OVARIAN AND UTERINE

CYCLES

Dr. Saeed Vohra

Female Reproductive Cycles

Starts at puberty
Normally continues throughout the
reproductive years
Monthly female sexual/reproductive cycle
involves activities of hypothalamus,
pituitary gland, ovaries, uterus, uterine
tubes, vagina and mammary glands

Female Reproductive Cycles

The two cycles of the female
1. The ovarian cycle = (changes in ovary)
2. The uterine cycle = (changes in the mucosa of the uterus)

GnRH

Gonadotropin-releasing hormone (GnRH)

is synthsized by neurosecretory cells in
the hypothalamus

Carried to the anterior pituitary gland by

hypophysial portal system

Stimulates the release of 2 hormones

produced by this gland that act on ovaries

FSH

Follicle-Stimulating Hormone stimulates

the development of ovarian follicles

Production of Estrogen by the follicular

cells

LH

Luteinizing Hormone serves as the trigger

for ovulation

Stimulates the follicular cells and corpus

luteum to produce progesterone

OVARIAN CYCLE
Beginning at puberty (11-14 years) & ending at the menopause (40-45 yrs),
the rhythmic cyclic changes which from the OVARIAN CYCLE.

FSH and LH produce cyclic changes in ovaries.

They cause
1.
2.
3.

Development of follicles
Ovulation
Formation of corpus luteum

Follicular Development
The development of the ovarian
follicle is characterized by
1. Growth and differentiation of primary
oocyte
2. Proliferation of follicular cells
3. Formation of Zona Pellucida
4. Development of the Theca Folliculi

Theca Folliculi

Formed as the primary follicle increases in

size and the adjacent connective tissue
organizes into a capsule

Theca Interna: Internal, vascular and

glandular

Theca Externa: A capsule like layer

Antrum

Is a large fluid filled cavity

appears around the follicular
cells of ovarian follicle

Contains follicular fluid

Ovarian follicle now called a

vesicular or secondary follicle

Cumulus Oophorus

The primary oocyte

is pushed aside of
the follicle called
Cumulus Oophorus
Here it is
surrounded by a
mound) mass( of
follicular cells
It projects into the
antrum

The follicle becomes enlarge until it gets

maturity

Produces swelling on the surface of the

ovary

Early development of ovarian follicle is

induced by FSH

Final stages of maturation require LH

Estrogen

Growing follicles produce estrogen

It regulates the development and functions

of reproductive organs

Vascular theca interna also produces

some estrogen

Ovulation

It occurs around mid cycle about 14 days in a 28

day menstrual cycle

Ovarian follicle undergoes sudden growth spurt

(burst) under the influence of FSH & LH

Producing swelling or a bulge on Ovarian

surface

An avascular spot appears on this swelling

called Stigma

Ovulation

Cumulus Oophorus detach from interior of the

distended follicle

It is triggered by a surge of LH production

It usually follows the LH peak 12-24 hrs

LH Surge causes the stigma to balloon out

forming a vesicle

The stigma ruptures and expel secondary oocyte

with the follicular fluid

Ovulation

Expulsion of oocyte results from raised

intrafollicular pressure

The expelled secondary oocyte is

surrounded by Zona Pellucida and layers
of follicular cells called Corona Radiata

Zona Pellucida is composed of 3

glycoproteins ZPA, ZPB & ZPC

Corpus Luteum

After ovulation the walls of the ovarian follicle

and theca folliculi collapse and thrown into
folds called Corpus
Luteum

Corpus Luteum

It secretes Progesterone and little estrogen

These hormones prepare endometrium for

implantation of Fertilized Ovum (Blastocyst)

If the oocyte is fertilized the CL enlarges &

remains active for first 20 weeks of pregnancy

If the oocyte is not fertilized the CL

degenerates in 10-12 days

Uterine or Menstrual Cycle

It is the period during which the oocyte

matures, is ovulated and enters the
uterine tube

Cyclic changes in the endometrium

caused by estrogen and progesterone

These changes occur in the internal layer

of the uterus

Menstrual Cycle

Average menstrual cycle is 28 days

Day 1 is the day when menstrual flow

begins

It vary in length by several days in normal

women

Ranges between 23 and 35 days in 90%

of women

Phases of Menstrual Cycle

Menstrual Phase

Proliferative Phase

Luteal Phase

Ischemic Phase

Menstrual Phase

Starts with 1st day of menstrual cycle

Lasts for 4-5 days

Functional layer of uterine wall is sloughed

off and discarded with the menstrual flow

Blood discharge from vagina is combined

with small pieces of endometrial tissue

Proliferative Phase

Is a phase of repair and proliferation

Lasts for 9 days

Coincides with growth of ovarian follicle

Controlled by estrogen secreted by follicles

2-3 fold increase in thickness of endometrium

The glands increase in number and length and the

spiral arteries elongate

Luteal Phase

Is a secretory or progesterone phase

Lasting about 13 days

Coincides with formation, functioning and growth of

corpus luteum

Glandular epithelium secrete glycogen rich material

Endometrium thickens under the influence of estrogen

and progesterone

Luteal Phase

Spiral arteries grow into the superficial

layer

Arteries become increasingly coiled

Large venous network develops

Direct arterio-venous anastomoses are the

prominent features

If Fertilization Occurs

Fertilized ovum implants in endometrium

on about 6th day of this phase

HCG hormone secreted by

syncytiotrophoblast keeps the corpus
luteum secreting estrogen and
progesterone

The luteal phase continues and

menstruation does not occur

If Fertilization Doesnt Occur

No HCG

Corpus luteum degenerates

Estrogen and progesterone levels fall

Secretory endometrium enters an ischemic

phase

Menstruation occurs

Ischemic Phase

Decreased levels of estrogen & progesterone

Stoppage of glandular secretion
Loss of interstitial fluid
Marked shrinking of endometrium
Spiral arteries become constricted
Venous stasis & Ischemic necrosis
Rupture of damaged vessel wall
Blood seeps into the surrounding connective
tissues

Ischemic Phase

Pools of blood form and break through the

endometrial surface

Resulting in bleeding in uterine lumen and

from the vagina

Loss of 20-80 ml of blood

Entire compact layer and most of the

spongy layer of endometrium is discarded

Pregnancy Phase

If pregnancy occurs, endometrium passes

into the pregnancy phase

Menstruation cycle resumes 6-10 weeks

after the termination of pregnancy

Menopause usually occurs between the

ages of 48-55

Termination of reproductive period causes

psychic changes called Climacteric

Anovulation

Some women do not ovulate

Inadequate release of gonadotropins (FSH
& LH)
Ovulation can be induced by clomiphene
citrate
This stimulates pituitary to secrete
gonadotropins
Causes multiple ovulation
Multiple pregnancies
Spontaneous abortions