Female reproductive physiology

Question 1

what organs does the female reproductive system involve?

Answer 1

• 2 ovaries
• 2 fallopian tubes
• 1 uterus
• cervix
• vagina

Question 2

what is the lower portion of the uterus called?

Answer 2

the cervix

Question 3

what is puberty?

Answer 3

the period which the reproductive organs mature and reproduction becomes possible

Question 4

why does puberty occur earlier now than before?

Answer 4

• healthier environment
• perfect nutrition

Question 5

what are the main female sex hormones?

Answer 5

• oestrogen
• progesterone

Question 6

what is estradiol (form of oestrogen) & what is it important for?

Answer 6

• estradiol is the major ovarian steroid sex hormone
• essential for the development of secondary sex characteristics such as increases in bone density, breat development etc

Question 7

what are the phases of the menstrual cycle?

Answer 7

• menstruation
• follicular phase
• ovulation
• luteal phase

Question 8

what is the follicular phase?

Answer 8

• longest phase of the menstrual cycle
• the follicles in the ovary mature from a primary follicle to a fully mature follicle

Question 9

what is the luteal phase?

WHAT IS IT CHARACTERISED BY?

Answer 9

• fixed at around 14 days long
• characterised by **changes in hormone levels **- such as increases progesterone & estrogen levels and a decrease in FSH and LH
• there is also** changes to the endometrial lining** of the uterus in order to potentially implant a fertilised egg
• The corpus luteum also develops

Question 10

what are the main hormones involved in the hypothalamic pituitary ovarian axis?

what are they and what secretes them?

Answer 10

• GnRH released by the hypothalamus
• FSH and LH released by the anterior pituitry gland
• oestrogen, progesterone & inhibin released by ovaries

Question 11

Describe te secretion of FSH during the menstrual cycle

Answer 11

• FSH increases in the early follicular phase, and then steadily decreases throughout the remainder of the cycle

Question 12

Describe LH secretion during the menstrual cycle

Answer 12

• LH is constant during most of the follicular phase
• it then shows a big peak called the LH surge just before ovulation
• it then decreases during the luteal phase

Question 13

what is ovulation?

Answer 13

• the expulsion of a mature oocyte to the abdominal cavity and is collected by a trumpet shaped distal end of the uterine tube - triggered by LH surge

Question 14

Describe oestrogen during the menstrual cycle

Answer 14

• oestrogen concentration increases rapidly during the 2nd week of the menstural cycle
• it then starts to decline just before the LH surge
• after that there is a second increase as the corpus luteum secretes it
• then there is a rapid decrease during the final days of the cycle

Question 15

Describe progesterone secretion during the menstural cycle

Answer 15

• small amounts of progesterone are released during the follicular phase
• the corpus luteum begins to release progesterone and the pattern is then similiar to oestrogen

Question 16

what are the functions of oestrogen?

Answer 16

• development of secondary sex characteristics
• fertility
• increases fallopian tube motility (contractions) uterine contraction
• stimulates endometrial growth

Question 17

why is an increase in fallopian tube contractions / female reproductive organ contractions important for sperm motility?

Answer 17

the contractions help to push the sperm forward

Question 18

what are the functions of progesterone?

Answer 18

• decreases uterine contractions
• decreases cervical/ vaginal actions and therefore decreases sperm motility
• inhibits milk let down
• important for the maintenance of the pregnant state

Question 19

what hormones inhibit and stimulate milk let down?

Answer 19

• prolactin stimulates milk let down
• progesterone inhibits milk let down

Question 20

what are the several functions of the ovary?

Answer 20

• oogenesis - production of female gametes
• maturation of the oocyte
• expulsion of the mature oocyte (ovulation)
• secretion of the female sex hormones - oestrogen, progesterone & inhibin

Question 21

what is a ovarian follicle?

Answer 21

• they are the basic functioning unit of an ovary
• each one contains an oocyte

Question 22

what is an oocyte?

Answer 22

a female germ cell that gives rise to an ovum (egg)

Question 23

what are the 2 endocrine cells of the ovary?

Answer 23

• theca cells
• granulosa cells

Question 24

what are the theca cells (ie what are the 2 layers and what is their function?)

Answer 24

• 2 layers - theca externa and theca interna
• they synthesise androgen called androstenedione in response to LH
• they are indirectly involved in the production of estradiol (E2)

Question 25

what are the granulosa cells & what is their function?

Answer 25

* endocrine cells of the ovary * They **produce estradiol in response to FSH** but** only if the theca cells produce androgens in response to LH**

Question 26

what is the primary type of follicle?

Answer 26

primordial follicles - consist of 1 primary oocyte surrounded by a single layer of cells called granulosa cells

Question 27

what does the primordial/primary follicle develop into?

Answer 27

* secondary follicles * this is characterised by an increase in size of the oocyte * proliferation of the granulosa cells into multiple layers

Question 28

what do the secondary follicles develop into ? ## Footnote & what are the distinctive characteristics?

Answer 28

* tertiary follicles * characterised by proliferation of the granulosa cells and differentiation into different layers called theca cells * the primary oocyte reaches its full size and is surrounded by a fluid filled space called an antrum

Question 29

what is a mature oocyte called?

Answer 29

a graafian follicle

Question 30

what is the corpus leteum?

Answer 30

* a temporary endocrine structure within the ovary * forms at the site of a follicle in the ovary that has released its ovum * secretes progesterone, oestrogen and inhibin

Question 31

what is the difference between granulosa cells and theca cells?

Answer 31

* **Granulosa** lutein cells are closest to the central connective tissue core of the corpus luteum and **produce progesterone.** .. also secrete estrogen * **Theca** lutein cells are smaller cells than the former with** dark-staining nuclei**. These cells produce estrogen and are located peripherally between the folds of the granulosa lutein cells.

Question 32

what is **ovotesticular disorder of sex development**?

Answer 32

* when an infant is born with the internal reproductive glands of both sexes (female ovaries & male testes) * 46 XX

Question 33

what is female psuedohermaphroditism?

Answer 33

* a female has matching chromosomal and gonadal tissue sex but mismatching external genitalia * clitorial hypertrophy is present

Question 34

what is the main cause of female pseudohermaphroditism?

Answer 34

* congenital adrenal hyperplasia (enlargement of the adrenal gland) * excessive production of androgens

Question 35

what is male pseudohermaphroditsm?

Answer 35

* matching chromosomal and gonadal sex tissue but mismatching external genitalia

Question 36

what is the main cause of male psuedohermaphroditism?

Answer 36

* inadequate production of testosterone and AMH (anti-mullarian hormone)

Question 37

what is androgen insensitivity syndrome?

Answer 37

* when an individual has testes but female appearance including breasts * there is no mensturation and no pubic hair

Question 38

what is the cause of androgen insensitivity syndrome?

Answer 38

* a genetic defect on X chromosome resulting in resistance to the action of testosterone in the fetus - therefore masculisation is inhibited

Question 39

what is 5 alpha reducatse deficiency?

Answer 39

* an inherited autosomal recessive disorder * mutation in the SRD5A2 gene enoding 5 alpha reductase * a lack of 5AR means a lack of the conversion of testosteroe into dihydrotesosterone

Question 40

what are the characteristics of 5 alpha reducatse deficiency?

Answer 40

* female external genitalia * micro penis * decreased male fertility

Question 41

Describe natural contraception

Answer 41

* 80% effectivity * no side effects * requires a daily record of temperature and mucous secretion * temperature drops before ovulation * can only be used by women who have a regular cycle

Question 42

Describe the 2 forms of oral contraception

Answer 42

1. combined oral contraception - the pill - contains both estradiol and progesterone, 99% effective, prevents ovulation 2. progesterone only pill - ie the mini pill, prevents ovulation, and prevents sperm getting through the cervix and prevents an egg from implanting, 99% effective

Question 43

what are the advantages of 17b - estradiol (E2) versus ethinylestradiol?

Answer 43

* less negative impact on liver metabolism * higher protective effect in rgard to osteoporosis * higher positive effects on skin, vaginal epithelium and connective tissue

Question 44

what is emergency contraception? ## Footnote what are the different types

Answer 44

* morning after pill * progesterone - effective up to 72 hours after intercourse * ullipristol ECF - effective up to 5 days after intercourse - from GP

Question 45

what is an IUD?

Answer 45

* T shaped device * contains either copper or levonorgestrel (progesterone) * inserted into the uterus * lasts for 3 years / 5 years