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LECT 28 : THE MENSTRUAL CYCLE

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Learning Objectives
At the end of the lesson, students will be able to:

1. Define puberty, menarche, menopause and

menstrual cycle.

2. List the hormones involved in the menstrual

cycle.

3. Explain the phases of the menstrual cycle.

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Puberty
Puberty is the age at which the internal
reproductive organs reach maturity.

It marks the beginning of child bearing

period for females.

A number of physical and physiological

changes takes place at this time, for females:
▫ There is an increase in the growth rate
(height) and widening of pelvis.
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Puberty (con’t)
• Pubic and axillary hair begins to grow.
• Increase in fat amount deposited in
subcutaneous tissue, especially at hips and
breasts.
• The uterus, uterine tubes, and ovaries reach
maturity.
• The menstrual cycle and ovulation begins.
The first menstrual cycle is termed as
menarche.
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Puberty (cont)
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Menopause
 It is the permanent cessation of the
menstrual cycle.
 Generally occurs between ages 40-50
year old.
 The cause is aging of the ovaries.
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Menopause (con’t)
Changes that occur in this stage:

• Shrinkage of breasts, vagina, uterus,

uterine tubes, and ovaries.
• Thinning of pubic and axillary hair.
• Vaginal dryness.
• Insomnia.
• Thinning of skin.
• Decreased bone mineral density.
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Menopause (cont)

• Weight gain.
• Hot flashes.
• Heavy sweats.
• Mood swing.
• Depression
• Stress
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Menstrual cycle
The menstrual cycle is a series of events,
occurring regularly in females every 26 to 35
days throughout the childbearing period of
about 36 years.

It is further divided into:

a) ovarian cycle: a series of events in the
ovaries that occur during and after the
maturation of an oocyte.
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Menstrual cycle(con’t)
b) uterine cycle: a series of changes in the
endometrium of the uterus to prepare it
for the arrival of a fertilized ovum that
will develop there until birth.

Both cycles take place

concurrently, stimulated
by changes in the blood
concentrations of hormones.
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Hormones involved in the

menstrual cycle
1. Gonadotropin-
releasing hormone
(GnRH)
2. Follicle-
stimulating
hormone (FSH)
3. Luteinizing
hormone (LH)
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Hormones involved in the

menstrual cycle (cont)
4. Estrogen
5. Progesterone
6. Relaxin
7. Inhibin
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Hormones involved in the menstrual cycle (cont)

Hormone Function
GnRH Stimulate FSH and LH release from anterior pituitary
gland.
FSH Initiate follicular growth, stimulate ovarian follicles to
secrete estrogen.
LH Stimulate ovarian follicles to secrete estrogen, trigger
ovulation, promote corpus luteum formation.
Estrogen Promote and maintain female reproductive structures and
secondary sex characteristics.
Progesterone Cooperate with estrogen to prepare and maintain
endometrium for receival of fertilized ovum, and prepare
mammary glands for milk secretion.

Relaxin Relax uterus by inhibiting myometrium contractions.

Inhibin Inhibit secretion of FSH, and to lesser extent, LH.
Phases of Menstrual Cycle
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Phases of the menstrual cycle (cont)

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Phases of the menstrual cycle (con’t)

Day Ovarian cycle Uterine cycle
1-6 Menstrual phase Menstruation
Follicular phase
phase Day 1-6
6-13 Preovulatory Day 1-13 Proliferative
phase phase
14 Ovulation phase Ovulation Day 6-14
phase
Day 14
15- Postovulatory Luteal phase Secretory
28 phase Day 15-28 phase
Day 15-28
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Menstrual phase
 Also called menstruation or menses.
 Lasts about 4 to 6 days.
 Generally, the first day of the menstrual
phase is considered day 1 of a new cycle.

* Last Menstrual Cycle (LMP) e.g. 8.3.2018

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Menstrual phase (con’t)

Ovaries
 Circulating levels of
ovarian progesterone
and estrogen in the
blood are low.
 This leads to increased
concentration of FSH
and LH.
 However, under the
influence of FSH only,
several primordial
follicles are stimulated
to mature.
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Menstrual phase (con’t)

Uterus
 Low circulating
levels of ovarian
progesterone and
estrogen causes blood
vessels in the
endometrium to
constrict.
 This results in Days 1 5
reduced oxygen and
nutrients supply to
the cells they supply.
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Menstrual phase (con’t)

 Eventually, the
entire stratum
functionalis layer
sloughs off.
 It exits the uterine
cavity through the
cervix and vagina as
menstrual flow.
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Menstrual phase (con’t)

 The volume of menstrual flow of each
cycle is generally 50 -150 ml of blood,
and consists of:
• Blood.
• Endometrial glands secretion.
• Endometrial cells.
• Unfertilized ovum.
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Menstrual phase (cont)

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Menstrual phase (con’t)

Day Ovarian cycle Uterine cycle
1-6 Menstrual phase Menstruation
Follicular phase
phase Day 1-6
Day 1-13
6-13 Preovulatory Proliferative
phase phase
14 Ovulation phase Ovulation Day 6-14
phase
Day 14
15- Postovulatory Luteal phase Secretory
28 phase Day 15-28 phase
Day 15-28
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Preovulatory phase
 It is the time between the end of
menstruation and ovulation.
 This phase is more variable in duration
compared to other phases.
 Therefore, it is responsible for most of
the differences in the length of the
menstrual cycle.
 It normally lasts from about days 6 to 13
of the cycle.
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Preovulatory phase (cont)

Ovaries
 At about day 6, a single primordial
follicle develops into a mature
(graffian) follicle.
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Pre-ovulatory phase (cont)

 This follicle is the
dominant follicle, and it
secretes estrogen and
inhibin to decrease FSH
secretion, which stops
the maturation of other
primordial follicles.
 The mature follicle
continues to grow till it
is more than 20 mm in
diameter in preparation
for ovulation.
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Pre-ovulatory phase (cont)

• By about the 14th day of the cycle, the
follicle appears on the surface of the
ovary as a blister like bulge due to the
swelling antrum.
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Pre-ovulatory phase (cont)

Uterus
 Increasing blood
concentration of
estrogen, secreted
by growing ovarian
follicles stimulates
the proliferation of
the functional layer Days

of the endometrium.
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Preovulatory phase (cont)

 Cells in the stratum basalis layer

undergo mitosis and produce new
stratum functionalis.

 The endometrium layer thickens,

accompanied by an increase in the
numbers of mucus secreting glands and
blood capillaries.
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Preovulatory phase (cont)

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Preovulatory phase (con’t)

Day Ovarian cycle Uterine cycle
1-6 Menstrual phase Menstruation
Follicular phase
phase Day 1-6
6-13 Preovulatory Day 1-13 Proliferative
phase phase
14 Ovulation phase Ovulation Day 6-14
phase
Day 14
15- Postovulatory Luteal phase Secretory
28 phase Day 15-28 phase
Day 15-28
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Ovulation
 It is the rupture of the mature follicle and
the release of the secondary oocyte into
the pelvic cavity, usually on day 14 of the
cycle.
 The event of ovulation is
preceded by a number
of events during the
last part of the
preovulatory phase.
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Ovulation (cont)
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Ovulation (cont)
Day Ovarian cycle Uterine cycle
1-6 Menstrual phase Menstruation
Follicular phase
phase Day 1-6
6-13 Preovulatory Day 1-13 Proliferative
phase phase
14 Ovulation phase Ovulation Day 6-14
phase
Day 14
15- Postovulatory Luteal phase Secretory
28 phase Day 15-28 phase
Day 15-28
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Post-ovulatory phase
 It is the time between ovulation and the
onset of the next menses.

 In duration, it is the most constant phase

of the reproductive cycle.

 The length is about 14 days, from day 15

to day 28.
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Post-ovulatory phase (cont)

Ovaries
 Following ovulation, the
mature follicle collapses.
 Minor bleeding takes place
within the ruptured follicle, which fills
the space containing follicular fluid with
blood.
 Once a blood clot forms, the follicle
becomes corpus hemorrhagicum.
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Post-ovulatory phase (cont)

 Then, under the
influence of LH,
thecal and follicular
cells mix to form the
corpus luteum.

 The corpus luteum

absorbs the blood
clot, and secretes
progesterone,
estrogen, relaxin,
and inhibin.
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Post-ovulatory phase (cont)

 High levels of progesterone and estrogen
inhibit the release of LH and FSH from the
anterior pituitary gland.
 Consequently, no other follicles are
stimulated to develop while the corpus
luteum is active.
 If the secondary oocyte released is not
fertilized, the corpus luteum degenerates
into a corpus albican.
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Postovulatory phase (con’t)

 This takes place

around day 24 of
the cycle.

Days
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Postovulatory phase (con’t)

Uterine
 Progesterone and
estrogen produced
by the corpus
luteum causes the
endometrium to
become more
vascular and
glandular.
 This thickens the
endometrium layer.
Days
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Postovulatory phase (con’t)

 The endometrial glands
begin to secrete
glycogen and lipids,
filing endometrial
tissues with nutrients in
preparation to receive a
fertilized ovum.
 If fertilization does not
occur, the levels of the
progesterone and Days
estrogens decline,
resulting in
menstruation.
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Postovulatory phase (con’t)

Day Ovarian cycle Uterine cycle
1-6 Menstrual phase Menstruation
Follicular phase
phase Day 1-6
6-13 Pre-ovulatory Day 1-13 Proliferative
phase phase
14 Ovulation phase Ovulation Day 6-14
phase
Day 14
15- Post-ovulatory Luteal phase Secretory
28 phase Day 15-28 phase
Day 15-28
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Summary
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Conclusion:
• The menstrual cycle is a naturally
occurring process that will take place
monthly until menopause age is reached.
• Both the uterine cycle and the ovarian
cycle has to work together in tandem with
the endocrine system for a normal
menstrual cycle to take place.

• A defect in any of these elements will

result in abnormal menstrual cycle
physiology.
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