Ovulation and Menstrual

Cycle
Reproductive hormones
Reproductive hormones
1. Follicle stimulating hormone (FSH) – secreted during
the first half of cycle; stimulates development of
graafian follicle; secreted by anterior pituitary gland.
2. Interstitial cell- stimulating hormone, leuteinizing hormone (ICSH,
LH) stimulates ovulation and development of corpus luteum;
secreted by pituitary gland.
3. Estrogen – assists in ovarian follicle maturation; stimulates
endometrial thickening; responsible for development of secondary
sex characteristics; maintains endometrium during pregnancy.
secreted by ovaries and adrenal cortex during cycle and by
placenta during pregnancy.
4. Progesterone – aids in endometrial thickening; facilitates secretory
changes; maintains uterine lining for implantation and early
pregnancy; relaxes smooth muscle. Secreted by corpus luteum and
placenta.
5. Prostaglandins – substances produced by various body organs that
act hormonally on the endometrium to influence the onset and
continuation of labor. Used to efface the cervix before induction of
labor in term pregnancies.
OVARIAN CYCLE
 PROLIFERATIVE OR FOLLICULAR PHASE

• First half of the ovarian cycle

• Always variable in length
• Follicles of ovaries are growing Uterus lining
(endometrium) is proliferating
• Elevated Hormones
• Anterior Pituitary INCREASES SECRETION OF FOLLICLE STIMULATING
HORMONE
• Therefore, the follicle in the ovary ENLARGES
• As it enlarges, it becomes more mature
• GRAAFIAN FOLLICLE
• Most mature of all follicles
• With cavity
• With ovum ready to be extruded
• With clear fluid rich in ESTROGEN
• Only one (1) follicle matures per menstrual cycle
• Approximate number of growing follicles:
• At twenty-eight (28) weeks Age of Gestation
• 6,000,000
• At Term
• 1,000,000
• At menarche
• 400,000
• At forty (40) years of age
• 8,000
 Estrogen secretion effect in uterus

• Thickens the uterine lining

• Usually eight-fold of previous
• From one millimeter to eight millimeter
• Peak of uterine lining coincides with ovulation
• Peaking of Estrogen will signal Leutinizing Hormone surge or increase
in blood levels of Leutinizing Hormone
LH Surge
• Coincides with ovulation
• Extrusion of ovum from the Graafian Follicle
• Signal for Ovulation
• Ovum stays in the Fallopian tube for one (1) to three (3) days
• Peak is twenty-four hours
LUTEAL OR SECRETORY PHASE
Second half of the ovarian cycle
• Constant part
• Always fourteen (14) days in length
• Production of Corpus Luteum
• Uterus / uterine lining is secretory in nature
• Because of the secretion of Leutinizing Hormone
• Leutinizing Hormone influences follicle
• Cavity is left inside the follicle
• Stimulates change in fluid in Graafian follicle
• Yellowish, milky white fluid high in PROGESTERONE
Progesterone
• Maintains uterine lining
• Organizes uterine lining
• If only estrogen is present, the uterine lining would
continue to thicken and thicken and thicken
• PRO-VERA
• Progesterone
• For dysfunctional uterine bleeding
• For organization of the uterus
• Anticipates possible fertilization
• If there is pregnancy, to MAINTAIN PREGNANCY
• If ovum degenerates,
• LH and Progesterone no longer needed
• Therefore, there is menstruation
If there is coitus and fertilization
• Corpus Luteum must persist up to twelve (12) weeks of gestation
• After twelve (12) weeks, it degenerates and the placenta produces
hormones
• Approximate menstrual cycle
• NORMAL is 28 days
• 28 + or – 7 days or 21 – 35 days is also NORMAL
• If the menstrual period is short (i.e. 21 days), a person
can menstruate twice in a month – this is still
NORMAL
• If a person’s menstrual cycle is 28 days, 14 days for the proliferative or
follicular phase and 14 days for the secretory or luteal phase, then
OVULATION IS ON THE 14TH DAY
• If a person’s menstrual cycle is 35 days, the OVULATION IS ON THE
21ST DAY
Given the following:
• Last Menstrual Period (LMP) is January 1, 2005
• Menstrual Cycle is 35 days
January 2005
01 02 03 04 05 06 07
08 09 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31
February 2005
xx xx xx 01 02 03 04
05 06 07 08 09 10 11
The LAST MENSTRUAL PERIOD or LMP is the FIRST DAY OF THE PERIOD
• Therefore, counting of the MENSTRUAL CYCLE, starts from this same date
• Thus, February 4, 2005
• Is the 35th day
• Is the expected start of the next cycle
• Is the LMP of the next cycle
Thus, February 3, 2005
• Is the 34th day
• Is the end of the cycle that started on January
1, 2005
• This is WHERE YOU START COUNTING BACK
FOURTEEN DAYS TO GET THE DAY OF
OVULATION
 Therefore, count fourteen (14) days, starting February 3 going backward
• Thus, the expected OVULATION DAY is February 21, 2005
• If the cycle is irregular, do not do this procedure
• If the Menstrual Cycle is not given, it is UNDERSTOOD
THAT IT IS 28 DAYS
NAGELE’S RULE
NAGELE’S RULE
• If LMP is from APRIL TO DECEMBER, use the formula
• 03 + 07 + 01 (MM,DD,YY)
• If LMP is from JANUARY TO MARCH, use the formula
• + 09 + 07 (MM,DD)
CONSTANT OF 11 AND 18
• Another way of getting the ovulation period if the cycle is variable is
by the use of the constant of 11 and 18
Example:
• Menstrual Cycle is 22 – 35 days
• Monitor the menstrual cycle in one year’s time
• Subtract higher number (18) from shortest cycle
• 22 – 18 = 4
• Subtract lower number (11) from the longest cycle
• 35 – 11 = 24
 Therefore, from the 4th to the 24th day of the cycle, there is NO COITUS
• There is 80% failure in the rhythm method
• If menstrual cycle is 28 – 35 days
• 28 – 18 = 10
• 35 – 11 = 24
Therefore, from the 10th to the 24th day of the cycle, there is NO COITUS