PHYSIOLOGY OF NON

PREGNANT FEMALE

Dr. Nisha Ghimire

Asst. professor
Dept of Physiology
 Female reproductive system
• Female reproductive physiology can be
divided into two major phases
– Preparation of female body for
conception
– Period of pregnancy itself
 Female reproductive Organs

• Gonads-Two ovaries
• Accessory sex
organs- fallopian tube,
uterus, cervix and
upper end of vagina
– External genitilia-
– Lower part of vagina,
clitoris,
– Labia majora, minora
 Female reproductive system
• Reproduction begins with
development of ova in
ovaries
• Ova expelled from an
ovarian follicle into the
abdominal cavity near
fimbriated end of two
fallopian tubes into uterus
• If fertilized by sperm=
implants in uterus=
changes to fetus= placenta
and fetal membrane =baby
 Female Hormonal System
GnRH
Hypothalamus
• Gonadotropin
releasing hormone
(GnRH)
LH, FSH Anterior • Lutenizing
pituitary hormone(LH)
Estrogen • Follicle stimulating
Inhibin B
hormone (FSH)
• Estrogen
Ovary
• Progesterone

Androgen
Interaction between theca interna and granulosa
cells in secretion and circulation of estradiol

• Granulosa cells has

less
17alphahydroxylase,
and 17, 20 lyase
- cannot form
androgens from
cholesterol
• Theca cells lack
-aromatase
-cannot form estrogens
from androgens
Events occuring in the ovary
 Menstrual cycle
1. Ovarian Phase
2. Uterine Phase
3. changes in other
reproductive
organs
4. changes in temp.
of body
 MENSTRUAL CYCLE (28 DAYS)
OVULATION

OVARIAN
EVENT
PROGESTERON,
ESTROGEN estrogen

Endomertial
thickness

5 10
14
DAY 1 15 20 25 28

UTERINE MENSTRUAL PROLIFERATIVE SECRETORY MENSTRUAL

PHASE
OVARIAN FOLLICULAR(1-14) LUTEAL PHASE(15-28)
PHASE Pre-ovulatory Post-ovulatory
 MENSTRUAL CYCLE
Ovarian Phase
– FOLLICULAR PHASE
– LUTEAL PHASE
Uterine phase
– Menstrual- ( menstrual bleeding)
– Secretory
– Proliferative
• Length of menstrual cycle= 28 days (20-45)
days
N.B
• If length of menstrual cycle changes that is
change in follicular phase
 (1-14days)
MENSTRUAL CYCLE
(15-28 days)
• Ovarian cycle
Ovarian phase (post ovulatory
• Follicular phase
(preovulatory phase) paseLuteal phase
• period of onset of – between ovulation and
bleeding to day of onset of next menstrual
ovulation cycle (15-28 days)
• K/a follicular phase coz
dominant follicle in ovary – K/a as luteal phase coz
matures in this phase to luteum is formed in
terminate in ovulation ovary
(1-14) days
Uterine Cycle • Uterine phase
1. Menstrual phase (phase of – secretory phase of
menstrual bleeding-4 days menstrual cycle
2. proliferative phase ( phase • This phase constant 14
of proliferation of uterine
endometrium days
N.B. The preovulatory phase may
vary i.e it can be more or less
than 14 days
 Uterine phase of ovarian cycle

1 5 10 15 20 25 28
DAY
MENSTRUAL PROLIFERATIVE SECRETORY MENSTRUAL
UTERINE
PHASE
OVARIAN LUTEAL PHASE(15-28)
FOLLICULAR(1-14)
PHASE
Hormonal changes in the ovary
 STEPS OF OOGENESIS
fetal Oogonia
developmen
t=7 million Mitosis differenciation
primordial
follicles.

1st Meotic differenciation

Birth begins in utero and
2 million ova no new ova are formed Primary arrest in prophase of first
after birth. Oocyte- meiotic

1st Meotic differenciation

completed prior to ovulation
puberty > The secondary oocyte
300,000 immediately begins the
second meiotic division,
Secondary oocyte
But stops at metaphase
2nd meiotic division
Adult =300-500 (13-45 yrs) complete if
fertilization occurs
 Development of a human oocyte and
ovarian follicle
FSH and LH in very low concentration Granulosa cells secretes
stimulates proliferation of continuous estrogen and forms more receptors for
layer of cells FSH

imary oocyte at the

centre surroundedprimordial
by a layer of follicle
spindle
(pregranulosa)
cells

LH stimulates Theca cells are also

androgen synthesis in formed
theca cells= substrate Estrogens+ FSH
for estrogen = expression of LH
production in receptors on granulosa
granulosa cells cells and mainly theca
LH stimulates cells
progesterone
secretion Estrogen causes LH surge
 OVARIAN CYCLE
1. Primordial follicle-Primary
Preantral oocyte at the centre
follicle surrounded by a layer of
Primary follicle
spindle (pregranulosa) cells
1.Primordial
follicle antral follicle 2. Primary follicle
FSH predominantly and LH in very low
concentrationstimulates proliferation
of continuous layer of granulosa cell
Zona pellucida forms
3. Preantral follicle-Granulosa cells
Estrogen from granulosa cells
INCREASE receptors for FSH-local
positive cycle
Theca cells are also formed-

Mature follicle
Antral follicle- = expression of LH
mainly on theca cells
Estrogen causes LH surge
 Process of ovulation

Hypothalamus (GnRH)

ANTERIOR PITUITARY (LH)

Large amount of estrogen

 LH SURGE SIGNIFICANCE – OVUALTION AND LUTENIZES
CORPUS LUTEUM
LH

Follicular steroid
(progesterone)
Proteolytic enz (Collagenase) Foll Hyperemia
PG & secretion
Weak foll. wall
Follicular swelling
DegeneratN of stigma

Follicular rupture

Evagination of follicle& Ovulation

Events occuring in the ovary
• Luteal Phase.
• After ovulation= ruptured
follicle filled with blood K/a
corpus hemorrhagicum
• LH lutenizes (filledwith lipid
inclusions) Granulosa &
theca interna Lutein cells.
(yellow colour)
• Corpus luteum (lutein cells)
full dev-7-8 days after
ovulation.
• Involute if no fertilization
corp albicans. (12 th days of
ovulation)
• HCG(placenta) involution of
CL in pregnancy.
Ovarian events during menstrual
cycle
 8
1. Increase FSH I from 1st day of menstrual cycle
2. Starts growth of primordial follicle
3. Estrogen starts to from growing follicle
4. Estrogen further increases growth of follicle
5. Estrogen slowly starts increasing in blood
6. Inhibits LH and FSH so low level in blood
7. Estrogen reaches peak about 48 hrs
before ovulation
1. 6
13 16 8. INCREASED ESTROGEN BEYOND CERTAIN
LEVEL- LH SURGE
12 9. Increased progesterone-
7
10. OVULATION- ova released in peritoneal cavity ,
taken to fallopian tube of uterus- 14 day
5
11.The granulosa and theca cell in ovary acted
3. 10 upon by LH forms CORPUS LUTEUM
15 12 INCREASED Mainly PROGESTERONE and
estrogen too
9 13. Decrease LH and FSH by –ve feedback
11 14 14. corpus luteum fully matures after 7 days
2 4
. of ovulation
15. If no fertilization corpus luteum atrophies
12th day Of ovulation
16. Decreased prog. And estrogen , menstruation
17. Next cycle after 28 days
 IN UTERUS
ESTRADIOL in follicular PROGESTERONE in luteal
phase phase
• endometrial growth, • endometrium
long gland vascularized, edematous,
glands tortuous, coiled&
• Promotes hypertrophy
secrete fluid
of myometrium in • Arrests endometrial
uterus and mitosis and induces
hyperplasia of secetory activity
endometrium • inhibits uterine motility
• Promotes uterine • Maintain the decidua and
motility assists in implantationof
blastocyst
 CERVIX AND VAGINA
ESTRADIOL in follicular PROGESTERONE in luteal
phase phase
• Cause thinning of cervical • cause thickening of
mucus in cervix cervical mucus in cervix
• Causes maturation of • Progest:- epitheloid
vaginal epithelial cells and
cells& leukocytes
the thickening and
cornification of vaginal
mucosa • Thick mucus
• At ovulation mucus thinnest
& elastic (Spinbarkeit) .
Dryingfern like pattern
(estrogen induced)
 Micsllaneous
Estrogen Progesterone
• Promotes ductal growth • Produces lobuloalveolar
in breast growth in breast
• increased basal body
temperature,
stimulates breathing
 MECHANISM OF
MENSTRUATION
• Mechanism of menstruation
– corpus luteum degenarates= after 13 days of
ovulation
– Luteolysins= (locally produced) oxytocin,
prostaglandins, and GNrh-luteolysins promote the
luteal regression by preventing the action of LH
on corpus luteum
– Degenarated corpus luteum is replaced by
avascular and non functional tissue known as
corpus albicans

– hormonal support to endometrium withdrawn

(decrease progesterone and estrogen)
mechanism of menstruation contd..
• Mechanism is initiated by
– Reduction of steroid causes destability of
lysosomal membrane = leads to release of
proteolytic enzyme and produ ction of
prostaglandin PGF2α.
– The proteolytic enzyme= lysis of endometrial
tissue and PGF2α=vasospasm producing
endometrial ischemia
– Ischemia =results in area of local necrosis
– foci of necrosis coaleses leading to hemorrhage
with sloughing of endometrium
 Menstruation….
• Endometrium is
supplied by
– Stratum functionale –
long coiled spiral
arteries sheds during
menstruation
– Stratum basale- short
straight arteries which
doesnot shed during
menstruation
 Normal menstruation
• Arterial
• 25%venous
• Constituents
– Fibrinolysin– no clots unless bleeding is
excessive
– Tissue debris
– Prostaglandin
Days: 3- 5 days. (1- 8 days)
Amount: slight spotting to 80 ml
 INDICATORS OF OVULATION

• Rise in basal body temp

• mittelschmerz pain
• vaginal discharge
• spinbarkeit
• Fern test
• Laparoscopic observation
• hormonal assay
 Ovarian hormone action
Estrogen:
• growth of ovarian follicle, ovary
• Fallopian tube contraction
• Increases uterine size
• Uterine blood flow increase
• Increases contractile protein of uterus
• Increases excitability and sensitivity to
oxytocin
• Increases breast size, pigmentation
• Body configuration, wide carrying angle
Cont.
• Female like fat distribution
• Pubic hair
• Endocrine function-thyroxine binding globulin
Blood pressure increase.
• Androgen secretion
• Activates limbic system
• Epiphysial closure
• Water and electrolyte balance.
• Cholesterol lowering, increases HDL
• Inhibits acne formation
 Cont..
Progesterone:
• Implantaion of fertilized ovum, pregnancyion of
• Relaxation of uterine smooth muscle
• Uterine quiescence to maintain pregnancy
• Cervical mucus become thick
• Increases secretion from endometrial gland
• Breast growth- lobular and alveolar, lactation
• Body tem increases-thermogenic effect
• Prevents ovulation (contraceptive)
• Tachypnoea
• Diastolic BP decreases
• Natriuresis, Diuresis
hormonal changes during different
cycle
• PROGESTERONE
• minimal in proliferative phase
• peak-4-5 days after ovulation
• decreases towards the end of luteal phase
due to regression of corpus luteum
 Menopause
• 40-50 yrs= irregular menses
• late cycle ceases
• production of estrogen decreases
• Increase FSH and LH
• symptoms
– hot flushes
– dyspnea
– fatigue
– Ostoeporosis
• Thankyou