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geekymedics.com /the-menstrual-cycle/
How is it controlled?
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1. The hypothalamus produces Gonadotrophin Releasing Hormone (GnRH).
The follicle most sensitive to FSH becomes dominant and is known as the Graafian follicle
Production of oestrogen which is required for ovulation and thickening of the endometrium
Conversion of the Graafian follicle into the progesterone producing corpus luteum
Progesterone causes the endometrium to become receptive to implantation of a fertilised ovum
5. Oestrogen, Progesterone and Inhibin all cause negative feedback on the pituitary and hypothalamus.
7. In pregnancy GnRH, FSH and LH all remain inhibited, causing cessation of menstruation.
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Follicular phase
1. At the start of the cycle levels of FSH rise causing stimulation of a few ovarian follicles.
3. The 1st follicle to become fully mature will produce large amounts of oestrogen.
5. The 1 follicle reaching full maturity is called the Graafian follicle (oocyte develops within this).
7. Oestrogen causes:
Endometrial thickening
Thinning of cervical mucous to allow easier passage of sperm
9. However when the ovum is mature, oestrogen reaches a threshold level which conversely causes a
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sudden spike in LH around day 12.
10. The high amounts of LH cause the membrane of the Graafian follicle to become thinner.
11. Within 24-48 hours of the LH surge, the follicle ruptures releasing a secondary oocyte.
12. The secondary oocyte quickly matures into an ootid and then into a mature ovum.
13. The ovum is then released into the peritoneal space and is taken into the fallopian tube via fimbriae
(finger like projections).
Luteal phase
14. Once ovulation has occurred the hormones LH and FSH cause the remaining graafian follicle to develop
into the corpus luteum.
15. The corpus luteum then begins to produce the hormone progesterone.
17. As the levels of FSH and LH fall, the corpus luteum degenerates.
18. The falling level of progesterone triggers menstruation and the entire cycle starts again.
19. However if an ovum is fertilised it produces hCG which is similar in function to LH.
20. This prevents degeneration of the corpus luteum (continued production of progesterone).
22. The placenta eventually takes over the role of the corpus luteum (from 8 weeks).
It is composed of 2 layers:
Functional layer this grows thicker in response to oestrogen and is shed during menstruation
Basal layer this forms the foundation from which the functional layer develops it is not shed
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Phases of the uterine cycle
The uterine cycle has 3 phases known as the proliferative, secretory and menstrual phases.
Proliferative phase
During the proliferative phase the endometrium is exposed to an increase in oestrogen levels caused by FSH and
LH stimulating the ovaries. This oestrogen causes repair and growth of the functional endometrial layer allowing
recovery from the recent menstruation and further proliferation of the endometrium.
Secretory phase
These secretions make the uterus a more welcoming environment for an embryo to implant.
Menstrual phase
At the end of the luteal phase the corpus luteum degenerates (if no implantation occurs).
The decreasing levels of progesterone cause the spiral arteries in the functional endometrium to contract.
The loss of blood supply causes the functional endometrium to become ischaemic and necrotic.
As a result the functional endometrium is shed and exits out through the vagina.
This is seen as the 3-5 day period of menstruation a woman experiences each month.
Window of fertility
A womans most fertile period is between 5 days before ovulation until 1 to 2 days after.
Women can therefore use knowledge of their cycle to improve chances of conception.
Nausea
Diarrhoea
Sweating
Fatigue
Irritability
Dysphoria (unhappiness)
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