Physiologyy of the female reproductive system

The female reproductive system consists of:

A. Essential Structures (Gonads): 2 ovaries
Function
 Oogenesis,
 Endocrine function (Estrogen+ Progesterone) secretion

B. Accessory sex organs include: oviducts, uterus, vagina,

external genitalia

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 Ovaries
• The ovaries are attached to the peritonium with
mesovarian and broad ligaments.
• Two roles: gametogenic and endocrine function
• The gametogenic potential is established early in the fetus
• Endocrine role of the ovary is not realized until puberty
• Has 2 structural parts
1. Medullary part: the central part that contains BVs,
connective tissues (elastin and collagen)
2. Cortical part: the peripheral part that contains actively
proliferating ovarian follicles

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 Ovaries cont‘d.......
Cellular components of the ovary
• The ovary consists of epithelial and
mesenchymal components
 Mesenchymal tissue differentiates into
interstitial tissue (hormone secreting cells)
• This tissue is the primary source of hormones
• Also associated with germinal elements of the
ovary
• Provides nutritive environment for the oocytes
 Epithelial tissue differentiates into granulosa
cells
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 Accessory structures
They include:
– Oviduct
– Uterus
– Vagina
– External genitalia
a. Oviduct/fallopian tube/uterine tube
• Function:
Site of normal fertilization
Transport ovum, sperm, blastocyst
 Secretory function
b. Uterus: a hollow muscular organ in non-pregnant woman
• Layers of the uterus wall from inner to outer
Endometrium (with uterine glands)
Myometrium (middle muscular layer
 Perimetrium (serous peritoneal membrane)
• 4
 Physiologyy of the female reproductive system cont‘d....
Uterus cont’d……………..
Function:
 Site of pregnancy
 Growth and development of fetus
 Produces pressure during labor
 Site of menstruation
c. Vagina: Lined with non-keratinized stratified epithelium.
Glands secrete glycogen and lactate, harbors Lactobacillus
liquificious that maintains acidic pH in the wall of the vagina .
Function
 Copulatory organ of female
 Birth canal
 Allows passage of menstruation
d. External genitalia: clitoris, labia minora and labia majora
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The female reproductive structures

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The female reproductive structures

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 Development of ova (Oogenesis)
• It undergoes 3 stages
1. Primordial follicles
2. Growing follicles (1o-follicles-2o-follicles-3o-follicles)
3. Mature (Graafian) follicle -ovum
Oogonia

1o-OOcyte (birth to puberty)

2o-Oocyte

Ovum

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 Oogenesis Active mitosis of
Primitive ova during
Prenatal
development
1 million primordial
(2n) Follicles at birth
400,000
follicles
at puberty

Prophase of
1st meiosis

Ovulation Metaphase of meiosis

II

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 The Female Sexual Cycle
• Also called menstrual cycle
• Appears at puberty and continues until menopause
• The first menstrual flow is called menarche
• Average of menarche is 12 yrs (9-16yrs)
• Total stoppage of menstruation is called menopause

• The female sexual cycle has two major phases:

 Ovarian cycle (follicular, ovulatory & luteal phases)

 Endometrial cycle (menstrual, proliferative & secretory
phases)

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 Ovarian cycle
Has three phases:
 Follicular phase
 Ovulatory phase
 Luteal phase

1. The follicular phase (1st to 13th day)

• Several primordial follicles start to grow at the beginning of the
monthly cycle (accumulated in the cavity antrum, rich in
estrogen)
• The primary follicles start to produce follicular fluid called
liquor folliculi.
• On the 6th day, a mature follicle called Graafian follicle is
formed that develops into mature ova.
• This phase is under the regulation of pituitary hormones- FSH
&LH

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 Ovarian cycle cont’d…
2. Ovulation phase (14th to 15th day)
• The wall of the graafian follicle ruptures and the ovum
+ zona pellucida + one layer of the corona radiata are
shed into the peritonial cavity.
Mechanism of ovulation:LH is the hormone of ovulation.
36 hrs before ovulation, APG produces large amount of
LH (LH surge). LH reaches peak level 12 hrs before
ovulation.
• ↑LH→ ↑antral fluid volume → ↑progesterone secretion
→ ↑BF to the graafian follicles → ↑follicular swelling
→ ↑pressure →rupture →release of ovum.

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 Ovarian cycle
1. Follicular phase/estrogen
3. Luteal /postovulatory/ phase/preovulatory phase
Progestational phase

2. Ovulation

Graafian follicles
Theca follicles
Thecca interna 13
Theca externa
 Ovarian cycle (cont´d)
3. The Luteal phase (15th to 25th day)
• After the rupture of the graafian follicle and
shedding of the ovum, the remaining part of
the graafian follicle collapses.
• Under the influence of LH, the granulosa cells
hypertrophied and proliferated to be
transformed into corpus luteum.
• Function of corpus luteum is secretion of
↑↑progesterone and
↑estrogen.
These hormones are necessary for the continuity
of pregnancy
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 Ovarian cycle (cont´d)
• After ovulation, the corpus luteum undergoes 4 stages:
1. Stage of vascularization/corpus hemorrhagicum:
vascularization of granulosal cells
2. Stage of glandular metamorphosis: Follicular granulosal and
theca cells are transformed into luteal cells, which can
concentrate cholesterol as a temporary glandular cells.
3. Stage of full development of corpus luteum: ↑↑progesterone
and ↑estrogen.
The fate of corpus luteum depends on 2 factors
a. If fertilization occurs, corpus luteum stays active for more
than 10 days (by hCG)
b. If no fertilization occurs, corpus luteum stays active for 10
days and then degenerated.
4. Stage of envolution: luteal cells are replaced by fibrous
tissues, transformed into corpus albicanus.

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Endometrial Cycle -3 phases-regulated by Ovarian hormones

Proliferative phase Secretory phase

Bleeding phase (3-5 •Growth & (Progestational
days) development of phase)
•Desquamation of the endometrial glands •Glands become
functional layer •Proliferation of secretory
•Loss of 50 ml (30-80 ml) endometrial stromal •Arteries become
of blood cells more spiral
•Caused by sudden •Growth of spiral •Thickness = 6 mm
withdrawal of sex arteries •Caused chiefly by
hormones •Prepared by estrogen progeterone & also
•→Menstruation estrogen

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 The female hormonal system

OC GnRH MB

Gonadotropes

FSH LH
•Follicular growth
•Maturation of graafian follicles •Stimulates estrogen
•Secretion of inhibin & prog. secretion
•Promotes ovulation
Ovary •Luteinization

Ovarian hormones ↓Androgen

↑Progesterone ↓Inhibin
↑Estrogen
↑Estrogen
↑progesterone 17
Hormonal Regulation

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 Ovarian hormones
• Ovaries secrete 4 hormones
• Estrogen (E1 = estrone, E2 = estradiol & E3 = estriol)
• Progesterone
• ↓ Androgens
• ↓ Inhibin (the only peptide gonadal hormone)
Estrogen
-Ovarian follicular cells
-Corpus luteum
Sources -Adrenal cortex
-Placenta
-Testes
Rate of secretion
• 36 µg/day in the follicular phase
• 380 µg/day just before ovulation
• 250 µg/day in the mid-luteal phase 19
 Function of Estrogen
1. Development of the body during puberty
• Growth and enlargement of sex organs
• Development of 2o-sex characteristics
2. Growth of the uterus during pregnancy
3. Growth of the breast
4. General metabolic effects:
• Enhances bone ossification
• Protein anabolic
• Salt and water retension
5. Functional relations with other hormones
• Estrogen has a synergestic action with progesterone on the uterus
endometrium and breast acinar cells
• Estrogen sensitizes the uterus to the action of oxytocin during labor
• Estrogen regulates rate of secretion of LH and FSH from APG
• Estrogen stimulates secretion of ACTH that leads to hyperthrophy of
adrenal cortex 20
 Progesterone
• Sources -Corpus luteum
-Follicular cells
-Adrenal cortex
-Placenta
-Testes
Rate of secretion
• 1 mg/ day in the early follicular phase
• 4 mg/day just before ovulation
• 25 mg/day in the mid-luteal phase
Function
1. On uterus
• Induces the progestational changes of endometrium
• Inhibits excitability of myometrium
• Stimulates secretion of thick, alkaline cervical mucous
2. On breast
• Stimulates development of secretory cells
• Stimulates differentiation of ductile system
3. On other hormones: inhibits secretion of LH and FSH
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4. Has a thermogenic action
 Other cyclical changes in the female body
• Other changes that occur in the female body coincides with
ovarian cycle include:
• BMR: Increases after ovulation by 5-10%
• Body temperature: ↑0.5-1oC
• Mammary gland: ↑BF to the breast, tender, painful and swelling
• Vagina: epithelial lines are cornified in the 1st half of the cycle.
• Then after, become more proliferative.
• Thick mucous
• Cervical secretion: In the 1st half of the cycle, cervical
secretions are thin, alkaline, which makes suitable medium for
sperm survival.
• Sexual desire: ↑libido in the middle of the cycle (ovulation) but
highest towards the end of the cycle
• Salt and water retention
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 Menstrual abnormalities

• Amenorrhea: absence of menstrual cycle except

during pregnancy
• Hypomenorrhea: scanty flow
• Menorrhea: profuse flow during regular periods
• Metrorrhea: bleeding b/n periods
• Oligomenorrhea: reduced frequency of periods
• Dysmenorrhea: painful menstruation

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 Contraceptive Methods
1. Intrauterine devices
Introduction of polythene device of different shapes in the
uterus preventing implantation of fertilized ovum by
stimulating endometrium
2. Controceptive pills
• They are made up of estrogen (ethinyl estradiol) +
progesterone (norethindrone).
• They are taken for 21 consecutive days (3 wks) and then
stopped for a week to permit menstrual flow.
• The mechanism is that they prevent the release of LH and
FSH from the APG by a NFM.
• No ovulation occurs
3. Progestin implantation under the skin: It makes cervical
mucus thick and unfavorable to sperm migration
It prevents pregnancy for up to 5 yrs
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 Contraceptive Methods (cont´d)
4. The safe period (natural family planning method): If the time of ovulation is
known, sexual intercourse must be avoided for 2-3 days before and after
ovulatory period.
5. Post-coital contraceptives:
• Large dose of estrogen for 4-6 days after coitus during the fertile period prevents
conception by stopping implantation.
6. Barrier methods: Include physical, biological, chemical means of preventing
sperm from reaching the egg.
Vaginal diaphragm, cervical cap, chemical spermicidal agents are forms of
female barrier contraceptives
7. Condom: oldest form of male barrier contraceptive
8. Vasectomy:
 surgical interruption of vas deferens (Male)
 Tubal ligation (Female)

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 PREGNANCY
• Pregnancy-also called gestation is a physiologic process occurring in
the mammals.
• Begins with the fertilization of an ovum in the ampulla of the
fallopian tubes.
• Pregnancy normally, takes place in the uterus.
• If occurs out side the uterus, it is known as an ectopic pregnancy

• Fertilization of the Ovum

• After the male ejaculates semen into the vagina during intercourse,
few sperm are transported within 5 to 10 minutes upward from the
vagina and through the uterus and fallopian tubes to the ampullae of
the fallopian tubes near the ovarian ends of the tubes.
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 Pregnancy…….

• This transport of the sperm is aided by

 Contractions of the uterus and fallopian tubes
 Prostaglandins in the male seminal fluid and
 Oxytocin released from the posterior pituitary gland
of the female during her orgasm.
• Of the almost half a billion sperm deposited in the
vagina, a few thousand succeed in reaching each
ampulla.

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 Pregnancy……….
• But before a sperm can enter the ovum, it must
first penetrate the multiple layers of granulosa
cells attached to the outside of the ovum (the
corona radiata) and then bind to and penetrate
the zona pellucida surrounding the ovum itself

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 Pregnancy……
• What Determines the Sex of the Fetus That Is Created?
• After formation of the mature sperm, half of these carry in
their genome an X chromosome (the female chromosome) and
half carry a Y chromosome (the male
chromosome).
• Therefore, if an X chromosome from a sperm combines with
an X chromosome from an ovum, giving an XX combination, a
female child will be born
• But if a Y chromosome from a sperm is paired with an X
chromosome from an ovum, giving an XY combination, a male
child will be born.

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 Pregnancy…….
Transport of the Fertilized Ovum in the Fallopian
Tube

• After fertilization has occurred, transport of the fertilized ovum down

to the cavity of the uterus occurs within 3 to 5 days.

 This transport is effected mainly by:

Fluid current in the tube resulting from epithelial secretion
Action of the ciliated epithelium that lines the tube; the cilia
always beat toward the uterus.
Weak contractions of the fallopian tube may also aid the ovum
passage.
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 Pregnancy……..
• After this time:
• The rapidly increasing progesterone secreted by the ovarian corpus
luteum first promotes increasing progesterone receptors on the
fallopian tube smooth muscle cells

• Then the progesterone activates the receptors, exerting a tubular

relaxing effect that allows entry of the ovum into the uterus.

• This delayed transport of the fertilized ovum through the fallopian

tube allows several stages of cell division to occur before the dividing
ovum—now called a blastocyst, with about 100 cells—enters the
uterus.

• During this time, the fallopian tube secretory cells produce large
quantities of secretions used for the nutrition of the developing
blastocyst. 32
 Pregnancy……
Implantation of the Blastocyst in the Uterus
• After reaching the uterus, the developing blastocyst
usually remains in the uterine cavity an additional 1 to 3
days before it implants in the endometrium

• Thus, implantation ordinarily occurs on about the fifth to

seventh day after ovulation.

• Before implantation, the blastocyst obtains its nutrition

from the uterine endometrial secretions, called “uterine
milk.”
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 Pregnancy ……..
• Implantation results from the action of trophoblast cells that
develop over the surface of the blastocyst.

• These cells secrete proteolytic enzymes that digest and

liquefy the adjacent cells of the uterine endometrium.

• Some of the fluid and nutrients released are actively

transported by the same trophoblast cells into the blastocyst,
adding more sustenance for growth.

• Once implantation has taken place, the trophoblast cells and

other adjacent cells (from the blastocyst and the uterine
endometrium) proliferate rapidly, forming the placenta and the
various membranes of pregnancy. 34
 Pregnancy……..
• Early Nutrition of the Embryo
• The progesterone has an effect on the uterine endometrium,
converting the endometrial stromal cells into large swollen cells
containing extra quantities of glycogen, proteins, lipids, and even
some minerals necessary for development of the conceptus.

Then, when the conceptus implants in the endometrium, the

continued secretion of progesterone causes the endometrial cells to
swell further and to store even more nutrients.
These cells are now called decidual cells

Later on the placenta will take over of meeting nutritional demand of

the fetus.

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 Pregnancy……..
• Human Chorionic Gonadotropin (hCG) and Its Effect

• Has MW of about 39,000dalton

• Prevents involution of the corpus luteum at the end of the monthly
female sexual cycle.
• Instead, it causes the corpus luteum to secrete even larger quantities
of its sex hormones—progesterone and estrogens—for the next few
months.
• These sex hormones prevent menstruation and cause the
endometrium to continue to grow and store large amount of
nutrients.
• hCG is a test for pregnancy.
• Corpus luteum persists for about 12 weeks and disintegrates
followed by formation of placenta.
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 PREGNANCY…..
• Functions of the placenta
• Endocrine function
Secretes a number of hormones such as
Estrogen
Progesterone
Placental lactogen
Human chorionic somatomammotropin, etc
• Supply of O2 and other nutrients to the fetus
• Removal of metabolic wastes out of the fetus

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 Parturition
• Parturition means birth of the baby.
• Toward the end of pregnancy, the uterus
becomes progressively more excitable,
until finally it develops such strong
rhythmical contractions that expels the
baby
• The exact cause of the increased activity
of the uterus is not known, but at least
two major effects lead up to the intense
contractions responsible for parturition:
 progressive hormonal changes that
cause increased excitability of the
uterine musculature, and
 progressive mechanical changes.
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 Parturition ……..
• Hormonal Factors That Increase Uterine Contractility
Increased Ratio of Estrogens to Progesterone.

• Progesterone inhibits uterine contractility during pregnancy

→prevention of expulsion of the fetus.
• Estrogens ↑uterine contractility because estrogens ↑ No of gap
junctions between the adjacent uterine smooth muscle cells
• From the seventh month onward, estrogen secretion continues to
increase while progesterone secretion remains constant or perhaps
even decreases slightly.

• Therefore, it has been postulated that the estrogen-to-progesterone

ratio increases sufficiently toward the end of pregnancy to be at least
partly responsible for the increased contractility of the uterus.
• Estrogen up regulates receptors for oxytocin
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 Parturition ……..
• Effect of Oxytocin on the Uterus.

• There are four reasons to believe that oxytocin might be

important in increasing the contractility of the uterus near
term:
 The uterine muscle increases its oxytocin receptors during the
latter few months of pregnancy.
 The rate of oxytocin secretion increased at the time of labor.
 Although hypophysectomized animals can still deliver their
young at term, labor is prolonged.
 Experiments in animals indicate that stretching of the uterine
cervix, during labor, can cause a neurogenic reflex through the
paraventricular and supraoptic nuclei of the hypothalamus that
causes secretion of oxytocin.
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 Parturition ……..
• Effect of Fetal Hormones on the Uterus.
• The fetus’s hypothalamus secretes increasing quantities of oxytocin,
which might play a role in exciting the uterus.

• The fetus’s adrenal glands secrete large quantities of cortisol,

another possible uterine stimulant.

• In addition, fetal membranes release prostaglandins in high

concentration at the time of labor. These, too, can increase the
intensity of uterine contractions.

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 Parturition ……..
• Mechanical Factors That Increase Uterine
Contractility
• Simply stretching smooth muscle organs usually increases
their contractility.
• Further, intermittent stretch, as occurs repeatedly
in the uterus because of fetal movements, can also elicit
smooth muscle contraction.
• Note especially that twins are born, on average, 19 days
earlier than a single child, which emphasizes the
importance of mechanical stretch in eliciting uterine
contractions.
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