PHYSIOLOGY OF THE

FEMALE REPRODUCTIVE
ORGANS
• The physiology of female reproductive system is concerned with the
functions from birth through puberty and adult hood to the
menopause.
• This is achieved through the neuroendocrine mechanism that
involves the cortico-hypothalamic-pituitary-ovarian axis.
• The hypothalamo pitutary ovarian axis is a well coordinated axis and
the hormones liberated from the hypothalamus, pituitary and the
ovary are dependent on one another.
Hypothalamus
• It produces specific releasing and inhibitory hormones or factors
which have effect on the production of pituitary hormones
Gonadotrophic releasing hormones (GnRh) is concerned with the synthesis
storage and release of gonadotrophic hormones, FSH and LH.
Prolactin inhibitory factor/ hormone (PIF) inhibits the release of prolactin.
hyrotrophin releasing hormone (TRH) stimulates the release of TSH.
Corticotrophin releasing hormone (CRH) stimulates the release of ACTH.
Growth hormone releasing hormone stimulates the release of growth
hormone.
Pituitary
• Produces follicle stimulating hormone (FSH) and leutinizing
hormone (LH).
• FSH is mainly stimulates the growth and maturation primary ooytes
of which only one develops into graffian follicle.
• LH responsible for full maturation of the Graffian follicle and
ovulation.
• Prolactin is responsible for the production of the milk in the breast.
ovary
• The function of ovary is ovulation and production of ovarian
hormone.
• The major ovarian hormones are estrogen and progesterone, also
called the female sex hormones.
• The other hormones produced by the ovary are androgens and
inhibin.
Functions of Estrogen include:

• Development of female secondary sexual characteristics including

deposition of fat in the breast, thighs & hips and growth and
development internal & external female genital organs.
• Decreases FSH and LH secretion by negative feedback mechanism
during the menstrual cycle except at mid cycle at which time it
increases LH secretion by positive feedback mechanism.
• In the breast it stimulates the growth of the ducts and fat deposition.
Functions of the progesterone :-
increases the glandular secretions of the endometrium and
diminishes the contractility of myometrium.
Stimulates the growth of the acini in the breast.
In large doses it inhibits LH secretions.
 Increases basal body temperature.
The ovarian endometrial
(menstrual cycle) cycle
• Menstruation is the visible manifestation of cyclic uterine bleeding as
a result of interaction of different hormones.
• For menstruation to occur:
- Intact hypothalamo-pituitary-ovarian axis
- Responsive endometrium
- Patent outflow tract.
• Period extending from beginning of menses to beginning of next one
is called menstrual cycle.
Cont’d
• Age of first menstruation is called menarche & occurs between 11-15
years, average being 13 years
• Age of menarche declining due to environmental condition and
nutritional status.
• Menstrual length is 28+/- 7 days, duration of flow is 1-8 days( average
3-5 days) and amount of flow is 10-80 ml( average 30-50 ml)
Cont’d
Menstrual discharge is composed of
• Dark altered blood
• Mucus
• Vaginal epithelial cells
• Fragments of endometrium
• PGs
• Enzymes and
• bacteria
Cont’d
• The normal menstrual cycle has
1. Ovarian cycle &
2. Endometrial cycle.
Ovarian cycle
Defn: The development & maturation of a follicle, ovulation, formation
of corpus luteum and degeneration. It is composed
1. Recruitment of group of follicles
2. Selection of dominant follicle & its maturation
3. Ovulation
4. Corpus luteum formation
5. Demise of corpus luteum
Number of germ cells
Pre-antral follicle
• Cohort of growing follicles
• Presumed 20 follicles/ cycle
• Initial recruitment is not under the control of hormone
• At diameter of 2-5 mm, growth & differentiation of primordial
follicle is under the influence of FSH
• Oocyte enlarged out of proportion to the follicle
Selection of dominant follicle &
Maturation
• Development of antrum containing secondary follicle
• Accelerated growth of all the components
• As early as day 5-7, one will be dominant
• Dominant follicle is one with the highest antral estrogen, lowest
androgen to estrogen ratio and whose granulosa cells contain
maximum FSH receptors
• Rest of follicle will be atretic
Ovulation
• Dominant follicle shortly before ovulation reaches the surface of
ovary
• Causes of ovulation:
1. Endocrinal: LH surge, FSH rise
2. Stretching factor: necrobiosis of overlying tissue
3. Contraction of micromuscles
Corpus luteum formation
• After ovulation, ruptured Graafian follicle is changed to corpus
luteum
• Opening is plugged by fibrin
• Corpus luteum has a life span of 12- 14 days
• Cause of degeneration is unknown but PGF2a is luteolytic.
Causes of germ cell loss & follicular
atresia
The exact cause is not known. But possible explanations:
• Oogonia with no granulosa cell layer
• Follicles that don’t enter the germ cell meiotic division
• Follicles not rescued by FSH
• Follicles not having estrogen induced FSH receptors
• Follicles losing FSH receptors due to high androgen to estrogen ratio.
• Genetic influence
• apoptosis
Endometrial cycle
• Endometrium is the lining epithelium of the uterine cavity above the
internal os of cervix
• Endometrium is composed of surface epithelum, glands, stroma &
blood vessels
• Endometrium has two layers: stratum basalis & stratum functionalis
• Stratum functionalis has two layers: stratum spongiosum & stratum
compactum.
Endometrial cycle-cont’d
• Four stages during ovulatory cycle:
- Regenerative
- Proliferative
- Secretary &
- Menstruation
• Regenerative stages: starts before menses ceases & ends 2-3 days after
menses.
• New blood vessels will be formed.
• Thickness will be 2 mm.
Stage of proliferation

• Extends from 6th -14th day

• Mainly because of estrogen
• Tubular glands, straight arteries
• Thickness: 3-4 mm
secretary phase:
• Combined effect of estrogen & progestrone
• Blood vessels undergo marked spiraling
• Thickness: 5-6 mm
Menstrual phase
• Regressive changes in endometrium are pronounced 24-48 hours
prior menses.
• Withdrawal of estrogen & progestrone causes intense vasospasm of
spiral arteries at basal part
• Regression of corpus luteum.
• Degeneration & casting off the endometrium prepared for
pregnancy
Mechanism of menstrual bleeding

• Degenerative changes are predominently of vascular origin

• Probable mechanisms:
1. Stasis of blood & spasm of arterioles
2. Degenerative process of functional layer
3. Local tissue destruction
4. Broken arteries, veins & capillaries
Cont’d
• Menstrual bleeding stops as a result of combined effects:
- Prolonged vasoconstriction
- Myometrial contraction &
- Local aggregation of platelets with deposition of fibrin
Normal menstrual cycle
Thank you