Lec: 12 Dr.Sajida
Indicators of ovulation:
1. Rise in body temperature occur in luteal phase (0.2-0.5c) due to
thermogenic effect of progesterone.
2. Abdominal pain.
3. Cervical mucous in slippery and copious.
4. Finding of spinnbarkeit positive (increase stretch).
5. Breast tenderness.
6. Mood change.
7. Finding of a secretory pattern in a biopsy of endometrium indicates
functioning of corpus luteum.
Uterine Cycle:
Uterine changes during the menstrual cycle include: proliferate phase and
secretory phase.
Proliferate phase (estrogen phase):
At the beginning of each menstrual cycle, most of the endometrium is
desquamated by menstruation, after menstruation only a thin layer of
endometrial stromen remains, under the influence of estrogen secreted by
the ovary, the stromal cells and the epithelial proliferate rapidly, the
endometrium is re-epithelized within 4-7 days after the beginning
menstruation, then during the next week and the half that is before
ovulation, the endometrium increase greatly in thickness due to increase
the number of stromal cells and progressive growth of endometrial glands
and the new blood vessels in the endometrium. At the time of ovulation,
the endometrium is about 3-4 mm thick, the endometrial glands
especially the cervical region secrete thin mucus.
Cervical changes:
Under effect of estrogen, thin alkaline mucous secreted that help in the
transport of sperm, spinnbarkeit positive. Fern like pattern when a thin
layer spread over the slide.
Secretory Phase:
Occur after ovulation when large quantities of estrogen and progesterone
secreted by corpus luteum, estrogen causes proliferation of endometrial
cells while progesterone causes marked swelling secretory development
of endometrium, the glands increase in tortuosity, blood vessels become
highly tortuous, at the peak of the secretory phase about 1 week after
ovulation, the endometrium is 5-6 ml thick, cervical mucous becomes
thick tenacious and cellular and fail to form fern pattern.
Function of estrogen
1- Effect on the uterus and external sex organs: at puberty estrogen
causes increase in size of uterus, fallopian tubes and vagina, the
external genitalia increase in size and deposition of fat in mons
pubis, labia majora and enlargement of labia minora. In addition
estrogen changes the vaginal epithelium into stratifies type which
is resistant to infection, also estrogen causes markes proliferation
of endometrium and development of endometrial glands.
2- Effect of fallopian tube: Estrogen causes proliferation of glandulat
tissues and increase the number of ciliated epithelial cells that line
the tubes which help in propel the fertilized ovum towards the
uterus.
3- Effect on the breast: Estrogen causes development of stromal
tissues and growth of ductile system, also deposition of fat it the
breast.
4- Effect on bones: Estrogen causes increase osteoblastic activity and
causes early unity of epiphysis with the shaft of long bones, that is
why the growth of female stops earlier than male.
5- Estrogen causes slight increase in the total body protein.
6- Estrogen increase BMR (Bone Marrow Rate) to about 1/3 less than
testosterone in male.
7- Estrogen causes deposition of fat in subcutaneous tissue in the
buttock and thighs.
8- Estrogen causes the development of pubic region and axillary hair.
9- Estrogen causes the skin to become smooth, soft, more vascular
and warm.
10-
Estrogen causes sodium and water retention by kidney
tubules.
Functions of progesterone:
1- It promotes secretory changes in the uterine and endometrium
during the later half of female sexual cycle thus preparing the
uterus for implantation of the ovum, also it decreases the frequency
and intensity of uterine contractions.
2- It promotes secretory changes in the mucosal lining of fallopian
tubes in which is necessary for nutrition of fertilized ovum.
3- It helps development of lobules and alveoli of the breast causing
alveolar cells to become secretory, also causes the breast to swell.
4- It enhances sodium, chloride and water reabsorption by kidney
tubules, competes with aldosterone on the same receptor protein
that causes transport of sodium through the tubules and prevent
aldosterone form binding.
Vaginal Cycle
Under influence of estrogen, the vaginal epithelium becomes cornified
and under influence of progesterone, a thick mucous is secreted and the
epithelium proliferates and become infiltrated with leukocytes.