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PHYSIOLOGY OF THE FEMALE REPRODUCTIVE TRACT

PHYSIOLOGY

Lecture Notes By: John Lorenz Beleno, RM, RN, MD

OBJECTIVES:
1
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To explain the role of hormones in the regulation of
the menstrual cycle
3
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Provide a fully mature fertilizable ovum for achievement of pregnancy
...
Provide an endometrial bed for potential nidation or
implantation of the fertilized ovum
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Neuromodulators

B
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OVARY
o master Gland
o ovarian Cycle
o controls the hypothalamus, pituitary gland, endometrium

PHYSIOLOGY-OBSTETRICS- HEALTH AND MEDICAL

PHYSIOLOGY OF THE FEMALE
REPRODUCTIVE TRACT

STAGES IN THE CONTROL OF REPRODUCTIVE FUNCTION
1
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2
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3
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• Ushers in the period of active reproduction
4
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• Gonads – less responsive to gonadotropins; ability
to reproduce, ceases

UTERINE
UM

ENDOMETRI-

Gonadotropins Releasing Hormone (GnRH) OVARIAN CYCLE:
2 PHASES:
Follicle-Stimulating Hormone (FSH)
a
...
Luteal phase
o occurs after ovulation, corpus luteum

A
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stimulates synthesis and storage of FSH and LH
2
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Recruitment
o day 1 to day 4
o small antral follicles will be mustered into the next
growth phase – “COHORTS”
COHORTS
▪ follicles with lowest FSH threshold undergo activation of the aromatase system and begin estradiol production
▪ increase estrogen gives a negative feedback on
FSH
Jlb_MD

Dr
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resumption of meiosis allowing oocyte to undergo maturation
b
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follicle rupture with extrusion of
mature oocyte: OVULATION
LUTEAL PHASE
o time between ovulation and menses
LUTEINIZATION
o LH receptors in the granulosa cells
o activate cholesterol side-chain cleavage
activity; produce pregnenolone
o pregnenolone promotes progesterone
synthesis
a
...
thick cervical mucus plug
OVULATION/ FOLLICLE RUPTURE
o 24 to 36 hours after LH surge
o mechanisms:
a
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prostaglandin: hydrolases
c
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muscle activity
o clinical aspects
a
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spinnbarkheit phenomenon
• the formation of an elastic
thread by mucus of the uterine cervix when it is drawn
out; the time of maximum
elasticity usually precedes or
coincides with ovulation
c
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bi-phasic temperature rise

4
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proliferation: K cells
b
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maturation: progesterone secretion
d
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Proliferative Phase
• first half of the cycle
• changes brought about by ESTROGEN
1
...
Late
• gland become more tortuous, elongated
• stroma: dense and abundant
• nuclei oval with scant cytoplasm
• just before ovulation: estrogen peak cause
Pseudostratification of cells lining lumen
b
...
Early
• glycogen rich subnuclear vacuoles appear in base of cells lining lumen
2
...
John Lorenz Beleno

3
...


2

PHYSIOLOGY OF THE FEMALE REPRODUCTIVE TRACT

PREMENSTRUAL DISCOMFORT
1) swelling and tenderness of the breasts
2) bloated feeling in the abdomen
3) weight gain up to 5lbs
4) dysmenorrhea
5) low back pain
6) pimples
7) mild fatigue and irritability
8) increased perspiration

MECHANISMS of REPRODUCTION
MITOSIS
o process of cell division giving rise to 2 daughter cells
that are genetically identical to the parent cell
o each duaghter cellr receives the complete complement of 46 chromosomes
o stages
Prophase
• chromosomes begin to coil, shorten and
thicken
Metapahase
• chromosomes line up in the equatorial
plane
• each chromosome is attached by microtubules extending from the centromere to the
centriole, forming the mitotic spindle
Telophase
b) chromosomes uncoil and lengthen
c) nuclear envelope forms
d) cytoplasm divides

OOGENESIS
o near birth, all primary oocytes have started prophase of meisosis I
o instead of proceeding into metaphase, they enter
the DIPLOTENE stage, a resting stage during prophase and will remain until just before ovulation
o during ovulation: enter metaphase of the first meiotic division
o oocyte maturation inhibitor (OMI), a substance secreted by follicular cells
▪ primary oocytes at birth - 700,000 to 2M
▪ puberty - 400,000- < 500 will be ovulated
o Meiosis II is completed only if the oocyte is fertilized
otherwise, the cell degenerates approximately 24hrs
after ovulation

PHYSIOLOGY-OBSTETRICS- HEALTH AND MEDICAL

PREMENSTRUAL PHASE
o 2-3 days before menstruation
o marked decrease in estrogen and progesterone
o collapse of glands due to loss of tissue fluid
o intense coiling of spiral arteries
▪ resistance to blood flow
▪ hypoxia
▪ vasoconstriction (24-36hrs pre menses)
▪ vasodilation (24-36hrs after VC)
▪ bleeding

SPERMIOGENESIS
o from spermatids into spermatozoa
a) formation of the acrosome
b) condensation of the nucleus
c) formation of neck, middle piece, and tail
d) shedding of most of the cytoplasm
o spermatogonium to mature spermatozoon - 64 days
BLASTOCYST
o cells undergo differentiation and morphogenesis
o cells of the trophoblast mediate the implantation of
the blastocyst into the uterine wall
o mplantation begins when blastocyst comes in contact with the ENDOMETRIUM
IMPLANTATION
o takes place during the second week of development
o trophoblast cells surrounding the blastocyst secrete
digestive enzymes that break down the endometrial
cells
o Syncytiotrophoblast
▪ the trophoblast that grows into the endometrium
o cytotrophoblast

DR

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