MENSTRUAL CYCLE

Maria Nazarethe A. Sulit, RN

 What is menstruation?

Menstruation is the
periodic shedding of
the endometrium
accompanied by
blood loss, that
identifies the
reproductive years of
a woman's life.
 Menstrual Cycle

Prepare for pregnancy

Ave. 28 day cycle
As short as 20 days
As long as 45 days
Hypothalamic-Pituitary Cycle
 Ovarian Cycle
• Follicular phase (Day 1-14)
 Time before ovulation
 LH surge causes ovulation
 Ovarian follicle mature under the influence of FSH &
estrogen
 1st day of menstruation until ovulation
 Very variable period
 24-46 hrs before ovulation Estrogen & LH
 Ovarian Cycle
• Luteal phase (Day 15-28)
 Period following ovulation
 Ovum discharged from mature follicle
 Corpus luteum develops under the influence of LH
 Corpus luteum life span is 7 days
 Degeneration of CL=decrease in progesterone
 Fertilization: zygote secretes HCG
 Fixed 14 days after ovulation=menstruation
Ovarian Cycle
Layers of the Endometrium
 Endometrial Cycle
• Menstrual Phase
 1st day of menstruation to 5 days
 Menstruation: regression of the corpus luteum
& decline in estrogen & progesterone
 2/3 of endometrium is shed off
 Uterus lining is thinnest at this point
 Blood loss 30-80 ml
 Woman’s life span 10-20 liters blood loss
 Endometrial Cycle
• Menstrual Phase
 Saturating more than 1
pad or tampon/hr or 8
pads/day = heavy flow
 Average Iron loss 12-
29 mg
 Fe supplements
 Endometrial Cycle
• Proliferative Phase
 Follicular/Estrogenic phase
 6 to 13 day
 Endometrial surface is restored to normal
thickness 4-5 days after the 1st day of menstruation
 Estrogen promotes the growth of new cells &
capillaries in the endometrium
 Endometrial Cycle

• Secretory Phase
 14 to 25 day
 Mittleschmerz
 Spinnbarkheit
 Endometrial Cycle

• Secretory Phase
 Progesterone causes dilation of blood vessels in the
endometrium:spiral/corkscrew shape
 Increase vascularity of the uterus
 Endometrial glands elongate, more active & secrete
glycogen containing fluid
 Endometrium becomes soft, spongy, edematous, very
rich in nutrients & blood
 Endometrial Cycle

• Ischemic Phase
 Regression of corpus luteum
 Decrease in progesterone
 Formation & release of protaglandin & endothelin 1
 Vasospasm of spiral arteries & contraction
myometrium
 Vasospasm ischemia necrosis rupture of blood
vessels sloughing off