- paired organ

- has a dual function (gamete and steroid

hormone production)

- production of a solitary gamete

Length: 2-5cm
Weight: 14g



-oval organ that lies in the pelvic fossa
-formed by pelvic walls
-attached to the posterior surface of the broad
ligament by peritoneal fold (mesovariom)

PRIMORDIAL FOLLICLE:
-present at birth but maturation occurs during
puberty
-only one of the follicle will undergo atrophy
(follicular phase)


GRAAFIAN FOLLICLE
-composed of outer and inner layer
(theca interna and enterna respectively)

Granulosa cell
-layer of cell that enclosed the fluid
filled cavity


Corpus luteum
-rich in cholesterol
-acts as substrate for production of
estrogen and progesterone


1. Estrogen
-naturally synthesized estrogen are carbon -
18 compounds.
-promote breast, uterine, and vaginal
development.

ESRADIOL- principal estrogen produced by the
ovary.
ESTRONE & ESTRIOL- primary metabolites of
intraovarian and extraglandular conversion.

2. Progesterone
-Is a 21-carbon compound
-produced by the corpus luteum
-Induces secretory activity of endometrial
glands that have been primed by estrogen
(embryo implantation)
-Dominant hormone responsible for the
luteal phase

3. Androgens
-All of w/c are carbon 19 compounds
Androstenedione
Dehydrodroandrostenedione
Testosterone
Dihydrotestosterone

Excess androgens in Women:
Hirsutism- excess hair growth

4. Inhibin A and B
-inhibit FSH production

5. Activin
-Enhances FSH secretion and induces
steroidogenesis

6. Folliculostatin, Relaxin, Follicle regulatory
protein, oocyte maturation factor, and
meiosis-inducing substances
-not clearly characterized functions.

-start on the first day of menses (day 1)
2 phases:
Ovaries
-follicular phase
-luteal phase
Endometrium
-proliferative phase
-secretory phase
-begins at the onset of menses
-ends on the day of LH surge
a rise in FSH, stimulates estrogen
production

Estrogen stimulates:
-uterine epithelial cells
-blood vessel growth
-endometrial gland development

-extrusion of the ovum (36 hrs. after LH
surge)
Graafian follicle
forms corpus luteum
progesterone secretion
embryo implantation


- when no fertilization occurs:
gradual decline of progesterone and estrogen
production shedding of endometrium
(14 days after ovulation) loss of endometrial
blood supply

menstrual bleeding
- 3-5 days
Blood loss
-50 ml


GnRH (hypothalamus)
-central control of FSH and LH secretion
Increase FSH and LH- after menopause
Psychosocial or physical stressors leads to
changes in hormonal cues
-anovulation
-amenorrhea







Menarche
-2 to 3 years after the onset of puberty

Thelarche
-development of breast tissue
-earliest sign of sexual development

1. Prepubertal
2. Elevation of breast bud and papilla,
areolar enlargement
3. Elevaton of breast tissue and papilla
4. Elevation of areolar and papilla in
secondary mound above the level of the
breast
5. Mature stage: recession of areola into the
breast with projection of papilla only

Pubic hair development

1. Lanugo-type (prepubertal)
2. Dark terminal hair on labia majora
3. Terminal hair covering labia majora and
spreading to the mons pubis
4. Terminal hair fully covering the labia
majora and mons pubis
5. Terminal hair covering the labia majora,
mons pubis and inner thighs

1.Amenorrhea
-absence of menses

a. Primary- never menstruated

b. Secondary- atleast one menstrual cycle
followed by absences of menses for a
minimum of 3-6 mos.

2.Oligomenorrhea-refers to infrequent or
irregular menstrual bleeding, with cycle
lengths in excess of 35-40 days.
*Menorrhagia-uterine bleeding in excess
of 7 days is dysfunctional

3. Polymenorrhea- occurs when the
menstrual cycle is less than 21 days long.

FEMALE

Hypothalamus- GnRH
Pituitary- FSH,LH
Ovaries- estradiol or progesterone
Fallopian tubes- inadequate endometrium,
tubal scarring
Conception- sperm destruction


MALE

Hypothalamus&pituitary- oligospermia to
azoospermia
Testes- testosterone
Prostate- seminal fluid
Urethrogenital tract- absent ejaculation
-gonadotropin deficiency

-cause of secondary amenorrhea

Causes:

Weight loss
- anorexia nervosa
Runners amenorrhea
-intense physical exercise
Pituitary tumors
Prolactinoma


- bone loss osteopeniaosteoporosis

primary or peripheral/gonadal hypogonadism

-hypogonadism due to impaired response of
the gonads to FSH and LHlack of sex
steroid production elevated gonadotropin
levels (compensation)

- naturally occur between 45 & 55 years of age.

Premature ovarian failure

-is defined as Primary Hypogonadism in a
women before the age of 40
-result of congenital chromosomal abnormality.
(e.g., Turners syndrome) or premature
menopause.


- occur in association with other endocrine
gland failure (e.g., hypoparathyroidism,
hypothyroidism or hyperadrenalism)

-one of the most common genetic endocrine
disorders among females

Immediate symptoms:
Infertility
Hirsutism
Chronic Anovulation
Glucose Intolerance
Hyperlipidemia
Hypertension

*A polycystic ovary shown on an ultrasound image. PCO
is not necessary for diagnosing PCOS, but it is a
common sign. As many as 30% or more of women with
PCOS do not have PCO as a sign.
*Treatment: Glucophage- normalizes menstrual cycles
and improves conception rates.

Is abnormal, abundant, androgen-sensitive terminal hair
growth in areas in which terminal hair follicles are
sparsely distributed

Not normally found in women

5%- 10% of American women have hirsutism

- measurement technique to quantify hirsutism
Scale of 1-4 based on hair thickness&pigmentation
Score of > 8- consistent with diagnosis of hirsutism

9 areas:

1. Lip
2. Chin
3. Sideburn region
4. Neck
5. Chest
6. Abdomen
7. Upper and
8. Lower back
9. Thigh

Functional (normal androgen levels with excess
hair growth)
True androgen excess (elevated androgens)
Ovarian (LH mediated)
Adrenal (ACTH mediated)
Peripheral conversion of androgens
(obesity)
Tumoral hyperandrogenism (ovarian, adrenal)
Chronic gonadotrophin mediated

COMMON


Idiopathic( 60% cases)

Polycystic ovary syndrome

-next most common (35%)

-remains a treatment option in select women after careful
risk counseling.

Womens Health Initiative study
-showed:
increase of invasive breast cancer
venous clot formation
no benefits in coronary artery disease.
reductions in bone loss, colon polyp formation and
menopausal symptoms ( hot flashes, vaginal dryness )