The Endocrinology of the Menstrual Cycle
The Endocrinology of the Menstrual Cycle
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DOI：
10.1007/978-1-4939-0659-8_7
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发表时间：
2014-01-01
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影响因子：
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通讯作者：
Barbieri, Robert L.
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文献类型：
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作者：
Barbieri, Robert L.
排卵性月经周期是下丘脑、垂体、卵巢和子宫内膜综合作用的结果。就像一个节拍器，下丘脑通过脉冲式释放促性腺激素释放激素（GnRH）为月经周期设定节拍。GnRH脉冲在周期的卵泡期每1 -1.5小时出现一次，在周期的黄体期每2-4小时出现一次。脉冲式GnRH分泌刺激脑垂体分泌促黄体激素（LH）和促卵泡激素（FSH）。垂体将下丘脑设定的克里思转化为信号，LH和FSH分泌，这可以被卵泡理解。卵泡由三个关键细胞组成：卵泡膜细胞、颗粒细胞和卵母细胞。在卵泡中，LH刺激卵泡膜细胞产生雄烯二酮。在小窦卵泡的颗粒细胞中，FSH刺激芳香化酶（Cyp 19）的合成，该酶催化卵泡膜衍生的雄烯二酮转化为雌二醇。由大的优势窦卵泡产生的雌二醇的临界浓度在下丘脑中引起正反馈，可能通过kisspeptin系统，导致GnRH分泌增加和LH激增。LH峰导致排卵过程的开始。排卵后，卵泡转化为黄体，黄体在LH或绒毛膜促性腺激素（hCG）的刺激下分泌孕酮。孕激素为子宫内膜的着床做好准备。雌二醇刺激子宫内膜增殖。雌激素和孕激素使子宫内膜分化为分泌上皮。在周期的黄体中期，当黄体酮产生达到峰值时，分泌期子宫内膜为胚胎着床做好了最佳准备。在图1中提供了协调月经周期所涉及的复杂相互作用的图示。
The ovulatory menstrual cycle is the result of the integrated action of the hypothalamus, pituitary, ovary, and endometrium. Like a metronome, the hypothalamus sets the beat for the menstrual cycle by the pulsatile release of gonadotropin-releasing hormone (GnRH). GnRH pulses occur every1-1.5 h in the follicular phase of the cycle and every 2-4 h in the luteal phase of the cycle. Pulsatile GnRH secretion stimulates the pituitary gland to secrete luteinizing hormone (LH) and follicle stimulating hormone (FSH). The pituitary gland translates the tempo set by the hypothalamus into a signal, LH and FSH secretion, that can be understood by the ovarian follicle. The ovarian follicle is composed of three key cells: theca cells, granulosa cells, and the oocyte. In the ovarian follicle, LH stimulates theca cells to produce androstenedione. In granulosa cells from small antral follicles, FSH stimulates the synthesis of aromatase (Cyp19) which catalyzes the conversion of theca-derived androstenedione to estradiol. A critical concentration of estradiol, produced from a large dominant antral follicle, causes positive feedback in the hypothalamus, likely through the kisspeptin system, resulting in an increase in GnRH secretion and an LH surge. The LH surge causes the initiation of the process of ovulation. After ovulation, the follicle is transformed into the corpus luteum, which is stimulated by LH or chorionic gonadotropin (hCG) should pregnancy occur to secrete progesterone. Progesterone prepares the endometrium for implantation of the conceptus. Estradiol stimulates the endometrium to proliferate. Estradiol and progesterone cause the endometrium to become differentiated to a secretory epithelium. During the mid-luteal phase of the cycle, when progesterone production is at its peak, the secretory endometrium is optimally prepared for the implantation of an embryo. A diagrammatic representation of the intricate interactions involved in coordinating the menstrual cycle is provided in Fig. 1.