Bone by : Wafa'a Al-Sati ievieweu by: uhaua uaui Page 1

Lec14
The Menstrual Cycle
Important point


*7million premordial follicles (during fetal development)
*2 mllllon ova aL Lhe (Llme of blrLh)
*one mllllon ova presenL aL Lhe Llme of blrLh enLer a
sLage of arrest |n prophase Llll adulLhood.MCC
*300,000ova (at the time of puberty).

*Cn|y one of these ova per cyc|e reaches matur|ty.MCC
1he number of ova reachlng maLurlLy durlng Lhe
reproducLlve llfe of a woman ls 300.
1he resL of Lhe folllcles degeneraLe.
*1he lengLh of Lhe mensLrual cycle ls var|ab|e.



















Bone by : Wafa'a Al-Sati ievieweu by: uhaua uaui Page 2

Uterine cycle Ovarian cycle
!"#$%&'()*%+,(-* /0+1*2 &%
#$%*&-3'+,&%4 /0+1*2 &% ,0*
#5&''(63'+% /0+1*2
!,&!7 8+4 &) 9:
;+%(+<'* /0+1*=6>?
AL Lhe end of mensLruaLlon
Lhe superf|c|a| two th|rds of
Lhe endometr|um ls sloughed
off.
Under the |nf|uence of
estrogens from Lhe developlng
folllcle, Lhe endomeLrlum
lncreases rapldly ln Lhlckness
from Lhe 3LhLo Lhe 14Lhdays of
mensLrual cycle.
-As Lhe Lhlckness lncreases,
Lhe uLerlne glands are drawn
ouL so LhaL Lhey lengLhen
1he prollferaLlve phase
represenLs Lhe resLoraLlon of
Lhe eplLhellum from Lhe
precedlng mensLruaLlon
@A:BACDBE $FG@AH '*3,*+'
/0+1*H
From14 to 28day
Fixed phase mcq
AfLer ovulaLlon Lhe
endomeLrlum becomes more
vascularlsed and sllghLly
oedemaLous under the
|nf|uence of estrogen and
progesterone from the corpus
|uteum.
1he glands become colled
and LorLuous and Lhey begln Lo

1here are many prlmordlal
folllcles under Lhe ovarlan
capsule.
Lach folllcle conLalns an
|mmature ovum.
AL Lhe sLarL of each cycle,
several of Lhese folllcles
enlarge.
A cavlLy known as Lhe
anLrum" ls formed around
Lhe ovum.
1hls cavlLy ls fllled wlLh
folllcular fluld.
Cne of Lhe folllculas ln one
ovary sLarLs Lo grow rapldly on
abouL Lhe slxLh day and
becomes Lhe domlnanL folllcle.
1he oLher folllcles regress
formlng aLreLlc folllcles.
1he maLurlng ovarlan folllcle
ls also known as Lhe Crafflan
folllcle".
1he cells of 1heca |nterna" of
the fo|||c|e are the pr|mary
source of c|rcu|at|ng
estrogens.
1he folllcular fluld conLalns
hlgh level of esLrogen. 1hls
estrogen comes from the
"Granu|osa ce||s".
AL abouL Lhe 14thday of Lhe
Bone by : Wafa'a Al-Sati ievieweu by: uhaua uaui Page S
secreLe a clear fluld.
1he secreLory phase
represenLs preparaLlon of Lhe
uLerus for lmplanLaLlon of Lhe
ferLlllzed ovum.
1he |ength of the secretory
phase |s remarkab|y constant
at about 14 days.
When Lhe ferLlllzaLlon falls Lo
occur Lhe endomeLrlum ls
shed and a new cycle sLarLs.
1he superf|c|a| two th|rds of
Lhe endomeLrlum LhaL ls shed
durlng mesLruaLlon ls called as
"Stratum Iunct|ona|e".
lL ls supplled by Lhe long
colled splral arLerles.
1he deep one th|rd LhaL ls noL
shed ls called Stratum
8asa|e" and lL ls supplled by
basllar arLerles
When Lhe corpus luLeum
regresses, hormonal supporL
for Lhe endomeLrlum ls
wlLhdrawn, Lhe endomeLrlum
becomes Lhlnner..
1here ls spasm and Lhen
necrosls of Lhe walls of Lhe
splral arLerles leadlng Lo spoLLy
hemorrhages LhaL become
confluenL and produce Lhe
mensLrual flow
cycle Lhe dlsLended maLure
folllcle rupLures and Lhe ovum
ls exLruded lnLo Lhe abdomlnal
cavlLy. 1hls process ls called
#D-3'+,(&I2
1hls ovum ls plcked up by Lhe
flmbrlaLed ends of Lhe uLerlne
Lubes and lL ls LransporLed Lo
Lhe uLerus.
*Lhere ls no ferLlllzaLlon lL goes
ouL Lhrough Lhe vaglna.
1he folllcle LhaL rupLures aL
Lhe Llme of ovulaLlon prompLly
fllls wlLh blood, formlng a
corpus hemorrhaglcum.
Mlnor bleedlng from Lhe
folllcle lnLo Lhe abdomlnal
cavlLy may cause perlLoneal
lrrlLaLlon and fleeLlng lower
abdomlnal paln known as
MlLLelschmerz".
lf pregnancy occurs Lhe
corpus luLeum perslsLs and
Lhere are usually no more
perlods unLll afLer dellvery.
lf Lhere ls no pregnancy Lhe
copus luLeum beglns Lo
degenaraLe abouL 4 days
before Lhe nexL menses, and ls
evenLually replaced by scar
Llssue, formlng a Corpus
Alblcans"
Bone by : Wafa'a Al-Sati ievieweu by: uhaua uaui Page 4

VERY IMPORTANT MCQ

Days of ovulation=mensteral cycle - secretory phase
Secreto
ry phase always = 14 due to 28 -14

e.g girl has menses every 35 days the ovulation day is
35 -14 = 21 days from the beginning of period.
*******************************************

*MensLrual blood ls predomlnanLly arter|a| MCC

* anovu|atory cyc|es are common for Lhe flrsL 12-18
monLhs afLer mearche and agaln before Lhe onseL of
menopause

*Lstrogen makes the mucus th|nner and more a|ka||ne. MCC

*rogesterone makes |t th|ck tenac|ous and
ce||u|arMCC
*mucus |s th|nnest at the t|me of ovu|at|onMC

*Lstrogens cause pro||ferat|on of mammary ducts,
whereas progesterone causes growth of |obu|es and
a|veo||

*lor lndlcaLor Lhe Llme of ovulaLlon ls a r|se |n the basa|
body temparature.due Lo lncrease ln progesLerone
secreLlon -progesterone |s thermogen|c.
*Cvum llve for 72h 3days
*sperm = = 120h 3 days