The menstrual cycle is a term used to describe monthly events that occur within a woman's body in preparation for the possibility of pregnancy. Each month, an egg is released from an ovary in a process called ovulation. At the same time, the lining of the uterus thickens, ready for pregnancy. If fertilization does not take place, the lining of the uterus is shed in menstrual bleeding and the cycle starts over.

1. Understanding the
Menstrual Cycle.
With Raghavendra S Hegde

2. Understanding the menstrual cycle.
• The menstrual cycle is a term used to describe
monthly events that occur within a woman's body in
preparation for the possibility of pregnancy.
• Each month, an egg is released from an ovary in a
process called ovulation.
• At the same time, the lining of the uterus thickens,
ready for pregnancy.
• If fertilization does not take place, the lining of the
uterus is shed in menstrual bleeding and the cycle
starts over.

3. • An ovary contains hundreds of thousands of primary oocytes -
immature eggs, or ova.
• Each of these is enclosed in a structure called a follicle, and at this
stage -- a primordial follicle.
• The menstrual cycle is under control of hormones secreted by the
pituitary gland and the ovaries.
• The pituitary itself is under control of the hypothalamus.

4. • The hypothalamus produces a hormone called
the gonadotropin-releasing hormone or GnRH.
• GnRH stimulates the anterior lobe of the
pituitary to secrete follicle-stimulating hormone
(FSH).
• FSH travels in the bloodstream to the ovaries
and stimulates a group of follicles to grow.
HPG Axis

5. • These primordial follicles develop into primary follicles and then
secondary follicles.
• These produce a hormone named estrogen which acts to stimulate
the growth of the endometrium -- the inner lining of the uterus.
• The secondary follicles compete with each other and only one of
them will survive and become a mature follicle, the rest atrophy and
die.

6. • The increasing level of estrogen also acts on the hypothalamus and
the anterior pituitary to increase the level of GnRH and induce the
production of another hormone -- luteinizing hormone (LH).
• A surge in LH secretion triggers ovulation - the release of the egg
from the follicle and the ovary.
• The egg is then swept up by the fimbriae and taken into the uterine
tube.

7. • Fertilization by a spermatozoon, when it occurs, usually takes place
in the ampulla, the widest section of the fallopian tube.
• The fertilized egg immediately begins the process of development
while travelling toward the uterus.
• After 6 days it becomes a blastocyst and is implanted into the
endometrium of the uterus.

8. • Meanwhile, the left-over of the ruptured follicle has become a corpus
luteum which secretes progesterone.
• Progesterone further stimulates uterine development making it a
nutritious bed for the embryo in the event of pregnancy.
• In the absence of pregnancy, the corpus luteum atrophies and
progesterone level falls.
• This leads to the breakdown of the endometrium, menstruation begins
and the cycle starts over.