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Updated: Jun 9 2021

Estrogen and Progesterone

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  • Overview
  • Introduction
    • Female hormones
      • in follicular phase of menstrual cycle, follicle synthesizes estrogens
        • major product is 17β-estradiol
      • in luteal phase of menstrual cycle, corpus luteum synthesizes progesterone and estrogen
        • major product is progesterone
  • Estrogen
    • Sources of estrogens
      • ovary (17β-estradiol)
      • placenta (estriol)
      • blood (aromatization)
    • Estrogens biosynthesis
      • two-cell, two-gonadotropin model
        • 17β-estradiol synthesis requires granulosa cells and theca cells
          • theca cells do not express aromatase
            • aromatase catalyzes conversion of androstenedione to 17β-estradiol
        • biosynthetic pathway
          • LH acts on theca cells
            • increases activity of cholesterol desmolase
              • increases synthesis/secretion of androstenedione
              • androstenedione freely diffuses from theca cells to granulosa cells
          • FSH acts on granulosa cells
            • increases activity of aromatase
              • increases synthesis/secretion of 17β-estradiol
    • Estrogens potency
      • 17β-estradiol > estrone > estriol
    • Estrogen receptor
      • estrogen receptor (ER) functions as a homodimer and resides in cell cytoplasm
      • estrogen-ER complex translocates to cell nucleus, interacts with steroid response elements on chromatin, and rapidly induces transcription of target genes
    • Function of estrogens
      • at puberty, functions in development of female sex characteristics
        • genitalia, breasts, and female fat distribution
      • functions in proliferation and development of ovarian granulosa cells of follicles
      • functions in maturation and maintenance of uterus
        • proliferates endometrium of uterus
        • lowers uterine threshold to contractile stimuli
          • increases myometrial excitability
      • upregulates estrogen, progesterone, and LH receptors
      • negatively feeds back on anterior pituitary in follicular phase of menstrual cycle
        • ↓ FSH and ↓ LH
      • positively feeds back on anterior pituitary at midcycle in response to LH surge
        • ↑ FSH and ↑ LH
      • stimulates prolactin secretion
        • blocks action of prolactin on breasts
      • upregulates transport proteins
        • in blood plasma, estrogens are mostly bound to carrier proteins
          • e.g., albumin and sex hormone-binding globulin (SHBG)
      • upregulates HDL cholesterol and downregulates LDL cholesterol
    • Notes
      • pregnancy
        • 50-fold ↑ in 17β-estradiol and estrone
        • 1,000-fold ↑ in estriol
          • increase in estriol levels is an indicator of well-being of fetus
  • Progesterone
    • Sources of progesterone
      • corpus luteum, placenta, adrenal cortex, and testes
    • Function of progesterone
      • stimulates endometrial glandular secretions
      • stimulates development of spiral arteries
      • maintains pregnancy
      • raises uterine threshold to contractile stimuli during pregnancy
        • decreases myometrial excitability
      • relaxes uterine smooth muscle
        • prevents contractions
      • produces thick cervical mucus that inhibits sperm entry into uterus
      • increases basal body temperature
        • increases hypothalamic temperature set-point
      • negatively feeds back on anterior pituitary in luteal phase of menstrual cycle
        • ↓ FSH and ↓ LH
      • downregulates estrogen receptors
    • Notes
      • increase in biosynthesis of progesterone is characteristic of mid cycle or ovulation
      • "PROGESTerone is PRO-GESTation"
  • Estrogen and Progesterone in Pregnancy
    • Overview
      • estriol is major estrogen in pregnancy
    • Maternal-placental-fetal unit
      • elevated levels of estrogens and progesterone are necessary for maintaining pregnancy
      • corpus luteum is not adequate to generate very high hormone levels
      • placenta emerges as major source of estrogens and progesterone
      • placenta is an imperfect endocrine organ
        • placenta cannot synthesize sufficient cholesterol
          • cholesterol is a precursor for hormone synthesis
        • placenta lacks necessary enzymes for estrogen synthesis
      • maternal-placental-fetal unit overcomes shortcomings of placenta to very high hormones levels
    • Progesterone synthesis
      • mother provides cholesterol (LDL particles) to placenta
      • placenta converts cholesterol to pregnenolone then to progesterone
      • placenta provides high progesterone levels to mother
    • Estriol synthesis
      • mother provides cholesterol (LDL particles) to placenta
      • placenta converts cholesterol to pregnenolone to progesterone
      • placenta provides high progesterone levels to fetus
      • fetal adrenal cortex converts progesterone to DHEA-sulfate
      • fetal liver hydroxylates DHEA-sulfate to 16-OH DHEA-sulfate
      • fetus provides high levels of 16-OH DHEA-sulfate to placenta
      • placenta converts 16-OH DHEA-sulfate to estriol
      • placenta provides high estriol levels to mother
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