Physiology department1 Physiology of reproduction. Define footer – presentation title / department2 Hypothalamus – hypophysis – gonads 3 Hypothalamus – hypophysis – gonads Testosterone functions 5 Hypothalamus – hypophysis – gonads Define footer – presentation title / department6 Puberty Menstrual cycle Ovarian cycle Endometrial cycle 10 Contraceptives BARRIER CONTRACEPTIVES: • condoms • contraceptive sponges with spermicide • diaphragms • cervical caps HORMONAL: • oral pills • implants under the skin • injections • patches • IUDs • vaginal ring INTRAUTERINE DEVICES: • copper IUDs • IUD with levonorgestrel STERILIZATION: • tubal ligation • vasektomy BEHAVIORAL: • fertility awareness methods • coitus interruptus • lactation 11 Oral pills 0,4 0 0,1 0,2 0,3 1 7 14 21 28 day P E 12 Oral pills 13 Oral pills ̶ Inhibition of Ovulation ̶ Estrogen suppresses the secretion of follicle-stimulating hormone (FSH) from the pituitary gland. This prevents the development of dominant follicles in the ovaries. ̶ Progestin suppresses luteinizing hormone (LH) secretion, blocking the LH surge necessary for ovulation. ̶ Thickening of Cervical Mucus ̶ Progestin increases the viscosity of cervical mucus, making it difficult for sperm to penetrate through the cervix and reach the egg. ̶ Endometrial Alteration ̶ Progestin induces changes in the uterine lining (endometrium), making it thinner and less receptive to implantation of a fertilized egg. ̶ Slowing Tubal Motility ̶ pH changes ̶ Alteration of Cervical Mucus Composition: ̶ Impact on Vaginal Microbiota (lactobacilli) 14 Benefits and riscs of HC reducing the risk of total cancer by 12%: ― ovarian cancer ― endometrial cancer ― colorectal cancer ― ovarian cysts acne ― venous thromboembolism (VTE) ― arterial thrombosis (AT) ― breast cancer ― diseases associated with VTE and AT 15 Functions of the PLACENTA ̶ TRANSPOR function ̶ Respiratory gases ̶ transport and metabolism of sacharides ̶ transport and metabolism of aminoacods ̶ transport and metabolism of fat ̶ transport of H2O, minerals and vitamines ̶ ENDOCRIN function ̶ Estrogens ̶ Progesteron ̶ HCG ̶ HPL ̶ Growth factors (epidermal and insulin-like growth factors) ̶ PROTECTIV function ̶ Cytochrom P450 ̶ Pinocytosis (IgG) ̶ Barier against bacterias, virus etc. 16 HCG 1 2 3 4 8 12 16 20 24 28 32 36 40 HCG (Human Chorionic Gonadotropin) ― Glycoprotein ― secreted by the syncytial trophoblast cells ― prevents involution of the corpus luteum ― prevent menstruation and cause the endometrium to continue to grow ― can first be measured in the blood 8 to 9 days after implantation ― effect on the fetal testes ― ↓ - ectopic pregnancy, dead fetus ― ↑ - multiple pregnancy and diagnosis of trisomy 21 - Down syndrome 17 HCG 18 RX 1 2 3 4 8 12 16 20 24 28 32 36 40 RX RX (Relaxin) ― relaxes the pubic symphysis and other pelvic joints and softens ― dilates the uterine cervix ― mediate hemodynamic changes (pregnancy) 19 RX 20 HCS/HPL HCS/HPL 1 2 3 4 8 12 16 20 24 28 32 36 40 HCS (Human Chorionic Somatomammotropin) placental growth hormone - Human placental lactogen (hPL) ― has weak actions similar of growth hormone ― causes retention of nitrogen, potassium, calcium ― causes decreased insulin sensitivity and decreased utilization of glucose in the mother ― secretion of this hormone increases progressively in direct proportion to the weight of the placenta 21 PROL 1 2 3 4 8 12 16 20 24 28 32 36 40 PROL PROL (Prolactin) luteotropic hormone or luteotropin ― stimulates the mammary glands to produce milk (lactation) ― provides the body with sexual gratification after sexual acts ― plays an important role in maternal behavior ― inhibits maturation of ovum 22 OX 1 2 3 4 8 12 16 20 24 28 32 36 40 OX OX (Oxytocin) ― secreted by the neurohypophysis (nucleus paraventricularis) ― causes uterine contraction ― mediates the let-down reflex 23 OX 24 Progesteron P 1 2 3 4 8 12 16 20 24 28 32 36 40 P (Progesteron) ― causes decidual cells to develop in the uterine endometrium ― decreases the contractility of the pregnant uterus ― contributes to the development of the conceptus even before implantation ― prepares the mother’s breasts for lactation 25 Estroen E 1 2 3 4 8 12 16 20 24 28 32 36 40 E (Estrogen) ― enlargement of the mother’s uterus ― enlargement of the mother’s breasts and growth of the breast ductal structure ― and enlargement of the mother’s female external genitalia ― relax the pelvic ligaments of the mother ― dampen the formation of the pituitary gonadotropins - not mature further follicles, miss menstrual cycles 26 HCG P E HPL 1 2 3 4 8 12 16 20 24 28 32 36 40 PROL OX RX 27 UTERINE RELAXATION PROGESTERONE ESTROGEN CRH PGs OT RLX UTERINE CONTRACTIONS (+) (-) CERVICAL RIPENING CERVICAL RIGIDITY Phases of uterine activity. A listing of the various agents involved during: quiescence (phase 0), activation (phase 1), stimulation (phase 2) and involution (phase 3) of the uterus during pregnancy are represented. PGI2: prostacyclin; PTHrP: parathyroid hormone related peptide; and CRH: corticotrophin-releasing hormone. 29 FETOPLACENTAL UNIT MATERNAL COMPARTMENT hypotalamus neurohypophysis oxytocin cortisol FETUS cortisol hypotalamus adenohypophysis ardenal glands cortisol CRH ACTH (preparation of fetal organs) cortisol uterus PGs placental OT estrogens cholesterol placental CRH (vazodilation of the placenta) PARTURITION Fetoplacental unit 30 Lactation 31 Physiological changes during pregnancy 32 THANK YOU FOR YOUR ATTENTION