Aspek Fisiologi Organ Genetalia Prp2017

Reproductive Physiology
The Female Reproductive

System
Suyasning HI
Female Reproductive Anatomy
Ovaries are the primary female

reproductive organs
Make female gametes (ova)
Secrete female sex hormones (estrogen
and progesterone)
Accessory ducts include uterine tubes,
uterus, and vagina
Internal genitalia ovaries and the
internal ducts
External genitalia external sex organs
Physiological stage
Neonatus period : birth 4 weeks

Childhood : 4 weeks -- 12 years
Puberty : 12 years - 18 years
Sexual maturalis : 18 years 50 years
Perimenopause : decline ovum function
(40 years) 1 year postmenopause
Post menopause
Female Reproductive Anatomy
The Ovaries
Ovaries
Ovary: histology
Menstruation
Menstruation
cyclic endometrium sheds and bleeds due
to cyclic ovulation
Mense
1. Endometrium is sloughed (progesterone
withdrawal)
2. Nonclotting menstrual blood mainly comes
from artery (75%)
3. Interval: 24-35 days (28 days). duration: 2-
6 days. the first day of menstrual bleeding
is consideredy by day 1
4. Shedding: 30-50 ml
Central reproductive hormones
Hypothalamus-Pituitary-Ovary(H-P-O axis)
Neuroendocrine regulation
1. Gonadotropin-releasing hormone,GnRH
1) chemical structure
(pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-
NH2
2) Synthesize and transport
nerve cells portal vein anterior lobe

hypothalamus pitutary
Hypothalams
GnRH
3) Regulation of GnRH
Pituitary
FSH, LH
Ovary
E,P
2. Gonadotropins
1) Composition (glycoprotein)
Follicle stimulating hormone,FSH
Luteinizing hormone,LH
2) Synthesize and transport
Gonadotroph Blood ovary

(pulse) circulation
3. Prolactin (PRL)
Regulated by the prolactin inhibiting factor
(PIF)
The Ovarian cycle
Function of ovary
1. Reproduction
development and maturation of follicle;
ovulation
2. Endocrine
estrogens, progesterone, testosterone
The Ovarian cycle
Cyclic changes of ovary
1. The development and maturation of follicle
1) Primordial follicle: before meiosis
2) Preantral follicle: zona pellucida, granulosa
cells (FSH receptor)
3) Antral follicle: granulosa cells (LH receptor),
E
4) Mature follicle: E,P
Theca externa, theca interna, granulosa,
follicular antrum, mound, radiate coronal
5) Follicular phase: day 1 to follicle mature (14
days)
Ovarian Cycle
Monthly series of events associated with

the maturation of an egg
Starts at puberty (beginning of the
menstrual cycles is termed menarche
Average duration 28 days (20-45 days)
Phases of ovarian cycle:
Follicular phase period of follicle
growth (days 114)
Luteal phase period of corpus luteum
activity (days 1428)
Ovulation occurs midcycle (day 14)
Follicular Phase
Upon FSH stimulation, (6-12) primordial

follicles becomes a primary follicle (one
layer of cells)
Primary follicle then becomes a secondary
follicle
The theca and granulosa cells cooperate
to produce estrogens
The antrum is formed
Before ovulation, only one follicle grows
and the rest (5-11) becomes atretic
The Ovarian cycle
Ovarian Cycle
Follicular Phase (hormonal regulation)
GnRH rises in response to a decline in

inhibin and sex steroids
GnRH stimulates rise in pituitary FSH &
LH secretion.
FSH stimulates new follicle growth
LH induces thecal cell growth,
vascularization & androgen synthesis
FSH stimulates granulosa cell production
of E2 & LH receptor
The Ovarian cycle
2. Ovulation
1) First meiosis completed collagen
decomposed oocyte ovulated
2) Regulation
a) LH/FSH peak
E2(mature follicle) GnRH
(hypothalamus) LH/FSH peak (positive
feedback)
b) P cooperation
LH P (follicle luteinized before ovulation)
positive feedback
Ovulation
Rapidly rising estrogen levels stimulate LH surge

(positive feedback-GnRH sensitization) about 2
days before ovulation
LH surge triggers ovulation
Ovulation occurs when the ovary wall ruptures
and expels the secondary oocyte
Mittelschmerz a twinge of pain sometimes felt
at ovulation
Luteal Phase
After ovulation, the ruptured follicle collapses,

granulosa cells enlarge, and along with internal
thecal cells, form the corpus luteum (LH action)
The corpus luteum secretes progesterone and
estrogen
If pregnancy does not occur, the corpus luteum
degenerates in 12 days after ovulation, leaving a
scar (corpus albicans)
If pregnancy does occur, the corpus luteum
produces hormones until the placenta takes over
that role (at about 3 months)
The Ovarian cycle
3. Corpus luteum
1) follicle luteinized after ovulation: luteal
cells
2) LH VEGF corpus hemorrhagicum
3) Regression
non fertilized corpus albicans
4) Luteal phase
Ovulation to day 1
Luteal Phase (cont.)
Estrogens and progesterones shut off FSH and LH

release
Days 26-28 decline of the ovarian hormones
Ends the blockade of FSH and LH
The cycle starts anew
The Ovarian cycle
sex hormones secreted by ovary
1. Composition
Estrogen, progesterone, testosterone
2. Chemical structure
Steroid hormone
3. Synthesis
Cholesterolpregnenoloneandrostenedione

testosteroneestradiol
5 or 4 pathway of estrogen production
The Ovarian cycle
4. Metabolism: liver
5. Cyclic change of E and P in ovary
1) Estrogen
a) E(day 7) E peak (pre-ovulate) E
E (1 day after ovulate) E peak (day 7-8)
E
b) theca interna cells (LH receptor)
testosterone
c) Granulosa (FSH receptor) estrogen
Feedback Mechanisms in Ovarian Function
Hormonal Interactions During the Ovarian Cycle
The Hormonal Regulation of the Female
Reproductive Cycle
Uterine (Menstrual) Cycle
Series of cyclic changes that the uterine

endometrium goes through each month in
response to ovarian hormones in the blood
Days 1-5: Menstrual phase uterus sheds
all but the deepest part of the
endometrium
Days 6-14: Proliferative (preovulatory)
phase endometrium rebuilds itself
Days 15-28: Secretory (postovulatory)
phase endometrium prepares for
implantation of the embryo
The Ovarian cycle
2) Progesterone
P (after ovulation) P peak (day 7-8) P
granulosa
LH
progesterone
The Ovarian cycle
H-P-O axis
1. Positive feedback
Sex hormones (E) GnRH or LH/FSH
E peak (200pg/ml) LH/FSH peak
ovulation
2. Negative feedback
Sex hormones (E) GnRH or LH/FSH
Follicular phase: E FSH
Luteal phase: EP LH/FSH(formation)
EP LH/FSH(regression)
Ovarian responses
Menses
If fertilization does not occur, progesterone levels
fall, depriving the endometrium of hormonal
support
Spiral arteries kink and go into spasms and
endometrial cells begin to die (prostaglandin
effect)
The functional layer begins to digest itself
Spiral arteries constrict one final time then
suddenly relax and open wide
The rush of blood fragments weakened capillary
beds and the functional layer sloughs
Fibrinolysin is produced to prevent clotting
The endometral cycle
Proliferative phase
1. E(mitogen) stroma thickens and
glands become elongated proliferative
endometrium
2. Duration: 2 weeks
3. Thickness: 0.5mm 5mm
Proliferative Phase (estrogen phase)
preovulation
Rising levels of estrogens cause re-
epithelialization of the endometrium,
vascularization, and growth of endometrial glands
At the time of ovulation, the endometrium is 3-5
mm thick
The endometral cycle
Secretory phase
1. P(differentiation) secretory
endometrium
2. Features
stroma becomes loose and edematous
blood vessels entering the endometrium
become thickened and twisted
glands become tortuous and contain secretory
material within the lumina
3. Duration: 2 weeks
4. Thickness: 5-6mm
Secretory Phase (progesterone phase)
After ovulation
Estrogen and progesterone levels are high
More growth, progesterone causes swelling and
secretory development of the endometrium
One week after ovulation, the endometrium is 5-6
mm thick
Provide appropriate conditions for fertilized ovum
Overview of the Menstrual Cycle
The Hormonal Regulation of the Female Reproductive Cycle
Effects of Estrogens
Estrogen levels rise during puberty

Change of vaginal epithelium from stratified cuboidal
to..
Promote oogenesis and follicle growth in the ovary
Exert anabolic effects on the female reproductive tract
Uterine tubes, uterus, and vagina grow larger and
become functional
Uterine tubes and uterus exhibit enhanced motility
Vaginal mucosa thickens and external genitalia mature
In breast, estrogen causes development of stromal
cells, ductile system, and fat deposition
Effects of Estrogens (cont.)
Estrogens cause increased osteoblastic activity as well as

closure of epiphyseal plates
The skin is thicker, smoother, and more vascular
Estrogen-Induced Secondary Sex Characteristics
Growth of the breasts

Increased deposition of subcutaneous fat,
especially in the hips and breasts
Widening and lightening of the pelvis
Effects of Progesterone
Promote secretory changes in the uterus

Increased secreion of fallopian tubes
Promote development of ducts and alveoli of the
breast
Change of Other genital organs
Cervix
endocervical glands (E) mucus(thin,clear,
watery) maximal (ovulation)
endocervical glands (P) mucus(thick,
opaque, tenacious)
Vagina
Vaginal mucosa (E) thickening and
secretory changes
Vaginal mucosa (P) secrete
Female Sexual Response
Like in male, depends on psychic and local stimulation

The clitoris, vaginal mucosa, and breasts engorge with
blood
Activity of vestibular glands lubricates the vestibule and
facilitates entry of the penis
Orgasm accompanied by muscle tension, increase in
pulse rate and blood pressure, and rhythmical
contractions of the uterus
Females do not have a refractory period after orgasm and
can experience multiple orgasms in a single sexual
experience
Orgasm is not essential for conception
Menopause
At age 40-50 years

Ovulation and menses cease entirely
Without sufficient estrogen, reproductive organs
and breasts atrophy
Irritability and depression result
Skin blood vessels undergo intense vasodilation
(hot flushes occur)
Gradual thinning of the skin and bone loss
Bartholins Glands
(aka: Vestibular Glands)
The Bartholin's glands are located on each

side of the vaginal opening.
They secrete fluid that
helps lubricate the vagina.
Sometimes the ducts of
these glands become
obstructed.
Fluid backs up into the gland
and causes swelling
(Bartholin's cyst)
50
Mammary Glands
Modified sweat glands that produce milk
(lactation)
Amount of adipose determines size of
breast
Milk-secreting glands open by lactiferous
ducts at the nipple
Areola is pigmented area around nipple
Suspensory ligaments suspend breast
from deep fascia of pectoral muscles
(aging & Coopers droop)
Mammary line is a thickened ridge of
embryonic tiwwue that extends from the
axilla to the groin. 51
Breast
52
Breast
Prolactin from
the pituitary
gland
stimulates the
synthesis of
milk
Oxytocin from
the posterior
pituitary gland
stimulates milk
ejection
53
Lymphatic
Drainage
Lymph
nodes
draining the
breast are
located in
the axilla.
54
Oogenesis: Before birth
During fetal development,

oogonia (stem cells) divide by
mitosis to make primary oocytes
Primary oocytes begin meiosis
and stop in prophase I until
puberty
Primordial follicles: Support cells
that surround the oocyte in the
ovary
2 million present at birth
400,000 remain at puberty
55
Oogenesis: After Puberty
Each month, hormones cause several

follicles to develop, which triggers the
primary oocyte to resume meiosis I
Polar bodies: When the cell divides, all the
cytoplasm and organelles stay with one of
the new cells, the other cell is just DNA, and
is called a polar body and is discarded
Secondary oocyte: The stage at which
ovulation occurs.
56
Oogenesis: After Puberty
The secondary oocyte begins meiosis II,

but stops in metaphase II
The secondary oocyte is ovulated
Meiosis II is completed only if it is
fertilized.
57
Female Reproductive Physiology
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Reproductive Physiology

The Female Reproductive

Ovaries are the primary female

Neonatus period : birth 4 weeks

nerve cells portal vein anterior lobe

Gonadotroph Blood ovary

Monthly series of events associated with

Upon FSH stimulation, (6-12) primordial

GnRH rises in response to a decline in

Rapidly rising estrogen levels stimulate LH surge

After ovulation, the ruptured follicle collapses,

Estrogens and progesterones shut off FSH and LH

Series of cyclic changes that the uterine

Estrogen levels rise during puberty

Estrogens cause increased osteoblastic activity as well as

Growth of the breasts

Promote secretory changes in the uterus

Like in male, depends on psychic and local stimulation

At age 40-50 years

The Bartholin's glands are located on each

During fetal development,

Each month, hormones cause several

The secondary oocyte begins meiosis II,

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