DYNAMICS OF THE FEMALE REPRODUCTIVE SYSTEM AND CHANGES WITH AGING
Janet E. Hall, MD
Reproductive Endocrine Unit Department of Medicine Massachusetts General Hospital Boston, MA
Follicular Phase
Luteal Phase
FSH LH
primary antral ovarian follicles dominant ovulation corpus luteum
E2 Prog Endo
Proliferative Secretory
GnRH
LH FSH
Inhibin A Inhibin B Estradiol Progesterone
Hall JE. Yen and Jaffe’s Reproductive Endocrinology 2004
Mid-Cycle Surge Early/Mid/Late Follicular Phase LFP
40
200
Early/Mid/Late Luteal Phase ELP
40 0
0
MFP
40
0
MLP
40 0
EFP
40 0
0
LH FSH E2
P 4
LLP
40 0
MENSES
Hall JE et al, Nutrition and Reproduction 1998. .
Variability in Androgen Levels Across the Menstrual Cycle
150 Testosterone (ng/dL) 200
N = 68
150 100
SHBG (nmol/L)
100
**
50
50 0 Androstenedione (ng/mL)
0 6 5 4 3 2 1 0 EFP MCS MLP
*
1.25 1.00 0.75 0.50 0.25 0.00
Free T (ng/dL)
**
EFP
MCS
MLP
Adams JM., Taylor AE, Crowley WF, Hall JE J Clin Endocrinol Metab Aug 2004.
Hypothalamic (GnRH), Pituitary (LH, FSH, free a -subunit ) & Gonadal (Steroid) Hormone Secretory Dynamics
GnRH
t 1/2
2-4 min
GnRH
FAS LH FSH
15 min 20-40 min 3 hours
LH FSH
LH FSH
P E2
2-8 hours P