This is a presentation that provides a concise idea of the physiology of menstruation

1. LITTY K S

2. Menstruation is the periodic efflux of the
sloughed endometrium & blood out of the
uterine cavity into the vagina & ultimately
outside the body.

3. 1) Actively coordinated H-P-O axis
2) Responsive endometrium
3) Patent outflow tract.

5. Normal menstrual cycle- 2 segments
1. Ovarian cycle – a. follicular phase
b. luteal phase
2. Uterine cycle – a. proliferative phase
b. secretory phase

6. a) Recruitment of gp. of follicles (preantral phase)
b) Selection of dominant follicle
c) Ovulation
d) Corpus luteum formation
e) Demise of corpus luteum

10.  LH surge- stimulates completion of redn. div.
 FSH rise – preovul.rise of 17-α-hydroxy
progesterone →incr. in plasminogen →
plasmin → lysis of wall of follicle.

12. I. Stage of proliferation- collapsed wall of empty
follicle forms convolutions→opening is plugged with
fibrin→granulosa cells undergo hypertrophy→granulosa
lutein cells.( greyish yellow)
II. Stage of vascularisation-small vessels grow into
granulosa layer.
III. Stage of maturation-hypertrophy of theca lutein cells.
Lutein cells enlarge & attain lipid inclusions( yellowish)
IV. Stage of regression-Appearence of vacoule→hyaline
degen.→atrophy(corpus albicans).

14. Life span- 12-14
days

15. 1. Regenerative phase- starts even before menses ceases
& completed 2-3 days aftr. the end of menstruation. Thickness-
ave. 2mm.
2 .Proliferative phase – 5th/6thday till 14th day. Glands-
tubular & perpendicular to surface.
Epithelium- columnar & spiral vessels extend unbranched
forming loose network below epith. Thickness- 3-4mm.

16. • 3.Secretory phase-
a) epith.- more columnar & ciliated at places
b) glands- more tortous & incr. in size- corkscrew shaped
c) bd. Vessels – marked spiralling.
d) stromal cells become swollen.
e) spongy layer- convoluted glands & coiled arterioles.
f) Thickness- 6-8 mm.

18. Proliferative phase
Secretory phase

19.  Endometrial growth ceases 5-6 days prior to
menstruation( 22nd/23rd) day of cycle
 Withdrawal of hormones causes intense spasm
of spiral arterioles at basal zone leading to
stasis & tissue anoxemia.→release of
proteolytic enzymes from lysozymes.
 Enzymatic autodigestion of functional zone.

21.  Follicular phase → estrogen→ cevical mucus:
copious, serous & elastic-
 Spinnburkeit - ( stretchability & elasticity)-
withstand stretching upto 10cm.
At the midcycle→cervical mucus dried on glass
slide→fern pattern.(high sod. Chloride & low protein)
 Luteal phase→progesterone→thick & scanty.

23.  Proliferative phase→estrogen→vaginal epith
cells get cornified.
 Secretory phase→progesterone→thicker &
leukocytic infiltration takes place.

25. THANK YOU