MENSTRUAL CYCLE

Friday, 26 August 2022 7:52 AM

- Episodic uterine bleeding; periodic series of changes that recur

- Begins at puberty and ending at menopause
- First day of mens to the next first day
MENSTRUATION
- periodic sloughing off of the endometrium which occurs every 28 days but could be anywhere
from 25 to 35 days and lasts for 3-5 days
MENOPAUSE
- permanent cessation between 40 & 55 y/o
- No functioning oocytes remain
Functions of mens: prep for ovulation, fertilization, implantation
Abnormalities of Mens:
1. Amenorrhea - temporary absence of menstrual flow; common to those with PCOS
2. Dysmenorrhea - painful mens
3. Oligomenorrhea - markedly diminished mens
4. Polymenorrhea - too frequent that occurs in less than 3 weeks
5. Menorrhagia - excessive menstrual bleeding
6. Metorrhagia - bleeding between period; intercyclic bleeding
7. Hypomenorrhea - abnormally short menstruation
8. Hypermenorrhea - abnormally long menstruation

SIGNS AND SYMPTOMS OF MENOPAUSE

1. Hot Flashes - sensation of heat that begins in the face to the chest & profuse perspiration
2. Loss of breast mass & firmness, atrophy of repro organs
3. Dyspareunia (painful intercourse) due to decreased vaginal lubrication
4. Osteoporosis - estrogen promotes calcium deposition; decrease level will liberate calcium from
the bones making them brittle; prone to fractures
5. Mood instability, loss of sexual desire, depression & anxiety bcos of fluctuating hormone levels

MANAGEMENT:
• Estrogen replacement therapy
• Calcium (1g a day at HSZ) Vit D supplement
• Liberal fluid intake to dilute urine as more Ca is liberated from the bones & could cause renal
calculi
• Weight bearing exercise
MANAGEMENT OF HOT FLASHES:
• Dress in layer, remove outer clothing during attacks
• Avoid hot envi
• Avoid emotional stress
• Avoid food that could trigger hot flushes: spicy, coffee, tea, alcohol
• Use cooling techniques: fans, showers, ice cubes
NURSING CARE:
• Encourage woman to engage in regular exercise program to maintain muscle tone
• Emphasize adequate intake of Ca
• Vit D for better Ca absorption
• Instruct proper use of water soluble vaginal lubricant for painful intercourse
• Instruct to avoid smoking & alcohol
• Regular physical examination

Involved in menstruation: hypothalamus, APG, ovaries, uterus

NCM 107 LEC Page 1

 - FSH and LH are the pituitary hormones which regulate menstrual cycle activities
- Estrogen and progesterone for the ovarian hormones

PHASES OF THE MENSTRUAL CYCLE

1. Proliferative/ Follicular/ Estrogenic/ Preovulatory/ Post menstrual
2. Secretory/ Luteal/ Progestational Post Ovulatory/ Premenstrual
3. Premenstrual or Ischemic Phase
4. Menstrual Phase

SIGNS OF OVULATION
• Mittlescmerz - a certain degree of pain felt at the lower L or R iliac
• Cervical mucus method or Billing's method - from clear to elastic and watery (most reliable
sign)
• Spinnbarkheit Test - for elasticity of cervical mucus
• Increase in basal body temp
• Mood changes
• Breast changes and enlargement
• Increased libido

FUNCTIONS OF ESTROGEN
- Assists with the maturation of the primary follicle
- Causes the proliferation of the endometrium
- Development of secondary sex characteristics (breast development)
- Inhibits FSH production
- Increases contractions of the myometrium
- " " " of the fallopian tubes
- Increase quantity and ph of cervical mucus causing it to become thin & watery & can be
stretched to a distance of 10-13mm (spinnbarkheit test)
- Stimulates uterine contraction

FSH - stimulates development of graafian follicle

LH - " ovulation and development of corpus luteum

SEXUAL RESPONSE CYCLE

1. Excitement phase - occurs with physical, psychological (sight, sound, emotion, or thought)
stimulation that causes parasympathetic nerve stimulation
- vaginal lubrication, arterial dilation & venous constriction in genital area,
overall muscle tension increases; erection increases, CR, RR, BP increases

2. Plateau Phase - nipples become further engorged; vasocongestion leads to fill distention of the
penis, flushing, breathing becomes deeper, CR, RR, & BP increase markedly
3. Orgasmic Phase - shortest stage; strong muscular contractions (voluntary & involuntary) in
many parts of the body, RR, CR doubles and BP increasing as much as 1/3 above normal
4. Resolution Phase - approx 30 mins for both men & women general muscle relaxation occurs,
external & internal organs to unaroused state

NCM 107 LEC Page 2