Menstruation

definition

 Episodic uterine bleeding in response to

cyclic hormonal changes.
 Process that allows for conception and
implantation of new life.
 Purpose: To bring an ovum to maturity and
renew a uterine tissue bed that will be
responsible for its growth.
menarche
First menstrual period in girls

Occurs as early as 8-9 years old as late as 17 years old

As early as children in Grade IV – teaching on menstruation starts

Average age : 12-13 years old

Average length of menstruation (28 days) – beginning of first day of menstrual flow
to the beginning of the next cycle

Length of menstruation : as short as 23 days and as long as 35 days

Average length of menstrual flow : 4-6 days , as short as 2 days and as long as 7 days
 
Physiology of Menstruation

 Hypothalamus
 Pituitary gland
 Ovary
 Uterus
 cervix
Phases of menstrual cycle

Menstrual Phase- day 1 to 5

 Corpus luteum degenerates
 There is cessation of progesterone and
estrogen produced by the corpus luteum and
blood level drops
 drop in blood levels of estrogen and
progesterone stimulate the production of
FSH and new cycle begins
Proliferative Phase –day 6 to 14
 Follicle stimulating hormone (FSH) released by the
anterior pituitary stimulates the development of the
graafian follicle
 As graafian follicle develops, it produces increasing
amounts of follicular fluid containing a hormone called
estrogen
 Estrogen stimulates thickening of the endometrium
 As estrogen increases in the blood stream, it suppresses
secretion of FSH and favors secretion of the b
luteinizing hormone (LH)
Secretory Phase- day 15-21
 Follows ovulation which is the release of mature ovum
from the graafian follicle
 Cavity of the graafian follicle is replaced by the corpus
luteum (secretes progesterone and some estrogen
 Progesterone acts upon the endometrium to bring
about secretory changes that prepare it for
pregnancy. It also maintains the endometrium during
the early phase of pregnancy, should a fertilized ovum
be implanted
Pre-menstrual – day 22 to 28
 If fertilization does not occur the corpus
luteum in the ovary begin to regress
 Production of estrogen and progesterone
decreases
 Endometrium of uterus begins to degenerate
and sloughs off
 If fertilization occurs, the corpus luteum will
stimulate the production of progesterone