Physiology of Menstruation PDF

**By**   - Define the menstruation. - Explain Physiology of Menstrual cycle : 1. Hypothalamic pituitary axis 2. Ovarian cycle. 3. Uterine cycle. - Introduction. - Definitions. - Physiology of Menstrual Cycle: 1. The h...

**By**   - Define the menstruation. - Explain Physiology of Menstrual cycle : 1. Hypothalamic pituitary axis 2. Ovarian cycle. 3. Uterine cycle. - Introduction. - Definitions. - Physiology of Menstrual Cycle: 1. The hypothalamic pituitary axis: 2. The ovarian cycle: a. Follicular Phase. b. Ovulation. c. Luteal Phase. 3. The uterine cycle: d. Proliferative Phase. e. Secretory phase. f. Ischemic phase. g. Menses phase.  - ***Puberty*** is a phase of life during which the sex organs and its functions reach maturity. - ***Menarche*** is the age of onset of menstruation. - ***Menstruation*** is the monthly shedding of a portion of endometrium (Compact and spongy layers come down while basal layer remains) from puberty to menopause except during pregnancy.  - ***Interval of menstruation*** is the period extends from the onset of one menstruation to the onset of the following one. - ***Duration of menstruation*** is the period of menstruation.  - **Menarche** (age of first menstruation): 10-16 years. - **Duration:** 2-7 days - **Amount:** 30:80 ml. uses 3 napkins per day (\>80 ml. is - **Interval** Normal menstrual cycle 21-35 days. average 28 days   - hypothalamus secrete Gonadotropin Releasing Hormones (GnRH) - GnRH stimulates pituitary gland to secrete Follicular stimulated Hormone (FSH) and luteinizing Hormone (LH).  - ***Follicle-stimulating hormone (FSH)*** A hormone that is active and rises during first half of the cycle (1- 14 day) and is responsible for maturation of the ovum. It causes one of several follicles to develop and enlarge more than all the others. FSH stimulates the Graafian follicle to secrete estrogen which responsible for growth of the uterine lining during the first half of the menstrual cycle. - ***Luteinizing hormone (LH):*** A hormone that becomes most active at the midpoint of the cycle and is responsible for ovulation or release of the mature egg cell from the ovary and growth of the uterine lining during the second half of the menstrual cycle.   - This phase starts on day 1 of the menstrual cycle and continues until ovulation, approximately 12 to 14 days later. - FSH is responsible for **[the growth of several primary] [follicles ]**(stimulates the ovary to produce 5 to 20 immature follicles). - **[Only one follicle on one ovary reaches maturity]** ( called **[Graafian follicle]** which secretes oestrogen). - The oestrogen peak stimulates secretion of LH.  - The LH peak leads the mature follicle to burst open (rupture), releasing the mature ovum into the abdominal cavity this process called (ovulation) - This usually occurs on day 14. - When ovulation occurs there is a drop in estrogen - The lifespan of the ovum is only 24 hours.  - After ovulation, LH levels remain elevated and cause the remnants of the follicle to develop into a yellow body called the corpus luteum. - The corpus luteum secretes estrogen and progesterone. - When progesterone reaches a high level it inhibits the secretion of LH leads degeneration of the corpus luteum (If fertilization does not take place), and so estrogen and progesterone drop & separation of the endometrium (menstruation) & stimulates the hypothalamus to secrete more GnRH, a new cycle is started.  - Start Immediately after a menstrual flow & continues for the first half of the menstrual cycle (from approximately day 5 to day 14). - The endometrium begins to proliferate under influence of **estrogen** and increases the thickness approximately eight fold.  - **[If fertilization does not occur]**, the corpus luteum in the ovary begins to regress after 8 to 10 days. As it regresses, the production of progesterone and estrogen decreases. - **[With the withdrawal of progesterone stimulation]**. The endometrium of the uterus begins to degenerate (at approximately day 24 or day 25 of the cycle). - The capillaries rupture, with minute hemorrhages & the endometrium sloughs off. ---------------------------- [Menses, or the menstrual flow, is composed of:] ============================================================ - Blood from the ruptured capillaries - Mucin from the glands - Fragments of endometrial tissue - The microscopic, atrophied, and unfertilized ovum   ### [Some women use these characteristics to help determine time of] [ovulation] - During the menstrual phase the cervix doesn't produce mucus. - As the proliferative phase begins, the cervix produce a [tacky,]  - When ovulation becomes near, the mucus becomes progressively [clear, thin and lubricative, with the] [properties of raw egg white.] - At the peak of fertility (i.e., during ovulation), the mucus has [a distensible, stretchable called spinbarkheit sign].  1. [ Choosing the right method of sanitation] =========================================================  2. **[Change pads in regular intervals]** Preferably in an interval of five to six hours. 3. **[Wash perineal area properly]** use warm water and wash from front to back. 4. [Avoid using soaps and intimate wash] =================================================  [Wear proper underwear] ----------------------------------- 6. **[Avoid vaginal douching]** during menstruation 7. [Have regular bath] ------------------------------- 8. **[Safe disposal of menstrual products]** 9. [ **Do not ignore any signs of infection or rash**] 10. ### [Heat and massage] - Using of hot application as hot tub, heating pads may be beneficial during pain. - Massage can also sooth aching back muscles, promote relaxation and blood flow.  Each month , a developing graffian follicle produce --------------------------------------------------- a. Proliferative phase b. Menstrual phase c. Secretory phase d. Ischemic phase Estrogen peak stimulates secretion of...... -------------------------------------------- a. FSH b. LH c. Progesterone d. Prolactin a. Days 1 -- 5 b. Days 5 -- 14 c. Days 15 -- 28 d. Days 20 -- 28 a. 9 to 17 years b. 45 to 55 years c. 21 to 35 days d. 2 to 7 days  a. Thyroid - stimulating hormone (TSH). b. Follicle stimulating hormone (FSH) c. Conlicotropin -releasing hormone (CRH). d. Gonadotropin releasing hormone (GnRH). a. Fertility index. b. Follicular residual. c. Ovarian residual. d. Corpus luteum**[.]**  a. Luteinizing hormone**[.]** b. Follicle stimulating hormone. c. Prolactin hormone. d. Progesterone hormone - **Define menstruation** - **Define menarche** - **List normal characteristics of menstruation** - **List phases of ovarian cycle** - **List phases of uterine cycle**