M1 : Lesson 3B: Menstrual Cycle
• The process by which the seminiferous
Menstrual cycle
• A menstrual cycle is a periodic uterine
bleeding in response to cyclical
hormones beginning at puberty and
ending at menopause.
• Menstrual cycles are possible because
of the interplay between the
hypothalamus, pituitary, ovaries and
uterus.
• The cycle varies in length from 23 to 35
days, averaging 28 days (from the
beginning of one menstrual flow to the
beginning of the next).
• The menstrual cycle is divided into four
phases that are characterized by
changes in the uterine endometrium:
(Silbert-Flagg and Pillitteri, 2018)
o (1) the proliferative
o (2) the secretory,
o (3) the ischemic
o (4) Menses
Spermatogenesis
tubules of the testes produce sperm.
• Begins in males at puberty.
• 65 to 75 days.
• Begins with spermatogonia (stem
cells)with diploid (2n) number of
chromosomes.
• Some spermatogonia lose contact with
the basement membrane and undergo
developmental changes.
• Differentiate into primary
spermatocytes (2n) 46 chromosomes.
• Each primary spermatocytes replicates
its DNA and meiosis begins.
• 2 Secondary spermatocytes are formed
by meiosis I.
• Each secondary spermatocytes 23
chromosomes, haploid number.
• No further replication occurs in the
secondary spermatocytes.
• Spermiogenesis – final stage of
spermatogenesis.
• Development of haploid spermatids
into sperm.
• No cell division occurs in
spermiogenesis.
• Spermatids transform into elongated,
slender sperm.
• •Sperm
o 300 million sperm complete the
process of spermatogenesis each
day.
o 60 um long
o Structures that are highly adapted
for reaching and penetrating
secondary oocytes.
o Once ejaculated, most sperm do
not survive more than 48 hours
within the female reproductive
organ.
o Parts of the sperm:
▪ Head
➢ contains nucleaus with 23
chromosomes
▪ Acrosome
 ➢ covers the anterior two
thirds of the nucleus.
➢ Filled with enzymes that
help a sperm penetrate a
secondary oocytes for
fertilization.
➢ Hyaluronidase and
proteases.
▪ Tail
➢ • Neck – constricted region
just behind the head that
contains centrioles.
➢ Middle piece – contains the
mitochondria which provide
the energy (ATP) for
locomotion of sperm.
➢ Principal piece – longest
portion.
➢ End piece – terminal,
tapering portion of the tail.
HORMONAL CONTROL & SEXUAL
DEVELOPMENT
• Androgens – male sex hormones ,
produced in testes and adrenal glands
• For devt of male sex organs and
secondary sex characteristics,
spermatogenesis
• Testosterone is one major androgen
• Leydig cells ( located in testes) secretes
testosterone
OOGENESIS AND FOLLICULAR DEVELOPMENT
• Oogenesis
o formation of gametes in the
ovaries.
o Begins in females before they are
born.
o Same manner as spermatogenesis;
meiosis takes place.
o Fetal development
primordial(primitive) germ cells
migrate from the yolk sac to the
ovaries.
o Germ cells differentiate within the
ovary into oogonia diploid (2n).
o Diploid oogonia divide mitotically to
produce millions of germ cells.
o Most of the germ cells degenerate ,
process known as atresia.
o Few, develops into larger cells
called primary oocytes.
o Primary oocytes enter prophase of
meiosis I during fetal development
but do not complete that phase
until after puberty.
o During the arrested meiosis I, each
primary oocyte is surrounded by a
single layer of follicular cell.
o Primordial follicle.
o Between 5-7 million ova are form in
utero
o At birth - 2M primary oocytes
remain in each ovary.
o By age 7 – 500,000 are present in
each ovary
o By 22 years – 300,000are present
o By menopause – none are left
o The remainder of the primary
oocytes undergo atresia.
o Primordial follicle starts to grow,
developing into primary follicles
stimulated by the gonadotropins
(FSH and LH) secreted by the
anterior pituitary.
o Primary follicles consists of a
primary oocytes is surrounded by
granulosa cells.
o As the primary follicle grows, it
forms a cleart glycoprotein layer
called zona pellucida between the
primary oocytes and the granulosa
cells.
▪ Theca folliculi – encircles the
basement membrane of the
granulosa cells.
▪ Theca interna – vascularized
internal layer
▪ Theca externa – outermost
layer.
 o Secondary follicle becomes larger
turning into a mature (graafian)
follicle.
o While in this follicle, the diploid
primary oocytes completes meiosis
I, producing two haploid cells of
unequal size – each with 23
chromosomes.
o First polar body
▪ Smaller cell produced By
meiosis I.
o Secondary oocytes
▪ Begins meiosis II Then stops in
Metaphase.
o Mature (graafian) Follicle soon
ruptures And releases its Secondary
oocytes then ovulation
▪ Secondary oocyte is expelled
into the pelvic cavity together
with first polar body.
▪ Swept into the uterine tube.
o If fertilization does not occur, it
degenerates.
o If sperms are present In the uterine
tube and one penetrates the
secondary oocytes, meiosis II
resumes.
▪ Ovum or mature egg unite with
sperm cell forming diploid (2n),
zygote.
o Corpus luteum
▪ contains the remnants of a
mature follicle after ovulation.
▪ Produces progesterone,
estrogens, relaxin and inhibin
until it degenerates into fibrous
scar tissue called corpus
albicans.
HYPOTHALAMIC
PITUITARYOVARIAN/TESTICULAR AXIS
Gonadotrophin Releasing Hormone (GnRH)
• Secreted by the hypothalamus.
• Controls the ovarian and uterine cycles.
• Stimulates the release, synthesis and
storage of follicle stimulating hormone
(FSH) and luteinizing hormone (LH)
from the anterior pituitary.
• Involved mainly in ovarian functions.
• Follicle Stimulating Hormone (FSH)
o Released from the anterior pituitary
gland
o Initiates follicular growth.
o Receptors of FSH exist primarily on
the cell membrane of the granulosa
cells of the ovarian follicle
• Luteinizing Hormone (LH).
o Stimulates androgen synthesis by
the theca cells.
o Progesterone synthesis by the
corpus luteum.
o Stimulates prostaglandin synthesis
by intracellular production of cAMP.
o Triggers ovulation and formation of
corpus luteum.
• Estrogen
o Secreted by ovarian Follicles.
• Progesterone
o Secreted mainly by cells of the
corpus luteum.
MENSTRUATION
• Is an episodic uterine bleeding in
response to cyclic hormonal changes
• The purpose is to bring an ovum to
maturity and renew a uterine tissue bed
that will be responsible for the ova’s
growth should it be fertilized
• That allows for conception and
implantation of a new life
• Menarche
o first menstrual period in girls.
o May occur as early as 9 years old or
as late as 17 years old.
o Average onsest at 12.4 years
• Normal menstrual Cycle: 23 to 35 days,
average of 28 days.
• Length/duration: 2 to 7 days, ranges of
1-9 days
• Average amount blood loss of 30 to 80
ml
• Color of menstrual flow: Dark red; a
combination of blood, mucus and
endometrial cells.
• Odor: Similar to marigolds.
• Teaching about Menstrual Health
o 1. Exercise – moderate exercise
o 2. Sexual relations- not
contraindicated
o 3. Activities of daily living- nothing
is contraindicated
o 4. Pain relief- Prostaglandin
inhibitors, applying local heat
o 5. Rest – more rest if dysmenorrhea
is present
o 6. Nutrition- iron supplementation
• Four body structures involved
o 1. Hypothalamus
o 2. Pituitary gland
o 3. Ovaries
o 4. Uterus
• 4 Phases:
o Menstrual phase
▪ Episodic uterine bleeding in
response to cyclic hormonal
changes.
▪ Cyclic monthly changes in
ovaries and endometrium in
preparations for ovulation.
▪ Monthly shedding off uterine
lining in response to drop in
estrogen and progesterone
level
▪ Purpose:
➢ To bring an ovum to
maturity
➢ Renew uterine tissue bed
that will be responsible for
its growth should it be
fertilized.
▪ • Events in the Ovaries:
➢ Under the influence of FSH
– primordial follicles
develop into primary
follicles then into secondary
follicles.
➢ Takes several months to
occur.
➢ Follicle that begins to
develop at the beginning of
a particular menstrual cycle
may not reach maturity and
ovulate until several
menstrual cycles later.
➢ Menstrual flow from the
uterus
➢ 50-150 ml of blood, tissue
fluid, mucus and epithelial
cells shed from the
endometrium.
▪ Events in the Uterus
➢ Decrease estrogen and
progesterone stimulate the
release of prostaglandins.
➢ Prostaglandins causes
uterine spiral arterioles to
constrict
➢ cells they supply become
oxygen deprived
➢ starts to die
➢ stratum functionalis sloughs
off
➢ menstrual flow passes from
the uterine cavity through
the cervix and vagina
o Preovulatory phase (proliferative)
▪ Time between the end of
menstruation and ovulation.
▪ Events in the Ovaries:
➢ Secondary follicles in the
ovaries begin to secret
estrogen and inhibin.
➢ A single secondary follicle in
one of the two ovaries
become dominant follicle.
➢ Dominant follicle secretes
estrogen and inhibin which
will decrease the secretion
of FSH.
➢ Decrease of FSH will cause
other less well developed
follicles to stop growing and
undergo atresia.
➢ One dominant follicle
becomes the mature
 (graafian follicle) and
continues to enlarge and
ready for ovulation.
➢ During the final maturation
process, the mature follicle
continues to increase its
estrogen production.
➢ Follicular Phase because
ovarian follicles are growing
and developing.
▪ Events in the Uterus
➢ Estrogens secreted by the
growing ovarian follicles
stimulate the repair of the
endometrium.
➢ Stratum basalis undergo
mitosis and produces a new
stratum functionalis.
➢ The thickness of the
endometrium doubles to 4
to 10 mm.
➢ Termed as Proliferative
phase because the
endometrium is
proliferating.
o Ovulation
▪ The rupture of the mature
(graafian) follcile.
▪ Release of the secondary
oocyte into the pelvic cavity
▪ Occurs on day 14 in a 28 day
cycle.
▪ High levels of estrogens during
the last part of the preovulatory
phase exerts a positive
feedback.
▪ Secrete LH and GnRH and
causes ovulation.
▪ Mittelschmerz – the small
amount of blood that leaks into
the pelvic cavity from the
rupture follcile can cause pain.
▪ Signs and symptoms of
ovulation:
➢ Basal body temperature
slightly increase 0.2 to 0.5
˚C on the day following
ovulation preceded by
sudden drop.
➢ Cervical mucous under the
influence of estrogen is
favorable to spermatozoa.
➢ Fern test:
o Cervical mucus forms
fernlike patterns when
placed on a glass slide
and allowed to dry.
o Caused by
crystallization of
sodium chloride on
mucus fibers known as
arborization or ferning.
➢ Spinnbarkeit Test :
o Cervical mucus
becomes thin and
watery and can be
stretched into long
strands.
➢ Midmenstrual pain
➢ Breast tenderness
o Postovulatory phase (secretory)
▪ Time between ovulation and
onset of the next menses.
▪ It is the most constant part of
the female reproductive cycle.
▪ Last 14 days in a day cycle, from
day 15 to day 28.
▪ Events in one ovary
➢ After ovulation, the mature
follicle collapses.
➢ A blood clot forms from
minor bleeding of the
ruptured follicle – corpus
hemorrhagicum Corpus
luteum.
➢ Corpus luteum secretes
progesterone, estrogen,
relaxin and inhibin under
the influence of LH.
➢ Termed as Luteal Phase.
➢ Oocyte is not fertilized –
the corpus luteum has a
lifespan of 2 weeks.
 ➢ Its secretory activity
declines
➢ Degenerates into corpus
albicans.
➢ Decrease progesterone,
estrogen, and inhibin
causes loss of negative
feedback suppression Rise
of GnRh, FSG,LH
➢ If the secondary oocyte is
fertilized and begins to
divide.
➢ Corpus luteum persist for 2
weeks.
➢ Chorion of the embryo after
8 days of fertilization will
produce human chorionic
gonadotropin (hCG).
➢ hCG like LH, stimulates the
secretory activity of the
corpus luteum.
▪ Events in the Uterus
➢ Progesterone and estrogens
produced by the corpus
luteum promote growth
and coiling of the
endometrial glands.
➢ Vascularization of the
endometrium.
➢ Thickening of the
endometrium to 12 to 18
mm.
➢ Secretory Period –
secretory activity of the
endometrial glands,