Homework

1. The use of steroid hormones

The woman steroid hormones estrogen and progesterone play central role in the
regulation of all aspects of female reproductive activity leading to establishment and
maintenance of pregnancy. Both hormones are also essential for post-natal mammary gland
development regulating post pubertal mammary ductal morphogenesis in the case of estrogen
and pregnancy associated lateral ductal branching an lobular alveolar differentiation in the case
of progesterone.
In women, estrogen has function to improve menstrual cycle. Estrogen has three
different type of hormones which are estron, estradiol, and estriol. Earlier of menstrual cycle the
amount of estradiol decreasing to the lowest amount. After FSH formed estradiol will increase
again. In the 13-15 days of menstrual cycle, estradiol will reach the top amount. Estrogen will
decrease in luteal phase, and make the negative feedback effect to hypophisis. Estradiol levels,
produced by the dominant follicle together with a small rise in progesterone, exert a positive
feedback on the kisspeptinergic neurons, hypothalamus, and hypophysis. The positive feedback
mechanism induced the mid-cycle gonadotropin surge. Follicular rupture and ovulation occur.
(Del Rio, 2018)
Estrogen has been shown to play an important role in protection against osteoporosis in
post-menopausal woman, prevention of coronary heart disease and maintenance of cognitive
function (Endocrinology, 2001). Estrogen protects certain cognitive functions in the presence of
stress in menopausal woman. Furthermore, through its effect on PFC and limbic regions,
estrogen influences emotional and motivational behavior, for example by decreasing impulsive
behavior (Del Rio, 2018).
Progesterone rises due to follicular luteinization and the corpus luteum formed. The
corpus luteuM secrets progesterone and estrogens, which further inhibits follicular
development. If fertilization does not occur, the corpus luteum will last for 11-17 days. Estradiol
and progesterone concentration drop, eliminating the negative feedback exerted upon the HPG
axis and a new cycle begins. The other use of progesterone especially alloprgenanolone has
been attributed as having anti-anxiety effects similar to benzodiazepines. In the other hand,
progesterone can stimulate dopamine release only if there has been preexposures with
estrogen. If this action happens in striatum, it could be associated with the observed
improvement in sensorimotor function during phases of the menstrual cycle when progesterone
is elevated. If this action happened in the POA, it may mediate some influence of maternal
behavior. In the nucleus accumbens, could have an effect on behavior lead to drug abuse,
including depression. In this way, the effect of progesterone on dopaminergic system would
depend primarily on the previous priming by estrogen and on the location of activity.
In the pregnancy, progesterone is largely produce by corpus luteum until about 10
weeks gestation. Progesterone production is relevant to understand prevention of preterm
labor. Progesterone is also important in suppressing the immunologic response to fetal antigens,
thereby preventing maternal rejection of the trophoblast. And of course, progesterone prepares
and maintains the endometrium to allow implantation earlier. (Kumar, 2012) Progesterone also,
has function in mammary gland, endometrium and increasing of basal temperature.
Progesteron help ovum to implant in uterus. In pregnancy, progesterone inhibit uterus
contractility and prepare mammary gland for lactation.
 Estrogen and progesterone participate in the physiological regulation of neurogenesis,
neuronal survival, synaptic function and myelin formation, thus influencing neuronal plasticity.
Because of this effect, both of these hormones will have different modulatory actions, exerting
control over mood, cognition, and behavior (Del Rio, 2018)

2. The clinical aspect if there are no steroid hormones in fetal condition

Fetal demise, caused by placental estrogen biosynthesis was eliminated upon fetal death.
Fetal anencephaly, caused by only small amount of DHEA produced by fetus because of
there are no fetal adrenal stimulation from ACTH
Fetal adrenal hypoplasia
Fetal placental sulfatase deficiency, caused by DHEA (dehydroepiandosterone) that can not
hydrolysed
Fetal placental aromatase deficiency
Trisomy 21- Down Syndrome
Deficiency in fetal LDL cholesterol biosynthesis
Fetal erythroblastosis
3. Other clinical aspect if there are no steroid hormones
Maternal adrenal dysfunction
Maternal ovarian androgen producing tumors
Gestational trophoblastic disease
4. Hormones that increase during pregnancy
In the phase of implantation, human chorionic gonadotropin formed and can tested in
pregnancy serum. This hCG hormones has function to prolonged biosynthesis of corpus luteal so
the progesterone has produced and hold the gestational endometrium.
Cytotrophoblast of placenta is depend on Gonadotropin releasing hormone (GnRH),
corticotropin releasing hormone (CRH) and thyrotropin releasing hormone (TRH). (Chard,1992)
Sinsitiotrophoblat consist of hypophiseal homones such as human chorionic gonadotropin
(hCG), luteinizing hormone (LH), adrenocorticropic hormone (ACTH) and human chorionic
thyrotropin hormones (hCT). The human placenta also synthesizes such as Placental lactogen
(hPL), parathyroid hormone related protein, calcitonin, relaxin, inhibin, activins, and atrial
natriuretic peptide.
Decidua hormones are formed in pregnancy to suppressing maternal immune response. Some
of decidua hormones that increasing in pregnancy are decidual prolactine, Decidual insulin-like
growth factor binding protein I (IGFBP-I), and decidual pregnancy protein-14 (PP14).
Steroid production increase in near term pregnant women such as estradiol 17β, estriol,
progesterone, aldosterone, deoxycorticosterone. Estrogens and progesterone are produced by
placenta. Aldosterone is produced by the maternal adrenal in response to the stimulus of
angiotensin II . Deoxycorticosterone is produce in extragladular tissue sites by way of the 21-
hydroxylation of plasma progesterone.
In addition, there are varios hypothalamic like releasing hormone (TRH), gonadotropin releasing
hormone (GnRH), corticotropin-releasing hormone (CRH), somatostatin and growth hormone
releasing hormone (GHRH)
Prolactin hormone increase markedly during normal pregnancy.
Physiological changes of pregnancy cause the thyroid glands to increase thyroid hormones.