female reproductive system

• primary oocyte increases in size, granulosa proliferation, gap jx form between granulosas and oocyte, granulosas develop estrogen/FSH receptors, thecal cells develop w/receptors for LH
• Independent of LH/FSH!

• LH surge leading to ovulation about 16hrs after
• The LH surge is triggered by critical level of estradiol

• formation of corpus luteum after ovulation
• increased progesterone (&estradiol) - peaks 8 days after LH surge, then declines to baseline by 12days after LH surge
• Estradiol no longer has a positive feedback effect on LH/FSH secretion - instead estradiol and progesterone have a neg feedback effect on secretion
• decreased pulse frequency of GnRH, LH/FSH

• second part of follicular phase
• follicles undergo atresia, death of oocyte unless there are sufficient levels of FSH/LH & receptors
• estradiol and FSH stimulate LH receptors on outer layers of granulosa cells

• Third part of follicular phase
• LH acts on LH receptors and stimulates synth and secretion of prostagladins
• LH surge stimulates ovulation and formation of corpus luteum

• Thecal cells make androstenedione from cholesterol when stimulated by LH
• Granulosa cells convert androstendione to estradiol w/aromatase

• Causes downregulation of receptors, loss of responsiveness
• Treatment for precocious puberty

• around 55YO
• vasomotor instability: hot flashes
• cardiovascular disease: incr. risk of atherosclerosis and MI
• Reproductive tract: uterus atrophy, vaginitis, vaginal atrophy&dryness, pain during intercourse, bladder atrophy leading to urethritis, frequency, urgency
• Bone: osteoporosis
• Behavior: depression, anxiety, irritability, fatigue

Estrogen + progesterone: neg side effects of breast cancer and cardiovascular disease, pos effects on osteoporosis and colorectal cancer

• rhythm and withdrawal methods, having few side-effects but a high failure rate
• barrier methods, some of which can also be used to help prevent the spread of sexuallytransmitted diseases (male and female condoms, diaphragm, cervical cap, spermicides)
• intrauterine devices (IUDs) that: prevent implantation of the blastocyst by inducing achronic inflammatory reaction in the endometrium; disrupt directed and coordinateduterine contractions, thereby preventing sperm movement towards fallopian tubes
• sterilization (vasectomy in men; tubal ligation in women)
• hormonal contraception
• abortion

• Estrogen and progestin
• Suppress LH surge/ovulation via steroid neg feedback
• >99% efficacy
• SE: thrombosis, PE, hemorrhagic stroke, impaired glucose tolerance, HTN - smoking worsens risks
• No good evidence for incr. risk of cancer. May decrease risk of uterine and ovarian cancer

• functional unit of the breast, complexity varies with hormonal status of woman
• acini: secretory epithelium w/basal nuclei + myoepithelial cells
• wall of terminal duct: inner layer simple cubiodal epithelium, outer layer myoepithelial cells
• intralobular stroma: loose
• extralobular stroma: denser, contains adipose
• TDLUs -> intralobular duct -> extralobular duct -> lactiferous duct

• part of broad ligament
• ends at ovarian germinal epithelium

• Germinal epithelium (simple cubiodal)
• tunica albuginea
• cortex: contains germinal cells
• medulla: contains branches of ovarian artery/vein, collagen fibers, elastic fibers, fibroblasts, sparse smooth muscle cells

• Uterine artery (carried in cardinal ligament): gives off 6-10 arcuate arteries
• Straight arteries: basal layer of endometrium
• Radial/helical arteries: functional layer of endometrium, degenerate during menstrual phase

• lose cell membranes to form syncytium
• invade endometrial stroma by proteolytic enzymes
• endometrial stroma cells become decidual cells
• syncytio. engulfs decidual cells, produce hCG to maintain corpus luteum

• lined by layer of epiblast cells
• eventually surrounds entire embryo
• baby drinks amnionic fluid for nutrients

• lining of blastocyst cavity - Heuser's membrane
• extraembryonic reticulum secreted by Heuser's membrane between cytotrophoblast and Heuser's
• extraembryonic mesoderm invades extraembryonic reticulum and divide it into 2 layers = chorionic cavity
• separates amnionic cavity from cytotrophoblast cells

• between amnion and yolk sac
• suspended in chorionic cavity by mesoderm called connecting stalk

• mom's blood comes from radial artery, squirts into intervillous space (fused lacunae)
• syncytiotrophoblast, cytotrophoblast, fibrous tissue, endothelial
• blood in fetal umbilical artery is deoxygenated; oxygenated blood returns to fetus in umbilical vein

• decidua basalis: between fetus and uterine wall -> becomes chorion frondosum by end of 8th wk
• decidua capsularis: superficial tissue overlying fetus -> becomes smooth chorion at the end of 8th wk
• decidua parietalis: remaining decidual tissue

• placenta covers the internal os
• painless bleeding @ 30wks gestation

• increased ratio of ER/PR on the uterine myometrium prior to the onset of labor.
• uterus is more sensitive to the stimulatory effects of estradiol on myometrial contractions.

• bulbospongiosus muscles
• superficial transverse perineal muscles
• deep transverse perineal muscles
• external anal sphincter

Inhibits the stimulatory effects of estrogen on uterine myometrial contractions, leading to a decrease in the magnitude and frequency of uterine contractions

prolactin is high, estrogen and progesterone are high and supress milk production until birth of baby