• The menstrual cycle is the regular natural changes that occurs in
the uterus and ovaries that make pregnancy possible Cycle is required
for the production of eggs for the preparation of
the uterus for pregnancy • Common symptoms: acne, tender breasts, bloating , feeling tired , irritability and mood changes • Premenstrual syndrome in 20 to 30 %
3 to 8 % severe premenstrual syndrome
The first period menarche The average age of menarche is 12-15. They may occasionally start at eight The typical length of time between 21 to 45 ( with average of 28 - bleeding lasts 2 to 7 ). Factors affect timing are- genetics diet overall health Menopause cessation of menstrual cycles at the end of a woman’s reproductive period . Menstruation stops occurring after menopause which usually occurs between 45 and 55 The average age of menopause 52 years,. Menopause before age 45 is considered premature in industrial countries. The age of menopause is largely a result of cultural and biological factors The menstrual cycle is gaovern by hormonal changes. Menstrual cycle ovarian cycle uterine cycle
follicular luteal menstruation secretory
phase phase phase ovulation proliferative phase Fertility . Fertile period- ( the time with the highest likelihood of pregnancy resulting from sexual intercourse ) covers the time from about 5 days before and until 2 days after ovulation. In a 28-day cycle with a 14- day of luteal phase corresponds to the second and the beginning of the third week. The menstrual cycle can be described by the ovarian or uterine cycle. Ovarian cycle describes changes that occur in the follicles of the ovary Uterine cycle describes changes in the endometrial lining of the uterus. Ovarian cycle Ovarian cycle consists of - follicular phase - ovulation - luteal phase The follicular phase -is the first part of the ovarian cycle. During this phase the ovarian follicles mature and get ready to release an egg. This phase overlaps proliferative phase of the uterine cycle.
Process of follicles developing folliculogenesis.
Under the influence of several hormones-one dominant follicle in the ovary will continue maturity. The follicle that reaches maturity Graafian follicle contains the ovum. Ovulation mature egg is released from the ovarian follicles in the oviduct. Egg has nearly matured , levels of estradiol reaches a threshold, above which it is reversed and estrogen stimulated the production of a large amount of LH. LH surge around day 12 of the average cycle and may last 48 hours. Which of the two ovaries -left or right-ovulates appears essentially random ; no known left and right co-ordinations exists. Both ovaries will release an egg, if both eggs are fertilized fraternal twins. After being released from the ovary, the egg is swept into the fallopian tube by the fimbria, which is a fringe of tissue at the end of each fallopian tube.
An unfertilized egg will disintegrate or
dissolve in the fallopian tube. Fertilization by a spermatozoon - takes place in the ampulla, the widest section of the fallopian tubes. A fertilized egg immediately begins the process of embryogenesis or development. The development embryo takes about 3 days to reach the uterus and another 3 days to implant into the endomterium. It has usually reached the blastocyst stage at the time of implantation . Luteal phase Luteal phase- 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 progesterone. The hormones produced by the corpus luteum also suppress production of the FSH and LH that the courpus 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 trigger menstruation and the beginning of the next cycle . From the time of ovulation until progesterone withdrawal has caused menstruation to begin, the process typically takes about 2 weeks with 14 days considered normal. Uterine Cycle
menstruation proliferative secretory phase
phase
Menstruation (also called menstrual bleeding, menses,
catamenia or a period)- is the first phase of the uterine cycle. The flow of menses normally serves as a sign that a woman has not become pregnant. Eumenorrhea denotes normal, regular menstruation that lasts for a few days. The average blood loss during menstruation is 35 milliliters with 10-80 ml considered normal. Painful ramping in the abdomen , back or upper thighs is common during the first few days of menstruation. Dysmenorrhea severe uterine pain during menstruation is known as and it is most common among adolescents and younger women . Proliferative phase The proliferative phase -is the second phase of the uterine cycle when estrogen causes the lining of the uterus to grow, or proliferate , during this time . As they mature , the ovarian follicles secrete increasing amounts of estradiol and estrogen . The estorgens initiate the formation of a new layer of endometrium in the uterus , histologically identified as the proliferatifve endometrium. The estrogen also stimulates crypts in the cervix to produce fertile cervical mucus. Secretory phase The secretory phase -is the final phase of the uterine cycle and it corresponds to the luteal phase of the ovarian cycle. During the secretory phase , the corpuse luteum produces progesterone, which plays a vital role in making the endometrium receptive to implantation of the blastocyst and supportive of the early pregnancy. Hormonal Control of Ovulation Menstrual cycle is controlled hypo-thalamo-pituitary axis. The pituitary is a small gland the size of a cherry that sits at the base of the brain, behind the bridge of the nose . GNRH is secreted from the hypothalamus via venous channels in a pulsatile manner. Gonadotrophin Releasing Hormone (GNRH) deca- peptide (a hormone made up of ten amino acids). Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) are secreated by the anterior pituitary gland. FSH levels are higher in the early follicular phase of the menstrual cycle (initiating follicular development- foliculogenesis ) than in the luteal phase. It has a small peak, which accompanies the very important Luteinising Hormone (LH) peak, just prior to ovulation . The anterior pituitary also secretes LH, which remains at basal levels throughout the cycle with the exception of the LH peak. The LH peak commences about 36 h. prior to ovulation, and it last for 24 h. with the peak occurring 24 h. prior to ovulation. Development of the Graafian Follicle As the follicles start to develop from Day 1 of the cycle, the granulosa cells of the follicules start to secrete the hormone oestrogen. Oestrogen has an effect on many parts of the body and aloes has the effect of regulating the release of gonadotropins. As the oestrogen level rises, the FSH secretion is reduced, so that usually only one follicle matures. This is a negative feedback. Various follicles have different sensitivity to FSH, and it is the most sensitive follicle, which becomes dominant, the one destined to ovulate. The other developing follicles undergo atresia. The hormone Inhibin (type A and B) is also secreted from the ovary and it too has an inhibitory effect on the pituitary with respect to FSH secretion. The Effect of Oestrogen and Progesterone on the Endometrium Circulating oestrogen causes both the glands and the stroma of the endometrium to proliferate. Following ovulation progesterone, is released resulting in secretory changes in the endometrium with tortuous glands containing lots of glycogen able to provide a welcoming nutritional environment should an embryo arrive. Ovulation of the Follicle When the follicle is ready to ovulate, oestrogen primes the pituitary gland to release LH in a peak. This is responsible for the release of the ovum from the follicle about 36h. after the start of the rise and 24h. after the LH peak. The hormone would more accurately be called “Ovulatin Hormone “ and that is what Luteinising Hormone means (as it induces the Corpus Luteum - yellow body -after ovulation ). When the mature oocyte is released from the ovary, it is about 0. 135 mm in diameter and is surrounded by cells called the Cumulus Oophorus. The tissue forming the theca interna and externa ( the human equivalent to the egg shell) remain as the corpus luteum. The yellow colour comes from the deposition of carotene in the cytoplasm of the thecal cells. The Corpus Luteim and Pregnancy The corpus luteum is respoincible for secretion of hormones essential for a pregnancy to be established (oestrogen and progesterone ). These hormones stimulate the uterine lining (endometrium) to prepare, in anticipation of an embryo arriving in a few days time, if a sperm has fertilized the ovum. It is the combined secretion of oestorgen and progesterone that induces the secretory changes in the endometrium. The corpuse luteim has an inherent life span of about 14 days and as it succumbs in the absence of a pregnancy . Thank you for attention !