Physiology of

• is periodic uterine bleeding that begins

approximately 14 days after ovulation.
• 1st menstrual period in girls;
• may occur as early as age 8 or 9, or as late as age
17 and still be within normal limits
• also termed as female reproductive cycle;

• defined as episodic uterine bleeding in response

to cyclic hormonal changes
 :
• to bring an ovum to maturity and renew a uterus
that will be responsible for its growth should it be
fertilized
• The process that allows for conception and
implantation of a new life
• Good to include health teaching information on
menstruation to both girls and their parents as early as
4th grade as part of routine care

• First day of bleeding is day 1 of menstrual cycle

• Length varies - average length is 28 days (from the beginning
of one menstrual flow to the beginning of the next)

• As short as 23 days or as long as 35 days

• Length of the average menstrual flow (menses): 4 – 6

days; short – 2 days; long – 7 days
Amount of menstrual flow:
• difficult to estimate;
• average 30 – 80 mL per menstrual period;
• saturating pad or tampon in less than an hour is heavy
bleeding
Color:
• dark red;

• a combination of blood, mucus, and endometrial cells

• 4 body structures involved in the physiology of the
menstrual cycle:

1.HYPOTHALAMUS ALL 4 STRUCTURES MUST CONTRIBUTE

2.PITUITARY GLAND THEIR PART FOR A MENSTRUAL CYCLE TO

3.OVARIES BE COMPLETE; inactivity of any part

4.UTERUS results in an incomplete or
ineffective cycle
 Release Initiates menstrual cycle

Stimulates

To release

Angeline R. Cuizon, RM, RN, MN

Maturation of ovum • Ovulation (mid-cycle)
• Growth endometrium
(2nd half)

Acts on
• From approximately day 5 – day 14
• Increase (thickness) – continues for the
1st half of the menstrual cycle
• Also termed – proliferative, estrogenic,
follicular, or postmenstrual phase
  estrogen and progesterone

Follicle Stimulating Hormone releasing
hormone (FSHRh)

Follicle Stimulating Hormone (FSH)

Follicle to mature (primordial – Graafian)

Estogen (follicular fluid)

Endometrium proliferates –
increase thickness (eightfold)
• Day 15 to 21
• After ovulation, the formation of progesterone in the
corpus luteum (under the direction of the LH) causes
the glands of the uterine endometrium to become
“corkscrew” or twisted in appearance
• Endometrium also becomes dilated w/ quantities of
glycogen (elementary sugar) and mucin (protein)
• Capillaries of the endometrium increase in amount until
lining takes on the appearance of rich, spongy velvet –
ready for implantation
• Also termed – progestational, luteal, premenstrual, or
secretory phase
 If fertilization does not occur, corpus luteum in
the ovary begins to regress after 8 – 10 days
 Progesterone and estrogen decreases =
endometrium begins to degenerate at
approximately day 24 or day 25 of the cycle
 Corpus luteum degenerates

 estrogen and  progesterone

Capillaries rupture, minute hemorrhages

Endometrium slough/ shed off
 The following products are discharged from the
uterus as the menstrual flow or menses:
 Blood from the ruptured capillaries
 Mucin from glands
 Fragments of endometrial tissue
 Microscopic, atrophied, and unfertilized ovum
Pre-Menstrual Syndrome
• Occurs in the Luteal Phase
• Relieve by onset of menses
• Symptoms:
• Behavioral and physiologic sypmtoms
• Anxiety, fatigue, abdominal bloating, headache,
appetite disturbance, irritability, depression.
• May include migraine
• Poor renal clearance
Angeline R. Cuizon, RM, RN, MN