Ana 213 Puh 2

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MENSTRUAL CYCLE

• Ovarian Cycle

• Uterine Cycle
ANA 213 IDOWU OLUMAYOWA IDOL
MENSTRUAL CYCLE
• Recurring cycle of changes in the reproductive system of an
nongestational female

• It involves the maturation, ovulation and entry of the oocyte


into the uterine tube

• The hormones produced by the ovarian follicles and corpus


luteum (estrogen and progesterone) produce cyclic changes in
the endometrium
• It takes an average of 28 (not invariably) days to complete a
cycle

• This comprises the ovarian cycle and the uterine cycle

• The ovarian cycle is composed of 3 phases


- Follicular phase
- Ovulation
- A postovulatory or luteal phase

• If cycle is prolonged, follicular phase will lengthen while luteal


phase will remain constant at 14 days
Hormonal Control of the Cycle
Hypothalamo-pituitary-ovarian axis
• Hypothalamus releases
gonadotrophin-releasing
hormone in pulsatile manner
anterior pituitary release of
LH and FSH ovary
FSH:
• Stimulates follicular maturation during follicular phase
• Stimulates steroid hormone secretion – oestrogen (by the
granulosa cells of mature ovarian follicle)
LH:
• Stimulates steroid hormone secretion – oestrogen
• Ovulation – mid-cycle surge of LH
• Progesterone production by corpus luteum
Ovarian Cycle (Follicular Phase)
Days 1-8: FSH and LH relatively high levels
• High LH and FSH triggered by drop in
estrogen and progesterone levels from last
cycle
• Stimulate development of 10-20 follicles
• Results in full maturation of a single
dominant follicle, while the rest undergo
atresia
• Estrogenolevels start to rise as follicular
development occurs
Days 9 – 14:
• Follicle increases in size
• Localized accumulation of fluid among
granulosa cells (antrum formation)
• Transforming primary follicle to Graafian
follicle
• Oocyte occupies excentric position,
surrounded by cumulus oophorus (2-3 layers
of granulosa cells)
• Rise in oestrogen by granulosa cells,
associated with follicular maturation
• Inhibin produced by granulosa cells,
restricting number of follicles maturing
Ovarian Cycle (Ovulation)
Day 14:
• Rapid enlargement of follicle and rupture of the follicle
with extrusion of the oocyte and adherent cumulus
oophorus
• Rise in oestrogen mid-cycle surge of LH and to a lesser
extent FSH ovulation
• Immediately before ovulation there is a drop in estrogen
and an increase in progesterone
• Ovulation follows within 18 hours of mid-cycle surge of LH

• If there is not enough of a LH surge, then no ovulation


occurs
Ovarian Cycle (Luteal Phase)
Days 15-28:
• Remainder of the follicle retained in the ovary,
penetrated by capillaries and fibroblasts from
the theca
• Grunlosa cells undergo luteinization (corpus
luteum formation) – the major source of sex
hormones – oestrogen and progesterone
secreted during postovulary phase
• This leads to marked increase in
progesterone and oestrogen
If conception and implantation occur:
• Corpus luteum does not regress, it is maintained by
gonadotrophins secreted by trophoblasts

If conception does not occur successfully:


• Corpus luteum regresses and menstruation occurs
• Drops in steroid sex hormones leads to a rise in
gonadotrophin levels (FSH and LH) initiate next cycle
Uterine Cycle
• Influenced by the cyclical
production of steroid hormones

• Causes changes to the uterus

• Involving the endometrium and


cervical mucus
Uterine Cycle (The
Endometrium)
• Two layered
- Superficial layer that sheds during the menstrual cycle
- Basal layer that does not take part, but regenerates the
superficial layer
• The basal layer has straight arterioles whereas the superficial
layers has spiral ones – important in the process of shedding
Uterine Cycle (Proliferative Phase)
• Occurs during follicular phase of
ovarian cycle
• Endometrium exposed to
estrogen regeneration from
the last menstrual cycle
• Glands in endometrium are
straight in this phase, parallel to
one another and contain little
secretion
Uterine Cycle (Secretory Phase)
• After ovulation – progesterone
production causes secretory
changes in endometrial glands
• Appearance of secretory vacuoles
in glandular epithelium below
nuclei
• Secretions in lumen of glands
which become tortuous and
develop serrated margins
Uterine Cycle (Menstrual Phase)
• Luteal phase lasts 14 days, then there is
a regression of corpus luteum decline
in estrogen and progesterone
• This leads to a intense spasmodic
contraction of spiral section of
endometrial arterioles ischaemic
necrosis shedding of superficial layer
bleeding.
• These spasms are associated with
prostoglandin, which are also associated
with increased uterine contractions
during menstrual flow.
Ovarian and Uterine Cycle
Changes during the menstrual cycle
Cervical Mucus:
• Early follicular phase – viscid and impermeable
• Late follicular phase – increasing oestrogen levels mucus
becomes watery and easily penetrated, allowing spermatozoa to
get through
• Post-ovulation – progesterone from corpus luteum counteracts
oestrogens effects mucus becomes impermeable and the
cervical os contracts
Other Changes
• Body temperature – Rise of 0.5°C after ovulation till onset of
menstruation. Due to progesterone levels. If conception occurs –
this temperature is maintained throughout pregnancy
• Breast changes – breast swelling during luteal phase due to
increasing progesterone levels
• Psychological changes – change in mood and an increase in
emotional lability. Might be due to falling progesterone levels
Menses
• Production of 35-80ml of blood
• Over an average of 3-5 days
ASSIGNMENT (Read up)

• Amenorrhea
• Oligomenorrhea
• Polymenorrhea
• Menorrhagia

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