The menstrual cycle is regulated by hormones released by the hypothalamus and pituitary glands. The hypothalamus releases hormones that stimulate the pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH causes follicles in the ovaries to mature and estrogen levels to rise. The LH surge triggers ovulation. If fertilization does not occur, progesterone and estrogen levels fall and menstruation begins. The typical cycle is around 28 days and consists of the follicular, ovulatory, and luteal phases. Menstruation involves shedding of the uterine lining if pregnancy does not occur.
The female reproductive system provides several functions.
The ovaries produce the egg cells, called the ova or oocytes.
The oocytes are then transported to the fallopian tube where fertilization by a sperm may occur.
The fertilized egg then moves to the uterus, where the uterine lining has thickened in response to the normal hormones of the reproductive cycle.
Once in the uterus, the fertilized egg can implant into thickened uterine lining and continue to develop.
If implantation does not take place, the uterine lining is shed as menstrual flow.
In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.
During menopause, the female reproductive system gradually stops making the female hormones necessary for the reproductive cycle to work. At this point, menstrual cycles can become irregular and eventually stop.
One year after menstrual cycles stop, the woman is considered to be menopausal.
DEFINITION OR MEANING OF MENSTRUAL (REPRODUCTIVE) CYCLE:-
Menstruation (Greek word, men-month) is monthly uterine bleeding out flowing through vagina into vulva for 4-5 days every 28 days (24-35 days)during reproductive life of a woman from menarche to menopause.
The Menstrual cycle of 28 days starts on day of onset of menstruation and ends at day 28 on start of next mens.
The cycle consists of a series of changes taking place concurrently in the ovaries and uterine lining, stimulated by changes in blood concentration of hormones.
The female reproductive system provides several functions.
The ovaries produce the egg cells, called the ova or oocytes.
The oocytes are then transported to the fallopian tube where fertilization by a sperm may occur.
The fertilized egg then moves to the uterus, where the uterine lining has thickened in response to the normal hormones of the reproductive cycle.
Once in the uterus, the fertilized egg can implant into thickened uterine lining and continue to develop.
If implantation does not take place, the uterine lining is shed as menstrual flow.
In addition, the female reproductive system produces female sex hormones that maintain the reproductive cycle.
During menopause, the female reproductive system gradually stops making the female hormones necessary for the reproductive cycle to work. At this point, menstrual cycles can become irregular and eventually stop.
One year after menstrual cycles stop, the woman is considered to be menopausal.
DEFINITION OR MEANING OF MENSTRUAL (REPRODUCTIVE) CYCLE:-
Menstruation (Greek word, men-month) is monthly uterine bleeding out flowing through vagina into vulva for 4-5 days every 28 days (24-35 days)during reproductive life of a woman from menarche to menopause.
The Menstrual cycle of 28 days starts on day of onset of menstruation and ends at day 28 on start of next mens.
The cycle consists of a series of changes taking place concurrently in the ovaries and uterine lining, stimulated by changes in blood concentration of hormones.
Physiology Of Menstruation
By: Nur Afiqah Binti Jasmi (11-2013-031) & Luqman Hakim Bin Mohd Jais (11-2013-170)
Dokter Pembimbing: Dr. Harianto Wijaya Sp.OG
Physiology for medical students in university.
Assignment done by students to be used for other university students also.
Focus more on the menstruation in female.
Why females living in one dorm menstruate at period and synchronization occur for their period.
Students can understand the reason why this occur and come to common understand the reason.
PHYSIOLOGY OF MENSTRUATION
Introduction :
Typically, a woman of childbearing age should menstruate every 28 days or so unless she's pregnant or moving into menopause. But numerous things can wrong with the normal menstrual cycle.
Definition:
Menstruation means cyclic uterine bleeding caused by shedding of progestational endometrium it occurs between menarche and menopause
Menstruation (also called menstrual bleeding, menses, or a period)
Characteristics of normal menstruation
1-Menarche: 10-16 years. average 13 years.
2-Duration: 2-7 days (<2days>7 days is menorrhagia
3-Amount: 30-80 ml., uses 3 napkins per day, >80 ml. is menorrhagia and < 30 ml. is hypomenorrhea.
4-Normally menstrual blood doesn’t coagulate as a result of secretion of fibrinolysin enzyme (plasmin) secreted by the endometrium.
5-Menstrual molimina refers to mild symptoms of 7-10 days before menstruation relieved once menstruation occurs exaggerated condition called (premenstrual syndrome).
The hypothalamic-pituitary-ovarian axis:
There are two main components of the menstrual cycle,
1. the changes that happen in the ovaries in response to pituitary hormones (the ovarian cycle)
2. and the variations that take place in the uterus,
but it is important to remember that both cycles work together simultaneously to produce the menstrual cycle.
Changes in cervical mucus also take place during the course of 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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Hormone
• A Hormone is a chemical released by a cell or a
gland in one part of the body that sends out
messages that affect cells in other parts of the
organism.
• Hormones are released in a very small amount.
• Endocrine Hormones are secreted (released)
directly into the bloodstream, whereas Exocrine
Hormones (or ectohormones) are secreted
directly into a duct, and, from the duct, they flow
either into the bloodstream or from cell to cell by
diffusion in a process known as paracrine
signalling.
3.
4. HYPOTHALAMUS
• The Hypothalamus is a portion of the brain that
contains a number of small nuclei with a variety
of functions.
• One of the most important functions of the
hypothalamus is to link the nervous system to the
endocrine system via the pituitary gland.
• It synthesizes and secretes certain
neurohormones, often called hypothalamic-
releasing hormones, and these in turn stimulate
or inhibit the secretion of pituitary hormones.
• The hypothalamus controls body temperature,
hunger, thirst, fatigue, sleep, and circadian cycles.
5. • Pituitary Gland, is an endocrine gland about the size
of a pea and weighing 0.5 gm.
• Also called “Master Gland”.
• It secretes variety of hormones, which stimulate the
other endocrine glands to secrete their own
hormones.
• Pituitary gland functions under the control of
Hypothalamus.
• The pituitary gland is functionally linked to the
hypothalamus by the Pituitary Stalk
PITUITARY GLAND
6. • Anterior Pituitary Gland synthesizes and releases
following Gonadotropins
- Follicle Stimulating Hormone (FSH)
- Lutenizing Hormone (LH)
• Both of these hormones are released under
influence of Gonadotropin Releasing Hormone
(GnRH) from Hypothalamus
PITUITARY GLAND
7. • Also called FSH
• FSH regulates the development, growth, pubertal
maturation, and reproductive processes of the body.
• FSH and Luteinizing Hormone (LH) act synergistically in
reproduction.
• In females, FSH initiates follicular growth.
• Decline in FSH levels during late follicular phase seems
to be critical in selecting only the most advanced
follicle to proceed to ovulation.
• At the end of the luteal phase, there is a slight rise in
FSH that seems to be of importance to start the next
ovulatory cycle.
FOLLICLE STIMULATING HORMONE
8. • Also called LH or Lutropin
• In females, an acute rise of LH called the LH surge
triggers ovulation and development of the
corpus luteum.
• LH is necessary to maintain luteal function for the
first two weeks.
• In case of a pregnancy luteal function will be
further maintained by the action of hCG (a
hormone very similar to LH) from the newly
established pregnancy.
LUTEINIZING HORMONE
9. • The three major naturally occurring estrogens in women
are estrone (E1), Estradiol (E2), and Estriol (E3).
• Estradiol (E2) is the predominant form in nonpregnant
females, Estrone (E1) is produced during menopause, and
Estriol (E3) is the primary estrogen of pregnancy.
• Estradiol levels vary through the menstrual cycle, with
levels highest just before ovulation.
• Estrogens are produced primarily by developing follicles in
the ovaries.
• Luteinizing Hormone (LH) stimulates the production of
estrogen in the ovaries.
ESTROGENS
10. • Promote formation of female secondary sex
characteristics
• Reduce muscle mass
• Stimulate endometrial growth
• Increase uterine growth
• Increase vaginal lubrication
• Thicken the vaginal wall
• Maintenance of vessel and skin
• Reduce bone resorption
• Increase bone formation
Role of ESTROGENS
11. • "Pro" means "for" and “gesterone” means "gestation".
• Gestation is the carrying of an embryo or fetus inside
the Uterus.
• Progesterone is sometimes called the “Hormone of
Pregnancy“
• Progesterone converts the Endometrium to its
secretory stage to prepare the uterus for implantation.
At the same time Progesterone affects the Vaginal
Epithelium and Cervical Mucus, making it thick and
impenetrable to sperm.
PROGESTERONE
12. • If the egg is fertilized (Pregnancy occurs), the
Corpus Luteum will begin receiving hCG from the
embryo. hCG tells the Corpus Luteum to keep
producing Progesterone.
• If pregnancy does not occur, Progesterone levels
will decrease, leading to Menstruation. Normal
Menstrual Bleeding is Progesterone-withdrawal
Bleeding.
PROGESTERONE
13.
14. • also called hCG
• hCG is a glycoprotein hormone produced in
pregnancy that is made by the developing
embryo after conception and later by the
syncytiotrophoblast (part of the placenta).
• Its role is to prevent the disintegration of the
corpus luteum of the ovary and thereby maintain
progesterone production that is critical for a
pregnancy.
• Early pregnancy testing, in general, is based on
the detection of hCG.
HUMAN CHORIONIC GONADOTROPIN
15.
16. • Menstruation is the periodic discharge of blood
and sloughed endometrium (collectively called
menses or menstrual flow) through the vagina.
• Menstruation occurs throughout a woman's
reproductive life in the absence of pregnancy.
• The average Menstrual Cycle length is 28 days
(usual range, about 25 to 36 days).
• Average duration of menses is 5 (± 2) days.
• Blood loss per cycle averages 30 mL (normal
range, 13 to 80 mL) and is usually greatest on the
2nd day.
MENSTRUAL CYCLE
17. • Menarche is the first menstrual cycle, or first
menstrual bleeding, in female human beings.
• The average age of menarche is 11.75 years.
• Menopause is the permanent cessation of
menses.
• Menopause typically (but not always) occurs in
women during their late 40s or early 50s, and
signals the end of the fertile phase of a woman's
life.
MENSTRUAL CYCLE
18. • The Menstrual Cycle can be divided into 3
Phases.
- Follicular (Preovulatory) Phase
- Ovulatory Phase
- Luteal (Postovulatory) Phase
MENSTRUAL CYCLE
19. Follicular Phase
Day 1-13
During this Phase ovary also
secretes increasing level of
Estrogen, to initiate
Endometrium
Pituitary gland produces FSH
(Follicular Stimulating Hormone)
FSH act on ovary for prompt
development of several follicles
(Each Follicle Contains Egg)
During this phase one follicle
mature
Hypothalamus releases GnRF which stimulates
release of LH and FSH from Anterior Pituatary
20.
21. Ovulatory Phase
Lasts for 16 to 32 hours
Phase begins when the level of LH surges.
LH stimulates dominant follicle to bulge from the
surface of ovary and finally rupture, releasing the Egg.
Egg travel to Fallopian Tube. This is the time when the
women is most likely to become Pregnant. The Egg can be
fertilized for only up to about 12 hours after its release.
22. Luteal Phase, Day 15-28
After releasing Egg this empty Follicle develops the structure
called Corpus Luteum (CL)
CL secrets increasing amount of Progesterone. CL prepares
Uterus in case fertilization occurs.
Progesterone causes the Endometrium to thicken
If Egg is Fertilized If Egg is not Fertilized
CL destroys after 14 days
an new Menstrual Cycle
begins
The embryo produces Human Chorionic
Gonadotropin (hCG) which will be detected by
CL and this Human Chorionic Gonadotropin
maintains CL and its Progesterone secretion.
The egg moves to the uterus and attaches itself to the
endometrium about six or seven days after ovulation,
where it begins to develop into a fetus.
23.
24. Amenorrhea
Amenorrhea is the absence of a menstrual period in a
woman of reproductive age.
Primary Amenorrhea
Primary Amenorrhea is the absence of menstruation in
a woman by the age of 16.
Secondary Amenorrhea
Secondary Amenorrhea is where an established
menstruation has ceased—for 3 months in a woman
with a history of regular cyclic bleeding, or 9 months in
a woman with a history of irregular periods.
MENSTRUAL DISORDERS
25. Dysmenorrhea
Dysmenorrhea is a gynecological medical condition
characterized by severe uterine pain during
menstruation.
Menorrhagia/Hypermenorrhea
Menorrhagia is an unusually heavy and prolonged
menstrual period at regular intervals.
A blood loss of greater than 80 ml or lasting longer than
7 days constitutes menorrhagia
Hypomenorrhea
Hypomenorrhea is extremely light menstrual blood flow
(scanty periods).
MENSTRUAL DISORDERS
26. Metrorrhagia
Metrorrhagia is uterine bleeding at frequent, irregular
intervals, particularly between the expected menstrual
periods.
Menometrorrhagia
Menometrorrhagia is a condition in which prolonged or
excessive uterine bleeding occurs irregularly and more
frequently than normal.
Polymenorrhea
Polymenorrhea is the medical term for cycles with intervals of
21 days or fewer.
Oligomenorrhea
Oligomenorrhea is infrequent (or very light) menstruation.
More strictly, it is menstrual periods occurring at intervals of
greater than 35 days.
MENSTRUAL DISORDERS