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The Menstrual Cycle

The menstrual cycle involves two main phases - the follicular phase and luteal phase. During the follicular phase, follicle stimulating hormone (FSH) causes follicles in the ovaries to mature. Estrogen levels rise until an LH surge causes ovulation. In the luteal phase, the corpus luteum forms and secretes progesterone to thicken the uterine lining. If pregnancy does not occur, progesterone levels fall and menstruation begins.

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79 views14 pages

The Menstrual Cycle

The menstrual cycle involves two main phases - the follicular phase and luteal phase. During the follicular phase, follicle stimulating hormone (FSH) causes follicles in the ovaries to mature. Estrogen levels rise until an LH surge causes ovulation. In the luteal phase, the corpus luteum forms and secretes progesterone to thicken the uterine lining. If pregnancy does not occur, progesterone levels fall and menstruation begins.

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lieynna4996
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The Menstrual Cycle

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The Menstrual Cycle: Two Phases


Ideally 14 days each Follicular and Luteal
Describe changes in the ovary

Proliferative and Secretory


Describe changes in the endometrium

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Hormones in the Menstrual Cycle

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Follicular phase
Begins with the onset of menses and ends on the day of the luteinizing hormone (LH) surge During late luteal phase/ early follicular phase:
withdrawal of estrogen and progesterone in late luteal phase In early follicular phase, ovary is least hormonally active low serum estradiol and progesterone release from negative feedback effects of estrogen + progesterone increase in GnRH pulse frequency in early follicular phase Increased GnRH pulse 30% increase in serum FSH concentrations

FSH release from the pituitary stimulates growth of 5-15 primordial follicles
By late follicular phase, a single dominant follicle has been selected.
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Follicular Phase
The developing dominant follicle produces estrogen in a 2-cell process
Theca interna cells produce androstenedione in response to LH stimulation Granulosa cells convert androstenedione estradiol when stimulated by FSH

Estrogen causes the uterine lining to thicken / proliferate GnRH pulse frequency increase rise in LH Rise in LH also stimulates androgen synthesis androgens are converted to estrogens
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Follicular Phase
Serum estradiol concentrations peak approximately 1 day before ovulation Midcycle (~day 14) there is an LH spike in response to this estrogen surge Ovulation occurs as increase in LH level causes the follicle to rupture and release mature ovum

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LH Surge
Involves a poorly-understood neuroendocrine phenomenon in which there is a switch from negative feedback control of LH secretion by estradiol and progesterone to positive feedback Rising estradiol levels at the end of the follicular phase result in a 10-fold increase in serum LH concentration

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LH Surge: Effect on the Ovary


In response to LH:
Oocyte in the dominant follicle completes 1st meiotic division Increase in local secretion of plasminogen activator and cytokines required for ovulation Oocyte released from follicle at ovarian surface ~ 36 hrs after LH surge. Even before oocyte is released, granulosa cells around it begin to luteinize and produce progesterone. Progesterone slows LH pulses/ decreases LH pulse frequency
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Ovulation
LH spike stimulates ovulation, the release of the ovum from the follicle

After ovulation, the luteal phase begins, and remnants of the follicle left behind in the ovary develop www.freelivedoctor.com into the corpus luteum

Ovulation
Ovum usually passes into adjoining fallopian tube and is swept down to the uterus by the cilia lining the tube Takes 3-4 days for ovum to travel down tube to the uterus Fertilization must occur within 24 hrs of ovulation or ovum degenerates

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Luteal Phase
After ovulation, granulosa and theca interna cells lining the wall of the follicle form the corpus luteum cyst (stimulated by LH) The corpus luteum synthesizes estrogen and large amounts of progesterone
Progesterone stimulates the endometrium to become more glandular/secretory in preparation for implantation of fertilized ovum
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Luteal Phase
If fertilization occurs:
developing trophoblast synthesizes human chorionic gonadotropin (hcg) hcg maintains the corpus luteum so it may continue producing estrogen and progesterone to support the endometrium

By ~ 8-10 weeks gestation, the placenta is developed, and takes over production of estrogen and progesterone
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Luteal Phase
If fertilization does not occur:
corpus luteum is not maintained by hcg Corpus luteum degenerates after ~ 14 days Estrogen and progesterone levels fall Withdrawal of progesterone causes secretory endometrium to slough FSH levels slowly rise again in absence of negative feedback

MENSTRUATION
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