Question

Using this diagram, explain why: a. A woman with elevated LH levels and low FSH levels might not ovulate: b. A woman with an estrogen-secreting ovarian tumor might have endometrial hyperplasia: c. A woman with decreased progesterone levels might have an extra thick uterine lining, leading to heavy menstrual bleeding (menorrhagia): d. A woman with a pituitary infection might not menstruate (amenorrhea): e. An injection of FSH might be given to an infertile woman:

Answer 1

There is no diagram in question. I am giving answer assuming there would be a normal healthy diagram which was presenting menstrual cycle.

answer of a : FSH (Follicular stimulating hormone) is required for 1. Growth of granulosa cells in ovarian follicle 2. Increase activity of aromatase , which further responsible for conversation of androgen to estrogen. 3. Increase number of receptors of LH on Theca cells.

LH required for 1. Stimulate androgen production from theca cells.

Initially in a menstrual cycle FSH level is high and LH level is low so gradually androgen secreted by the influence of LH converted to estrogen. Which stimulate maturation of follicle.

If FSH is low and LH is high then androgen would be secreted by theca cell by the influence of LH but could not be converted into estrogen because low aromatase activity (due to Low FSH)as well as less growth of FSH induced granulosa cell. Low Estrogen result in no follicle maturation. So no mature follicle no ovulation.

Answer of b : Estrogen increase the bulk of uterine muscle, contractile protein, proliferation of epithelial cells, and augment height of epithelial cell of uterus in proliferative stage of menstrual cycle. It is on day 5 to day 14(day of ovulation). In secretory stage estrogen level gradually goes down.

If estrogen would be remain high by estrogen secretary ovarian tumour then above mention function of estrogen would be augmented so number and size of endometrial epithelium would increase , which is known as endometrial hyperplasia.

answer of c : progesterone increases in secretory phase ( day of ovulation to menstrual bleeding ) (day 14 to 28) in this phase it decreases the number of estrogen receptor so growth of endometrium by influence of estrogen ceases. If progesteron in low, estrogen inducing growth would be continue and uterine lining would be extra thick.

Progesteron decreases the myometrial contractility. If progesteron level is low then there is extra growth of estrogen induced endometrium. And during menstrual bleeding there would be more tissue to be shed so menorrhagia occur.

answer of d: pituatory secret gonadotropins (FSH and LH) these are hormones which are responsible for ssecretion of estrogen and progesteron as well as growth of follicle from day 1 of mentrual cycle.

So in pituatory infection there might be less or nil secretion of LH and FSH. So less or nil estrogen and growth of follicle. So no mature follicle, then finally no ovulation (amenorrhea)

answer of e : in answer of a , we have discussed that FSH is first hormone which is highest initially and initiate the menstrual cycle. It increase receptor of LH and Increase synthesis of estrogen. Hence the name given follicular stimulating hormone (FSH). And in remaining cycle FSH level remain low.

Infertility means female is fail to conceive by any reason.

If infertility is due to low FSH then a single injection of FSH is enough to start a menstrual cycle. Which may result in ovulation.