Menstruation cycle

1. MENSTRUATION CYCLE
MR.SHYAM BHATEWARA
LECTURER AT
INDEX NURSING COLLEGE

2. DEFINITION
 Menstrual cycle is the visible manifestation
of cyclic physiological uterine bleeding due
to shedding of endometrium & blood
outflow through the vagina followed by
invisible role of hormone, known as
menstruation cycle.

3. HPO Axis
 Hypothalamus :-
GnRH (gonadotropin releasing hormone)
 Pitutary:- Anterior pituitary called adeno-hypophysis
Gn hormone (gonadotropin hormone)
 Ovary :- oestrogen & progesterone

4. GnRH
Activate anterior
pituitary hormone
Secrete hormone
FSH & LH
These hormone
are work on ovary
And ovary release
oestrogen &
progesterone
Menstruation
cycle occur

5. IMPORTANT POINT FOR MENSTRUATION CYCLE
 Duration of cycle = 28 days
 1st menstruation cycle called menarche
 Amount of blood loss during one cycle 35 ml (20-80 ml)
 Menstrual phase = 1-7 days
 Duration of bleeding = 2-7 days (3-5 days)
 Puberty = development of secondary sexual characteristics
 age of puberty -10-16 years in female
- 12-16 years in male

6. ACCORDING TO TANNER & MARSHALL 5
STAGES OF PUBERTY
1. Breast development – Thelarche (1st sign of puberty in female)
2. Axillary hair development – Adrenarche
3. Pubic hair development –pubarche
4. Increase in hight
5. 1st menstrual cycle- menarche (last sign of puberty in female)
 Peak age of menarche – 13 years
 1st menstrual cycle mostly eggless
 Last menstrual cycle is also eggless

7. REPRODUCTIVE AGE
 Reproductive age = child bearing age
 Menarche to menopause 30 years
 15 years to 45 years
 Female ovary has 13 menses in a year
 Around 400 menses in complete reproductive life

8. NO. OF FOLLICLES
 20 weeks of female fetus – 7 million on. Of
follicles(70 lacs)
 At birth – 2 million
 Reproductive age – 4 million
 After menopause – less than 10000no. Of
follicles

9. MENSTRUAL BLOOD
 Menstrual blood is totally waste & dark red blood
in colour
contain-
 Mucus
 Dead endometrial cells
 Prostaglandins
 Micro-organisms
Menstrual does not clot because of plsmin

10. CHANGES DURING MENSTRUAL CYCLE
1. Ovarian changes –
a) Follicular phase
b) Luteal phase
2. Uterine changes-
a) Bleeding phase
b) Proliferative phase
c) Secretory phase

11. OVARIAN CHANGES
1. Follicular phase-
 It is first half of the menstrual cycle
 It also called pre-ovulatory phase
 Up to 14 days
 Immature follicles become mature in the presence of FSH
2. Luteal phase-
 15 – 28 days
 2nd half of menstrual cycle
 Post ovulatory phase
 Formation of corpus luteum
 Corpus luteum is yellow colour body formation after rapture of
graafian follicle
 Function- secretion of hormone progesterone( in large amount)
& oestrogen (in small amount )

12. UTERINE CHANGES
 Bleeding phase/ menstrual phase:- (menses, periods, catamania)
 Bleeding phase 1-5 days may up to 7 days
 At the end of the bleeding phase thickness of endometrium 1-2 mm
 Normal thickness 8-10 mm

13. If fertilization
not occur
Corpus luteum
disappear at 26-
28 dyas
Decrease
progesterone &
oestrogen
Causes
vasoconstriction
Contraction of
uterine artery
Decrease blood
supply to the
uterus
Hypoxia &
ischemia occur
Endometrial
cells dead
Shedding of
Endometrial
cells
Blood vessels
open & bleeding
from uterus
Blood & dead
cells collected in
uterus
nerve
stimulation of
uterus
Posterior
pituitary release
Oxytocin
Act on
myometrium of
uterus
Causes uterine
contraction
Blood through
the vagina

14. PROLIFERATIVE PHASE
 6-14 days
Division of the endometrium cells
Increase no of endometrial cells
Due to oestrogen hormone
Growing follicles release oestrogen hormon
Division of endometrial cells

15. SECRETARY PHASE
 Also known as preparatory phase
 15-28 days
 Secretory activity of corpus luteum
 Progesterone increase size of endometrial cells
 at this phase endometrium is prepared for next M. cycle
if fertilization not occur
 Endometrium also prepare for implantation if fertilization
occur

16. HORMONAL REGULATION OF
MENSTRUATION CYCLE
 Follicle phase – FSH
 Ovulation – LH
 Luteal phase- FSH & LH
 Bleeding phase- decrease progesterone & oestrogen
 Proliferative phase – oestrogen hormone
 Secretory phase - progesterone & oestrogen