Female reproductive physiology: the menstrual cycle and menopause
The two-cell, two-gonadotrophin model, how rising oestradiol switches to positive feedback and triggers the LH surge, how to time a luteal progesterone, what AMH measures, why hypothalamic amenorrhoea and menopause give opposite gonadotrophin patterns, and the KNDy neuron mechanism of hot flushes that NK3 antagonists target.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- GnRH pulse frequency steers the pituitary. Fast pulses favour LH, slow pulses favour FSH.
- Theca cells make androgen under LH; granulosa cells aromatise it to oestradiol under FSH.
- Oestradiol normally suppresses LH, but a sustained high level switches to positive feedback, causing the LH surge and ovulation.
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Sources
- Williams Textbook of Endocrinology, 15th editionElsevier (Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, editors), 2024
- Harlow SD, Gass M, Hall JE et al. Executive summary of the Stages of Reproductive Aging Workshop + 10 (STRAW+10). J Clin Endocrinol Metab 2012;97:1159-68Journal of Clinical Endocrinology and Metabolism, 2012
- Panay N, Anderson RA, Bennie A et al. Evidence-based guideline: premature ovarian insufficiency (ESHRE, ASRM, CRE, IMS). Hum Reprod Open 2024;hoae065European Society of Human Reproduction and Embryology, 2024
- Australasian Menopause Society information sheets and practitioner resourcesAustralasian Menopause Society, 2025
- The 2022 hormone therapy position statement of The North American Menopause Society. Menopause 2022;29:767-94The North American Menopause Society, 2022
- VEOZAH (fezolinetant) US prescribing information, boxed warning for hepatotoxicity (DailyMed, SPL version 8)US National Library of Medicine (DailyMed), 2026
- Fezolinetant: PBS medicine status, November 2025 PBAC meeting (outcome Recommended; listing not yet occurred)Pharmaceutical Benefits Scheme, 2026
- Fezolinetant: PBS medicine status, March 2025 PBAC meeting (not recommended)Pharmaceutical Benefits Scheme, 2025
- Last updated
- 14 November 2026
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