University of Melbourne, Melbourne, Victoria 3010, Australia.
Hum Reprod Update. 2011 Mar-Apr;17(2):141-58. doi: 10.1093/humupd/dmq040. Epub 2010 Oct 5.
There are many types of ovarian activity that occur in women. This review provides information on the relationship between the hormone values and the degree of biological response to the hormones including the frequency and degree of uterine bleeding. The continuous process is termed the 'Continuum' and is thus similar to other processes in the body.
This review draws on information already published from monitoring ovarian activity by urinary oestrogen and pregnanediol measurements using timed 24-h specimens of urine. Much of the rationalization was derived from 5 to 6 year studies of girls progressing from childhood to adulthood, women progressing through menopause, and the return of fertility post-partum. During these times, all the reported types of ovarian activity were encountered.
All cycle types can be understood in terms of steps in the normal maturation of fertility at the beginning of reproductive life, its return post-partum and its demise at menopause. Each step merges into the next and therefore the sequence is termed the 'Continuum'. Unpredictable movement from fertile to infertile types and back can occur at any time during reproductive life. Stress is a major causative factor. Hormonal definitions for each step, the relevance of the various cycle types in determining fertility and in the initiation of uterine bleeding and the roles of the pituitary hormones in causing them, are presented.
The findings explain the erratic fertility of women and why ovulation is not always associated with fertility. They provide an understanding of the various types of ovarian activity and their relation to pituitary function, fertility and uterine bleeding.
女性的卵巢活动有多种类型。本综述提供了激素值与激素生物学反应程度之间关系的信息，包括子宫出血的频率和程度。这一连续过程被称为“连续统”，因此类似于身体中的其他过程。
本综述借鉴了已经发表的信息，这些信息是通过对尿液中的雌激素和孕烷二醇进行监测，使用 24 小时定时尿液样本得出的。其中大部分推理来自于对从儿童期到成年期、从更年期到产后生育能力恢复的女孩和女性进行的 5 到 6 年研究。在这些时期，所有报告的卵巢活动类型都被遇到。
所有的周期类型都可以根据生育能力在生殖生命开始时的正常成熟过程中的步骤来理解，包括产后的恢复和更年期的结束。每个步骤都与下一个步骤融合，因此这个序列被称为“连续统”。在生殖生命的任何时候，都可能会出现从可育到不育类型之间不可预测的变化。压力是一个主要的致病因素。本文介绍了每个步骤的激素定义、各种周期类型在确定生育能力和启动子宫出血方面的相关性，以及垂体激素在引起这些变化中的作用。
这些发现解释了女性生育能力的不稳定，以及为什么排卵并不总是与生育能力相关。它们提供了对各种卵巢活动类型及其与垂体功能、生育能力和子宫出血的关系的理解。
