Physiology of the

Female Reproductive
System
 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:
 Menstruation
• Menstruation
cyclic endometrium sheds and bleeds due to cyclic
ovulation
• Mense
1. Endometrium is sloughed (progesterone withdrawal)
2. Nonclotting menstrual blood mainly comes from
artery (75%)
3. Interval: 24-35 days (28 days). duration: 2-6 days.
the first day of menstrual bleeding is consideredy
by day 1
4. Shedding: 30-50 ml
Central reproductive hormones
• Hypothalamus-Pituitary-Ovary(H-P-O axis)
 Central reproductive hormones
• Neuroendocrine regulation
1. Gonadotropin-releasing hormone,GnRH
1) chemical structure
(pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2
2) Synthesize and transport

nerve cells portal vein anterior lobe

hypothalamus pitutary
Central reproductive hormones
Central reproductive hormones
3) Regulation of GnRH

Hypothalams
GnRH

Pituitary
FSH, LH

Ovary
E,P
Central reproductive hormones
2. Gonadotropins
1) Composition (glycoprotein)
Follicle stimulating hormone,FSH
Luteinizing hormone,LH
2) Synthesize and transport

Gonadotroph Blood ovary

(pulse) circulation
Central reproductive hormones
3. Prolactin (PRL)
Regulated by the prolactin inhibiting factor (PIF)
 The Ovarian cycle
• Function of ovary
1. Reproduction
development and maturation of follicle;
ovulation
2. Endocrine
estrogens, progesterone, testosterone
 The Ovarian cycle
• Cyclic changes of ovary
1. The development and maturation of follicle
1) Primordial follicle: before meiosis
2) Preantral follicle: zona pellucida, granulosa cells
(FSH receptor)
3) Antral follicle: granulosa cells (LH receptor), E↑
4) Mature follicle: E↑,P↑
Theca externa, theca interna, granulosa, follicular
antrum, mound, radiate coronal
5) Follicular phase: day 1 to follicle mature (14 days)
The Ovarian cycle
 The Ovarian cycle
2. Ovulation
1) First meiosis completed → collagen
decomposed → oocyte ovulated
2) Regulation
a) LH/FSH peak
E2↑(mature follicle) → GnRH ↑ (hypothalamus)
→ LH/FSH peak (positive feedback)
b) P cooperation
LH ↑ → P ↑(follicle luteinized before ovulation)
→positive feedback
 The Ovarian cycle
3. Corpus luteum
1) follicle luteinized after ovulation: luteal cells
2) LH → VEGF → corpus hemorrhagicum
3) Regression
non fertilized → corpus albicans
4) Luteal phase
Ovulation to day 1
 The Ovarian cycle
• sex hormones secreted by ovary
1. Composition
Estrogen, progesterone, testosterone
2. Chemical structure
Steroid hormone
3. Synthesis
Cholesterol→pregnenolone→androstenedione→
testosterone→estradiol
Δ5 or Δ4 pathway of estrogen production
 The Ovarian cycle
4. Metabolism: liver
5. Cyclic change of E and P in ovary
1) Estrogen
a) E↑(day 7) → E peak (pre-ovulate) → E↓ → E↑
(1 day after ovulate) →E peak (day 7-8) → E↓
b) theca interna cells (LH receptor) →
testosterone
c) Granulosa (FSH receptor) → estrogen
 The Ovarian cycle
2) Progesterone
P↑ (after ovulation) → P peak (day 7-8) → P↓

granulosa

LH

progesterone
Ovarian responses
 The Ovarian cycle
• H-P-O axis
1. Positive feedback
Sex hormones (E)↑ → GnRH or LH/FSH↑
E peak (≥200pg/ml) → LH/FSH peak → ovulation
2. 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)
 The endometral cycle
• Proliferative phase
1. E↑(mitogen)→ stroma thickens and glands
become elongated → proliferative
endometrium
2. Duration: 2 weeks
3. Thickness: 0.5mm → 5mm
 The endometral cycle
• Secretory phase
1. P↑(differentiation) → secretory endometrium
2. 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
3. Duration: 2 weeks
4. Thickness: 5-6mm
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↓
Physiological function of sex hormones
• Estrogen
END