You are on page 1of 3

Endocrinology of the Ovaries and Menstrual Cycle

I. THE OVARIES (also, see Figure of female reproductive tract) 1. Ovarian follicles (and stroma) surrounded by a thin tunica albuginea. 2. Oogenesis: a. as early as 5 weeks into human gestation, primordial germ cells begin differentiating into oogonia [oogonium], arresting at prophase I, and becoming primary follicles with a layer of granulosa cells. b. between 12-28 wks, as many as 7 million primary follicles develop via the process of oogenesis. c. by birth, these decline to 2 million. d. by puberty, these decline further to 300,000. e. during each cycle, 10-20 primary follicles develop to secondary follicles. f. usually only one develops to a tertiary follicle that will become a mature Graafian (ovarian) follicle. g. only about 400 ova actually ovulate during the fertile years. II. PUBERTY III. MENSTRUAL CYCLE (follicular vs luteal phase) (proliferative vs secretory phase) 1. The 1st day is the day of onset of menses. (click for graphic illustration) (and, Figs. 18.2, 18.11, 18.12) a. FSH is only moderately high (compared to in the luteal phase). (1) FSH stimulates 10-20 primary follicles to develop into secondary follicles. b. LH also begins to increase and is important for folliculogenesis, i.e. for follicular development. c. E2 and P4 are initially low. 2. After 4-5 days, only one secondary follicle (the "queen") survives and grows. a. FSH eventually stimulates granulosa cells to secrete E2 in greater amounts by day 9-10. b. LH increases slowly and complements action of FSH, and causing differentiation of theca interna. c. E2 continues to increase and stimulates LH-receptor transcription and translation. 3. Around the 13-14th day, E2 reaches a threshold level: a. it stimulates the CNS-hypothalamic circuit to secrete GnRH. b. E2 conditions the anterior pituitary to preferentially release LH. c. E2 promotes "estrus" behavior in most mammals. 4. On 14-15th day, the LH (and FSH) surge induces ovulation. a. before follicular rupture E2 secretion suddenly drops, while P4 increases dramatically. 5. By day 16, the rising P4 (with E2) shuts down the hypothalamo-hypophyseal axis. 6. By day 25, P4 and E2 have peaked, and they begin to decline. 7. By day 28, these steroids near zero, the endometrium can no longer be sustained, and GnRH increases.

IV. ACTIONS OF OVARIAN STEROIDS A. ESTROGENS (mainly 17-estradiol) 1. Acts as a growth hormone on vagina, uterus, and mammary glands. 2. Stimulates early closure of epiphysis of the long bones (females stop growing). 3. Promotes deposition of fat in breasts, thighs, and buttocks 4. Promotes female "estrus" behavior. B. PROGESTERONE 1. Causes changes in inner lining of oviducts and uterus. 2. Reduces muscular activity of myometrium. 3. Stimulates alveoli development in mammary glands. 4. Has a pyrogenic effect (i.e., acts as a pyrogen) on basal body temperature (BBT). (Fig. pyrogenic P4 ) V. MISCELLANEOUS ITEMS ON FEMALE SYSTEM 1. Ovarian follicle estradiol metabolism (Fig. 18.6) 2. Two-cell hypothesis of E2 production (P450arom in placenta, adrenals, adipose, brain) (Fig. 18.5). 3. Diethylstilbestrol (DES). (Fig. 18.9) 4. Inhibin/Activin/Follistatin (from granulosa) (Fig. 18.10) a. inhibin has 2 subunits (E and ), and inhibits FSH synthesis & secretion. b. activin has 2 subunits ((E and ) and selectively stimulates FSH synthesis & secretion (but not LH). c. follistatin is a single peptide chain that binds inhibin and activin, and it blocks FSH release. 5. Methods of Birth Control (Fig. 19.12) a. mechanical methods: (i) condom (ii) male sterilization (vasectomy) (iii) female sterilization (tubal ligation) (iv) diaphragm/cap/foam b. hormonal methods: (i) oral contraceptive (ii) injected/implanted progestin (iii) emergency contraceptives (ECs) (morning-after pills) (a) high doses of estrogens/progestins (b) mifiprestone (RU-486) (iv) progesterone antagonist, RU-486 c. other methods: (i) intrauterine device (hormonal disturbance?) (ii) dilation& curettage (i.e., suction)

VI. QUOTES "The omnipresent process of sex, as it is woven into the whole texture of our man's and woman's body, is the pattern of all the process of our life." Havelock Ellis "It is said that no woman ever produced a child without the cooperation of a man." Plutarch "An egg and a spermand then everything else comes from the grocery store." Anonymous "Man alone, at the very moment of his birth cast naked upon the naked earth, does abandon to cries and lamentations." Pliny the Elder "It is the symmetry of person, the vivacity, the voluptuous softness of temper, the affectionate kindness of feelings, the imagination and the wit of a woman that excite the passion of love, and not the mere distinction of her being female." Thomas Malthus