OVARIAN AND UTERINE
CYCLES
By: Dr. Mujahid Khan
Female Reproductive Cycles
• Starts at puberty
• Normally continues until the reproductive
years
• Sexual or reproductive cycle involves
activities of hypothalamus, pituitary gland,
ovaries, uterus, uterine tubes, vagina and
mammary glands
GnRH
• Gonadotropin-releasing hormone (GnRH)
is synthsized by neurosecretory cells in
the hypothalamus
• Carried to the anterior pituitary gland by
hypophysial portal system
• Stimulates the release of 2 hormones
produced by this gland that act on ovaries
FSH
• Follicle-Stimulating Hormone stimulates
the development of ovarian follicles
• Production of Estrogen by the follicular
cells
LH
• Luteinizing Hormone serves as the trigger
for ovulation
• Stimulates the follicular cells and corpus
luteum to produce progesterone
OVARIAN CYCLE
• FSH and LH produce cyclic changes in
ovaries called Ovarian Cycle
• They cause development of follicles,
ovulation and corpus luteum formation
Follicular Development
• Growth and differentiation of primary
oocyte
• Proliferation of follicular cells
• Formation of Zona Pellucida
• Development of the Theca Folliculi
Theca Folliculi
• Formed as the primary follicle increases in
size and the adjacent connective tissue
organizes into a capsule
• Theca Interna: Internal, vascular and
glandular
• Theca Externa: A capsule like layer
Antrum
• Is a large fluid filled cavity appears around
the follicular cells of ovarian follicle
• Contains follicular fluid
• Ovarian follicle now called a vesicular or
secondary follicle
Cumulus Oophorus
• The primary oocyte is pushed aside of the
follicle called Cumulus Oophorus
• Here it is surrounded by a mound of
follicular cells
• It projects into the antrum
• The follicle becomes enlarge until it gets
maturity
• Produces swelling on the surface of the
ovary
• Early development of ovarian follicle is
induced by FSH
• Final stages of maturation require LH
Estrogen
• Growing follicles produce estrogen
• It regulates the development and functions
of reproductive organs
• Vascular theca interna also produces
some estrogen
Ovulation
• It occurs around mid cycle about 14 days
in a 28 day menstrual cycle
• Ovarian follicle undergoes sudden growth
spurt under the influence of FSH & LH
• Producing swelling or a bulge on Ovarian
surface
• An avascular spot appears on this swelling
called Stigma
Ovulation
• Cumulus Oophorus detach from interior of the
distended follicle
• It is triggered by a surge of LH production
• It usually follows the LH peak 12-24 hrs
• LH Surge causes the stigma to balloon out
forming a vesicle
• The stigma ruptures and expel secondary oocyte
with the follicular fluid
Ovulation
• Expulsion of oocyte results from raised
intrafollicular pressure
• The expelled secondary oocyte is
surrounded by Zona Pellucida and layers
of follicular cells called Corona Radiata
• Zona Pellucida is composed of 3
glycoproteins ZPA, ZPB & ZPC
Corpus Luteum
• After ovulation the walls of the ovarian follicle
and theca folliculi collapse and thrown into
folds called Corpus
Luteum
Corpus Luteum
• It secretes Progesterone and some estrogen
• These hormones stimulate endometrial glands
to secrete and prepare endometrium for
implantation of fertilized Ovum (Blastocyst)
• If the oocyte is fertilized the CL enlarges
• If the oocyte is not fertilized the CL involutes
and degenerates in 10-12 days
Uterine or Menstrual Cycle
• It is the period during which the oocyte
matures, is ovulated and enters the uterine
tube
• Cyclic changes in the endometrium
caused by estrogen and progesterone
• These changes occur in the internal layer
of the Uterus
Menstrual Cycle
• Average menstrual cycle is 28 days
• Day 1 is the day when menstrual flow
begins
• It vary in length by several days in normal
women
• Ranges between 23 and 35 days in 90%
of women
Phases of Menstrual Cycle
• Menstrual Phase
• Proliferative Phase
• Luteal Phase
• Ischemic Phase
Menstrual Phase
• Starts with 1st day of menstrual cycle
• Lasts for 4-5 days
• Functional layer of uterine wall is sloughed
off and discarded with the menstrual flow
• Blood discharge from vagina is combined
with small pieces of endometrial tissue
Proliferative Phase
• Is a phase of repair and proliferation
• Lasts for 9 days
• Coincides with growth of ovarian follicle
• Controlled by estrogen secreted by follicles
• 2-3 fold increase in thickness of endometrium
• The glands increase in number and length and the
spiral arteries elongate
Luteal Phase
• Is a secretory or progesterone phase
• Lasting about 13 days
• Coincides with formation, functioning and growth of
corpus luteum
• Glandular epithelium secrete glycogen rich material
• Endometrium thickens under the influence of estrogen
and progesterone
Luteal Phase
• Spiral arteries grow into the superficial
layer
• Arteries become increasingly coiled
• Large venous network develops
• Direct arterio-venous anastomoses are the
prominent features
If Fertilization Occurs
• Fertilized ovum implants in endometrium
on about 6th day of this phase
• HCG hormone secreted by
syncytiotrophoblast keeps the corpus
luteum secreting estrogen and
progesterone
• The luteal phase continues and
menstruation does not occur
If Fertilization Doesn’t Occur
• No HCG
• Corpus luteum degenerates
• Estrogen and progesterone levels fall
• Secretory endometrium enters an ischemic
phase
• Menstruation occurs
Ischemic Phase
• Decreased levels of estrogen & progesterone
• Stoppage of glandular secretion
• Loss of interstitial fluid
• Marked shrinking of endometrium
• Spiral arteries become constricted
• Venous stasis & Ischemic necrosis
• Rupture of damaged vessel wall
• Blood seeps into the surrounding connective
tissues
Ischemic Phase
• Pools of blood form and break through the
endometrial surface
• Resulting in bleeding in uterine lumen and
from the vagina
• Loss of 20-80 ml of blood
• Entire compact layer and most of the
spongy layer of endometrium is discarded
Pregnancy Phase
• If pregnancy occurs, endometrium passes
into the pregnancy phase
• Menstruation cycle resumes 6-10 weeks
after the termination of pregnancy
• Menopause usually occurs between the
ages of 48-55
• Termination of reproductive period causes
psychic changes called Climacteric
Anovulation
• Some women do not ovulate
• Inadequate release of gonadotropins (FSH
& LH)
• Ovulation can be induced by clomiphene
citrate
• This stimulates pituitary to secrete
gonadotropins
• Causes multiple ovulation
• Multiple pregnancies
• Spontaneous abortions
