第37章内分泌系

Regulation of the reproductive system is a process that requires the action of hormones from the pituitary gland, the adrenal cortex, and the gonads. During puberty in both males and females, the hypothalamus produces gonadotropin-releasing hormone (GnRH), which stimulates the production and release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland. These hormones regulate the gonads (testes in males and ovaries in females) and therefore are called gonadotropins. In both males and females, FSH stimulates gamete production and LH stimulates production of hormones by the gonads. An increase in gonad hormone levels inhibits GnRH production through a negative feedback loop.

In the testes, FSH stimulates the maturation of sperm cells. FSH production is inhibited by the hormone inhibin, which is released by the testes. LH stimulates production of the sex hormones (androgens) by the interstitial cells of the testes and therefore is also called interstitial cell-stimulating hormone.

The most widely known androgen in males is testosterone. Testosterone promotes the production of sperm and a suite of secondary sex characteristics, such as the growth and development of the testes and penis, increased skeletal and muscular growth, enlargement of the larynx, increased growth and redistribution of body hair, and increased sexual drive. The adrenal cortex also produces small amounts of testosterone precursor, although the role of this additional hormone production is not fully understood. Testosterone secretion is regulated by both the hypothalamus and the anterior pituitary gland. The hypothalamus sends releasing hormones that stimulate the release of gonadotropins from the anterior pituitary gland.

In the ovaries, FSH stimulates development of egg cells, called ova, which develop in structures called follicles. Follicle cells produce the hormone inhibin, which inhibits FSH production. LH also plays a role in the development of ova, induction of ovulation, and stimulation of estradiol and progesterone production by the ovaries (as well as testosterone production by the testes), as illustrated in Figure 37.9.Estradiol and progesterone are steroid hormones that serve several functions in the human body. Estradiol causes the egg to mature and release during the menstrual cycle, and thickens the uterine lining prior to egg implantation. Estradiol also helps with bone health, nitric oxide production, and brain function. (Low levels of estradiol have been connected to osteoporosis, mood swings, weight gain, and interrupted menstrual cycle. High levels of estradiol correlate with an increased risk of uterine and breast cancer, and cardiovascular disease.) During puberty, estradiol produces a suite of characteristics such as the increased development of breast tissue, redistribution of fat towards hips, legs, and breast, and the maturation of the uterus and vagina. Both estradiol and progesterone regulate the menstrual cycle.

In addition to producing FSH and LH, the anterior portion of the pituitary gland also produces the hormone prolactin (PRL). Prolactin stimulates the production of milk by the mammary glands following childbirth. Prolactin release inhibits the release of GnRH from the hypothalamus, resulting in a loss of FSH and LH release from the anterior pituitary. Prolactin levels are regulated by the hypothalamic hormones prolactin-releasing hormone (PRH) and prolactin-inhibiting hormone (PIH), which is now known to be dopamine. PRH stimulates the release of prolactin and PIH inhibits it.

The posterior pituitary releases the hormone oxytocin, which stimulates uterine contractions during childbirth. The uterine smooth muscles are not very sensitive to oxytocin until late in pregnancy when the number of oxytocin receptors in the uterus peaks. Stretching of tissues in the uterus and cervix stimulates oxytocin release during childbirth. Contractions increase in intensity as blood levels of oxytocin rise via a positive feedback mechanism until the birth is complete. Oxytocin also stimulates the contraction of myoepithelial cells around the milk-producing mammary glands. As these cells contract, milk is forced from the secretory alveoli into milk ducts and is ejected from the breasts in milk ejection (“let-down”) reflex. Oxytocin release is stimulated by the suckling of an infant, which triggers the synthesis of oxytocin in the hypothalamus and its release into circulation at the posterior pituitary.