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7423318 
Journal Article 
Hypothalamic-Pituitary-Ovarian Axis and Control of the Menstrual Cycle 
Beshay, VE; Carr, BR; , 
2013 
Springer New York 
New York, NY 
Clinical Reproductive Medicine and Surgery 
31-42 
Menstruation is the cyclic and orderly sloughing of the endometrium. In order for normal menstruation to take place, a complex interaction between the brain, the ovaries, and the uterus has to take place. This interaction involves fluctuating levels of hormones produced by the brain as well as the ovaries, while the uterus responds to the changing hormone levels. This process of hormone production is initiated in the hypothalamus through the production and release of GnRH, which leads to FSH and LH release from the anterior pituitary gland. As a result, oocyte development takes place in the ovaries, and estradiol is produced from the growing ovarian follicle. As the growing follicle matures and estradiol rises further, LH from the pituitary surges, leading to the process of ovulation. After ovulation, the remnant of the follicle becomes the corpus luteum, which is responsible for progesterone production. If the cycle does not result in a pregnancy, progesterone levels decline and menstruation takes place. Throughout this process, there are many other hormones from the central nervous system as well as from the ovary that play a role in the control of the menstrual cycle. We will examine the role of the central nervous system and how it interacts with the ovaries to control the menstrual cycle.