OVULATION AND MENSTRATION

- The reproductive process begins in the brain. A series of both NEGATIVE and POSITIVE
feedback loops are responsible for the ovulatory process.
- Ovulation is the process in which a mature egg cell is release from the ovary.
- Menstration is a cyclic physiologic process of regular discharge of blood and mucosal tissue
1from the inner lining of the uterus through the vaginal canal. This only occurs in the absence of
fertilization

Great to know:

GnRH-synthesizing neurons do not originate within the brain, rather it forms from the olfactory placode
with subsequent migration to the brain during fetal development.

X linked Kallmann syndrome - hypogonadotropic hypogonadism with anosmia. Results from the
failure of GnRH neurons to migrate.

HORMONE ACTION
Gonadotropin releasing - HL: 3 minutes, Not measurable in the blood
- PULSATILE release Progesterone affects
hormone
- Low pulse frequency favors FSH synthesis Prequency. P=P
- High pulse frequency favors LH synthesis
- Pulse amplitude is decreased by Estrogen
- Pulse Frequency is decreased by progesterone

Follicle stimulating - Acts on the Ovarian granulosa cells to stimulate follicular growth.
hormone - HL: 3 to4 hours
- Inhibited by rising estrogen and Inhibin A.
Luteinizing Hormone - Acts on Theca cells resulting to androgen synthesis.
- Dominant on the Luteal phase of the menstrual cycle

Folliculogenesis:

1. Primary oocyte is surrounded by a single layer of granulosa cells in a unit referred to as the
primordial follicle
2. Hormonal influence of FSH promotes ANTRAL DEVELOPMENT.
3. Positive feedback loop - Rising levels of estrogen is inhibitory to FSH but after a higher
threshold, estrogen produces an FSH and LH surge which comes 32 hours prior to ovulation.

1
Menstrual cycle:

- DIvided into 2 phases: Follicular and luteal phase

- Ovulation separates the 2 cycles

Must knows

- Mean duration of cycle ——————————————————— 28 days ± 7 days.

- Most variable ———————————————-2 years post-menarche and pre-menopause
- Mean age of menarche ————————————————————age 12 years
- Mean age of menopause———————————————————- ages 45 to 55 years old
- Average blood loss for menstration ——————————— 35 mL (10 - 80ml still normal)
- Regular menstruation usually lasts ————————————3 to 5 days (2 to 7 still normal)

Collect - Select - Grow

FOLLICULAR PHASE:
- subdivided into: Recruitment, Selection, Growth

RECRUITMENT

LUTEAL PHASE
- After ovulation, the proliferative endometrium undergoes a rapid secretory differentiation.
- well-developed subnuclear glycogen rich vacuoles appear in the glands.
- Histological, Coiling of the spiral arteries is highly evident during the Luteal phase.
- Endometrium has 2 layers
- The Functionalis layer sheds during menstration

- The Basalis Layer promotes reepithelization and does not shed off.

Overly aggressive Curettage may damage

the Basalis layer resulting into ASHERMANN
SYNDROME which can lead to infertility or
Abnormal placentation
- The window of implantation (WOI) occurs at days 20 to 24 of a 28-day menstrual cycle, with
implantation occurring about 1 week after fertilization.

- During the Luteal phase formation of the corpus luteum occurs with progesterone synthesis as
its main function.

- If Pregnancy does not occur, Corpus luteum atrophies and becomes the corpus albicans.

- The Main function of the Beta-HCG hormone is to rescue the corpus luteum to continue
progesterone synthesis.

- The end of the luteal phase is characterized by a decrease in progesterone, estradiol, and
inhibin A, with a rising level of FSH to begin another cycle.

MENSTRATION:

- If implantation does not occur in the late luteal phase and hCG is not produced to maintain the
corpus luteum, the endometrial glands begin to collapse and fragment.

- The degrading actions by Matrix Metalloproteinases lead to the loss of blood vessel integrity, the
destruction of endometrial interstitial matrix, and the resultant bleeding characteristic of
menstruation.

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