THE OVARIES

GROUP 4
 If no Y chromosome or
TDF, the Gonad forms an
THE EARLY ovary.
OVARIAN • The development of
DEVELOPMENT Cortex and Medulla
• Oogonia begins to
develop in the follicles.
 • The oogonia are derived from
the primitive germ cells by a
THE EARLY series of about 30 mitoses.
OVARIAN • The oogonia begins to enter the
DEVELOPMENT meiosis I
Oogonia • 400 oogonia matures into ova
during the 30 years
 • Estrogen formation in the fetal
ovary begins in early
THE EARLY development
OVARIAN • The gonadotropins take over
DEVELOPMENT the role of placental hCG
• Postpartum, a smaller peak of
LH and FSH occur
 The onset of puberty is
characterized by:
Pubertal • ↑ secretion of GnRH
• ↑ secretion of LH and FSH
Changes of
Ovarian • In the ovary, both LH and FSH
Function are involved in the control of
steroidogenesis
 • As the puberty approaches,
Pubertal the secretion of FSH and LH
Changes of increases
Ovarian
• Chromosome 2p21 codes
Function the LH and FSH receptors.
• Oval organs that lie in the pelvic fossa.
• Formed by the Posterior and Lateral
Pelvic Wall
• 2-5 cm in length
• Weighs an average of 14g
• Contains 2-4 million Primordial
Follicles
• Basic endocrine/reproductive unit of the
ovary.
• Present at birth; maturation is blocked until
puberty.
• Theca externa
• Theca interna
• Granulosa cells
• Liquor Folliculi
• Cumulus Cells
• Ovum
HORMONAL PRODUCTION
ESTROGEN
• Promote breast, uterine
and vaginal development
• Not produced by
ovaries after
menopause
• Reproductive period,
responsible for follicular
phase changes in the
uterus
• If deficient, irregular and
incompelete development
of the endometrium
• 3 forms:
• Estrone, Estradiol, Estriol
• Estradiol- principal estrogen
• Estrone and estriol- metabolites of intraovarian extraglandular conversion
1. Estrone E1- most abundant estrogen in post menopausal women
2. Estradiol- E2- most potent estrogen; precursor of both E1 and E3
3. Estriol E3- metabolite of estradiol;found in maternal urine
-Major estrogen secreted by the placenta during pregnancy
PROGESTERONE
• Dominant hormone for luteal
phase
• Produced by granulose cells of
Corpus Luteum
• Readies the endometrium for
embryo implantation and breast
for lactation
• Thickening of cervical mucus,
reduction of uterine
contractions, thermogenic effect
• If deficient, failure of embryo
implantation
ANDROGENS
• Androstenedione,
dehydroandrostenedione,
testosterone,
Dihydrotestosterone
• If excess, hirsutism,
defiminization, virilization
• Androgen synthesis
continues well into advanced
age
Miscellaneous Hormones
HUMAN CHORIONIC
GONADOTROPIN HUMAN PLACENTAL
• Produces by the trophoblast cells of placenta
LACTOGEN
• Maintain progesterone production in the • Functionally, structurally,
early pregnancy immunologically similar to GH
and PRL
• Down syndrome marker
• Stimulates development of
mammary gland
• Increases maternal plasma
glucose levels
• Important in diagnosis of
intrauterine growth retardation
• Inhibins A and B- inhibit FSH production
• Activin- enhances FSH secretion and induces
steroidgenesis
• Folliculostatin
• Relaxin-loosens the pelvic ligaments so they can
stretch during labor
• Follicle Regulatory Protein
• Oocyte Maturation Factor
• Meiosis inducingsubstance
THE MENSTRUAL CYCLE
HORMONAL CONTROL OF
OVULATION
• Central control of FSH and
LH resides in the GnRH
pulse generator of the
arcuate nuclei and medial
preoptic nuclei of the
hypothalamus.
• FSH levels are elevated
early in the follicular
phase.
PUBERTAL DEVELOPMENT IN THE FEMALE
• Puberty in females consist of a sequence of hormonally
mediated events resulting in the development of
secondary sexual characteristics.
• Thelarche (development of breast tissue) the earliest sign
of sexual development.
• Menarchae is the culminating event of pubertal
development in females,occurs 2 to 3 years after the
onset of puberty.
PRECOCIOUS SEXUAL DEVELOPMENT
• Precocious sexual development occurs in the response to premature
exposure of tissue sex to steroids.
• Premature breast development is characterized by isolated breast
development and occurs in response to earlier estrogen secretion
• Premature adrenarche may occur 4 and 8 years of age and is
characterize by pubic hair growth and most commonly precious
puberty does not ensue.
• Girls with delayed puberty, sex steroids and gonadotropin are low
•Also known as Primary
Hypogonadism
•Characterized by ovarian failure
resulting in elevation of FSH and
LH concentration.
•Ovarian failure occurs naturally
between 45 and 55 years old of
age.
HYPOGONADOTROPIC HYPOGONADISM
• Also known as Secondary Hypogonadism /

• A form of hypogonadism due to a problem with

pituitary gland or hypothalamus.

•SEVERAL CAUSES:
- Damage to Pituitary gland/Hypothalamus from
surgery, injury, tumor.
- absence of menstrual bleeding
 HIRSUTISM

- is the abnormal, abundant, androgen-sensitive terminal hair growth in

areas in which terminal hair follicles are sparsely distributed or not
normally found in women.
 AMENORRHEA
- absence of menstrual bleeding

2 TYPES OF AMENORRHEA
1.PRIMARY AMENORRHEA
2.SECONDARY AMENORRHEA
PRIMARY AMENORRHEA
- a female fails to begin her monthly
menstruation cycle by the age of 16.
- can be caused by an anatomical problem with
the female’s reproductive system or the HPG
axis.
CAUSES OF PRIMARY AMENORRHEA
GONADAL DYSGENESIS
- abnormal development of the gonads, leading to the
failure to produce the hormones estrogen and progesterone.
- a term used for a unique subset of disorders of
sexual development characterized by incomplete or defective
formation of the gonads (ovary or testis) due to either
structural or numerical anomalies of the sex chromosomes or
mutations in the genes involved in the development of the
gonad.
CAUSES OF PRIMARY AMENORRHEA

TESTICULAR FEMINIZATION
- women are born with a Y chromosome and develop testes
as a fetus
- their body cannot recognize the testosterone being produced
by the testes and so the rest of the body develops just like any
normal females would.
SECONDARY AMENORRHEA
- is the cessation of menstruation for at least 6 months in a
woman who had established a normal menstrual cycle.
HYPOTHALAMIC-PITUITARY-GONADAL AXIS

- the hypothalamic-pituitary-gonadal axis is the key

regulator of sex development and reproduction,
processes that are initiated through the GnRH.
HYPOTHALAMIC-PITUITARY-GONADAL AXIS
HYPOTHALAMIC-PITUITARY-GONADAL AXIS
POLYCYSTIC OVARY SYNDROME
- is a hormonal disorder common among women of reproductive age.
Women with PCOS may have infrequent or prolonged menstrual
periods or excess male hormone (androgen) levels. The ovaries may
develop numerous small collections of fluid (follicles) and fail to
regularly release eggs.
POLYCYSTIC OVARY SYNDROME
SIGNS AND SYMPTOMS
- OBESITY - INFERTILITY
- FACIAL HAIR OR HIRSUTISM
- ACNE
- IRREGULAR PERIODS
- RISK FOR : TYPE 2 DIABETES MELLITUS
PATHOPHYSIOLOGY
PATHOPHYSIOLOGY
UTERINE FIBROIDS
- also called myomas or leoimyomas
- a benign tumor that mainly consists of
muscular tissue and usually grows inside the
uterus
- Ranges from a size of the pea to a large
tumor almost of the size of the uterus.
3 TYPES OF UTERINE FIBROIDS
1. INTRAMURAL MYOMA
- a fibroid that grows in the muscular wall of the
uterus.
2. SUBSEROSAL MYOMA
- a fibroid located just beneath the outside mucosal
covering of the uterus.
3. SUBMUCOSAL MYOMA
- a tumor that grows beneath the surface of the
uterine lining.
3 TYPES OF UTERINE FIBROIDS
3 TYPES OF UTERINE FIBROIDS
UTERINE FIBROIDS

- etiology is unknown but it is said to be

associated with gene defect and levels of
estrogen.