SCRAMBLE WORD
STENMRUAL
YECCL
MENSTRUAL
CYCLE
PASEMENOU
MENOPAUSE
NARMECHE
MENARCHE
EALUTL SEPHA
LUTEAL
PHASE
THE MENSTRUAL CYCLE
Gen-Ed 111 :
Group 1
THE MENSTRUAL CYCLE
The menstrual cycle is the cycle of the natural changes that
occurs in the uterus and ovaries as an essential part of making
sexual reproduction possible. Its timing is governed by
endogenous biological cycles. The menstrual cycle is essential
for the production of ova and for the preparation of the uterus
for pregnancy.
The menstrual cycle occurs repeatedly between the age of
menarche, when cycling begins, until menopause when it ends.
The length of menstrual cycle varies greatly among women
(ranging from 21 to 35 days) with 28 days designated as the
average length. Each cycle can be divided into three phases
based on events in the ovary (ovarian cycle) or in the uterus
(uterine cycle)
PURPOSE OF MENSTRUAL CYCLE
1. To bring an ovum to maturity
2. To renew a ut
erine tissue bed that will be responsive to fetal
growth
3. To prepare the uterus for pregnancy
OVARIAN CYCLE
This consists of:
a. The follicular phase
b. Ovulation
c. Luteal phase
UTERINE CYCLE CONSISTS OF
a. Menstruation
b. Proliferative phase
c. Secretory phase
The average age of menarche is 12-13 years, but it
is considered normal for it to occur anywhere
between ages 8 and 16 years. Factors such as
hereditary, diet and overall health can accelerate or
delay the menarche. The cessation of menstrual
cycles at the end of a woman’s reproductive period
is termed menopause. The average age of
menopause is 52 years with anywhere between 45
and 55 being common. Menopause before age 45
is considered premature.
THE OVARIAN CYCLE
a. The follicular phase. This is the first part of the ovarian
cycle. During this phase, the ovarian follicles mature and
get ready to release an ovum. The latter part of this
phase overlaps with the proliferative phase of the uterine
cycle. Through the influence of a rise in follicle
stimulating hormone (FSH) during the first days of the
cycle, a few ovarian follicles are stimulated. These
follicles which were present at birth and have been
developing in a process known as folliculogenesis,
compete with each other for dominance. Under the
influence of several hormones, all but one these follicles
will stop growing, while one dominant follicle in the ovary
will continue to maturity. The follicle that reaches
maturity is called tertiary or Graafian follicle and it
contains the ovum.
b. Ovulation is the second phase of the ovarian cycle
in which a mature ovum is released from the
ovarian follicle into the fallopian tube.
During the follicular phase oestradiol production
occurs and it suppresses production of luteinizing
hormone (LH) from the anterior pituitary . When
the ovum has nearly matured, levels of oestradiol
reach a threshold above which this effect is
reversed and the oestrogen stimulates the
production of a large amount of LH. This process,
known as the LH surge, starts around day 12 of
the average cycle and may last 48 hours.
The release of LH matures the ovum and weakens
the wall of the follicle in the ovary causing the
fully developed follicle to release its secondary
oocyte. The secondary oocyte promptly matures
into the mature ovum. This ovum has a diameter
of 20 mm. After being released from the ovary,
the ovum is swept into the fallopian tube by the
fambria which is a fringe of tissue at the end of
the fallopian tube. After about a day, an
unfertilized ovum will disintegrate or dissolve in
the fallopian tube.
Fertilization by a spermatozoon usually takes place
in the ampulla, the widest section of the fallopian
tube. A fertilized ovum immediately begins the
process of embryogenesis. The developing
embryo takes three days to reach the uterus and
another three days to implant into the
endometrium. It has usually reached the
blastocyst stage at the time of implantation.
c. Luteal Phase
This is the final phase of the ovarian cycle and it corresponds
to the secretory phase of the uterine cycle. During the luteal
phase, the pituitary hormones FSH and LH cause the
remaining parts of the dominant follicle to transform into the
corpus luteum, which produces progesterone. The hormones
produced by the corpus luteum also suppress production of
the FSH and LH that the corpus luteum needs to maintain
itself. Consequently, the level of FSH and LH fall quickly over
time and the corpus luteum subsequently atrophies. Falling
levels of progesterone and oestradiol triggers menstruation
and the beginning of the next cycle. For an individual woman,
the follicular phase often varies in length from cycle to cycle;
by contrast the length of her luteal phase is fairly consistent
from cycle to cycle at 14 days.
The loss of corpus luteum is prevented by
fertilization of the ovum. The syncytiotrophoblast,
which is the outer layer of the resulting embro-
containing structure (the blastocyst) and later also
becomes the outer layer of the placenta, produces
human chorionic gonadotrophin (hCG) which is
very similar to LH and which preserves the corpus
luteum. The corpus luteum can then continue to
secrete progesterone to maintain the new
pregnancy. Most pregnancy tests look for the
presence of hCG.
UTERINE CYCLE
a. Menstruation
This is the first phase of the uterine cycle. The flow of
menses normally serves as a sign that a woman has
not become pregnant.
Normal menstruation lasts for a few days usually 3 to 5
days but anywhere from 2 to 7 days is considered
normal. The average blood loss during menstruation is
35 ml with 10-80 ml considered normal. Women who
experience menorrhagia >80 ml are more susceptible
to iron deficiency than the average person. An enzyme
called plasmin inhibits clotting in the menstrual fluid.
Painful cramping in the abdomen, back or upper thigh is
common during the first few days of menstruation. Severe
uterine pain during menstruation is known as dysmenorrhoea
and is most common among adolescents and younger
women (affecting about 2/3 of adolescent females)
b. The proliferative phase is the second phase of the uterine
cycle when oestrogen causes the endometrium to grow or
proliferate. As they mature, the ovarian follicles secret
increasing amount of oestradiol. The oestrogens initiate the
formation of a new layer of endometrium in the uterus,
histologically identified as the proliferative endometrium.
The oestrogen also stimulates crypts in the cervix to produce
fertile cervical mucus.
c. Secretory phase:
This is the final phase of the uterine cycle and it
corresponds to the luteal phase of the ovarian
cycle. During the secretory phase, the corpus
luteum produces progesterone which plays a vital
role in making the endometrium receptive to
implantation of the blastocyst and supportive of the
early pregnancy by increasing blood flow and
uterine secretions and reducing the contractility of
the smooth muscle in the uterus. It also raises the
woman’s basal body temperature.