Female Reproductive System, Study notes of Clinical chemistry

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ANASTACIO│SECTION 14 Female Reproductive System OUTLINE INTRODUCTION FUNCTIONAL ANATOMY HORMONAL PRODUCTION MENSTRUAL CYCLE PUBERTAL DEVELOPMENT MENSTRUAL ABNORMALITIES ESTROGEN REPLACEMENT THERAPY INTRODUCTION →Oval organs →Lie in the pelvic fossa →Paired organs that perform gamete (ovum) & steroid hormone production →Unlike in males, the primordial reproductive cells in females typically produce a solitary gamete →FORMED BY ▪ Posterior & lateral pelvic wall →ATTACH TO ▪ Posterior surface of the broad ligament by thre peritoneal fold known as mesovarium →POSITION ▪ Near th fimbral end of the fallopian tubes connected to uterine cavity →ADULT OVARY ▪ LENGTH: 2-5 cm ▪ WEIGHT: 14g ▪ CONTAINS: 2-4 million primordial cells FUNCTIONAL ANATOMY →OVARIAN & MENSTRUAL EVENTS ▪ Carefully synchronized by a complex interplay of hormones among the hypothalamus, pituitary, & ovaries ▪ To prepare the uterus for implantation of an embryo ▪ Absence of implantation leads to shedding of uterine lining, thus menses →LENGTH OF MENSTRUAL CYCLE ▪ Time between any 2 consecutive cycles ▪ Typical duration is 28 (±3) days w/ average menstrual flow about 2-4 days →PRIMORDIAL FOLLICLES ▪ Present at birth ▪ Maturation is blocked until puberty ▪ Following onset of puberty, each ovarian cycle is marked by recruitment of a few primordial follicles for maturation →FOLLICULAR PHASE ▪ Primordial follicels are recruited after maturation ▪ All but one (Graafian follicle) of these follicles will atrophy ▪ GRAAFIAN FOLLICLE IS COMPOSED OF ✓ Theca externa- outer ✓ Theca interna- inner ▪ Maturing ovum attaches to the inside of the follicle via cells derived from granulosa cells (Cumulus cells) →LUTEAL PHASE ▪ In response to ovarian stimulation by LH, Graafian follicle releases its ovum ▪ The theca & granulosa cells of the Graafian follicle undergoes hypertrophy to become the corpus luteum (Luteinization) ▪ Corpus luteum is rich in cholesterol ▪ Corpus luteum acts as a substrate for continued production of progesterone & estrogen, maintaining the endometrium for conception ▪ If no conception or implantation, endometrium is shed & corpus luteum atrophies to an atretic follicle XY XX SRY MIS MALE FEMALE Encases the granulosa layer (layer of cells) a central fluid-fille cavity Primordial follicles containing primary oocytes 2ND MEIOTIC DIVISON STARTS 1ST MEIOTIC DIVISON STARTS OVULATION Corpus Luteum Corpus albicans Secondary follicle Early Primary follicle If no fertilization FSH, LH Secretion at Sexual maturity At birth, no further development until sexual maturity Graafian follicle containing secondary oocyte Primary follicle J. ANASTACIO│SECTION 14 Female Reproductive System HORMONAL PRODUCTION 1) ESTROGEN 2) PROGESTERONE 3) ANDROGENS 4) OTHERS ESTROGEN →Produced by follicle →Naturally Synthesized Estrogens →C-18 compound →Responsible for the follicular changes in the uterus during the reproductive period →Promotes breast, urine, & vaginal development →Affects skin, vascular smooth muscles, bone cells, & CNS →ESTRADIOL- principal estrogen produced by ovary →ESTRONE & ESTRIOL- primary metabolites of intraovarian & extraglandular conversion →LACK OF ESTROGEN ▪ Naturally occurs w/ onset of menopause ▪ Leads to atrophic changes in organs →DURING REPRODUCTIVE PERIOD ▪ Responsible for follicular phase changes in uterus ▪ Deficiency results in irregular & incomplete development of the endometrium PROGESTERONE →Produced by corpus luteum →C-21 compound w/I the steroid family →Induces secretory activity of endometrial glands that have been primed by estrogen →Readies the endometrium for embryo implantation →Promotes thickening of the cervical mucus and reduction of uterine contraction →Marker of ovulation →Dominant hormone in luteal phase →Deficiency results in failure of implantation of embryo ANDROGENS →PRODUCES C-19 COMPOUNDS ▪ Androstenedione (Precursor to estradiol) ▪ Dehydroandrostenedione ▪ Testosterone ▪ Dihydrotestosterone (DHT) →EXCESS ANDROGEN IN WOMEN LEADS TO ▪ Excess hair growth (hirsutism) ▪ Loss of female characteristics ▪ Development of overt male secondary sexual features ✓ Masculinization ✓ Virilization ▪ Unlike estrogen, w/c is not produced in the ovary after menopause, ovarian androgen synthesis continues well into advanced age OTHER HORMONES →INHIBIN A & B ▪ Produced by the ovaries ▪ Inhibits FSH production →ACTIVIN ▪ Enhances FSh secretion ▪ Induces steroidogenesis →HORMONES THAT APPEAR TO HAVE IMPORTANT, YET NOT CLEALY CHARACTERIZED FUNCTIONS ▪ Folliculostatin ▪ Relaxin ▪ Follicle-regulatory protein ▪ Oocyte Maturation Factor ▪ Meiosis-inducing substance MENSTRUAL CYCLE →OVARIAN CYCLE ▪ Follicular phase ▪ Luteal phase →UTERINE/ENDOMETRIAL CYCLE ▪ Proliferative phase ▪ Secretory phase FOLLICULAR PHASE →Begins with onset of menses →Ends with LH surge →Early phase, the ovary secretes little estrogen →A rise in FSH stimulates follicular growth & estrogen production →ESTROGEN IS SECRETED BY THE FOLLICLE ▪ Stimulates uterine epithelial cells ▪ Growth of blood vessels ▪ Development of endometrial gland PROGESTERONE PRODUCTION OVULATION egg is released from the biggest follicle & travels through the fallopian tube where it can be fertilized. It is not fertilized and dissolves in about 24-48 hours FOLLICULAR PHASE This is when several eggs mature inside small cysts or follicles MENSTRUATION This is the “period” when the endometrium or lining of the uterus sheds over 3-7 days if there is no pregnancy LUTEAL PHASE This is when the endometrium (lining of the uterus) is thick & prepared to support a pregnancy or be released in a period OVARIAN CYCLE BODY TEMPERATURE AP HORMONES (GONADOTROPIC) OVARIAN HORMONES UTERINE CYCLE PHASES OF THE UTERINE CYCLE SECRETORY PHASE PROLIFERATIVE PHASE Inhibin MATURE PRIMARY FOLLICLE THECA ANTRUM