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More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation


Comments on the Corpus Luteum and Some Related Aspects

Dr. Nelson Soucasaux, Brazilian gynecologist

Let's talk a little about the corpus luteum, the ovarian structure responsible for the production of progesterone during the second phase of the menstrual cycle (and also the first two or three months of pregnancy). After ovulation (which is triggered by the pituitary ovulatory peak of LH [luteinizing hormone]) and the subsequent luteinization of the granulosa cells of the ruptured ovarian follicle, there is a change in the enzymatic system of these cells and, instead of producing mostly estrogens (as they did), they begin producing mainly high levels of progesterone and only some estrogens. On the other hand, the theca cells begin producing mostly estrogens. Therefore, the corpus luteum produces not only progesterone but also estrogens.

During the ovarian cycle, the corpus luteum exhibits a considerably steady life period of about 12 to 14 days. In this way, comparing the two phases of the ovulatory cycles (the follicular and the luteinic), the luteinic phase is the one that presents a more predictable duration. The corpus luteum seems to possess some intrinsic capability of self-regulation. Even so, there are indications that it depends on normal levels of LH and prolactin for maintaining itself. The corpus luteum involution between its 10th and 14th days of existence seems to be due to a reduction in its LH-receptors, what makes its responsivity to the LH become smaller. Some authors observe that, on a short term basis, the LH action upon the corpus luteum causes a reduction in the LH-receptors of the lutein cells, and that this may be the main mechanism responsible for limiting the normal lutein function to 12-14 days. It has also been postulated the possible existence of luteolithic factors causing the involution of the corpus luteum after its 10th to 12th days of activity (See Note below).

The progesterone produced by the corpus luteum seems to inhibit the follicular growth in the ovary in which this structure is present. This is one of the explanations for the possible alternation of ovulations in the ovaries (though the occurrence of this alternation does not seem to be entirely proved yet). In this way, due to the local action exerted by the corpus luteum that develops there, the ovary that ovulates in one cycle would be incapable of immediately re-starting the follicular growth and, therefore, of ovulating in the next cycle. If this theory is correct, in the next cycle ovulation would be in charge of the other ovary. Nevertheless, as I said and as far as I know, this has not been proved yet.

There are also curious aspects concerning the estrogens/progesterone relationships in women. However, some previous considerations become necessary here. Initially, from the exclusively biological point of view related to the original reproductive purpose of the actions of the sexual hormones, it is known that in each menstrual cycle estrogens and progesterone produce a series of sequential transformations in the female genitals intended to prepare it for fertilization, implantation and the beginning of the egg's development. In the course of the first phase of the cycle, the estrogens produce specific changes in the woman's sexual organs that are, after ovulation and during the second phase, completed by other changes induced by progesterone. If pregnancy occurs, the main function of progesterone changes into the maintenance of this condition.

All of these effects of the sexual steroids are well-known to present-day gynecology, and it is not my purpose here to go into details about them. Also, I want to make it clear that I do not intend here to discuss the interrelations between estrogens and progesterone from the point of view of the reproductive finality of the actions of these hormones. My opinion is that the entire human constitution by far transcends, existentially, many of its original biological purposes. It is a fact that almost all modern women only desire to become pregnant in a few moments in their whole lives. During most of their fertile years, pregnancy is undesired and avoided and, if it happens accidentally, it is almost always interrupted by an intentional abortion. Usually women only want to know that they are potentially fertile, that is, capable of having children, but only when they desire to be and if they so desire. Therefore I think it is much more relevant to talk about the estrogens/progesterone relationships from the point of view of women in their habitual state, which is the one of non-pregnant women.

An adequate balance between the actions of estradiol, estrone and progesterone is of fundamental importance in gynecologic physiology. This is so because, besides the progesteronic actions that are complementary to those of the estrogens, progesterone also exerts a "braking" action against the excessive proliferative effect of the estrogens. The effects of hyperestrogenism mostly on the endometrium and the breasts are well-known, causing hyperplastic changes in the endometrial glands and in the mammary ducts, acini and connective tissue.

The endometrial hyperplastic changes clinically manifest themselves through excessive or prolonged menstrual bleedings (menorrhagia and hypermenorrhea), and the mammary ones by thickenings of the breast parenchyma and the appearance of nodules in it (traditionally known as "functional mastopathies"). The problem is that some special types of such hyperplastic lesions can be pre-carcinogenic. In this way, the production of progesterone at adequate levels during the second phase of the cycle is fundamental for preventing the appearance and development of these pathologies (mostly in the endometrium, since presently some of the anti-proliferative effects of progesterone on the breasts are being questioned by several authors).

In order to have good levels of progesterone, the adequate formation of the corpus luteum - which usually results from the ovulatory process - is quite necessary. Even so, there are cases of luteinization of follicles that do not succeed in ovulating, a phenomenon known as "LUF" (luteinized unruptured follicles). However, as we do not know how frequent this luteinization of unruptured follicles may be, we must continue considering the occurrence of ovulation as a basic condition for the corpus luteum formation in normal circumstances.

Nevertheless, for women having an active sexual life, most of the time frequent ovulations are beneficial on the one hand and problematic on the other. They are beneficial for allowing the formation of the corpus luteum and the adequate progesterone production, preventing the appearance of the already mentioned endometrial and mammary alterations. They are problematic for creating the constant risk of pregnancy, with all its implications, problems and worries. Thus, here we are faced with one more of the several ambivalent and paradoxical situations typical of female nature.

Fortunately, with the hormonal contraceptives that contain a correct balance in their doses of synthetic estrogens and progestins, it is possible to provide women with efficient contraceptive guarantees and, at the same time, with a relative balance between estrogenic and progestogenic effects. For more details on the "Pill," see my article "Oral Hormonal Contraceptives (the "Pill")," published here at the MUM.

Note: Here we must remember that, when pregnancy occurs, the quick appearance of the chorionic gonadotropic hormone (CGH) produced by the egg begins stimulating the corpus luteum, impeding its regression and transforming it into the corpus luteum of pregnancy. This structure remains in activity during the first trimester of gestation.

The text above is an adapted excerpt from my book "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology"), published by Imago Editora, Rio de Janeiro, 1990. For more information on the book, see page http://www.nelsonginecologia.med.br/novas.htm at my Web site www.nelsonginecologia.med.br .

Copyright Nelson Soucasaux 1990, 2005

_______________________________________

Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993. He has been working in his private clinic since 1975.

Web site (Portuguese-English): www.nelsonginecologia.med.br

Email: nelsons@nelsonginecologia.med.br

NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation