FEMALE REPRODUCTIVE

PHYSIOLOGY
Dr. Sachin Rathod
MBBS, MD Physiology
Professor
ISM, Bishkek
 OVERVIEW
I. Primary sex organs or ovaries
• The primary sex organs are a pair of ovaries which correspond with testes
in males.
• The main functions of ovaries are:
• To produce ova
• To secrete female sex hormones
II. Accessory sex organs
• The accessory sex organs of females include internal genital organs and
external genitalia.
 FEMALE INTERNAL GENITALIA
• The internal genital organs include uterus, fallopian tubes and vagina.
I. Uterus
• Uterus is a hollow, thick-walled muscular organ, situated between the urinary bladder and the
rectum.
• It can be divided into two parts:
• 1. Body of the uterus.
• It forms the upper 2/3rd part of the uterus.
• Its lower limit is marked by a constriction which corresponds to narrowing of uterine cavity at internal os.
• Body of the uterus can be divided into two parts:
• Fundus is the rounded part of the body that lies superior to the opening of the fallopian tubes.
• Isthmus is the relatively constricted region of the body (approximately 1 cm long) just above the cervix.
• 2. Cervix of the uterus.
• It is the cylindrical lower part which protrudes into the upper most vagina.
• It is approximately 2.5 cm long in an adult non-pregnant woman.
• Its cavity extends from the internal os to external os which opens into the vagina.
 STRUCTURE OF UTERUS
The wall of body of uterus is consisting of three layers:
• 1. Perimetrium is the external serosal layer.
• 2. Myometrium is the middle muscular layer
comprising bundles of smooth muscles amongst
which there is connective tissue.
• The muscle fibres run in various directions and
distinct layers are difficult to define.
• The muscle cells of the uterus are capable of
undergoing great elongation in association with the
great enlargement of organ in pregnancy.
• Contractions of myometrium are responsible for the
expulsion of the fetus at the time of child birth.
• 3. Endometrium is inner layer of uterus which
consists of epithelial lining and the stroma :
• Epithelial lining is made up of columnar cells.
• Stroma of the endometrium is highly cellular and
contains numerous blood vessels and numerous
simple tubular uterine glands.
Functional divisions of endometrium.
• Functionally, the endometrium of body of uterus can be divided into two strata:
• 1. Stratum functionale
• Includes the superficial two-thirds thickness of endometrium,
• Undergoes monthly cyclic changes in preparation for the implantation of fertilized
ovum
• Shed during menstruation.
• This portion of endometrium is supplied by long and spiral (coiled) arteries.
• 2. Stratum basale
• The deeper one-third layer of endometrium.
• It does not participate in the cyclic changes but functions as a regenerative layer.
• This part of endometrium is supplied by short and straight basal arteries.
 STRUCTURE OF CERVIX
1. Perimetrium is the outermost serous layer.
2. Myometrium layer
• Much less muscular as compared to the body of uterus and contains more connective tissue.
• During child birth, when the myometrium of body of uterus contracts, the myometrium of cervix dilates,
• consequently the cervical canal becomes large enough for the fetal head to pass through.
3. Endocervix
• refers to the innermost mucosal layer of cervix in contrast to the endometrium of the body of uterus.
• Endocervix is not shed at the time of menstruation.
• Endocervix consists of:
• Epithelium.
• The mucous membrane of the upper twothirds of cervical canal is lined by ciliated columnar epithelium,
• Lower one-third epithelium is non-ciliated columnar.
• Near the external os, the canal is lined by stratified squamous epithelium.
• Stroma.
• The stroma of the cervix is less cellular than that of the body of uterus.
 FALLOPIAN TUBES
• Each fallopian tube is approximately 10 cm in length and 8 mm in diameter.
• It has a medial or uterine end which is attached to and opens into the uterus and a lateral end opens into
the peritoneal cavity near the ovary.
Parts:
• 1. Uterine or interstitial part
• The most medial part which passes through the thick uterine wall.
• 2. Isthmus
• The relatively narrow and thick-walled part which is just next to the uterine part.
• It is about 2.5 cm in length.
• 3. Ampulla
• The next thin walled and dilated part of the uterine tube.
• It is the largest part (7 cm) of uterine tube.
• 4. Infundibulum
• The funnel-shaped lateral end of the tube.
• It is prolonged into a number of finger-like processes known as fimbria.
• One fimbria is longer than rest of the fimbriae and is attached to the outer pole of ovary.
Structure.
• Fallopian tubes consist of same three coats as of the uterus viz. endometrium,
myometrium and perimetrium.
Functions.
• The uterine tubes convey ova, shed by the ovaries, to the uterus.
• Ova enter the tube at its fimbriated end.
• The sperms enter the uterine tube at its medial end after traversing the vagina and
uterine cavity.
• Secretions present in the tubes provide nutrition, oxygen and other requirements for ova
and spermatozoa passing through the tube.
• Fertilization takes place in the ampulla and the fertilized ovum travels towards the uterus
through the tube.
• The ciliated epithelial cells lining the tube help to move ova towards the uterus.
 VAGINA
• The vagina is a musculomembranous tube (about 8–10 cm long) located anterior to the rectum and posterior to the urethra and
urinary bladder.
• Its upper end surrounds the lower part of the cervix and its lower end opens into the vestibule of vagina.
Structure.
• The wall of vagina consists of a mucous membrane, a muscle coat and an outer fibrous coat or adventitia.
• 1. Mucous membrane
• Shows numerous longitudinal folds.
• In adult female, the vaginal mucosa lined by stratified squamous epithelium.
• The epithelial cells are rich in glycogen and this property is estrogen dependent.
• 2. Muscle coat
• Made up of an outer layer of longitudinal fibres and a much thinner layer of circular fibres.
• Many elastic fibres are present among the muscle fibres.
• The lower end of vagina is surrounded by striated fibres of the bulbospongiosus muscle that form a sphincter for it.
• 3. Adventitial coat
• Surrounds the muscle coat and is made up of fibrous tissue containing many elastic fibres.
• Functions:
• It serves as the excretory duct for menstrual fluid,
• It forms the inferior part of pelvic (birth) canal,
• It receives the penis and ejaculate during sexual intercourse.
 FEMALE EXTERNAL GENITALIA
• The external genital organs include mons pubis, labia majora, labia minora, clitoris, vestibule of vagina, bulbs of
vestibule and greater vestibular glands.
Clitoris
• An erectile organ located where the labia minora meet anteriorly.
• The clitoris is analogous to male penis.
• It functions solely as an organ of sexual arousal.
Vestibule
• The space between the labia minora that contains the opening of urethra, vagina, and ducts of greater and
lesser vestibular glands.
• The vaginal orifice is surrounded by a thin fold of mucous membrane called hymen which is usually ruptured
after first intercourse.
• After child birth, only a few remnants of the hymen—hymenal caruncles (tags)—are visible.
• The vulva serves:
• As sensory and erectile tissue for sexual arousal and intercourse
• To direct the flow of urine
• To prevent entry of foreign material into the urogenital tract
OVARIES
 FUNCTIONAL ANATOMY
• A pair of ovaries is located behind and below the fallopian tubes.
• The ovaries are ovoid glands with a combined weight of 10–20 g during
reproductive years, which decreases with an increasing age.
• Each ovary is about 3–5 cm in length and is attached to the uterus by the
broad ligament and round ligament of ovary.
Structure
1. Germinal epithelium.
• The epithelium lining the outer surface of ovary and
consists of a single layer of cuboidal cells.
• It does not produce germ cells.
2. Cortex.
• The outer thick main part of the substance of the
ovary.
• It consists of following tissues:
• Tunica albuginea is the outer condensation of the
connective tissue present immediately below the
germinal epithelium.
• Stroma of the cortex, present deep to the tunica
albuginea, is made up of reticular fibres and numerous
fusiform cells that resemble mesenchymal cells.
• Ovarian follicles at various stages of development are
scattered in the stroma. Each follicle contains a
developing ovum.
3. Medulla.
• The inner small part of the
substance of ovary.
• It consists of connective tissue in
which numerous blood vessels
(mostly veins), smooth muscles and
elastic fibres are present.
4. Hilum.
• The area where ovary attaches to
mesentery.
• It is the site for entry of blood
vessels and lymphatics.
 FUNCTIONS OF OVARIES
• Gametogenic function, i.e. oogenesis
• Endocrine function, i.e. secretion of female hormones
 OOGENESIS
• Oogenesis refers to the process of formation of ova from the primitive germ cells.
• Primitive germ cells. When the bipotential gonads differentiate into ovaries in genetic female (44 + XX) embryo by
• 10th week of gestation, the primitive germ cells increase in number by mitosis to form oogonia.
• Oogonia are the stem cells from which ova are derived.
• The oogonia proliferate by mitosis to form primary oocytes.
• Primordial follicles. The diploid primary oocytes become enveloped by a single layer of flat granulosa cells and in this
form are called primordial follicles.
• After puberty, the oogenesis or formation of ovum occurs in a highly cyclic fashion, once every 28 days till
menopause.
• Every month, in each ovary, more than one primordial follicles start undergoing maturation process but only one
reaches maturity and the rest undergo atresia at different stages of development. Thus throughout the whole
• normal reproductive life of about 30 years (from 13–42
• years) about 450 ova are expelled and the remainder
• degenerate.
• The different stages of maturation of primordial follicle
• into graafian follicle (folliculogenesis) are described below.