About all

The structures of the endocrine system. Structures of the Endocrine System: A Comprehensive Guide to Hormonal Regulation

How does the endocrine system maintain homeostasis in the body. What are the major endocrine glands and their functions. How do hormones differ from neurotransmitters in cellular communication. What role does the hypothalamus play in endocrine function.

Содержание

The Endocrine System: An Overview of Hormonal Regulation

The endocrine system plays a crucial role in maintaining homeostasis within the human body through the production and secretion of hormones. This complex network of glands and organs works in concert to regulate various physiological processes, from metabolism and growth to reproduction and stress response.

Unlike the nervous system, which uses electrical signals for rapid communication, the endocrine system relies on chemical messengers called hormones. These hormones are released directly into the bloodstream, allowing them to reach target cells throughout the body and elicit specific responses.

Key Components of the Endocrine System

  • Endocrine glands
  • Hormones
  • Target cells with hormone receptors
  • Blood vessels for hormone transport

Are endocrine glands the same as exocrine glands? No, endocrine glands are ductless and secrete hormones directly into the bloodstream, while exocrine glands release their secretions through ducts, such as sweat glands in the skin.

Major Endocrine Glands and Their Functions

The endocrine system comprises several key glands, each responsible for producing specific hormones that regulate various bodily functions. Understanding the role of these glands is essential for comprehending how the body maintains balance and responds to internal and external stimuli.

Pituitary Gland: The Master Conductor

Often referred to as the “master gland,” the pituitary gland sits at the base of the brain and produces a wide array of hormones that influence other endocrine glands. It consists of two lobes, each with distinct functions:

  • Anterior lobe: Produces growth hormone, adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), and follicle-stimulating hormone (FSH), among others
  • Posterior lobe: Stores and releases antidiuretic hormone (ADH) and oxytocin

How does the pituitary gland interact with the hypothalamus? The hypothalamus produces releasing and inhibiting hormones that control the secretion of pituitary hormones, forming a crucial link between the nervous and endocrine systems.

Thyroid Gland: Regulating Metabolism

Located in the neck, the thyroid gland produces hormones that play a vital role in regulating metabolism, body temperature, and growth. The two main thyroid hormones are:

  1. Thyroxine (T4)
  2. Triiodothyronine (T3)

These hormones influence nearly every cell in the body, controlling how quickly the body uses energy, makes proteins, and regulates sensitivity to other hormones.

The Hypothalamus-Pituitary Axis: Orchestrating Endocrine Function

The hypothalamus, although primarily considered part of the nervous system, plays a crucial role in endocrine function. It serves as a bridge between the nervous and endocrine systems, coordinating various physiological processes through its interaction with the pituitary gland.

Key Functions of the Hypothalamus

  • Produces releasing and inhibiting hormones that control pituitary secretions
  • Regulates body temperature, hunger, thirst, and sleep patterns
  • Influences emotional responses and sexual behavior

How does the hypothalamus communicate with the pituitary gland? The hypothalamus releases hormones into a specialized portal system that carries them directly to the anterior pituitary, allowing for precise control of hormone secretion.

Adrenal Glands: Mediators of Stress Response

Situated atop the kidneys, the adrenal glands play a crucial role in the body’s stress response and regulate various metabolic processes. Each adrenal gland consists of two distinct parts:

Adrenal Cortex

The outer layer of the adrenal gland produces several important hormones:

  • Cortisol: Regulates metabolism and helps the body respond to stress
  • Aldosterone: Controls blood pressure and electrolyte balance
  • Androgens: Weak male sex hormones also produced in females

Adrenal Medulla

The inner core of the adrenal gland secretes catecholamines:

  • Epinephrine (adrenaline)
  • Norepinephrine (noradrenaline)

These hormones are responsible for the “fight-or-flight” response, preparing the body for immediate action in stressful situations.

What is the difference between the effects of cortisol and adrenaline in stress response? Cortisol prepares the body for long-term stress by mobilizing energy reserves and suppressing non-essential functions, while adrenaline provides an immediate boost in energy and alertness for short-term stress responses.

Pancreas: Regulating Blood Sugar Levels

The pancreas serves both endocrine and exocrine functions, playing a crucial role in digestion and blood sugar regulation. As an endocrine gland, it produces several important hormones:

Insulin and Glucagon

These two hormones work antagonistically to maintain blood glucose levels:

  • Insulin: Lowers blood glucose by promoting cellular uptake and storage
  • Glucagon: Raises blood glucose by stimulating glycogen breakdown and gluconeogenesis

Other Pancreatic Hormones

  • Somatostatin: Inhibits the release of insulin and glucagon
  • Pancreatic polypeptide: Regulates pancreatic secretions

How do insulin and glucagon work together to maintain blood sugar balance? When blood glucose rises, insulin is released to lower it; when blood glucose falls, glucagon is released to raise it, creating a finely tuned feedback system.

Gonads: Sex Hormone Production and Reproduction

The gonads, or sex glands, are responsible for producing sex hormones and gametes (reproductive cells). These glands play a crucial role in sexual development, reproduction, and maintaining secondary sexual characteristics.

Ovaries

In females, the ovaries produce:

  • Estrogen: Promotes development of female secondary sexual characteristics and regulates the menstrual cycle
  • Progesterone: Prepares the uterus for pregnancy and maintains pregnancy
  • Small amounts of androgens

Testes

In males, the testes produce:

  • Testosterone: Promotes development of male secondary sexual characteristics and sperm production
  • Small amounts of estrogen

How do sex hormones influence behavior and physiology beyond reproduction? Sex hormones affect various aspects of physiology, including bone density, muscle mass, fat distribution, and even cognitive functions and mood.

Pineal Gland: Regulator of Circadian Rhythms

The pineal gland, a small endocrine gland located in the brain, plays a crucial role in regulating the body’s circadian rhythms and sleep-wake cycles. Its primary function is the production of melatonin, often referred to as the “sleep hormone.”

Functions of the Pineal Gland

  • Melatonin production: Synthesis and secretion of melatonin in response to darkness
  • Regulation of circadian rhythms: Helps synchronize the body’s internal clock with external light-dark cycles
  • Seasonal adaptation: Influences seasonal changes in physiology and behavior in some animals

How does light exposure affect melatonin production? Light exposure, particularly blue light, suppresses melatonin production, while darkness stimulates its release, helping to regulate the sleep-wake cycle.

Hormonal Feedback Mechanisms: Maintaining Balance

The endocrine system relies on complex feedback mechanisms to maintain hormonal balance and homeostasis. These mechanisms ensure that hormone levels are kept within appropriate ranges, preventing overproduction or underproduction that could lead to physiological imbalances.

Types of Feedback Mechanisms

  1. Negative feedback: The most common type, where the response to a stimulus reduces or shuts off the original stimulus
  2. Positive feedback: Less common, where the response to a stimulus increases or perpetuates the original stimulus

Example: Thyroid Hormone Regulation

The regulation of thyroid hormones exemplifies a classic negative feedback loop:

  1. Hypothalamus releases thyrotropin-releasing hormone (TRH)
  2. TRH stimulates the pituitary to release thyroid-stimulating hormone (TSH)
  3. TSH stimulates the thyroid to produce and release thyroid hormones (T3 and T4)
  4. Elevated levels of T3 and T4 inhibit the release of TRH and TSH, completing the negative feedback loop

Why are feedback mechanisms crucial for endocrine function? Feedback mechanisms allow for precise control of hormone levels, ensuring that physiological processes remain within optimal ranges and can adapt to changing internal and external conditions.

The endocrine system’s intricate network of glands and hormones plays a vital role in maintaining homeostasis and coordinating various bodily functions. From regulating metabolism and growth to influencing reproduction and stress responses, hormones act as chemical messengers that enable long-term, widespread effects throughout the body. Understanding the structures and functions of the endocrine system provides valuable insights into how the body maintains balance and responds to environmental changes, laying the foundation for comprehending various physiological processes and potential endocrine disorders.

14.1: Structures of the Endocrine System

  1. Last updated
  2. Save as PDF
  • Page ID
    59432
    • OpenStax
    • OpenStax

    The endocrine system consists of cells, tissues, and organs that secrete hormones as a primary or secondary function. The endocrine gland is the major player in this system. The primary function of these ductless glands is to secrete their hormones directly into the surrounding fluid. The interstitial fluid and the blood vessels then transport the hormones throughout the body. The endocrine system includes the pituitary, thyroid, parathyroid, adrenal, and pineal glands (Figure \(\PageIndex{1}\)). Some of these glands have both endocrine and non-endocrine functions. For example, the pancreas contains cells that function in digestion as well as cells that secrete the hormones insulin and glucagon, which regulate blood glucose levels. The hypothalamus, thymus, heart, kidneys, stomach, small intestine, liver, skin, female ovaries, and male testes are other organs that contain cells with endocrine function. Moreover, adipose tissue has long been known to produce hormones, and recent research has revealed that even bone tissue has endocrine functions.

    Figure \(\PageIndex{1}\): Endocrine System Endocrine glands and cells are located throughout the body and play an important role in homeostasis

    The ductless endocrine glands are not to be confused with the body’s exocrine system, whose glands release their secretions through ducts. Examples of exocrine glands include the sebaceous and sweat glands of the skin. As just noted, the pancreas also has an exocrine function: most of its cells secrete pancreatic juice through the pancreatic and accessory ducts to the lumen of the small intestine

    Contributed by

    Open Stax CNS http://cnx. org/contents/[email protected]


    1. Back to top
      • Was this article helpful?
      1. Article type
        Section or Page
        Author
        OpenStax
        License
        CC BY
        OER program or Publisher
        OpenStax
      2. Tags
          This page has no tags.

      17.1 An Overview of the Endocrine System – Anatomy and Physiology 2e

      Learning Objectives

      By the end of this section, you will be able to:

      • Distinguish the types of intercellular communication, their importance, mechanisms, and effects
      • Identify the major organs and tissues of the endocrine system and their location in the body

      Communication is a process in which a sender transmits signals to one or more receivers to control and coordinate actions. In the human body, two major organ systems participate in relatively “long distance” communication: the nervous system and the endocrine system. Together, these two systems are primarily responsible for maintaining homeostasis in the body.

      Neural and Endocrine Signaling

      The nervous system uses two types of intercellular communication—electrical and chemical signaling—either by the direct action of an electrical potential, or in the latter case, through the action of chemical neurotransmitters such as serotonin or norepinephrine. Neurotransmitters act locally and rapidly. When an electrical signal in the form of an action potential arrives at the synaptic terminal, they diffuse across the synaptic cleft (the gap between a sending neuron and a receiving neuron or muscle cell). Once the neurotransmitters interact (bind) with receptors on the receiving (post-synaptic) cell, the receptor stimulation is transduced into a response such as continued electrical signaling or modification of cellular response. The target cell responds within milliseconds of receiving the chemical “message”; this response then ceases very quickly once the neural signaling ends. In this way, neural communication enables body functions that involve quick, brief actions, such as movement, sensation, and cognition.In contrast, the endocrine system uses just one method of communication: chemical signaling. These signals are sent by the endocrine organs, which secrete chemicals—the hormone—into the extracellular fluid. Hormones are transported primarily via the bloodstream throughout the body, where they bind to receptors on target cells, inducing a characteristic response. As a result, endocrine signaling requires more time than neural signaling to prompt a response in target cells, though the precise amount of time varies with different hormones. For example, the hormones released when you are confronted with a dangerous or frightening situation, called the fight-or-flight response, occur by the release of adrenal hormones—epinephrine and norepinephrine—within seconds. In contrast, it may take up to 48 hours for target cells to respond to certain reproductive hormones.

      Interactive Link

      Visit this link to watch an animation of the events that occur when a hormone binds to a cell membrane receptor. What is the secondary messenger made by adenylyl cyclase during the activation of liver cells by epinephrine?

      In addition, endocrine signaling is typically less specific than neural signaling. The same hormone may play a role in a variety of different physiological processes depending on the target cells involved. For example, the hormone oxytocin promotes uterine contractions in people in labor. It is also important in breastfeeding, and may be involved in the sexual response and in feelings of emotional attachment in humans.

      In general, the nervous system involves quick responses to rapid changes in the external environment, and the endocrine system is usually slower acting—taking care of the internal environment of the body, maintaining homeostasis, and controlling reproduction (Table 17. 1). So how does the fight-or-flight response that was mentioned earlier happen so quickly if hormones are usually slower acting? It is because the two systems are connected. It is the fast action of the nervous system in response to the danger in the environment that stimulates the adrenal glands to secrete their hormones. As a result, the nervous system can cause rapid endocrine responses to keep up with sudden changes in both the external and internal environments when necessary.

      Endocrine and Nervous Systems

      Endocrine systemNervous system
      Signaling mechanism(s)ChemicalChemical/electrical
      Primary chemical signalHormonesNeurotransmitters
      Distance traveledLong or shortAlways short
      Response timeFast or slowAlways fast
      Environment targetedInternalInternal and external

      Table
      17. 1

      Structures of the Endocrine System

      The endocrine system consists of cells, tissues, and organs that secrete hormones as a primary or secondary function. The endocrine gland is the major player in this system. The primary function of these ductless glands is to secrete their hormones directly into the surrounding fluid. The interstitial fluid and the blood vessels then transport the hormones throughout the body. The endocrine system includes the pituitary, thyroid, parathyroid, adrenal, and pineal glands (Figure 17.2). Some of these glands have both endocrine and non-endocrine functions. For example, the pancreas contains cells that function in digestion as well as cells that secrete the hormones insulin and glucagon, which regulate blood glucose levels. The hypothalamus, thymus, heart, kidneys, stomach, small intestine, liver, skin, ovaries, and testes are other organs that contain cells with endocrine function. Moreover, adipose tissue has long been known to produce hormones, and recent research has revealed that even bone tissue has endocrine functions.

      Figure
      17.2

      Endocrine System

      Endocrine glands and cells are located throughout the body and play an important role in homeostasis.

      The ductless endocrine glands are not to be confused with the body’s exocrine system, whose glands release their secretions through ducts. Examples of exocrine glands include the sebaceous and sweat glands of the skin. As just noted, the pancreas also has an exocrine function: most of its cells secrete pancreatic juice through the pancreatic and accessory ducts to the lumen of the small intestine.

      Other Types of Chemical Signaling

      In endocrine signaling, hormones secreted into the extracellular fluid diffuse into the blood or lymph, and can then travel great distances throughout the body. In contrast, autocrine signaling takes place within the same cell. An autocrine (auto- = “self”) is a chemical that elicits a response in the same cell that secreted it. Interleukin-1, or IL-1, is a signaling molecule that plays an important role in inflammatory response. The cells that secrete IL-1 have receptors on their cell surface that bind these molecules, resulting in autocrine signaling.

      Local intercellular communication is the province of the paracrine, also called a paracrine factor, which is a chemical that induces a response in neighboring cells. Although paracrines may enter the bloodstream, their concentration is generally too low to elicit a response from distant tissues. A familiar example to those with asthma is histamine, a paracrine that is released by immune cells in the bronchial tree. Histamine causes the smooth muscle cells of the bronchi to constrict, narrowing the airways. Another example is the neurotransmitters of the nervous system, which act only locally within the synaptic cleft.

      Career Connection

      Endocrinologist

      Endocrinology is a specialty in the field of medicine that focuses on the treatment of endocrine system disorders. Endocrinologists—medical doctors who specialize in this field—are experts in treating diseases associated with hormonal systems, ranging from thyroid disease to diabetes mellitus. Endocrine surgeons treat endocrine disease through the removal, or resection, of the affected endocrine gland.

      Patients who are referred to endocrinologists may have signs and symptoms or blood test results that suggest excessive or impaired functioning of an endocrine gland or endocrine cells. The endocrinologist may order additional blood tests to determine whether the patient’s hormonal levels are abnormal, or they may stimulate or suppress the function of the suspect endocrine gland and then have blood taken for analysis. Treatment varies according to the diagnosis. Some endocrine disorders, such as type 2 diabetes, may respond to lifestyle changes such as modest weight loss, adoption of a healthy diet, and regular physical activity. Other disorders may require medication, such as hormone replacement, and routine monitoring by the endocrinologist. These include disorders of the pituitary gland that can affect growth and disorders of the thyroid gland that can result in a variety of metabolic problems.

      Some patients experience health problems as a result of the normal decline in hormones that can accompany aging. These patients can consult with an endocrinologist to weigh the risks and benefits of hormone replacement therapy intended to boost their natural levels of reproductive hormones.

      In addition to treating patients, endocrinologists may be involved in research to improve the understanding of endocrine system disorders and develop new treatments for these diseases.

      Which nervous system regulates the work of the endocrine system

      The human body is a complex mechanism. Its cells, tissues and organs must work harmoniously and harmoniously. This condition is ensured by the work of two signaling systems: endocrine and nervous. Their interconnection provides several important conditions:

      • homeostasis – the body’s ability to maintain constant characteristics;
      • adaptation – the ability to change some factors of the internal environment depending on changes in external conditions;
      • cell growth;
      • reproduction.

      The nervous system is a collection of organs that provide innervation to all organs and tissues. Its central section includes the brain and spinal cord, and the peripheral section includes the nerves. Information is captured by receptors, then moves in the form of impulses through nerve cells and reaches the brain. It provides a quick reaction in the form of muscle movement or other response to a stimulus. Also, the nervous system regulates the work of the endocrine system, controlling the intensity of hormone production.

      The endocrine system is a collection of glands that secrete hormones into the blood. It includes the hypothalamus, pituitary gland, as well as peripheral glands: thyroid, pancreas, genital, adrenal glands. Hormones are biologically active substances that combine with the cells of various organs and can change their work, speed up or slow down biochemical processes in the body.

      To understand which nervous system regulates the work of the endocrine system, you need to track the relationship. It is called “neuroendocrine regulation” and consists in controlling the production of hormones by the endocrine glands. This process is ensured by the work of several structures: the hypothalamus, neurotransmitter hormones, and the adrenal medulla.

      The role of the hypothalamus

      The hypothalamus is a small area of ​​the diencephalon, which is considered the center of neuroendocrine regulation. It is connected with other parts of the nervous system, the brain and spinal cord. Together with the pituitary gland, it forms the hypothalamic-pituitary system and regulates the intensity of the production of its hormones.

      The hypothalamus receives signals from the following structures:

      • basal nuclei (ganglia) – accumulations of gray matter in the white matter of the brain;
      • spinal cord;
      • parts of the brain: oblong, middle, thalamus, as well as some parts of the cerebral hemispheres.

      The hypothalamus is the center that accumulates data from the whole organism, as well as from the external environment. Nerve cells of the hypothalamus are able to produce several types of neuroendocrine transmitters – biologically active substances that affect the intensity of the synthesis of tropic pituitary hormones:

      1. Liberins – a group of compounds that stimulate hormonal synthesis. So, somatoliberin increases the production of somatotropic growth hormone, thyreoliberin – thyrotropic, gonadoliberin – luteinizing and follicle-stimulating hormones.
      2. Statins are substances that suppress the production of tropic hormones by the pituitary gland. There are varieties such as somatostatin, prolactostatin, melanostatin.
      3. Oxytocin and vasopressin are hormones produced by the hypothalamus but stored in the posterior pituitary gland. The first increases during childbirth and causes contraction of the muscular wall of the uterus, but also performs other functions. Vasopressin regulates water metabolism, increases vascular tone.

      Hormones of the hypothalamus enter the pituitary gland through the bloodstream and influence its functions there. Statins and liberins do not always act strictly selectively. So, somatostatin can suppress the production of not only somatotropin, but also thyrotropic hormone, insulin and prolactin.

      Nervous regulation of the adrenal glands

      Adrenal glands are paired glands, which in humans are located in the region of the upper pole of the kidneys. In their structure, two components are distinguished: cortical and medulla. The cortex performs an endocrine function and produces hormones into the blood, and the medulla is an intermediate link between the nervous and endocrine systems.

      One of the functions of the adrenal medulla is the production of catecholamines. This is a group of biologically active compounds that includes epinephrine and norepinephrine. They are activated to the maximum in stressful situations, when it is urgent to bring the body into tone, and trigger a number of changes:

      • accelerated heartbeat;
      • increased vascular tone;
      • increase in blood pressure;
      • expansion of the bronchial lumen;
      • inhibition of the digestive tract and decrease in the secretion of its glands;
      • dilated pupils;
      • increased activity of sweat glands.

      The adrenal medulla has a similar structure to the nervous tissues, since during fetal development it is formed from identical rudiments. Histologically, the cells in this area are deformed neurons of the sympathetic autonomic nervous system, which then transformed into endocrine cells. They are activated under the influence of sympathetic nerve fibers. As a result of their irritation, adrenaline and norepinephrine are released into the bloodstream.

      Catecholamines are considered “stress hormones” because their concentration increases in uncomfortable conditions for the body. They are activated during times of pain, exposure to cold, exercise, and muscle fatigue. Also, their increase can be caused by stress, vivid emotions, prolonged mental stress and other factors. The work of the adrenal medulla is controlled by structures such as the cerebral cortex and medulla oblongata, as well as the hypothalamus.

      Feedback

      In the process of neuroendocrine regulation, a two-way connection is observed. The organs of the endocrine system are under the control of nervous structures that stimulate or inhibit the synthesis of biologically active compounds. However, hormones also affect the central and peripheral parts of the nervous system. Thus, the thyroid gland secretes substances that act directly on the brain, bypassing the complex blood-brain barrier. They are useful for brain tissues, as they stimulate their growth and development, improve mental functions. Adrenaline and norepinephrine can also affect neurons, thereby participating in brain function.

      Specialists of the medical center “Yunona” are engaged in diagnosing changes in the nervous and endocrine systems: a neurologist and an endocrinologist. You can make an appointment by calling 8 (831) 225-56-56.

      Structure of the endocrine system Pathologies of the neuroendocrine system

      1. Main
      2. Analyzes
      3. Directory of Diseases
      4. Organization and pathology of the endocrine system

      The endocrine (neuroendocrine) function performs the regulatory activity of internal organs with the help of biologically active substances – hormones, which, released by endocrine structures, enter the bloodstream or pass into nearby cells.

      General concept and characteristics of the endocrine system

      Thanks to the endocrine function, many internal organs are controlled and regulated. In addition, adaptation of the body to periodic changes in the external environment is ensured, while maintaining a normal homeostasis balance to ensure a healthy and natural human existence.

      Neuroendocrine function is of the following categories:

      • Glandular . Produces glandular elements.
      • Diffuse . Endocrine biological elements are localized throughout the body and produce hormones called aglandular.

      Structural and functional organization of the endocrine system

      Some glands (gonads and pancreas) are joint, that is, they produce exogenous and endogenous secretions.

      It is also worth noting that certain organs can produce certain hormones to some extent. For example, the kidneys release renin , prostaglandin, erythropoietin into the blood, and the atrium – atrial natriuretic peptide.

      The diffuse endocrine system also plays an important role in the production of essential hormones. Thus, neuropeptides produced by the central and peripheral nervous system regulate all important physiological functions of the human body. It is also worth mentioning the gastropancreatic endocrine system, which produces biological (signal) elements.

      Pathologies of the endocrine system and their characteristics

      Endocrine pathologies are diseases caused by dysfunction of one or more endocrine glands.

      I. Violation of the combined structures of the pituitary and hypothalamus
      • Acromegaly . The disease is associated with increased production of somatotropic hormone (growth).
      • Itsenko-Cushing pathology . Pathology is characterized by an increase in the production of biological substances by the adrenal glands, which leads to hyperplasia of the pituitary tissue or the appearance of compaction in it.
      • Prolactinoma . Benign education, manifested most often in women.
      • Hyperprolactinemia . An increase in the concentration of the hormone prolactin in the bloodstream.
      • Diabetes insipidus . Polyuria (urine excretion – up to 8-15 liters per day) and polydepsia (heavy drinking).
      II. Thyroid dysfunction
      • Hyperthyroidism . Overproduction thyroxine (T4) and triiodothyronine (T3).
      • Hypothyroidism. Decreased thyroxine (T4) and triiodothyronine (T3).
      • Diffuse toxic goiter . Excessive secretion of thyroid hormones, which leads to thyrotoxicosis.
      • Thyrotoxic neoplasm . The presence of a benign tumor in the thyroid gland leads to an increase in the level of thyroid hormones.
      III. Diseases of the pancreas
      • Diabetes mellitus . Insufficient production of the hormone insulin, which leads to an increase in sugar in the bloodstream.
      • Adrenal hormonal tumor . Benign or malignant growth of atypical structures of the adrenal glands.
      IV. Pathological changes in the adrenal glands
      • Chronic adrenal insufficiency . Decreased glucocorticoid and mineralocorticoid function of the adrenal glands.
      • Primary hyperaldosteronism . It develops as a result of excessive release of aldosterone .
      V. Diseases of the gonads (in women)
      • Premenstrual syndrome . Occurs in premenstrual days (2-8 days before menstruation).