Hormones and Menstrual cycle

Chapter 3
Dr. Kandula

Menstrual Cycle
• The rhythmic changes that occur in the ovaries and uterus under hormonal
influences

Hormone
A hormone is a chemical messenger that carries a signal from one cell (or group of cells)
to another.
Hormones are released by glands called endocrine glands.

Endocrine glands associated with Menstrual cycle

• Hypothalamus – secretes GnRH which stimulates the pituitary gland to secrete
it’s hormones. It also secretes oxytocin.
• Pituitary gland – secretes FSH and LSH. It also secretes prolactin.
• Both hypothalamus and pituitary glands are found in the brain.

Hypothalamus
• Releases GnRH in pulses every 60 – 90 minutes.
• The beginning of chain of events that leads to hormone secretion that will
eventually lead to menstrual period.
• The hypothalamus is also part of the emotional brain.
• This is why severe emotions as seen in stressful conditions can lead to abnormal
onset of menstruation.
• Oxytocin causes uterine contractions and milk let down by the breasts

Pituitary gland
• In response to GnRH the pituitary gland will release FSH and LH.
• FSH causes  eggs to mature in ovary
 ovary to secrete estrogen
in males causes sperm development
• LH causes  progesterone secretion
 ovulation
 development of corpus
luteum
in males it causes testosterone release

Estrogen
• promotes formation of female secondary sex characteristics, such as breasts
• stimulates growth of vagina and increases glycogen content of vaginal cells,
making it favorable for bacterial growth and the resulting decreased pH
• stimulates endometrial growth and uterine growth
• increases beating of cilia in fallopian tubes
• makes cervical mucus watery, for easy passage of sperm
• increases bone formation
• accelerates height growth
• accelerates metabolism (burn fat), and decreases blood cholesterol

Progesterone
• Prepares endometrial lining for implantation of fertilized egg
• Inhibits uterine contractions
• Inhibits beating of cilia in fallopian tubes
• Increases glandular cells in breasts
• cervical mucus becomes thick
• increases basal body temperature
• increases water and sodium losses in urine

Androgens: testosterone
Produce masculinizing effects
In fetus - causes development of male reproductive structures
After puberty
• Causes male pattern hair distribution
• Enlargement of larynx or voice box and deepening of voice
• Increase muscle mass
• Increase size and strength of skeleton
• Increase basal metabolic rate
• Increase number of red blood cells

Definitions
• Puberty : transition between childhood and adulthood when physical and
psychological changes associated with the ability to reproduce take place
• Menarche : onset of menstrual periods, but ovulation will not occur for a year or
more afterwards

• In childhood the anterior pituitary does not respond to GnRH released by the
hypothalamus.
• At puberty for unknown reasons the pituitary starts to respond and secretes FSH
and LH and this begins the cycle
• Some suspected factors : genetics, social and environmental, nutrition, general
health

Hormone events
• Hypothalamus releases GnRH every 60-90 minutes
• LH and FSH released by anterior pituitary
• Ovaries release estrogen and lesser amounts of progesterone
• Estrogen levels increase in blood and peak around day 14
• This causes surge of LH and FSH release by anterior pituitary
• This causes ovulation and development of corpus luteum which secretes large
amounts of progesterone and smaller amounts of estrogen
• The corpus luteum has a life of about 14 days. If fertilization does not occur it
degenerates and stops secreting estrogen and progesterone.
• Estrogen and progesterone levels fall
• At this point all the hormones – FSH, LH, estrogen and progesterone levels are
low and the GnRH will take over and the menstrual hormone cycle starts over again.

Changes in ovaries and uterus

Endocrine glands
• Hypothalamus
• Anterior pituitary
• Ovaries
Structures affected
• Ovaries
• Uterus

Menstrual Cycle
Ovarian Cycle
• Cycle of events that occur in the ovaries
• Purpose : to produce a mature ovum
Divided into 3 phases
• Follicular phase
• Ovulation
• Luteal phase

1. Follicular phase
• Day one : first day of menstrual period
• Beginning of cycle
• All hormone ( FSH,LH, estrogen and progesterone ) levels are low
• Hypothalamus secretes GnRH
• Anterior pituitary responds and releases FSH and LH
• FSH causes development of follicles in one ovary.
• By day 5 one of the follicles becomes dominant, all others degenerate
• LH released in slightly smaller amounts causes the ovaries to release estrogen
• Since this stage is mainly marked by development of follicles it is called
Follicular phase
• The dominant follicle becomes larger and mature and estrogen levels rise
• When estrogen levels peak about day 14, it causes the pituitary to release large
amounts of LH.
• This causes the dominant follicle in the ovary to swell – Graffian follicle

2. Ovulation
• The dominant follicle in the ovary bursts and releases the egg.
• The released egg is pulled into the fallopian tubes with the help of the fimbria
• These events occur about day 14 in a 28 day cycle

3. Luteal phase
• The Graffian follicle cells that remain in the ovary after the release of the eggs are
called the corpus luteum. The cells become yellow and secrete progesterone and smaller
amount of estrogen under the influence of high LH levels
• The activity of corpus luteum lasts for about 14 days
• If no fertilization, the corpus luteum degenerates and estrogen and progesterone
levels fall.
• This leads to menstrual period and the cycle begins anew.

Endometrial Cycle
• Cycle of events that occurs in the uterus
• Purpose : to prepare a haven to nourish, protect and maintain the fertilized
ovum
Divided into 3 phases
• Menstrual
• Proliferative – which occurs during the follicular phase of the ovarian cycle
• Secretory – which occurs during the luteal phase of the ovarian cycle

Changes in endometrium (lining) of uterus

Endometrium made up of 2 layers
Deeper stratum basalis
• One third thickness of endometrium
• Doesn’t change during menstrual cycle
• Rich blood supply
More superficial stratum functionalis
• Makes up two thirds of thickness, very responsive to hormones, almost entirely
shed during menstruation and then rebuilt every cycle
• Has rich blood supply with coiled blood vessels

1. Menstrual phase
• Day 1 to about day 4 or 5
• Levels of estrogen and progesterone very low, due to death of corpus luteum
• Stratum functionalis decays without hormone support and layers of cells fall off
• Blood vessels alternately constrict and starve tissue and dilate releasing blood but
tissue already dead sloughs off with blood
• This continues – blood, cells, secretions collect in uterine cavity and then come
out
• About 50 ml of blood, secretions and cells are lost
• Blood does not clot because enzymes in uterine cavity destroy the clotting
proteins
• The clots that are seen are actually collections of blood cells, mucus, tissue
fragments and glycogen from the vagina

2. Proliferative Phase
• After day 4 or 5, the endometrium starts rebuilding. GnRH stimulates FSH and
LH which cause the ovaries to release estrogen and small amounts of progesterone.
• The increasing levels of estrogen cause the repair and rebuilding of the
endometrium.
• This phase lasts until 1 or 2 days after ovulation

3. Secretory Phase
• After ovulation, progesterone levels increase due to secretion by the corpus
luteum
• This causes thickening of the endometrium, development of glands, secretions
and fat.
• The endometrium becomes twice as thick as it was during the proliferative phase,
forming a thick cushion for implantation of the zygote.
• If fertilization does not occur, the corpus luteum degenerates, hormone levels fall,
and the endometrium breaks down without the hormone stimulation. The cycle is
repeated.