CHAPTER 2 Physiology CHAPTER 2 Physiology of the female genital of the female genital

systemsystem Sec.1 physiologic characteristics in different staSec.1 physiologic characteristics in different sta

gesges Sec.2 menstruation and its manifestationSec.2 menstruation and its manifestation Sec.3 ovarian cycleSec.3 ovarian cycle Sec.4 cyclical changes of endometrium and othSec.4 cyclical changes of endometrium and oth

er genital organser genital organs Sec.5 endocrine mechanismSec.5 endocrine mechanism Sec.6 other glands of endocrine sys.Sec.6 other glands of endocrine sys.

Section 1 Physiologic characteristics of Section 1 Physiologic characteristics of female in different stagesfemale in different stages

（一）（一） neonatal periodneonatal period ：： <4w<4w （二）（二） childhoodchildhood ：： 4w→10y4w→10y （三）（三） adolescenceadolescence 11 ． ． General developmentGeneral development 22 ． ． Genital developmentGenital development 33 ． ． The 2nd sexualityThe 2nd sexuality 44 ． ． menarchemenarche

（四）（四） sexual maturitysexual maturity ：≥：≥ 18y18y sex-hormone secretion;periodic ovulationsex-hormone secretion;periodic ovulation （五）（五） climacteric periodclimacteric period ：： 45y→52y, oligome45y→52y, oligome

norrhea→menopausenorrhea→menopause DefDef ：： interval from the decline of ovarian funcinterval from the decline of ovarian func

tion and the atrophy of genital organs to the cetion and the atrophy of genital organs to the cease of genital function . ase of genital function .

（六）（六） senilitysenility ：： the further decline of ovarian the further decline of ovarian function .function .

manifestationmanifestation ：： cholesterol↑cholesterol↑ ，， muscular atrmuscular atrophyophy ，， decalcificationdecalcification ，， concentric deposit oconcentric deposit of fat. f fat.

Section 2 Menstruation and its Section 2 Menstruation and its manifestationmanifestation

11 ． ． menstruationmenstruation ：： regularregular ，， periodic bleeding periodic bleeding of uterus.one of the external mark of genital matuof uterus.one of the external mark of genital maturity.rity.

22 ． ． menarchemenarche ：： the first menstruationthe first menstruation ，， 13-15y13-15y 33 ． ． Menstrual cycleMenstrual cycle ：： the interval between two sthe interval between two s

uccessive menstruation onsetuccessive menstruation onset ，， 28-30d.28-30d. 44 ． ． Duration and amount of the flowDuration and amount of the flow ：： 2-7d2-7d ，， 33

0-80ml0-80ml 55 ． ． About menstrual bloodAbout menstrual blood ：： dark-reddark-red ，， partiallpartiall

y hemolyzed blood with mucus and cellular debrisy hemolyzed blood with mucus and cellular debris 6.CM.during menstrual cycle:pelvic discomfort6.CM.during menstrual cycle:pelvic discomfort

Section 3 Ovarian cycleSection 3 Ovarian cycle （一） （一） functionfunction ① ① genital→periodic ovulationgenital→periodic ovulation ② ② endocrine→sex-hormone secretionendocrine→sex-hormone secretion （二）（二） cyclical changescyclical changes 1. Development and maturation of follicle1. Development and maturation of follicle ① ① primitive follicleprimitive follicle：： oogonium surrounded by spinoogonium surrounded by spin

dle or flat cellsdle or flat cells ② ② developing follicledeveloping follicle ：： spindle cells→granulosa celspindle cells→granulosa cel

ls;interstitial cells→theca folliculi cellsls;interstitial cells→theca folliculi cells ③ ③ mature folliclemature follicle：： theca folliculi externa/interna,grtheca folliculi externa/interna,gr

anulosa cellsanulosa cells ，， follicle cavityfollicle cavity ，， cumulus oophorus,cumulus oophorus,zone pellucida,radiate zone,ovumzone pellucida,radiate zone,ovum

22 ．． Ovulation:mem.ruptured,ovum releasedOvulation:mem.ruptured,ovum released 33 ．． corpus corpus luteumluteum ：： ovulation→corpus rubrovulation→corpus rubr

um→mature corpus luteumum→mature corpus luteum （（ granulosa-corpgranulosa-corpus luteum cellsus luteum cells ，， theca-corpus luteum cellstheca-corpus luteum cells ））

4.decline of corpus luteum4.decline of corpus luteum ：： 12-16d→8-10w→12-16d→8-10w→corpus albicanscorpus albicans

(( 三三 ))sex hormonesex hormone:estrogen is produced by the:estrogen is produced by theca folliculi cells and granulosa cells before ovulca folliculi cells and granulosa cells before ovulation;estrogen and progesterone is produced bation;estrogen and progesterone is produced by corpus luteum. y corpus luteum.

1.physiologic action of estrogen.1.physiologic action of estrogen. (1)the second sexuality’s appearance.(1)the second sexuality’s appearance.

(2)action on external genital organs(2)action on external genital organs hypertrophy of uterus,fallopian tubes and lower ghypertrophy of uterus,fallopian tubes and lower g

enital tract at puberty;hypertrophy and increased enital tract at puberty;hypertrophy and increased vascularity in pregnancy.vascularity in pregnancy.

Controlling the monthly proliferative phases of thControlling the monthly proliferative phases of the endometrium.e endometrium.

Sensitizing uterus to the action of oxytocin.Sensitizing uterus to the action of oxytocin. Causing vaginal epithelium to proliferate with a inCausing vaginal epithelium to proliferate with a in

crease in thickness of the superficial stratified laycrease in thickness of the superficial stratified layers and a increase in their glycogen content.ers and a increase in their glycogen content.

Cervical orifice is loosened and cervical glands seCervical orifice is loosened and cervical glands secrete an abundance of mucus.crete an abundance of mucus.

Increasing the motility of the fallopian tubes to help tIncreasing the motility of the fallopian tubes to help the transport of ovum from ovary to uterus.he transport of ovum from ovary to uterus.

Necessary for the development of the follicles.Necessary for the development of the follicles. (3)relation to menstruation.(3)relation to menstruation. estrogen↑→proliferation and vascularity of endomet

rium;FSH↑,LH↑↑→follicle developing and ovulation(if no pregnancy)→withdrawl in the 4th week→shrinkage of endometrium and vasoconstriction of deeper coiled aterioles→the vessels relax intermittently→menstrual bleeding

(4)action on the breasts(4)action on the breasts enlarging breasts by the proliferation of the ducts; pigenlarging breasts by the proliferation of the ducts; pig

mentation of nipple and areolamentation of nipple and areola

(5)action on metabolism(5)action on metabolism sodium and water retention;cholesterol decrease.sodium and water retention;cholesterol decrease. (6)action on the bone:Ca(6)action on the bone:Ca2+2+-deposit on the bones-deposit on the bones (7)hormone-feed-back action(7)hormone-feed-back action 2.physiologic action of progesterone2.physiologic action of progesterone (1)action on the internal genital organs(1)action on the internal genital organs inhibiting the sensitivity of uterus;inhibiting the sensitivity of uterus; leading to the secretary phase of endometrium;leading to the secretary phase of endometrium; cervical orifice closed;cervical orifice closed; inhibiting the motility of the tubes;inhibiting the motility of the tubes; causing the desquamation of vaginal epithelium.causing the desquamation of vaginal epithelium. (2)action on breasts(2)action on breasts causing the development of the acinuscausing the development of the acinus

(3)feed-back action:negative(3)feed-back action:negative (4)action of temperature-rising on Hypothalamus (4)action of temperature-rising on Hypothalamus (5)Action on metabolism(5)Action on metabolism causing Nacausing Na++ and water excreted and water excreted

Sec.4 cyclical changes of endometrium Sec.4 cyclical changes of endometrium and other genital organsand other genital organs

(( 一一 ))endometrial cycleendometrial cycle 1.proliferative phase:soon after menstrua1.proliferative phase:soon after menstrua

tion,the low cuboidal surface epithelium ction,the low cuboidal surface epithelium covers the denuded area under the influenovers the denuded area under the influence of estrogen the cells of the surface and ce of estrogen the cells of the surface and glandular epithelium become taller and mglandular epithelium become taller and more columner,the glands elongated,widenore columner,the glands elongated,widened and more tortuous.ed and more tortuous.

2.secretory phase:although the surface epithelium re2.secretory phase:although the surface epithelium remains unaltered from that of the proliferative phase ,tmains unaltered from that of the proliferative phase ,the cells of the glandular epithelium show specific chahe cells of the glandular epithelium show specific changes(the glands more tortuous and twisted,the hypernges(the glands more tortuous and twisted,the hypertrophy of stroma cells continues,the arterioles growintrophy of stroma cells continues,the arterioles growing spirally into the functional layer become more coileg spirally into the functional layer become more coiled.)d.)

3.menstrual phase:toward the end of the cycle ,E3.menstrual phase:toward the end of the cycle ,E22 and and P P ↓→rapid decrease in the thickness of endometrium due to a diminished blood-supply,in the ischaemic functional zone metabolites↑and cause the coiled vessels in functional layer to contract →bleeding through their necrotic walls with desquamation following the necrosis of the functional layer →an

Intrauterine coagulum which is subsequently dissolved by thrombolysin and discharged as menstrual fluid.Intrauterine coagulum which is subsequently dissolved by thrombolysin and discharged as menstrual fluid. (( 二二 ))cyclical changes of other sites of genital tract.cyclical changes of other sites of genital tract. 1.1.vaginal epitheliumvaginal epithelium (1)before ovulation:estrogen(1)before ovulation:estrogen↑→hypertrophy of basal cells and thickness of epithelium↑ (2)after ovulation: progesterone↑ →desquamation of epithelial cells. 2.cervical mucus. (1)before ovulation:estrogen↑→amount↑,thin and translucent,liable to wiredrawing,fern-like crystals in mucous s

mear.

1. 1. 阴道粘膜的周期性变化阴道粘膜的周期性变化 .. 2. 2. 宫颈粘液的周期性变化宫颈粘液的周期性变化 3. 3. 输卵管的周期性变化输卵管的周期性变化 .. 第五节下丘脑第五节下丘脑 -- 垂体垂体 -- 卵巢轴的相互关系卵巢轴的相互关系

(2)After (2)After ovulation:progesteroneovulation:progesterone↑→amount↓, thick and turbid,ellipsoid in mucus smear.

Sec.5 the H-P-O axis in the menstrual cycle

Feed-back mechanism

hypothalamus

pituitary

ovary

uterrus

Endometrial cycle

Vaginal epithelium

Primitive follicle

Mature follicle

Corpus luteum

ovulationCorpus-luteum formation