1.

Characterisitics a. b. Shaped like inverted pear Muscular organ with thick walls i. c. Glandular lining called endometrium

Narrow end is called cervix i. ii. iii. iv. Projects into vagina Canal of the cervix is flattened from front to back and is somewhat larger in its middle part Opening into the vagina is called the external os of the uterus Lined by a mucous membrane containing numerous glands that secrete a clear, alkaline mucus

d.

Two uterine tubes i. ii. Fallopian tubes Connect ovaries to the fundus of the uterus

e.

The body of the uterus lies below the fundus i. ii. Inverted triangular shape Cavity is small except during pregnancy

f.

Uterus is anteverted i. Lies at a right angle to vagina

g.

Composed by three layers i. ii. iii. Serous coat of peritoneum Myometriummiddle layer of muscular tissue Endometriuminnermost layer of tissue in the uterus is the mucous membrane

h.

Endometrium i. ii. iii. iv. Contains numerous uterine glands that open into the uterine cavity Exhibits dramatic changes during each menstrual cycle Composed of three levels Two inner most layers are shed at menstruation

B. 1.

Hormones Definitionsubstance produced in one part of the body that affects another part of the body

a. 2.

Endocrinetravels through blood

GnRHgonadotropin releasing hormone a. Produced by hypothalamus i. b. Hypothalamus is part of the brain Travels via portal vein to anterior pituitary to control release of LH and FSH

3.

FSHfollicle stimulating hormone a. b. Produced by anterior pituitary Controls gonadic function

4.

LHluteining hormone a. b. Produced by anterior pituitary Controls gonadic function

5.

Estrogen a. Produced by gonads i. ii. Follicle in females Sertoli cells in males

6.

Progesterone a. b. Produced by corpus luteum Prepares uterus for implantation and pregnancy

7.

Testosterone a. Primarily a male hormone i. Also produced by adrenal gland

8.

HCGhuman chorionic gonadotropin a. Secreted by extramembryonic membranes during pregnancy

C. 1.

Menstrual cycle Prototypic: 28 days a. Range is 20-36 days i. b. Typically 26-32

Only 10% of women have a 28 day cycle

2.

Day 1: first day of menstruation a. Typical flow 2-7 days i. Duration, amount and pattern varies

3. 4.

Cycles varies in length at different times during female lifespan Pheromones a. b. c. Olfactory behavioral signals More important to lower species Affect human behavior i. Evidence: synchronicity of cycles among women living together

III. A. 1.

Phases of the menstrual cycle: based on ovarian events Follicular phase Hypothalamus secretes GnRH a. Controls activity of anterior pituitary

2.

Anterior pituitary secretes FSH & LH a. Controls activity of ovary

3. 4.

FSH stimulates ovarian follicles to begin to develop As follicle develops it begins to secrete estrogen a. b. c. Estrogen causes further follicular development Estrogen causes the endometrium to thicken Estrogen acts to signal hypothalamus to stop releasing GnRH i. ii. d. Negative feedbackreduced production Causes reduced FSH release

Elevated estrogen levels causes LH release from anterior pituitary i. Positive feedbackincreases production

5.

Although there are many follicles in the ovary, one becomes dominant a. b. Matures while others do not Fraternal twins, two become dominant

B. 1.

Ovulation Events:

a. b. 2. 3. 4.

Egg is released from follicle Follicle differentiates into corpus luteum

Estrogen levels peak 1-1.5 days prior to ovulation Elevated estrogen causes a surge in LH release from anterior pituitary Ovulation is a response to LH surge

5. 6.

Follicle differentiates into corpus luteum Corpus luteum produces progesterone a. Progesterone is thermogenic i. ii. Causes an increase in basal body temperature Following ovulation, body temperature will increase 0.5 degree and remain elevated until the beginning on the next cycle

b.

Progesterone causes reduced LH levels i. Negative feedbackreduced production

c.

Progesterone causes reduced GnRH levels i. Negative feedbackreduced production

7.

As follicle differentiates it produces testosterone a. As in males, testosterone increases libido

8.

Rupture of the follicle a. b. Releases egg into fimbria Mittelschmerzpain of ovulation in some women i. Stretching of the ovarian capsule and subsequent capsular rupture during expulsion of the egg

9.

Egg moved by cilia and motility of fallopian tube a. b. c. Egg is viable for approximately 36 hours Sperm is viable for approximately 3 to 5 days Window for pregnancy can be as large as 7 days i. ii. 5 days prior to ovulation 1-1.5 days after ovulation

C.

Luteal phase

1.

Last 14 days of the menstrual cycle a. Corresponds to the life of the corpus luteum

2.

Corpus luteumYellow body a. Derived from the follicle

3.

Corpus luteum produces a. b. c. Progesterone Estrogen (estradiol) Testosterone

4.

Progesterone a. Suppresses new follicle growth i. b. Prevents ovulation of other follicles

Maturation of glandular and blood supply to endometrium of uterus

5.

If no pregnancy: a. b. Corpus luteum degenerates into corpus albicans (White body) Estrogen and progesterone levels fall i. Causes endometrial lining to degeneratemenstruation

6.

If pregnant: a. Developing embryo produces HCG i. ii. Maintains corpus luteum Progesterone maintains uterus

IV. A. 1. 2.

Phases of the menstrual cycle: based on uterine/cervical events Proliferative phase Corresponds to follicular phase in ovary Uterine events a. b. Endometrium thickens Glands and blood vessels grow in response to estrogen

3.

Cervical events a. Estrogen causes changes to cervical mucus

i. ii. iii. iv. v. B. C. 1. 2.

Thinner Clearer More elastic (spinnbarkeit) Changes facilitate passage of sperm into uterus Cervix may feel softer and more open

Ovulationegg released from follicle Secretory phase Corresponds to luteal phase in ovary Uterine events a. Endometrial glands and blood supply mature i. b. Prepared to secrete glycogennutrition for egg

Progesterone maintains endometrium i. Increasing levels of progesterone cause a reduced quantity of thick and tacky cervical mucus

D. 1. 2. 3.

Menstruation Occurs if fertilization does not occur Progesterone and estrogen levels fall Uterine events a. Endometrial blood vessels constrict i. b. c. Loss of blood supply causes endometrium to be shed

Menstrual flow is a combination of endometrial tissue and blood Cramps are associated with lack of progesterone and presence of prostaglandins secreted in uterus

-----------------------------------------------------------------------------------------------------------------------------The sequence of events in the menstrual cycle is determined by the relative hormone levels at each stage. Below, the major physiological effects of the predominant hormones in each phase of the menstrual cycle are discussed. The details of follicular development and the endometrial cycle will be addressed in succeeding sections. Follicular Phase The follicular phase of the menstrual cycle spans the first day of menstruation until ovulation. The primary goal during the follicular phase is to develop a viable follicle capable of undergoing ovulation. The early events of the follicular phase are initiated by a rise in FSH levels at the first day of the cycle. The rise in FSH levels can be attributed to a decrease in progesterone and estrogen levels at the end of the previous cycle and the subsequent removal of inhibition of FSH by these ovarian hormones. FSH stimulates the development of 15-20 follicles each month and stimulates follicular secretion of estradiol by upregulating secretion of androgens by the theca externa and by inducing the aromatase enzyme receptor on granulosa cells. FSH further induces expression of FSH

receptors by follicles. As estradiol levels increase under the influence of FSH, estradiol inhibits the secretion of FSH and FSH levels decrease. Under normal circumstances, one follicle evolves into the dominant follicle, destined for ovulation, while the remaining follicles undergo atresia. It is currently not known how the dominant follicle is selected; yet it has been observed that the dominant follicle always expresses an abundance of FSH receptors. As FSH levels decrease towards the end of the follicular phase, the developing follicles must compete for relatively small amounts of FSH. The dominant follicle, with its high concentration of FSH receptors, continues to acquire more FSH even as FSH levels decrease. The dominant follicle can continue to synthesize estradiol, which is essential for its complete maturation. The remaining, poorly FSH receptor-endowed follicles can not produce the requisite amount of estradiol. These follicles cease to develop and ultimately undergo atresia. The dominant follicle matures and secretes increasing amounts of estrogen. Estrogen levels peak towards the end of the follicular phase of the menstrual cycle. At this critical moment, estrogen exerts positive feedback on LH, generating a dramatic preovulatory LH surge. Estrogen can only exert positive feedback on LH at this precise stage in the menstrual cycle; if estrogen is artificially provided earlier in the cycle, ovulation will not be induced. Ovulation The LH surge is required for ovulation. Under the influence of LH, the primary oocyte enters the final stage of the first meiotic division and divides into a secondary oocyte and the first Barr body. The LH surge induces release of proteolytic enzymes, which degrade the cells at the surface of the follicle, and stimulates angiogenesis in the follicular wall and prostaglandin secretion. These effects of LH cause the follicle to swell and rupture. At ovulation, the oocyte and corona radiata are expelled into the peritoneal cavity. The oocyte adheres to the ovary and muscular contractions of the fallopian tube bring the oocyte into contact with the tubal epithelium to initiate migration through the oviduct. Luteal Phase The luteal phase is defined by the luteinization of the components of the follicle which were not ovulated and is initiated by the LH surge. The granulosa cells, theca cells, and some surrounding connective tissue are all converted into the corpus luteum, which eventually undergoes atresia. The major effects of the LH surge are the conversion of granulosa cells from predominantly androgenconverting cells to predominantly progesterone-synthesizing cells, the expression of new LH receptors which fosters increased progesterone synthesis, and reduced affinity of granulose cells for estrogen and FSH. Combined, these changes promote increased progesterone secretion with some estrogen secretion. Progesterone secretion by the corpus luteum peaks between five and seven days post-ovulation. High progesterone levels exert negative feedback on GnRH and subsequently GnRH pulse frequency decreases. As GnRH pulse frequency decreases, FSH and LH secretion also decreases. The corpus luteum further loses its FSH and LH receptors. Lacking stimulation by FSH and LH, after 14 days corpus luteum undergoes atresia and begins evolving into the corpus albicans. With the decline of both estrogen and progesterone levels, an important negative feedback control on FSH is removed and FSH levels rise once again to initiate the next menstrual cycle. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Mensturation

Menstural cycle, continues for an average of 28 days, after which some blood along with the endometrium are discharged from the uterus as menstural bleeding. This process is called mensturation. Period

The length of the menstrual cycle varies widely in women, but on an average it extends to about 28 days. It is absent during pregnancy, may be suppressed during lactation and permanently stops at menopause. The menstrual cycle is divided into 4 phases.

Follicular phase or Proliferative phase Ovulatory phase Luteal or Secretory phase Menstrual phase

Follicular phase This phase lasts for about 10 - 12 days (from the 5th - 14th day of menstrual cycle). It comprises the following events.

The anterior lobe of the pituitary secretes the FSH, increasing the level of Follicle Stimulating Hormone in the blood. The FSH stimulates the growth of the selected primary ovarian follicle and maturation of the primary oocyte in this follicle. The follicular cells of the graafian follicle secrete estrogens. The uterine endometrium becomes thick, more vascular and more glandular, due to the rising level of estrogens. The uterine glands becomes cork screw shaped. The lining of the fallopian tubes is thickened and its ciliary movement is increased. These changes prepare the fallopian tubes for conveying the ovum into the uterus.

Ovulatory Phase The lutenising hormone induces the mature graafian follicle to burst and eject its egg into the fallopian tube. This is called ovulation. It occurs after about 14 days. The egg at this time is in the secondary oocyte stage with the second meiotic division in progress. The luteinising hormone starts to change the empty graafian follicle into a corpus luteum, and secretion of progesterone from corpus luteum. Luteal Phase

It is also called as secretory phase or the post - ovulatory phase. It lasts for about 12 - 14 days and extends from the 16th - 28th day of the menstrual cycle. During this period cells of the ruptured follicle enlarge and form golden coloured corpus luteum. It grows for about 7 days and secretes progesterone. As the level of progesterone increases in the blood it decreases the secretion of FSH and LH from the anterior pituitary. So this inhibits future maturation of follicle and ovulation till pregnancy is over. This phase is called secretory phase because the uterine wall secretes some nutritious fluid in the uterus. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Hormonal Relationship and Changes in Ovarian Follicle and Uterine Endometrium during One Menstrual Cycle Menstrual Phase

It lasts for about 3 - 5 days and extends from the 1st - 4th day of the menstrual cycle. When fertilisation of ovum does not take place, the corpus luteum starts degenerating. The level of progesterone in the blood starts decreasing. The uterine tissues fail to be maintained. Then the uterine wall (endometrium) is sloughed off. The glands and blood vessels of the endometrium are broken down and lost. This causes discharge of blood and is called menstruation (mensem month). This occurs monthly. About 50 - 100 ml of blood is discharged out through the vaginal orifice. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Different Phases of Menstruation At about the age of 10 to 13 years, the ovaries of females are stimulated by the follicle stimulating hormone (FSH) of the pituitary. This is called the onset of puberty and is accompanied by release of hormones oestrogen and progesterone. These hormones control the production of ova or eggs and appearance of secondary sexual characteristics. Unlike males where sperms can be produced through out the life of man, in females the reproductive phase only lasts till the age of 45-50years. This phase is characterised by the presence of menstrual cycle.

Menstrual Cycle Each menstrual cycle typically lasts for 28 days. Thus it occurs every month. Each cycle has the following phases:

Menstrual phase Follicular phase Ovulatory phase Luteal phase

Menstrual Phase Back to Top

It lasts for the first 3-4 days. During this phase the inner lining of the uterus is shed which causes the blood vessels to rupture. This causes bleeding and is called menstruation. The first occurrence of mensuration is termed menarche. It stops by the age of 45-50 years and is called menopause. In the ovary, during this phase, the follicles where the eggs are produced are growing. Follicles are structures formed by the aggregation of the germinal epithelial cells of the ovary. Follicular Phase Back to Top

In this phase, the follicles grow further. The FSH stimulates one of the follicles. The stimulated follicle grows in size.

T.S. of Ovary of a Mammal One of the cells of this follicle becomes bigger and separated from the rest by a follicular cavity. This cell becomes the egg. The outer layer of cells of this follicle is called theca interna. This layer secretes a hormone called oestrogen. This follicle is called the Graafian follicle. This phase lasts from the 6th to the 10th day. In the uterus, this phase sees the inner wall of the uterus being built up again in order to receive the product of fertilisation, if there is one. It is again supplied with blood vessels. Ovulatory Phase Back to Top

When the follicle is mature, the pituitary gland secretes another hormone called luteinizing hormone (LH). LH stimulates the follicle to rupture and release the egg. The release of egg is called ovulation and occurs between the 10th and the 16th day. The egg moves along the oviduct during this time and may be fertilized by the sperm. If not, it starts disintegrating. Luteal Phase

This phase lasts between the 16th and the 28th day. Once the egg is released, the Graafian follicle re-aggregates to form corpus luteum. The corpus luteum secretes two pregnancy hormones - progesterone and relaxin. The degenerating corpus luteum is called corpus albicans. In the uterus, its lining is thickened further. At the end of 28 days, if fertilisation has not taken place, the lining is shed along with the egg. This starts a new cycle all over again. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Hormonal Control of Menstrual Cycle in Human Female

During menstrual phase the levels of estrogen and progesterone falls considerably. This induces adenohypophysis to secrete FSH and LH. Increased levels of FSH stimulates the graafian follicle to mature and secrete estrogens. The rising level of estrogen, causes the endometrium to become thicker and more richly supplied with blood vessels. The level of estrogens in blood increases gradually for a few days and is at the peak on the 12th day of the cycle. The estrogen surge reduces FSH secretion and this in turn introduces LH surge within 12 hours i.e., on the 13 th day of the cycle. LH causes ovulation and formation of corpus luteum. During post ovulatory phase corpus luteum secretes progesterone. Corpus luteum secretes progesterone, which performs the following functions:

a) It facilitates the preparation of the endometrium of the uterus for receiving the blastocyst and its implantation. (whether fertilisation occurs or not) b) It inhibits the contraction of the uterus and any further development of a new follicle. c) If fertilisation does not occur, the rising progesterone level inhibits the release of Gonadotropin releasing hormone (GnRH), which inturn inhibits the production of FSH, LH and progesterone. d) Once the progesterone level drops, the corpus luteum begins to degenerate resulting in its transformation into a white body called the corpus albicans. e) These hormonal changes, further, cause the breakdown of the endometrium, inhibition of uterine contraction ceases and the menstrual bleeding begins.

The low level of estrogens and progesterone stimulates secretion of FSH and LH from anterior pituitary initiating the next ovarian cycle.

If fertilisation occurs, corpus luteum persists and secretes progesterone and estrogens during pregnancy. Fertilised egg starts developing and simultaneously travels down and gets implanted in the uterus. Ovarian cycle comes to a temporary halt.