female physiology Flashcards
female hormones
- estrogen
2. progesterone
estrogen - source
- ovary (17β-estradiol)
- placenta (estriol)
- adipose tissue (estrone via aromatization)
adipose produce … (estrogen) via …
estrone via aromatization
estrogen hormones - potency (from most potent to least)
- estradiol
- estrone
- estriol
estrogen hormones - function
- development of genitalia and breast
- female fat distribution
- growth of follicle
- increase myometrial excitability
- increase transport proteins, SHBG
- increase HDL
- decrease LDL
- effects on other hormones
estrogen hormones - effects on other hormones
- uperegulation of estrogen, LH, progesterone receptors
- feedback inhibition of FSH and LH
- LH surge
- stimulation of prolactin secretion
estrogen - concentrations in pregnancy
- 50-fold increase in estradiol and estrone
2. 1000-fold increase in estriol (indicatior of fetal well being)
estrogen - indicator of a fetal well-being
1000-fold increase in estriol
estrogen receptors mechanism
expressed in cytoplasm –> trasnlocate to nucleus when bound by estrogen
estrogen production - control
pulsatile GnRH –> LH and FSH
- LH –> desmolase (cholesterol to antogens) in theca interna cell
- FSH –> aromatase (Androgens –> estrogens) in granulosa cells
FSH vs LH location action according ot estrogen production
LH –> theca internal cells
FSH –> granulosa cells
- theca internal cells
- granulosa cells
homolog in mlaes
- Leyding cells (endocrine cells)
2. Sertoli (non gem)
progesterone source
- corpus lateum
- placenta
- adrenal cortex
- testes
increased progesterone is indicator of
ovaluation
progesterone function
- stimulation of endometrial grandular secretions and spiral artery development
- Maintenance of pregnancy
- decreases myometrial excitability
- production of thick cervical mucus (inhibits sperm entry into uterus)
- increases body temperature
- uterine smooth muscle relaxation (preventing contraction)
- prevents endometrial hyperplasia
- effects on other hormones
progesterone effects on other hormones
- inhibition of gonadotropins (LH, FSH)
- decrease estrogen receptor expression
- fall in progesterone after pregnancy disinhibits prolactin –> lactation
progesterone - production of thick cervical mucus –> …
inhibits sperm entry into uterus
gametes - types/definition/origin
types: 1. Oocytes 2. Spermatozoa
they are descendants of primordial germ cells that originate in the wall of yolk sac of the embryo –> migrate into the gonadal cells (6th week)
gametes originate in the
yolk sac of the embryo
meiosis occurs during
the production of gametes (only)
oogenesis - all the process
primordial cells from yolk sac to embryo and becomes oogonia (6th week) –> Oogonia (2N, 2C) undergo DNA replication to form 1ry oocytes (2N, 4C) and undergro begin meiosis during fetal life (5 mth) –> arresterd in prophase I complete meiosis I just prior to ovulation (1 1ry oocyte per ovaluation) –> 2ry oocyte (1N, 2C) + polar body –> Meiosis II is arrested in metaphase until fertilization –> if fertilization, ovume (1N, 1C), if not fertilization within 1 day, the 2ry oocytes degenerates
fate of polar body after meiosis I
can degenerate or give rise to 2 polar body (meiosis 2)
oogenesis - DNA status of cells
n=chromosomes
C=1 DNA
oogonioum –> Diploid (2n) and 2C
1ry oocyte –> diploid (2n) and 4C (46 doubled chromosomes, sister chromatides)
2r oocyte –> haploid (1n) and 2C (23 doubled chromosomes)
ovum –> haploid –> (1n) and 1c
1ry oocytes –> 2ry oocyte
1ry oocytes begin meiosis during fetal life (5 mth) –> arresterd in prophase I complete meiosis I just prior to ovulation –> 2ry oocyte (1N, 2C) + polar body
(1 1ry oocyte per ovaluation)
1ry oocytes are arrested in
prophase I
2ry oocytes are arrested in
metaphase of meiosis 2
hormone status during evaluation
- increased estrogen
- increased GnRH receptor on anterior pituitary
- estrogen surge tehn stimulates LH release –> ovulation (rupture of follicle)
- increased temperature (progensterone induced)
ovulation occurs as a result of
estrogen-induced LH surge
Mittelschmerz - definition/mechanism
transiet mid-cycle ovulatory pain –> classically associated with peritoneal irratation (eg. follicular swelling/rupture, fallopian tube contraction)
Menstrual cycle - periods (and time)
- funicular phase (vary in length - 0-14 in normal cycle)
- ovulation (14 days before menses, regardless the cycle length
- Luteal phase (after ovaluation for 14 days)
- mesnes (0-4 days)
Menstrual cycle - periods (and time)
- funicular phase (vary in length - 0-14 in normal cycle)
- ovulation (14 days before menses, regardless the cycle length
- Luteal phase (after ovaluation of 14 days)
- mesnes (0-4 days)
Folicular phase - events
- primordial follicle develops (with atresia of neighboring follicles) - growth fastest during 2nd week
- LH and FSH receptors are upregulated in Theca and and granulosa cells (on follicles) –> estradiol levels –> decreases FSH/LH levels
- at the end –> a burst of estradiol –> + feedback on LH/FSH secretion (LH surge) –> ovaluation
Folicular phase - progesterone levels
low
LH, FSH, estradiol levels during follicular phase
LH/FSH decrease, estrogen increase
at the end of the phase burst of estradiol –> + feedback on LH/FSH secretion (LH surge)
estrogen effects on uterus follicular phase
- growth of follicle
- endometrial proliferation
- increased myometrial excitability
developing follicle is developed by
- FSH
- LH
- estrogen
ovaluation day + …(number) days = menstruation
14
ovulation occurs as a result of
estrogen-induced LH surge
follicle after ovulation
corpus lateum
Luteal phase - events (generally)
corpus lateum produce estrogen + progesteron
Luteal phase - progesterone –>
- stimulation of endometrial grandular secretions and spiral artery development
- decreases myometrial excitability
- production of thick cervical mucus (inhibits sperm entry into uterus)
- increases body temperature
- uterine smooth muscle relaxation (preventing contraction)
- prevents endometrial hyperplasia
- inhibition of gonadotropins (LH, FSH)
- decrease estrogen receptor expression
progesterone - pregnancy
Progesterone maintains endometrium to support implantation
estrogen vs progesterone according to myometrial excitability
progesterone –> decrease
estrogen –> increase
Dysmenorrhea?
pain with menses
dysmenorrhea is often associated with
endometriosis
oligomenorrhea?
more than 35 days cycle
polymenorrhea?
less than 21 day cycle
Metrorrhagia?
frequent or irregular mestriation
Menorrhagia?
Heavy menstrual bleedin
more than 80ml loss or more than 7 days
Menometrorrhagia
heavy, irregular menstruation
Fertilization - location and time
MC in upper end of fallopian tube (the ampulla) day 0 (within 1 day of ovulation)
implantation within the wall of the uterus occurs (when)
6 days after fertilization (6-10)
gestational vs embryonic age according to calculation
gestational –> from date of last menstrual period
embryonic –> from date of conception (gestational minus 2 weeks)
Physiologic adaptions in pregnancy (namely)
- increased cardiac ouput
- anemia
- hypercoagulability
- hyperventilation
Physiologic adaptions in pregnancy - increased cardiac ouput - explain
increased preload, decreased afteload, increased HR
–> increased placental and renal perfusion
Physiologic adaptions in pregnancy - anemia - explain
increased plasma and RBCs (but plasma more) –> decreased hematocrit –> decreased viscosity
Physiologic adaptions in pregnancy - hyperventilation - explain
to eliminate fetal CO2
Physiologic adaptions in pregnancy - hypercoagulability - explain
low blood loss at delivery
hcG - source/secretion begins/peak
syncitiotrophoblast of placenta
around the time of implantation of blastocyst (within 1 week). peak: 8-10 weeks
hcG - function
maintains corpus luteum (and thus progesterone) for first 8-10 weeks of pregnancy by acting like LH –> After 8-10 weeks, placenta syntehsizes its own estriol and progesterone and corpus lateum degenerates
fate of corpus lateum in pregnancy
hcG maintains it (and thus progesterone) for 8-10 weeks –> then degenerates
hcG - structure
α subunit –> as LH, FSH, TSH
β subunit –> unique (detected by pregnancy test)
hcG - thyroid function
α subunit is similar to TSH –> states of increased hcG can cause hyperthyroidism
increased hCG - ddx
- multiple gestation
- hydatidiform moles
- choriocarcinomas
- Down syndrome
- testicular cancer
- Large cell Ca of lung
low hcG - ddx
- ectopic/failing pregnancy (spontaneous abortion)
- Edward syndrome
- Patau syndrome
estorgne and progesteron in pregnancy
increasing levels –> maintain endometrium for the fetus, suppress ovarian follicular function (by inhibiting FSH/LH secretion) and stimulates the development of the breast
action of estorgne and progesteron in pregnancy
- maintain endometrium for the fetus
- suppress ovarian follicular function (by inhibiting FSH/LH secretion)
- stimulates the development of the breast
estrogen and progesteron production during pregnancy
until 7-8 weeks from corpus luteum, then a transition state, and then from placenta
levels of hormones in pregnancy (generally)
placental hormone secretion generally increases over the course of pregnancy (estrogens, progesteron, human placental lactogen), but hCg peaks ta 8-10 weeks
human placental lactogen levels
increasing during pregnancy –> a peak/platue at the end of pregnancy and after birth