Menstrual Cycle

The recurring monthly series of physiological

changes in female primates in which an egg is
produced in the process known as ovulation, and
the uterine lining thickens to allow for
implantation if fertilization occurs. If the egg is
not fertilized, the lining of the uterus breaks
down and is discharged during menstruation.

Menstrual Cycle
In 7th-8th month of intrauterine life ----6 million primordial follicles in single
ovary
At the time of birth ---- only 1 million
primordial follicles in both ovaries and
the rest degenerates
At puberty ---- the number of total
promordial follicles get reduced to
300,000 40,000

Menstrual Cycle
During menstrual cycle
One primordial follicle is matured into
graafian follicle and ovum and is released
by one of the ovaries (about 450
primordial
follicle
in
females
reproductive life)
Many primordial follicle degenerates

Degeneration of follicle is known as

atresia and resulting degenerated
follicle is known as atresic follicle

Menstrual Cycle
Puberty (12-15 years)
Menarche
Menopause (40-45 years)
Duration: Start of menstruation
bleeding till the start of next
menstruation bleeding
20-40 days
Usually 28 days

Changes during menstrual

cycle
Ovarian changes
Uterine changes
Vaginal changes
Cervical changes

Menstrual cycle : Ovarian

changes
2 phases
Follicular phase
Luteal phase

Menstrual cycle : Ovarian

changes

Menstrual cycle : Ovarian

changes

Follicular phase
5th day 14th day of cycle
At each stage ovum is surrounded by
granulosa cells
Ovum and its surrounding granulosa cells
make follicle
Maturation of ovum with corresponding
development of follicle
Primordial follicle primary follicle
Vesicular follicle Graafian follicle or mature
follicle

Menstrual cycle : Ovarian

changes

Ovulation: rupture of graafian

follicle and release of ovum into
abdominal cavity
Enters fallopian tube
Usually on 14th day in normal 28 days
cycle
Remain viable for 24-48 hrs
Surge of LH is necessary for ovulation

Menstrual cycle : Ovarian

changes

Luteal phase

15th day 28th day

Development of corpus luteum
Yellow body

Menstrual cycle : Ovarian

changes
Luteal phase
Function of Corpus Luteum
1. Temporary endocrine organ
. LH influence CL to secrete
large amounts of progesterone
small amount of estrogen

2. Maintenance of pregnancy

Menstrual cycle : Ovarian

changes

Luteal phase

Fate of Corpus Luteum

1. If the ovum is not fertilized
. CL reaches maximum size after one week of
ovulation and secrete large quantity of
progesterone and small quantity of estrogen
. After one
luteolysis

week

of

ovulation

CL

undergo

Structure
and
functional
regression
and
degeneration
CL become smaller and cells decrease in size and
then later into white scar (corpus albicans)

Menstrual cycle : Ovarian changes

Luteal phase
Fate of Corpus Luteum
2. If
the
ovum
is
fertilized
pregnancy occurs

and

. CL increase in size and persist for 3-4

months (corpus luteum of pregnancy)
. First trimester----secrete large quantities of
progesterone and small quantities of
estrogen ------ maintenance of pregnancy
. After 3-4 months, placenta take over and CL
degenerates
. Abortion occurs if CL become inactive or is
removed before three months of pregnancy

Menstrual cycle : Uterine

changes

Simultaneous changes in ovary and

uterus
3 phases
Menstrual phase
Proliferative phase
Secretory phase

Menstrual cycle : Uterine

changes
Proliferative phase

5th 14th day of cycle

Menstruation stops ovulation
Corresponds to the follicular phase of
ovarian cycle
After menses thin layer of endometrium
remains
Proliferative phase: rapid proliferation
of endometrium, blood vessel and
development of glands
LH induces the ovulation on 14th day

Menstrual cycle : Uterine

changes
Secretory phase

15th 28th day of cycle

Ovulation start of next cycle
Development of corpus luteum
Secrete estrogen and progesterone to
prepare uterus for implantation of
fertilized ovum (pregnancy)
increase in the thickness of endometrium
development of glands
development of new blood vessel and increase
blood supply
Deposition of fats and glycogen

Menstrual cycle : Uterine

changes
Secretory phase

If pregnancy does
menstrual phase

not

occur

-----

If pregnancy occur ----- changes in uterus

for the development and survival of fetus

Menstrual cycle : Uterine

changes
Menstural phase
If the pregnancy occur then thickened
endometrium (uterine lining) persists
If pregnancy does not occur then
menstrual phase or period occurs (aka
menses, menstruation)
Thickened endometrium (uterine lining)
is shed and expelled through vagina with
some blood and tissue fluid
It lasts 4-5 days

Menstrual cycle : Uterine

changes
Menstural phase

During the last two days of secretory phase,

secretion of large quantities of estrogen
and progesterone inhibits secretion of FSH
and LH from anterior pituitary.
Without FSH and LH corpus luteum become
inactive and start degenerating
As a result there is a sudden decline in
amount of progesterone and estrogen
So thickened endometrium cannot be
maintained and menstrual bleeding ensues

Regulation of menstural cycle

Complex process
Hormones involved are:
Hypothalmic
hormones
----GnRH (gondaotropin releasing
hormone)
Anterior pituatry hormones ----LH, FSH
Ovarian
hormones
estrogen, progesterone

------

Menstrual cycle : Control

External factors,
feedback from ovarian
hormones

ovulation,
sustains corpus
luteum

by CL, by
ovarian
follicles

recruitment and
development of
immature ovarian
follicles

Estrogen: by
Ovarian
follicles, by CL

Disorders of menstrual cycle

Amenorrhea
Hypomenorrhea
Menorrhagia
Oligomenorrhia
Polymenorrhea
Dysmenorrhea
Metorrhagia

Disorders of menstrual cycle

Dysmenorrhea or Menstual Cramps
Occurs during regular ovulatory cycles.
Destruction of the endometrial cells and the resultant
release of their contents ----- Prostaglandins are
released during menstruation due to
Women with primary dysmenorrhoea have increased
activity of the uterine muscle with increased
contractility and increased frequency of contractions.
Drugs which inhibit the production of prostaglandins,
such as the non-steroidal anti-inflammatory drugs
(NSAIDs) Naproxen, Ibuprofen and Mefenamic Acid,
can provide relief for the discomfort and other
associated symptoms of excessive prostaglandin
release, such as nausea, vomiting, and headache.

Disorders of menstrual cycle

Dysmenorrhea or Menstural Cramps

Anovulatory cycles
It is the menstrual cycle in which
ovulation does not occur
Menstrual bleeding occurs
It is common during puberty and
few
years
before
menopause
(perimenopause)
If occurs in reproductive life of
female then leads to infertility

Anovulatory cycles
There are variety of underlying
causes for anovulatory cycles in
female reproductive life
Hormonal balance
Prolonged strenuous exercise program
Eating disorder
Hypothalamic dysfunctions
Tumors in pituitary, ovary or adrenal
glands
Long term use of certain
steroidal contraceptive

drugs

like

Menopause
Permanent stoppage of menstrual
cycle
Decrease in secretion of sex hormones
(estrogen and progesterone)
Age 45-55 years
Reasons
Natural
Gradual atrophy of ovaries
Less estrogen and progesterone

Surgical (ovariectomy, hysterectomy)