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Reproduction In Women
Women's life can be divided into seven
stages according to their physiological
characteristics
Different periods of Female
fetal period
Neonatal period : 4 weeks
childhood: 4 weeks to age of 12
Adolescence or Puberty
sexual maturity: maintains for 30 years
peri-menopausal period:begain 40, the short
1-2 years long maintains for 10-20 years
senility
fetal period
PUBERTY(adolescence)
Defination
Puberty is the period when the endocrine and
gametogenic functions of the gonads first
develop to the point where reproduction is
possible.
PUBERTY AND MENOPAUSE
PUBERTY
Events
1.Thelarche: 10 years of age began to appear breast
development (E,P)
2.Adrenarche: an increase in the secretion of adrenal
androgens. Pubarche: the development of axillary and pubic
hair.(A)
3.Menarche: the first menstrual period.
4.growth spurt 11-12
years 9cm/years
PUBERTY AND MENOPAUSE
Sexual Precocity
Precocious pseudopuberty :
the precocious sexual development in humans is
caused by exposure of immature males to androgen
or females to estrogen.
True precocious puberty:
Sexual Precocity
Precocious puberty,
The most frequent endocrine symptom of
hypothalamic disease.
Lesions of the ventral hypothalamus near the
infundibulum.
Interruption of neural pathways that produce inhibition
of the GnRH pulse generator.
Chronic stimulation of GnRH secretion.
PUBERTY AND MENOPAUSE
MENOPAUSE
conception:
The human ovary gradually becomes unresponsive to
gonadotropins with advancing age, and its function declines, so
that sexual cycles and menstruation disappear.
Age:
In women, the menses usually become irregular and cease
between the age of 45 and 55.
PUBERTY AND MENOPAUSE
MENOPAUSE
Age:the menses usually become irregular and cease between
the ages of 45and 55.
Hormones levels:
The ovaries no longer secrete progestrone an 17-estrodiol in
appreciable quantities. As the negative feedback effect of the
estrogens and progestrone is reduced, secretion of FSH and
LH is increased, and plasma FSH and LH rise to a high level.
Symptoms:
1.The uterus and vagina gradually become atrophic.
2.Sensations of warmth spreading from the trunk to the face(hot
flash), night sweats, and various psychic symptoms.
MENSTRUATION AND THE CLINICAL
FINDINGS IN THE MENSTRUAL PHASE
MENSTRUAL CYCLE
Conspicuous feature:
The periodic vaginal bleeding that occures with the
shedding of the uterine mucosa.
NORMAL MENSTRUATION
The origin of menstrual blood :
predominantly arterial.
Composition: tissue debris cervical mucus,vaginal
epithelial cells.
prostaglandins fibrinolysin unclot .
Duration of the menstrual cycle:
1to 8 days (3-5days).
The amount of lost blood:
Less than 80ml (30ml).
MENSTRUATION AND THE CLINICAL
FINDINGS IN THE MENSTRUAL PHASE
ANOVULATORY CYCLES
Time:
The first 12-18 months after menarche.
Before the onset of menopause.
MENSTRUATION AND THE CLINICAL
FINDINGS IN THE MENSTRUAL
PHASE
ANOVULATORY
CYCLES
Preceeding:
Ovarian function
Ovarian function
producing ova ovulation for
reproductive function
OVARIAN CYCLE
From the time of birth,there are many
primordial follicles under the ovarian capsule.
Each contains an immature ovum.
The periodic changes in ovaries
Cyclical changes in the
ovary
1 primordial follicle
2 preantral follicle
3 Antral follicle
4 preovulatory follicle
primordial follicle
OVARIAN CYCLE
Proceeding Of The Cycle
Start :several of these follicles enlarge and carvity forms around the ovum.
The sixth day: one of the follicles becomes the dominant follicle, the others regress (atretic follicles).
the follicle secretes estrogens
The 14th day: the distended follicle ruptures, and the ovum is extruded into the abdominal cavity
(ovulation).
Ovum ----oviducts--------uterus--------degenerates or out of the vagina.
The follicle that ruptures promptly fills with blood. The granulosa and theca cells of the follicle
lining promptly begin to proliferate,and the clotted blood is rapidly replaced with yellowish, lipid-
rich luteal cell,forming the corpus luteum( .
the luteal cells secret estrogens and progesterone
Pregnancy --------corpus luteum persists, no more menstrual periods until after delivery.
The 24th day: No pregnancy--------- corpus luteum begins to degenerated ,and eventually replaced
by fibrous tissue, forming a corpus albicans.
3. Formation and
degeneration of corpus
luteum
Ovarian follicular fluid outflow Decreased follicular cavity
pressure The follicle wall collapse, forming many folds
Follicular granulosa cells and theca cells of the follicle invade
inward formed corpus luteum Growth of the corpus luteum
depends on its developing an adequate blood supply, and there
is evidence that vascular endothelial growth factor (VEGF) is
essential for this process. If pregnancy occurs, the corpus
luteum persists, and there are usually no more menstrual
periods until after delivery If there is no pregnancy, the
corpus luteum begins to degenerate about 4 days before the
next menses ( day 24 of the cycle ) and is eventually replaced by
fibrous tissue, forming a corpus albicans After Corpus luteum
function decline begin new cycle
Proceeding Of The Cycle corpus luteum persists, no
more menstrual periods until
Ovum ----oviducts----uterus---- after delivery.
degenerates or out of the vagina.
Pregnancy
ovulation
The follicular phase The luteum phase
Start The 6th day No pregnancy
The 14th day The 24th day
several these one
several of these oneofof the
the follicles
follicles
follicles
follicles enlarge
enlarge becomes
becomes the the the distended follicle corpus luteum begins to
and
and carvity
carvity dominant
dominant follicle,
follicle, ruptures, and the ovum is
extruded into the degenerated ,and eventually
forms around the
forms around the others
others regress
regress abdominal cavity replaced by fibrous tissue,
the
the ovum.
ovum. forming a corpus albicans.
follicular fluid theca interna
granulosa cells
Maturity follicle
In humans, no new ova are formed after
birth. During fetal development , the ovaries
contain over 7 million germ cells; however,
many undergo involution before birth, and
others are lost after birth. At the time of birth,
there are approximately 2 million primordial
follicles containing ova, but approximately
50% of these are atretic.
OVARIAN CYCLE
atresia
continues
the million or so ova undergo
the first part of the first meiotic
Involutes division and enter a stage
before birth of arrest before adulthood.
the remainder
degenerated
OVARIAN CYCLE
1.Before ovulation, the first meiotic Primordial oocyte
division is completed.
GnRH Hypothalamus
Anterior Pituitary
LH FSH
Estrogen Inhibin B
Estrogenic
Theca interna Granulosa Ovary
effects
Androgens
Feedback Effects
It should be emphasized
that a moderate, constant
level of circulating Estrogen
exerts a negative feedback
effect on LH secretion,
whereas an elevated
Estrogen level exerts a
positive feedback effect and
stimulates LH secretion.
When circulating levels of
Progesterone were high, the
positive feedback effect of
Estrogen was inhibited.
Feedback Effects
ovulation occurs :
9 hours After the LH peak:.(FSH also peaks, despite a small rise in inhibin B)
The arborizing,
fernlike pattern
VAGINAL CYCLE
estrogens
Estrogens
cause proliferation of mammary ducts.
Progesterones
cause growth of lobules and alveoli.
CYCLIC CHANGES IN THE
BREASTS
distention of ducts,
hyperemia,
edema of the interstitial tissue of the breasts
indicators of ovulation
Knowing when during the menstrual cycle ovulation occurs
is important in increasing fertility or conversely, in
contraception.
ESTROGENS
Secretion Of Estrogens
Almost all of the estrogen comes from the
ovary. There are 2 peaks of secretion: one
just before ovulation (follicle)and one during
the midluteal phase(corpus luteum). After
menopause, estrogen secretion declines to
low levels.
SEXUAL HORMONES
ESTROGENS
Secretion Of Progesterone
The follicular phase :
0.9ng/ml ( by the cells in the ovarian
follicle)
The luteum phase :
18ng/ml ( by the corpus luteum)
progesterone
The principal target organs of P are the uterus, the breasts, and the brain.