Page 286 - Color Atlas Of Pathophysiology (S Silbernagl Et Al, Thieme 2000)

Effects of Female Sex Hormones
togens (progesterone and its analogs) raise the
Estrogens body’s metabolism and temperature, trigger
Estrogens promote the development of the fe- hyperventilation, and reduce sensitivity to in-
male sex characteristics, i.e., the transforma- sulin in the periphery. Additionally, they have
tion of the Müller ducts into Fallopian tubes, moderate glucocorticoid and antimineralocor-
uterus and vagina, as well as the secondary ticoid (natriuretic) actions. They lower the
sexual characteristics (e.g., development of production of cholesterol and the plasma con-
the mammary glands and female fat distribu- centration of HDL and LDL.
tion). They require the cooperation of andro-
gens in order to stimulate axillary and pubic
hair growth. Estrogens also influence the psy- Effects of Excess and Deficiency
chological development of women. In sexually In excess of female sex hormones (→ A2) go-
mature women estrogens and progestogens nadotropin release is inhibited, there is no
have partly opposite actions. maturation of the follicles, no regular shedding
Estrogens promote the proliferation of the of the uterine mucosa, and the woman will be
uterine mucosa. In the cervix and vagina they infertile. An excess of estrogens can cause
Hormones accelerate the exfoliation of the vaginal epi- In children high estrogen concentrations lead
thrombosis due to a raised clotting tendency.
reduce the viscosity of the cervical mucus and
to premature sexual maturation and acceler-
thelium, whose glycogen is broken down by
fusion may eventually result in short stature.
fall in pH stops pathogens from penetrating.
9 the vaginal flora to lactic acid. The resulting ate growth. However, premature epiphyseal
Estrogens stimulate the formation of ducts in Increased progestogen action causes natriure-
the mammary glands. They promote protein sis, a rise in body temperature and hyperventila-
anabolism and increase the formation of HDL tion, and via insulin resistance it can promote
and VLDL. Conversely, they reduce the concen- the development of diabetes mellitus.
tration of low density lipoproteins (LDL), and A deficiency of female sex hormones
thus lower the risk of atherosclerosis. On the (→ A3), like their excess, means that a normal
other hand, estrogens increase the coagulabil- menstrual cycle is not possible. In estrogen de-
ity of blood. Additionally, they raise electrolyte ficiency the phase of uterine proliferation is
retention in the kidneys as well as the mineral- absent and the progestogens are not able to
ization of the bones via hydroxylation of vita- bring about maturation; in progestogen defi-
min D 3 and the inhibition of parathyroid hor- ciency the uterine mucosa does not mature. In
mone (PTH). In children they promote bone both these cases the woman is infertile and
growth and maturation and accelerate epiphy- there is no menstrual bleeding (amenorrhea).
seal fusion. The lack of estrogens also expresses itself in re-
duced manifestation of the external sex charac-
teristics, in a tendency toward vaginal infec-
Progesterone tions, in osteoporosis, and in an increased risk
In the uterus progesterone promotes the mat- of atherosclerosis. In children there will be a
uration and secretory activity of the uterine delayed epiphyseal fusion that, despite slowed
mucosa and decreases the contractility of the growth, may ultimately lead to tall stature.
uterine muscle. When estrogen concentration The reproductive functions of a woman can
falls at the end of the menstrual cycle, the mu- also be abnormal independently of the sex
cosa is shed (menstruation). In the cervix and hormones, for example, due to malformations
vagina progestogens raise the viscosity of cer- or disease of the ovaries, fallopian tubes, or
vical mucosa, narrow the cervical orifice, and uterus.
inhibit fallopian motility. Furthermore, they
inhibit the proliferation and exfoliation of vag-
276 inal epithelium. They also promote the forma-
tion of alveoli in the mammary glands. Proges-
Silbernagl/Lang, Color Atlas of Pathophysiology © 2000 Thieme
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