6.2 Anatomy and physiology of the female reproductive system  (Page 22/76)

As a result of the degradation of the corpus luteum, a decline in progesterone concentrations triggers the shedding of the endometrial lining, marking the menses phase of the menstrual cycle. Low progesterone levels also reduce the negative feedback that had been occurring at the hypothalamus and pituitary, and result in the release of GnRH and, subsequently, FSH and LH. FSH stimulates tertiary follicles to grow and granulosa and theca cells begin to produce increased amounts of estrogen. High estrogen concentrations stimulate the endometrial lining to rebuild, marking the proliferative phase of the menstrual cycle. The high estrogen concentrations will eventually lead to a decrease in FSH because of negative feedback, resulting in atresia of all but one of the developing tertiary follicles. The switch to positive feedback that occurs with elevated estrogen production from the dominant follicle stimulates the LH surge that will trigger ovulation. The luteinization of the granulosa cells of the collapsed follicle forms the progesterone-producing corpus luteum. Progesterone from the corpus luteum causes the endometrium to prepare for implantation, in part by secreting nutrient-rich fluid. This marks the secretory phase of the menstrual cycle. Finally, in a non-fertile cycle, the corpus luteum will degrade and menses will occur.