THE MENSTRUAL

CYCLE
RICHA PATIL
SAKSHI HALVE

One complete cycle divided into 4 phases1. Menstrual Phase

2. Follicular Phase
3. Ovulation Phase
4. Luteal Phase

An average cycle lasts for 28 days.

Menstrual phase
Menstruation- It is the discharge of blood and mucosal tissue from the
inner lining of the uterus through the vagina. It lasts for 3-7 days.

Menarche- Onset
(beginning) of the first
menstruation is called
Menarche. It occurs at
the age of 12 15 years.
It marks the beginning of
puberty.

Menopause- Menstruation stops occurring after the age of 45 55

years due to a fall in the level of hormones. This is called
Menopause.

Cause of Menstruation Menstruation occurs as a result of failure of

fertilization.
The ovary releases an egg on 14th day of every cycle. The lining of
the uterus thickens in every cycle to provide nutrition for the coming
embryo. However, in the event of no fertilization (fusion of egg and
sperm) occurring, the uterine lining is shed along with the unfertilized
egg. This is called menstruation.

SOME MENSTRUAL DISORDERS

POLYMENORRHEA Average length of cycle is less than 21 days

(normal is 28 days), menstruation occurs too frequently.

AMENORRHEA- It is the absence of menstruation i.e. one or more

missed periods. The most common reasons are pregnancy and
lactation, however hormonal problems may also be responsible.

DYSMENORRHEA- It is a medical term that means difficult

or painful periods. Primary dysmenorrhea involves severe
abdominal cramping and it is more common. While secondary
dysmenorrhea is when cramps are a result of a medical
problem such as endometriosis.

PRE-MENSTRUAL SYNDROME (PMS) It refers to physical

and emotionalsymptoms that occur one or two weeks
before menstruation. Symptoms include acne, fatigue,
insomnia, headaches and irritability. Most common cause is
hormonal fluctuation.

Follicular phase

Hypothalamus secretes hormone GnRH (Gonadotropin releasing

hormone) which stimulates the secretion of hormone FSH (Follicle
Stimulation Hormone) from anterior pituitary gland.

FSH initiates follicular growth in ovary.

Primordial follicles mature and maturing stages of follicles release

hormone Estrogen.

Out of all maturing follicles, one finally becomes a mature Graafian

follicle.

Increased secretion of Estrogen triggers the secretion of LH

(Luteinizing Hormone) from anterior pituitary.

Estrogen also stimulates endometrial growth.

k
bac
feed

GnRH

Follicle stimulation by
FSH and feedback by
estrogen

FSH

ESTROGEN

LH

Section of ovary showing progression from growing follicles, to ovulation,

to the degeneration of corpus luteum.

CHANGES IN FOLLICULAR PHASEFSH level rises but then lowers as

Estrogen levels increase.
LH surge as Estrogen level rises.
------------------------------------------------Primary follicles Secondary follicles
Tertiary follicles Graafian follicle
--------------------------------------------------Estrogen level rises as follicles grow.
Progesterone remains low.
--------------------------------------------------Uterine lining disrupted in menstrual
phase.
As Estrogen rises, uterine lining rethickens.

Ovulation

LH surge- Surge means a sudden rush. On 12th 14th day of

the cycle, the secretion of LH from anterior pituitary increases
rapidly.

The release of LH matures the egg and weakens the wall of

the follicle in the ovary, causing the fully developed
Graafian follicle to release its secondary oocyte.

The release of secondary oocyte from Graafian follicle is

called Ovulation.

LH also initiates the conversion of residual follicle, into a corpus

luteum.

Luteal phase

Corpus luteum secretes Progesterone.

Functions of progesterone -

1.

Suppressing GnRH secretion and as a result, FSH and LH also.

2.

Stimulating endometrial (uterine lining) growth.

Corpus luteum also secretes small quantities of Estrogen and

Inhibin, both of which inhibit GnRH secretions, and as a result FSH
and LH.

When fertilization does not occur, the corpus luteum slowly

degenerates. Hence, progesterone, estrogen and inhibin levels also
decrease.

Low levels of progesterone, estrogen and inhibin can no

longer suppress GnRH secretion from hypothalamus.

As GnRH secretion increases, FSH secretion is again and this

marks the beginning of a new cycle.

Since fertilization has not occurred, the unfertilized egg and

uterine lining is shed off in the next menstrual phase.

When fertilization does occur, the corpus luteum does not

degenerate.

It is preserved by hormone hCG (Human Chorionic Gonadotropin)

which is secreted by the implanted blastocyst (future embryo).

As corpus luteum is preserved, it continues to secrete progesterone

to maintain the pregnancy.

 Both LH and FSH levels

lowered. (as a result of
corpus luteum hormones)
----------------------------------------After ovulation, residual
follicle becomes corpus
luteum.
When fertilization does
not occur, corpus luteum
degenerates to corpus
albicans.
----------------------------------------Progesterone and
Estrogen levels high after
corpus luteum formation,
but decrease as it
degenerates.
-----------------------------------------

REFERENCES

Harvard-MIT Division of Health Sciences and Technology (HST.071):

Human Reproductive Biology
by Prof.Henry Klapholz http://ocw.mit.edu/courses/health-sciences-and-technology/hst-071human-reproductive-biology-fall-2005/lecture-notes/normal_mens_cyc.pdf

Menstrual Cycle
by Robert G. Brzyski, MD, PhD, Jennifer Knudtson, MD
http://www.merckmanuals.com/home/women-s-health-issues/biology-ofthe-female-reproductive-system/menstrual-cycle

Women's Gynecologic Health

By Kerri Durnell Schuiling, Frances E. Likis
https://books.google.ca/books?
id=pj_ourS3PBMC&pg=PA94#v=onepage&q&f=false

Menstrual cycle fact sheet

by Office of Women's Health of U.S. Department of Health and Human
Services
http://www.womenshealth.gov/publications/our-publications/factsheet/menstruation.html

Human Reproductive Biology

By Richard E. Jones, Kristin H. Lopez
https://books.google.ca/books?id=M4kEdSnSpkC&pg=PA53#v=onepage&q&f=false

Ovulation Calender
By Pregnology 2013

http://www.pregnology.com/ovulate/16/2/10/1/15/2013

THANKYOU