 meiotic divisions, meiosis I and meiosis II are required to produce the 1st meiotic arrest: prophase I-diplotene stage
ovum 2nd meiotic arrest: metaphase II

Ovarian Development Chronology Meiosis II is only completed when a sperm fertilizes the ovum.

Q: What is the stage of oocyte during menstruation?

T A K E N O T E
Once the sperm fertilizes the ovum, you establish genetic sex
Fetus inside the uterus
In 6 weeks, the primordial germ cell migrates in the genital ridge.
After 6 months of pregnancy, that single primordial germ cell would undergo
mitosis to produce 7M pool of oogonia. Once the mitosis procedure is over or
once you have that 7M pool of oogonia, each oogonium will undergo meiotic
division. They undergo 2 meiotic divisions. But once entering the first meiotic
division, it is arrested at the first sub phase (prophase-diplotene stage).
A: metaphase II
Just to compare it with male spermatogenesis, 2 meiotic
divisions are required to produce a mature ovum or a mature sperm.
However the difference is that in males, you produce 4 spermatozoa. In
females, there is only 1 oogonium.
Q: What confers the sex?
A: The sperm (Because the sperm carries the Y chromosome. The egg
only carries X chromosome.)

When the fetus is born Female Hormonal System

The oocyte is still in that diplotene stage. This will only resume
during puberty (2 million oocytes).
T A K E N O T E
There are 46XX chromosomes to begin with. You only
divide it by half during puberty when the meiotic division is already
completed.
During the reproductive span of 13-46 years old is the age
where you can get pregnant. You ovulate only 400 oocytes.
Hypothalamus (GnRH)
Anterior Pituitary Gland (FSH, LH)
Ovaries (Estrogen, Progesterone)
Hormones from the ovaries are also guarded by hormones from the
pituitary and the hypothalamus. In the adrenals, we have the HPA Axis. In
females, we have the HPO Axis. The GnRH or the gonadotrophin releasing
hormone stimulates the anterior pituitary gland to secreat FSH and LH. These
2 hormones will stimulate the release of estrogen and progesterone.
Just like the other hormones that we have already discussed, this is also
guided by the same positive and negative feedback effect. Meaning, if the level
of estrogen and progesterone are low, GnRH, FSH, LH secretion will increase. If
they are high enough, the hormones will be negatively inhibited.

GnRH
The gonadotrophin-releasing hormone is produced in the
arcuate nucleus of the hypothalamus

T A K E N O T E
The release of GnRH must be pulsative in manner. Every 1-
2 hours: when you release the GnRH now (1 pulse), the next secretion
will be after 2 hours. In such manner, when GnRH is secreted in a
pulsative manner, it can stimulate the synthesis of FSH and LH in the
pituitary gland. But when the release of GnRH is continuous, it is
inhibitory. Menstrual irregularities can be due to continuous release
of GnRH.

Once it is secreted, it will now stimulate the anterior

The oogonia that didnt make it in the reproductive span undergo
programmed cell death, but it is not termed as apoptosis. It is otherwise
known as atresia.
pituitary gland to secrete FSH and LH.
Each FSH, LH, TSH and hCG (hormone in pregnancy) all
share the same subunit. Only the subunit will differentiate the 4
hormones.

T A K E N O T E
Mitosis occurs during 3-6 months of pregnancy
Once meiosis I is complete, you already have your 23x secondary
oocytes. When this ovum is ovulated, it will immediately enter the 2 nd meiotic
division but it will bypass prophase. It will immediately enter metaphase and
becomes arrested again (2nd meiotic arrest).
FSH
The follicular-stimulating hormone stimulates the granulosa
cells to stimulate follicular growth. So the follicles grow to become
dominant due to the presence of FSH. It stimulates the granulosa cells to
increase in number. And as the granulosa cells increase in number, the
follicle grows. It also stimulates the production of estrogen, as well as FSH
and LH receptors.

2 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r

LH
The leutinizing hormone acts synergistically with FSH for the final
follicular maturation.
T A K E N O T E
Ovulation will only occur after the influence of LH. LH acts
on the theca cells for the production of androgens. After ovulation, it
(granulosa cells) acts on the corpus luteum for the production of more
progesterone and estrogen.
The normal reproductive years of women are characterized by
variations in the secretion of their hormone together with the changes that
occur in the ovaries as well as the uterus. These changes become patterns and
they are termed as the monthly menstrual cycle.
The Menstrual Cycle
The average duration of the menstrual cycle occur every 28 7
days meaning if you are menstruating every 21-35 days, your cycle is normal.
Female Physiology Part I 2013
The endometrial cycle also has 2 phases: the proliferative phase
which involves the proliferation of the endometrium and the secretory phase
which is very receptive for pregnancy.
The monthly ovarian cycle depends completely on the
gonadotropic hormones (FSH & LH).
Q: Have you seen a child menstruating?
A: No
Q: Why?
A: Because their anterior pituitary gland doesnt secrete FSH and LH yet.
Why? It is because the anterior pituitary gland is inhibited by the estrogen
secreted by the adrenal gland. The adrenal gland secretes estrogen. It is
secreted by its 3rd layer together with progesterone. During childhood,
their adrenals secrete only little amounts of estrogen. But given that their
anterior pituitary is very sensitive, even with little amounts of estrogen,
the anterior pituitary is inhibited. No FSH and LH. No menstruation.
When puberty arrives/occurs, the anterior pituitary gland escapes
the inhibition from the adrenal gland resulting to the rise in FSH and LH which
occurs at about the age of 9. By the age of 11, that adolescent will experience
her first menstruation (menarche).

If you are menstruating every 3 weeks: normal Q: What are the 4 signs of puberty?
If you are menstruating every 5 weeks: normal A:
If you are menstruating every other week: abnormal 1. Boobies
If you are menstruating once a year: abnormal 2. Hair
3. Accelerated growth
Frequent menstruation is termed as polymenorrhea (<21 days) 4. Menstruation
while less frequent menstruation is termed as oligomenorrhea (>35 days).

There are 2 results that we expect from a monthly menstrual cycle: T A K E N O T E

1. The production of a mature ovum Its a misnomer that when a child menstruates, the elderly
2. The development of the endometrium (so that this endometrium states, nagdadalaga ka na. Menstruation is the last sign of puberty in
will be receptive if the ovum gets fertilized) which the correct statement should be ganap ka nang dalaga.

Therefore, there are 2 cycles that occur simultaneously in a monthly

menstrual cycle: the ovarian cycle and the endometrial cycle.
The Ovarian Cycle
1. Follicular Phase
2. Luteal Phase

Q: At birth, what is the stage of the oocyte?

A: diplotene stage of prophase I

The ovum arrested at the diplotene stage of prophase I is

surrounded by a single layer or granulosa cells which is termed as the
primordial follicle. The purpose of the single layer of granulosa cells is to
nourish the ovum and secretes an oocyte maturation inhibiting factor to
prevent that oocyte to mature prematurely. It prevents the preceding meiosis
which is only expected when the child hits puberty. During puberty, it is only
then that the FSH and LH increase, inhibition of the adrenal gland diminishes,
meiosis now proceeds. This is accompanied by the acquisition of additional
layer of granulosa cells and the ovum becomes bigger which is now termed as
the primary follicle (400K). As it grows due to rapid proliferation of granulosa
cells and the initial formation of theca cells, it becomes a pre-antral follicle.

Figure. The upper portion illustrates the hormonal secretion. E is estrogen

and P is progesterone. The middle portion is the ovarian cycle. The lower
portion is the endometrial cycle. T A K E N O T E
This is actually a story. For the purposes of simplicity of the The development of the primordial follicle to become a
discussion, let us assume that the lady were talking about is menstruating pre-anthral follicle is not gonadotrophin dependent. Meaning, one
religiously every 28 days making day 14 the midpoint, which is the point of does not need FSH for the primordial follicle to become pre-
ovulation. From day 0-day 14, for the ovarian cycle, it is called the follicular anthral.
phase because this phase involves the development of the follicles. After
ovulation, it is called the luteal phase because of the presence of the corpus
luteum.

3 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r
 Female Physiology Part I 2013
The next stage is what we call the anthral follicle. The pre-anthral Q: How many oocytes do you need to ovulate in a month?
follicle needs FSH for it to become an anthral follicle. When FSH is elevated at A: 400.
day 1, 6-12 pre-anthral follicles will be recruited from the pool to become Q: How many follicles did you produce to begin with?
anthral follicles. There will be rapid proliferation of their granulosa cells and A: At birth, 2 million
theca cells. There will also be the formation of the follicular fluid, which is very Q: Where will you use that?
rich in estrogen, termed as anthral follicle. The 6 recruited follicles wouldnt all A: You will recruit 12 for you to choose the best because if you only choose
be dominant only 1. 1 and that 1 has a damage of some sort, you already lose the chance of
getting pregnant in that month.

Q: Why only 1? Ovulation

A: This vesicular follicle contains the most number of FSH receptors which It occurs 14 days before the onset of menstruation.
actually exhibits a positive feedback effect.

The granulosa cells secrete T A K E N O T E

estrogen. The estrogen secreted to the
antrum stimulates back the granulosa cells It occurs 14 days before the onset of menses. Example, if
to increase FSH receptors. The estrogen today is the 1st day of my ovulation, I cant tell that I will menstruate
being produced, as it is accompanies FSH, 2 weeks from now. Now if today is my 1st day of menstruation, I can
now will form LH receptors. When the LH simply say that I ovulated 14 days ago. Since you do not know when
receptors are present, the LH can now you will menstruate, you do not know when you will ovulate. That is
combine with estrogen to promote the why natural family planning is hard, youre not really certain when
growth of theca cells, which produce you really are ovulating. Everything is retrospective.
androgens.

There is only one follicle that Q: What gonadotropin is responsible for ovulation?
will fully mature because of this positive A: LH (LH surge)
feedback of that dominant follicle. This
dominant follicle will secrete so much LH is necessary for the final follicular growth and maturation. You
estrogen into the anthral fluid. necessarily need an LH surge (highest secretion of LH) for your ovulation to
occur. Obstetricians can actually compute for this. If the LH surge is already
Q: What will the increased estrogen do to the anterior pituitary? documented, they can conclude that 10-12 hours after LH surge, ovulation will
A: It will inhibit your anterior pituitary (negative feedback) occur.
Q: What will now happen to the FSH?
A: Decrease.
Q: If the FSH decreases, what will happen to the remaining anthral T A K E N O T E
follicles?
After the peak of the LH surge, 10-12 hours after, ovulation
A: Atresia
will occur.
Q: Why is the dominant follicle continually grows even though the FSH is
declining?
A: Because it contains many receptors and because of the intrinsic positive Q: What causes the LH surge?
feedback. A: Caused by the sudden estrogen peak

Summary: The increased estrogen causes the FSH to fall down. The falling FSH
At day 1, when FSH is elevated, 6-12 pre-anthral follicles will grow causes the atresia of the remaining follicles. So the estrogen rises during the
to become anthral follicles. Only 1 follicle will become dominant because of 2 follicular stage. When it reaches a peak (estrogen peak), this is the stimulus of
reasons: the anterior pituitary gland to secrete large amounts of LH. Once the LH peak
is reached (LH surge), ovulation occurs.
1. It has the most FSH receptors
2. Intrinsic positive feedback Q: Why is there a sudden increase in LH from the anterior pituitary gland
when the ovarian secretion is increasing? Shouldnt it be inhibiting it?
Q: Why does the remaining follicle undergo atresia? A: When estrogen is secreted in very high amount, it is not inhibitory. It is
A: The level of FSH is falling due to the increase in estrogen. The falling FSH stimulatory.
is preventing the growth of the remaining follicles.

T A K E N O T E
Someone asked me a few years ago, What is the wisdom
of recruiting 6-12 follicles only to make one dominant? I couldnt
answer him then. I just figured that in Pinoy Big Brother, when they
hold auditions, they recruit thousands. The people that only get in the
house are only 20 but only one get to be the big winner. Probably
we are recruiting follicles to choose the best. Anyway, you dont need
the rest.
T A K E N O T E
Some women will complain of infertility. When we
investigated the cases, they were not having the LH surge which
prevents ovulation. One cant get pregnant if there is no egg.
VIDEO
Before ovulation occurs, 1st meiotic division is completed. During
ovulation, the oocyte enters the 2nd meiotic division in metaphase II and it
remains there until it is fertilized. If it is not fertilized, it is shed of as
menstrual blood arrested in metaphase II. After ovulation, what remains in
your ovary is the corpus luteum, the granulosa cells in this stage is producing
more progesterone than estrogen while the theca cells are still producing
androgens (androstenedione, testosterone). This is because of the effect of LH
on the granulosa and theca cells, making them lutein cells (leutinization: lutein
cells can secrete more progesterone than estrogen). That is why progesterone

4 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r

is only secreted in the latter half of the cycle. When the LH falls, the corpus
luteum will regress to become corpus albicans.
Q: What causes the decrease in LH?
A: The increasing levels of estrogen and progesterone.
If there is no pregnancy, the corpus luteum becomes the corpus
albicans 12 days after ovulation (day 26). So at day 26, you already have your
corpus albicans, which is actually an involuted corpus luteum but no longer
secreting estrogen and progesterone. If the level of estrogen but mainly
progesterone declines, this will signal the onset of menstruation.
Summary:
Ovulation is caused by LH surge. LH surge is caused by estradiol
(estrogen) peak. After ovulation, what remains inside the ovary is the corpus
luteum. The corpus luteum secretes more progesterone than estrogen which is
the function of LH. Meaning, the corpus luteum is present because of the LH.
When the corpus luteum secretes progesterone and estrogen, this will inhibit
the anterior pituitary which will cause the LH to decline. When the LH
declines, the corpus luteum will regress to become corpus albicans at around
day 26. At around day 26, the level of progesterone (mainly) and estrogen will
decline and this causes the onset of menstruation.
Back in day 1
The level of estrogen and progesterone is very low. The effect of
these on the anterior pituitary is stimulatory. The FSH levels are increased and
this hormone is responsible for the recruitment of 6-12 follicles with only 1 to
become dominant. Because of the 1 follicle secreting more estrogen causes the
FSH to decrease. The decreasing FSH causes the remaining follicle to undergo
atresia. The dominant follicle is continuously growing despite the falling FSH
because it has a lot of FSH receptors and the effect of positive feedback. The
dominant follicle will now secrete so much estrogen which will cause the LH
surge which will signal the onset of ovulation.
Endometrial Cycle & Menstruation
2 Phases
1. Proliferative
2. Secretory
Proliferative Phase
Also called as the estrogen phase because during the follicular
growth, there is only one hormone being secreted by the ovary and that is
estrogen. The function of estrogen is to make the stroma and epithelial cells of
the endometrium proliferate rapidly. This results to the progressive growth of
the endometrial glands which secrete thin mucus into the cervical canal.
T A K E N O T E
You will notice that when you menstruate on day 1 theres
blood. But in the following days (day 5-7) the bleeding stops. This is
because the endometrium is growing and is now covering the blood
vessels. The cessation of bleeding is caused by estrogen.
Secretory Phase
Also known as the progesterone phase (secreted by the corpus
luteum). The main function of progesterone is to cause marked swelling and
secretory development of the endometrium. There is also increase in the blood
supply. Another function is to prepare the endometrium for possible
implantation of the fertilized ovum.
However, if there is no pregnancy, progesterone levels decrease,
the secretory endometrium will no longer have support, the blood vessels
become vasospastic due to the prostaglandins, the endometrium becomes
necrotic, the endometrium sloughs off the uterus. Since all the endometrium
covering the blood vessels is sloughed off, the blood vessels are now exposed,
menstruation occurs.
5 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r
Female Physiology Part I 2013
Q: What hormone signals the onset of menstruation?
A: decline in (mainly) progesterone.
The average blood averages 40 ml. It does not clot because it
contains fibrinolysin (plasmin, it dissolves the clot). A clotted menstrual blood
means that the menstruation is very heavy because the plasmin content of the
blood is not enough for it to dissolve the clot. It ceases after 4-7 days due to re-
epithelialization.
T A K E N O T E
Day 1 FSH level is high. It is responsible of recruiting 6-
12 follicles to grow. The growing follicles, especially the dominant
follicle secrete estrogen. The estrogen will cause the endometrium
to proliferate. Thus the initial proliferation stops the menses after a
few days. After ovulation, the corpus luteum secretes progesterone
which makes the endometrium ready for the implanting ovum. If the
ovum will not implant (no pregnancy), progesterone declines, there
will be no more support in the endometrium, the endometrium
sloughs as the next menstrual blood.
Estrogen & Progesterone
Both estrogen and progestins are derived from the ovaries, from
the placenta of a pregnant woman and from the adrenal glands. The main type
of estrogen is interchangeable (estradiol, estrone, estriol.) They are all the
same. In gynecology, you will know some difference among the 3, but now in
physiology, they are all the same.
The most important progestin is progesterone. Its source is in the
second half of the ovary.
Q: You know why progesterone is only secreted in the luteal phase?
A: Because only lutein cells secrete high amounts of progesterone through
the effect of LH; also from the placenta of a pregnant woman and the
adrenal cortex.
All sex hormones come from a parent compound, cholesterol. ALL
STEROID HORMONES have the same rate-limiting step (cholesterol
pregnenolone).
T A K E N O T E
During the 1st part of the ovarian cycle (follicular phase),
pregnenolone can go in 2 ways: the DHEA pathway wherein you
produce androgens and convert them to estrogen, or the
progesterone pathway wherein you produce progesterone. In the
synthesis of estrogen and progesterone, during the follicular stage,
the DHEA pathway is favored. So you will only produce androgen
and estrogen, no progesterone during the second part of the cycle.
But once youve already produced the corpus luteum, under the
influence of LH, it goes to the progesterone pathway producing
more progesterone than estrogen.

Corpus luteum: secretes more progesterone than estrogen
Granulosa cells: secrete estrogen during the follicular phase
Theca cells: androgens (androstenedione, testosterone)
Q: Why is estradiol peak only occurring during the late phase of the
follicular phase?
A: The vesicular follicle, since it is exhibiting a (vaso-something) between
blood effect containing plenty of receptors, they are the only one capable of
growing many theca cells. (to be continued)
T A K E N O T E
Two-Cell Two-Gonadotrophin Hypothesis. These involve the
theca cells and the granulosa cells; and the LH and FSH.
Principle
The conversion of cholesterol to androgens only occur in
the theca cells because the enzymes that will convert cholesterol to
androgens is only present in the theca cells and those enzymes will
only respond under the influence of LH. The androgens produced
(androstenedione, testosterone) will all be brought inside the
granulosa cells, and they will be converted to estrogen through the
enzyme aromatase under the influence of FSH.
Q: Why doesnt everything happen in the granulosa cell, from cholesterol
straight to estrogen?
A: It cant because the enzymes required to convert cholesterol to
androgens is only found in the theca cells and these enzymes only respond
to LH.
Q: Then why doesnt the rest happen in the theca cells, after converting
cholesterol to androgens immediately convert the androgens to
estrogen?
A: It is no possible because androgens can only be converted to estrogen
via the aromatase only found in the granulosa cell which is only influenced
by the FSH
That is why once the vesicular follicle which contains increased
amounts of theca cells, there will be sudden increase in the production of
estrogen. The estrogen comes from the androgens being synthesized by the
theca cells.
A: (continuation) If the estradiol peak occurs during the mid or early
follicular phase, the ovum ovulated is still immature (the vesicular follicle
is not yet produced).
Fate of Estrogen & Progesterone
Estrogen is secreted 25% in the feces and 75% in the urine. The
role of estrogen is for the development and maturation of the female
reproductive organs (uterus, tubes, ovaries, external genitalia). Some women
who do not have ovaries (Turner Syndrome), they do not have estrogen, so
they demonstrate infantile genitalia. In the same manner, a child having
precocious puberty (meaning at around 5 years old, they are already secreting
estrogen because the HPO axis is already functioning), they already have a
mature vagina.
The following are the other roles or effects of estrogen in the female body:
- Development and maturation of the female maturation of the
secondary female sexual characteristics
- Promote proliferative changes in the uterine endometrium
- Extra fat deposition into the subcutaneous tissue of the breast,
buttocks and thighs
- Increase skin pigmentation of the nipples, areola and pubic region
- Stromal or ductal growth of the breast
- Maintenance of the normal structure of the skin and blood vessels
- Accelerates growth and closure of the epiphyses of long bones
- Growth of the ovarian follicles
- Production of cervical mucus that is clear, watery and slightly
alkaline (midpoint of ovulation: there is discharge)
- Osteoblastic activity
6 So we can take the world back from a heart attack one maniac at a time we will take it back Fallout Boy
j e b a l u r r r
Female Physiology Part I 2013
- Decrease in osteoclastic activity
o Osetoporosis: there is decrease in estrogen resulting to
the decrease in osteoblastic activity and increase in
osteoclastic activity
- Increased protein synthesis in the liver
- Enhances blood coagulation factors (made up of proteins)
o When someone is pregnant, blood coagulation is
enhanced
- Increase in aldosterone secretion that is why there is sodium and
water retention
The following are the other roles or effects of progesterone in the female body:
- Glandular and secretory development in reproductive organs
- Lobuloalveolar growth of the breasts (estrogen: stomal/ductal)
o This is responsible for making breasts ready for feeding
(breast tenderness)
- Promotes secretory changes in the endometrium
- Decreases frequency and intensity of the uterine contractions
o Pampakapit is actually progesterone tablets
- Promotes secretory changes in the fallopian tube to nourish the
zygote as it travels along the fallopian tube
- Production of cervical mucus that is scanty, viscous and acidic
- Increase the basal body temperature
-
Tell me if the hormone will inhibit or stimulate the next area of the
HPO Axis.
Q: The hypothalamus releases GnRH in what manner?
A: pulsative
Q: If pulsative, what is the effect?
A: Stimulatory
Q: If continuous?
A: Inhibitory
Q: If stimulatory, stimulates the anterior pituitary to secrete LH and FSH.
What is the effect of these hormones to the ovaries?
A: Stimulatory
Q: What is the effect of estrogen to anterior pituitary and hypothalamus?
A: it depends on the level
Q: If moderate or low?
A: inhibitory
Q: If high?
A: Stimulatory
T A K E N O T E
The corpus luteum secretes inhibin in addition to estrogen
and progesterone inhibiting the anterior pituitary to release FSH and
LH explaining the decline of both FSH and LH towards the middle of
luteal phase.