CHAPTER 4

PHYSIOLOGY OF THE
REPRODUCTIVE SYSTEM
PROF. DR. MEHMET ZEKİ AVCI
 Ovum and Sperm
• Individual genetic traits are present in every body cell, but these traits
are passed from generation to generation by the ovum in the woman
and the spermium in the man.

• The process of mature ova and sperm developing from primary germ
cells in the gonads (undifferentiated sexual gland) is called oogenesis
and spermatogenesis.
 Ovum

• It is a large and immobile cell

with a diameter of 150-200
microns.
 Spermium
• It is a small and mobile cell 50-60 microns long. The head part has a
piercing feature. The life expectancy in the female body is 48-72
hours.
 HORMONAL CONTROL OF THE REPRODUCTIVE SYSTEM

• The edocrine functions work with positive and negative feedback.

• For example, estrogen from the ovarian hormones stimulates the

secretion of luteinizing hormone. This is positive feedback.

• An increase in the level of pogesterone in the blood suppresses the

lutenizing hormone. This is negative feedback.
 Hypothalamus-Pituitary-Over Relationship
• The anterior pituitary lobe secretes 3 hormones that affect the ovaries.
• These;
• Follicle Stimulating Hormone (FSH)
• Luteinizing Hormone (LH)
• Luteotropic Hormone (LTH)

• Because these three hormones act on the gonads, they are called
Gonodotropic Hormones (GTH).
• These hormones are controlled by Gonodotropin Releasing Hormone
(GnRH) secreted from the hypothalamus.
• Estrogen and progesterone
are secreted from the
ovaries under the influence
of gonadotropic hormones
in women.
 Pituitary Anterior Lobe Hormones

• Follicle Stimulating Hormone (FSH);

• FSH ensures the formation of spermatogenesis by maturing

the epithelium of the tubuli contrati seminiferous epithelium
of the testes in men.
• With puberty, FSH affects primary follicles in the ovaries and ensures
their development and maturation. An increasing amount of estrogen is
secreted from these follicles, which develop with the effect of FSH in
each cycle. The rise of estrogen in the blood causes FSH to fall.On the
1st day of the cycle, FSH is high and estrogen is low. On the 14th day,
estrogen is at its highest and FSH is at its lowest.
 Pituitary Anterior Lobe Hormones

• Luteinizing Hormone (LH);

• LH in men is called Interstitial Cell Stimulating Hormone

(ICSH) and it controls the production of testosterone from
interstitial cells in the testicles.
 Pituitary Anterior Lobe Hormones
• Luteinizing Hormone (LH);
• LH provides ovulation and the formation of the corpus luteum
together with FSH in women.

• In the days just before ovulation, the secretion of LH increases.

• This increase in LH level allows ovulation to occur.
• LH controls the formation of the corpus luteum after ovulation and the
secretion of the hormone progesterone.
• An increase in LH stimulates progesterone with positive
feedback, while an increase in progesterone suppresses LH
with negative feedback.
 Pituitary Anterior Lobe Hormones
• Luteotropic Hormone (LTH);
• The man has no role.
• LTH does not have much of a role in the normal cycle in women,
but rather plays a role in milk production in the breasts. Excess
secretion of this hormone in lactation suppresses FSH and stops
the development of follicles in the ovaries. Therefore, ovulation
and menstrual cycle are not seen in lactation.
• This hormone is also called Prolactin or Lactogenic Hormone.
HORMONES RELEASED FROM THE
REPRODUCTIVE SYSTEM

 Testosterone

 Estrogens

 Progesterone

 Prostaglandins
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Testosterone:
• Begins to be secreted in the second month of embryonic life
• Provides intrauterine development of the male reproductive
system
• Insufficient secretion in embryonic life causes
pseudohermaphroditism.
• Testosterone promotes the development of secondary sex
characteristics in the adolescent male.
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Estrogens:
• It is secreted less in children.
• But at puberty this amount increases 20 times.
• It provides the development of primary and secondary sex
characters.
• At puberty, breast enlargement, pubic and axillary hair growth,
deepening of the voice, and increase in fat deposits in the hips
and thighs occur with the effect of estrogen.
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Estrogens:
• It enables the development of the uterus, fallopian tubes,
vagina and external genitalia at puberty.

• It is secreted in increasing amounts during pregnancy, causing

vascularization and growth in cells of the uterus and vagina.
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• The drop in estrogen levels in menopause causes atrophy in

the reproductive organs.

• It increases the motility of the fallopian tubes and enables the

ovum to be transported from the ovaries to the uterus.

• It makes the breasts grow.

HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• The high level of estrogen in the blood suppresses the

hormone prolactin, which is secreted from the anterior
pituitary lobe and provides milk production.
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Progesterone:

• In the normal cycle, progesterone is secreted from the corpus

luteum.

• It regulates biochemical and morphological changes in the

secretory phase of the endometrium in the second half of the
cycle.
 HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• These changes are to prepare the body for pregnancy.

• Progesterone ensures the continuation of pregnancy by
preventing the destruction of the endometrium during
pregnancy.
 HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Under the influence of progesterone, the cervical glands

produce a thick mucus. Thus, the passage of sperm through
the cervical blood becomes difficult. (Contraceptive effect)
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Progesterone:

• It suppresses uterine contractions by neutralizing the

stimulating effect of estrogen on uterine contractions during
pregnancy.
• Prepares the breasts for lactation.
• Suppresses LH with negative feedback.It raises basal body
temperature. (It plays a role in detecting ovulation)
HORMONES RELEASED FROM THE REPRODUCTIVE SYSTEM

• Prostaglandins:
• It is secreted more in men than in women.
• The place of secretion is the seminal vesicle and the seminal
maiden is abundant.
• It is used in therapeutic abortion (abortion for therapeutic
purposes).
• Prostaglandins in the seminal maiden increase uterine mobility
during coitus and allow sperm to be transported to the tubes.
REPRODUCTIVE
CYCLE
 Ovarial Cycle
• When a girl is born, her ovaries contain about 500,000 primary
follicles containing oocyte I. They begin to respond to FSH after
7-8 years of age.

• With this development, little but gradually increasing amount

of estrogen begins to be secreted from the primary follicles.
 Ovarial Cycle
 Follicular Phase
 Ovulation
 Luteal Phase
Ovarial Cycle
• Follicular Phase;
• It lasts an average of 12-14 days. Towards the end of the desguamation
phase of the endomertrial cycle, many follicles begin to mature in the
ovaries.

• One follicle develops faster than the other and secretes a greater
amount of estrogen.At this time, two cell lines that differentiate
around the follicle develop, theca externa on the outside and theca
interna on the inside.
 Ovarial Cycle
• Follicular Phase;
• The oocyte within the follicle develops and becomes Graff's Follicle.

• Graff's follicle is the state of the follicle just before ovulation.

• The expulsion of oocyte II from the ovaries due to the increasing follicular
fluid pressure within the Graff follicle is called ovulation. Oocyte II is a
female sex cell with 23 chromosomes.
 Ovarial Cycle
• About the 12th-14th day of the ovulation cycle.

• At this time, the estrogen hormone is at its highest level in the

blood.

• The increase in the level of estrogen hormone in the blood

suppresses FSH with negative feedback and encourages the
secretion of LH. When these two hormones reach a certain level
in the blood, ovulation occurs.
 Ovarial Cycle
• Luteal Phase;
• In the first 3 days after ovulation, the remenant of
the follicle remaining in the ovary turns yellow, as
cholesterol accumulates in it, so it is called the
Yellow Body or Corpus Luteum.

• More progesterone and less estrogen are secreted

from the corpus luteum.

• The 21st day of the cycle, that is, at the time of

implantation of the fertilized ovum into the uterus,
is the most mature time of the corpus luteum.
 Ovarial Cycle
• If the ovum has not been fertilized, the corpus luteum regresses
one week after ovulation.

• With the complete regression of the corpus luteum and the

withdrawal of estrogen and progesterone hormones, the
endometrium is destroyed and menstruation begins.
Endometrial Cycle
• A second cycle occurs in the endometrium prepared for implantation of
the fertilized ovum.

• The endomertium has 3 layers: Zona basalis, zona spongiosa and zona
campata.

• functional layer; zona spongiosa + zona compata

• It is the layer where monthly changes are seen and shed with
menstruation.
 Endometrial Cycle
• Proliferative Phase;
• Following menstruation, the
functional layer is rebuilt from the
basal layer. The hormone that
provides this structure is estrogen.

• The proliferative phase of the

endometrium occurs in the
follicular phase of the ovarian
cycle.
 Endometrial Cycle
• In this phase, the epithelium of the endometrium continues
until ovulation. Glands lengthen, vascularization increases.
Endometrial Cycle
• Secretory Phase;
• After ovulation, the endometrium
continues to thicken with the effect of the
hormone progesterone secreted from the
corpus luteum.

• Endometrial glands secrete mucus to meet

the needs of the fertilized ovum.
 Endometrial Cycle
• The secretory phase is under the control of progesterone due
to the luteal phase of the ovarial cycle.

• On the 21st day, one week after ovulation, the endometrium is

ready for the fertilized ovum to implant.

• If fertilization does not occur, ischemia occurs in the functional

layer.
 Endometrial Cycle
• Menstrual Phase;

• When the corpus luteum degenerates, the hormones it produces are not
secreted, and as a result, the endometrium begins to regress and
menstruation is confirmed.

• With the decrease in the level of estrogen and progesterone in the blood,
spasm is seen in the spiral arteries in the endometrium.
 Endometrial Cycle
• Blood flow decreases and ischemia occurs.
• The necrotized functional layer is poured into the uterine cavity, causing the
initiation of uterine contractions and is excreted vaginally.
• So menstruation takes place.
 Endometrial Cycle
• Normal menstruation lasts 2-7 days.
• Again, the amount of blood lost during a normal menstruation
varies between 30-100 cc.
• A normal menstrual cycle occurs every 28 days.(However,
between 22-30 days is considered normal)
• The cycle may sometimes be interrupted due to physical and
psychological factors.
• Menstrual blood does not clot.
Physical Symptoms in the Menstrual Phase

premenstrual Tension
Edema
dysmenorrhea