Female Menstrual Cycle PDF

Menstrual cycle By Dr. Fatma Zaghloul Lecturer at maternal & newborn health nursing Faulty of nursing, Cairo university Female Reproductive Cycle  The female reproductive cycle is called the menstrual cycle because menstruation provides a mark...

Menstrual cycle By Dr. Fatma Zaghloul Lecturer at maternal & newborn health nursing Faulty of nursing, Cairo university Female Reproductive Cycle  The female reproductive cycle is called the menstrual cycle because menstruation provides a marker for each cycle’s beginning and ends if pregnancy does not occur. Definition  Menarche:, the onset of menstruation that result in bodily changes in a female body  Menstrual cycle: Cyclic & regular changes in the anterior pituitary secretions, ovaries, uterine endometrium and cervical mucus Menstrual cycle  Average : 12-13 years old (9-17)  Interval: 28 days (21 to 35 days)  Duration: 3-7 days  Amount of bleeding: varies from woman to woman (25-50 ml)  Blood color can vary from bright red to dark Menstrual cycle  Women can experience fluid retention, cramping, mood swings, weight gain, breast tenderness, diarrhea, and constipation Menstrual cycle: control by hormones  It is a hypothalamus pituitary ovarian axis  hypothalamus releases( gonadotropin releasing hormons) GnRH that stimulates pituitary pituitary produces pituitary Follicle- Luteinizing stimulating hormone (LH) hormone(FSH) Follicle-stimulating hormone (FSH)  Ovum maturation in follicles inside ovaries  Estrogen production in ovaries Luteinizing hormone (LH)  Stimulates release of mature ovum  Stimulates development of corpus luteum, the progesterone-secreting part of the follicle that remains after egg is released Negative feedback mechanism  Each hormone is secreted until the organ it acts upon is stimulated--then that organ secretes a hormone that reduces secretion of the first hormone. example  The mature follicle secretes large amount of estrogen, which depresses FSH secretion.  The dip in FSH secretion just before ovulation blocks further maturation of the less developed follicles  Component of female reproductive cycle (menstrual cycle)  Ovarian cycle  Endometrial cycle  Ovarian cycle Follicular Ovulatory Luteal phase phase phase OVARIAN CYCLE  FSH and LH produce cyclic changes in ovaries Follicular phase  the primordial follicles start to grow under the effect of FSH. Only one reaches the maturity and called Graafian follicle. the grown follicle secrete estrogen. It begins with the first day of menstruation and end about 14 days later in a 28- day cycle Ovulatory phase  Ovulation is outward expulsion of a mature ovum from a ruptured Graafian follicle. Where it is picked up by the fimbirial end of the tube. It occurs about 14 th day of menstrual cycle luteal phase  Ruptured Graafian follicle are termed corpus luteum  It secretes Progesterone and little estrogen  These hormones prepare endometrium for implantation of Fertilized Ovum (Blastocyst)  If the oocyte is fertilized the corpus luteum enlarges & remains active for first 20 weeks of pregnancy  If the oocyte is not fertilized the corpus luteum degenerates in 10-12 days luteal phase  Levels of FSH and LH decrease during this phase in response to higher levels of estrogen and progesterone. Ovarian cycle  Luteal phase (cont.)  The loss of estrogen and progesterone from the corpus luteum at the end of one cycle stimulates the anterior pituitary to again secrete more FSH and LH, initiating a new female reproductive cycle.  The old corpus luteum is replaced by fibrous tissue called the corpus albicans. endometrial cycle ( menstrual cycle)  Cyclic changes in the endometrium caused by estrogen and progesterone  Endometrial cycle Menstrual Proliferative Secretory ischemic phase phase phase phase Menstrual Phase  Starts with 1st day of menstrual cycle  Lasts for 4-5 days  Decidua functional layer of uterine wall is sloughed off and discarded with the menstrual flow  Decidua basalis: deepest region, source of endometrial regeneration after each menses  Blood discharge from vagina is combined with small pieces of endometrial tissue Proliferative phase  Is a phase of repair and proliferation  Lasts for 9 days  Controlled by estrogen secreted by follicles  2-3 mm increase in thickness of endometrium  The glands increase in number and length and the spiral arteries elongate Secretory Phase  It begins with ovulation and end with menstruation. last about 12 days  Spiral arteries grow into the superficial layer  Large venous network develops  If Fertilization Occurs  Fertilized ovum implants in endometrium on about 6th day of this phase  HCG hormone secreted by syncytiotrophoblast keeps the corpus luteum secreting estrogen and progesterone  If Fertilization Doesn‘t Occur  No (human chorionic gonadotropin) HCG  Corpus luteum degenerates  Estrogen and progesterone levels fall  Secretory endometrium enters an ischemic phase  Menstruation occurs Ischemic Phase  Decreased levels of estrogen & progesterone( menstruation)  Marked shrinking of endometrium  Spiral arteries become constricted  Venous stasis & Ischemic necrosis  Rupture of damaged vessel wall  2 days before menses Changes in cervical mucus  During most of the female reproductive cycle, the mucus of the cervix is scant, thick, and sticky.  Just before ovulation, cervical mucus becomes thin, clear, and elastic to promote passage of sperms into the uterus and fallopian tube, where they can fertilize the ovum. Nursing role during menstrual cycle  Sanitary pads and tampons  Wash hands before and after giving self perineal care.  - Washing or wiping the perineum should be always done from front to back  Do not touch the side of the perineal pad that will come in contact with the perineum.  - Frequently take warm bath to maintain personal hygiene Diet  Decrease intake of caffeine (tea, coffee, coals, chocolate) to reduce anxiety.  - Decrease intake of simple sugars.  - Decrease intake of salty food to reduce fluid retention  Avoid alcohol which aggravates depression Nutritional self-care  Vitamin B complex neutralizes the excessive amounts of estrogen produced by the ovaries thus reduce nervousness that sometimes occur premenstrual. It is present in lean meats, whole grains, and dark green leafy vegetables  Vitamin B6 can relive the heavy bloated puffy feeling that is often experienced before the period such as chicken or turkey. some fish. peanuts. soya beans. wheatgerm. oats. bananas.  Vitamin E is a mild prostaglandin inhibitor similar to aspirin but without the side effects. It improves circulation; reduce muscular spasm and pain by reducing the uterus need for O2. It is present the yeast, wheat germ  Iron is needed to prevent depletion of the female iron stores.  - Calcium may also provide relief from menstrual symptoms, it is present in yogurt and cheese. Exercise  Daily exercise can prevent cramps, relieves constipation.  - Deep breathing brings more O2 to the blood which relaxes the uterus.  - Aerobic activities as walking alleviate irritability and tension. Heat and massage  Using any form of warm application may be beneficial during painful periods.  - Massage can also sooth aching muscles, promote relaxation and blood flow 11/1/2021 41