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Menstrual cycle
DEFINITION 
• Rhythmical series of physiological changes 
that occur in fertile women 
• Under the control of the endocrine system 
• Necessary for reproduction 
• Average length: 28 days, but typically varies, 
with shorter and longer cycles
DEFINITION 
• Menarche: a woman's first menstruation 
– typically occurs around age 12 
– occurrence depends on overall health and 
diet 
• Menopause: end of a woman's reproductive 
phase, commonly occurs between ages 45 
and 55 
– age of menopause is largely the result of 
genetics
DEFINITION 
• Physiological changes during menstrual cycle can 
be observed at three different levels: 
– neuroendocrine level 
– ovaries 
– uterus 
• Menstrual cycle can be divided into 3 phases: 
– menstrual phase 
– proliferative / follicular (estrogen) phase 
– secretory / luteal phase (progesterone) phase
Phase 
Average start and end day 
(assuming a 28-day 
cycle) 
Menstrual phase 1-4 
Proliferative phase 5-13 
Ovulation 13-16 
Secretory phase 16-28
MENSTRUAL PHASE 
• Menstruation 
– menstrual bleeding, menses, period 
– discharge of bloody fluid containing 
endometrial cells, glandular secretions 
and blood cells, lasts 3 -5 days 
– result of the previous menstrual cycle 
– due to strong vasoconstriction and 
proteolytic activity, functional stratum of 
endometrial tissue dies and is discharged 
during menstrual bleeding
MENSTRUAL PHASE 
• Endometrium becomes very thin, but 
due to low estrogen levels, hypophysis 
secretes more FSH 
• FSH stimulates secretion of estrogen, 
and estrogen serves as proliferation 
signal to the endometrial basal layer
FOLLICULAR PHASE 
• Due to the rise of follicle stimulating 
hormone (FSH) during the first days of the 
cycle, several ovarian follicles are stimulated 
• Follicles compete with each other for 
dominance 
• The follicle that reaches maturity is called a 
Graafian follicle
FOLLICULAR PHASE 
• As they mature, the follicles secrete 
increasing amounts of estrogen, which 
thickens the new functional layer of 
endometrium in the uterus 
• Estrogen also stimulates crypts in the cervix 
to produce fertile cervical mucus 
• At the end of this phase ovulation occurs
OVULATION 
• During the follicular phase, estrogen 
suppresses production of luteinizing 
hormone (LH) from the pituitary gland 
• When the ovum has nearly matured, levels of 
estrogen reach a threshold above which they 
stimulate production of LH (positive 
feedback loop) 
• The release of LH matures the ovum and 
weakens the wall of the follicle in the ovary, 
causing the fully developed follicle to release 
its secondary oocyte 
• After being released from the ovary, the 
ovum is swept into the fallopian tube
LUTEAL PHASE 
• Corpus luteum: solid body formed in an 
ovary after the ovum has been released into 
the fallopian tube 
• Produces significant amounts of 
progesterone, which plays a vital role in 
making the endometrium receptive to 
implantation of the blastocyst 
• High levels of E and P suppress production 
of FSH and LH that the corpus luteum needs 
to maintain itself 
• Falling levels of progesterone trigger 
menstruation and the beginning of the next 
cycle
CYCLE ABNORMALITIES 
• Anovulation 
• Anovulatory cycle 
• Hypomenorrhea 
• Metrorrhagia 
• Oligomenorrhea 
• Amenorrhea 
• Polymenorrhea
Menstrual cycle 2

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Menstrual cycle 2

  • 2. DEFINITION • Rhythmical series of physiological changes that occur in fertile women • Under the control of the endocrine system • Necessary for reproduction • Average length: 28 days, but typically varies, with shorter and longer cycles
  • 3. DEFINITION • Menarche: a woman's first menstruation – typically occurs around age 12 – occurrence depends on overall health and diet • Menopause: end of a woman's reproductive phase, commonly occurs between ages 45 and 55 – age of menopause is largely the result of genetics
  • 4. DEFINITION • Physiological changes during menstrual cycle can be observed at three different levels: – neuroendocrine level – ovaries – uterus • Menstrual cycle can be divided into 3 phases: – menstrual phase – proliferative / follicular (estrogen) phase – secretory / luteal phase (progesterone) phase
  • 5. Phase Average start and end day (assuming a 28-day cycle) Menstrual phase 1-4 Proliferative phase 5-13 Ovulation 13-16 Secretory phase 16-28
  • 6. MENSTRUAL PHASE • Menstruation – menstrual bleeding, menses, period – discharge of bloody fluid containing endometrial cells, glandular secretions and blood cells, lasts 3 -5 days – result of the previous menstrual cycle – due to strong vasoconstriction and proteolytic activity, functional stratum of endometrial tissue dies and is discharged during menstrual bleeding
  • 7. MENSTRUAL PHASE • Endometrium becomes very thin, but due to low estrogen levels, hypophysis secretes more FSH • FSH stimulates secretion of estrogen, and estrogen serves as proliferation signal to the endometrial basal layer
  • 8.
  • 9. FOLLICULAR PHASE • Due to the rise of follicle stimulating hormone (FSH) during the first days of the cycle, several ovarian follicles are stimulated • Follicles compete with each other for dominance • The follicle that reaches maturity is called a Graafian follicle
  • 10. FOLLICULAR PHASE • As they mature, the follicles secrete increasing amounts of estrogen, which thickens the new functional layer of endometrium in the uterus • Estrogen also stimulates crypts in the cervix to produce fertile cervical mucus • At the end of this phase ovulation occurs
  • 11.
  • 12. OVULATION • During the follicular phase, estrogen suppresses production of luteinizing hormone (LH) from the pituitary gland • When the ovum has nearly matured, levels of estrogen reach a threshold above which they stimulate production of LH (positive feedback loop) • The release of LH matures the ovum and weakens the wall of the follicle in the ovary, causing the fully developed follicle to release its secondary oocyte • After being released from the ovary, the ovum is swept into the fallopian tube
  • 13. LUTEAL PHASE • Corpus luteum: solid body formed in an ovary after the ovum has been released into the fallopian tube • Produces significant amounts of progesterone, which plays a vital role in making the endometrium receptive to implantation of the blastocyst • High levels of E and P suppress production of FSH and LH that the corpus luteum needs to maintain itself • Falling levels of progesterone trigger menstruation and the beginning of the next cycle
  • 14.
  • 15. CYCLE ABNORMALITIES • Anovulation • Anovulatory cycle • Hypomenorrhea • Metrorrhagia • Oligomenorrhea • Amenorrhea • Polymenorrhea