UTERINE

CYCLE
PRESENTED BY: Dr. Nibedita Talapatra.
3RD YEAR PGT
DEPARTMENT OF ANATOMY, AGMC
 INTRODUCTION
• The reproductive system of females, unlike men, shows regular cyclical changes that
teleologically may be regarded as periodic preparation for pregnancy & fertilization.

• These Rhythmic cyclical changes/events occurring in the uterus is known as Uterine cycle
or Menstrual cycle.

• Duration of each cycle is roughly 28days.

• Starts at puberty (age 10-16yrs) & terminate at menopause (age 45-55yrs)

• Uterine cycle runs parallel with the Ovarian cycle.

• Under control of hormones which are secreted in a negative & positive feedback manner.
Pupose of menstrual Cycle

• To prepare the endometrium for

embedding of fertilised ovum
(conceptus).

• If the ovum is not fertilised, most of the

endometrium is shed off in the form of
flow of blood (menstrual bleeding).
 THE UTERUS
• Pear shaped hollow thick-walled muscular organ of reproduction
present in the lesser pelvis.
• Site for implantation & development of embryo.
• Length- 7.5 cm
Breadth- 5cm
Depth(thickness)- 2.5 cm
Weight- 30-40gms.
• 3 parts
-Fundus
-Body
-Cervix.
Blood supply:
• Uterine Artery, B/O Anterior division of Internal iliac
artery.
• Enters uterus at the level of cervico-isthmic junction.
• Uterine artery is tortuous through out its coarce in the
broad ligament as well as in its branches within the
uterine wall.
• In the uterine wall ,it divides, run circumferentially as
Anterior & Posterior arcuate Arteries.
• Give rise to Helical/Spiral arteries, form dense capillary
plexus within the myometrium & Endometrium.

Venous drainage: Uterine veins– Drains into internal

iliac veins.

Nerve supply: Inferior Hypogastric Plexus– branches

terminate in the myometrium & Endometrium.
 MICROSTRUCTURE OF THE UTERUS
• 3 layers
Perimetrium lined with serosa/adventitia.
OUTER

Myometrium; thick, smooth muscle layer

MIDDLE

INNER Endometrium.
PERIMETRIUM: MYOMETRIUM:
• Outer most layer • 3 layers of smooth
• Either serosa or muscle.
adventitia. • Thin outer
• Serosa consists of longitudinal layer.
single layer of simple • Middle circular
squamous epithelium layer.
underlined by loose • Inner longitudinal
connective tissue. layer.
• Lower Anterior part • Containd blood
is covered by vessels & nerves.
adventitia (stratum vasculare)
• This layer remains • Pregnancy:
unchanged during hypertrophy &
uterine cycles. hyperplasia.
ENDOMETRIUM:
Lining Epithelium: simple columner
Lamina propria: connective tissue stroma
Clinically divided in 2 parts.
Stratum functionalis( 2/3rd ):
• Thick, oedematous, supplied by spiral arteries.
• Highly sensitive to oestrogen & progesteron.
• Top layer: Stratum Compactum.
• Upper 2/3rd of uterine glands (secret mucus).
• Cyclic monthly changes.
Stratum basale (1/3rd ):
• Thin, supplied by short straight arteries.
• Lower 1/3rd of uterine glands.
• No monthly cyclic change.
 PROLOFERATIVE
PHAGE

MENSTRUAL UTERINE SECRETORY

PHAGE CYCLE PHAGE

PRE-
MENSTRUAL
PHAGE
PROLIFERATIVE PHAGE (5-14 DAY)

• Coincides with follicular phage of ovarian cycle.

• Under the influence of oestrogen.

• Stratum Basale layer starts proliferating.

• Endometrium increase in thickness.

• Superficial & deepest part of stroma remains compact.

• Part around bodies of uterine gland become spongy.

• Arteries are initially small & straight, they grow in length.

PROLIFERATIVE
PHAGE
 SECRETORY PHAGE (15-25 DAY)
• Coincide with luteal phage of ovarian cycle.
• Under control of Progesteron.
• Secretion of mucus by uterine gland: Soft & oedematous
endometrium.
• Arteries of superficial 2/3rd become long & tortuous to supply
more blood (Spiral Artery)
• Uterine gland become elongated, dilated & saucer shaped.
SECRETORY
PHAGE
 PREMENSTRUAL PHAGE (26-28 DAYS)

• If ovum is not fertilised, corpus luteum degenerates.

• Blood level of Progesteron falls down.

• Lack of Progesteron: spasm of tunia media of Spiral Arteries.

• Ischemic necrosis of endometrim & wall of arteries.

• Blood supply to the spongy & compact layers of endometrium gets reduced.

Withdrawal of Oestrogen & Progesteron

Triggers Menstruation.
 MENSTRUAL PHAGE (1-5 DAYS)
• Blood supply cut off: Functional layer of endometrium undergoes
necrosis and sloughs off.
• Haemorrhage occurs from the stumps of the endometrial arteries.
• Continues till only the raw surface of stratum basale is left.
• Basal layer remain intact.

AFTER
BEFORE MENSTRUATION
MENSTRUATION
MENSTRUAL
PHAGE
• CHANGES IN THICKNESS OF ENDOMETRIUM:

Post menstrual phage: 0.5-1mm

Proliferative phage: 2-3mm
Early Secretory phage: 3-5 mm
Late Secretory phage: 5-7 mm
 CHANGES IN UTERINE GLANDS:

• Initially straight.

• Gradually grow in length & diameter, become convoluted & tortuous.

• “Saw-toothed” appearance on longitudinal section.

• Glandular epithelium accumulates glycogen, secrete carbohydrate rich fluids.

CHANGES IN EPITHELIAL LINNING OF UTERUS:
• At first simple cuboidal, apical surface have microvilli, some cells
ciliated.
• During proliferative phage: simple columnar.
• Secretory phage: Apical part of the cell sheds off,
cell again becomes cuboidal with irregular upper margin towards
lumen.
 HYPOTHALAMUS

HORMONAL
Gonadotropin Releasing hormone ( GnRH) CONTROL

Anterior Pituitary

Follicle Stimulating Hormone (FSH)

OVARY

Proliferation of
Estrogen Development of follicles uterine
Leutenizing Endometrium
Hormone (LH)
Progesteron
OVULAT CORPUS
I ON
LUTEUM
Estrogen
References:

1. Gray’s Anatomy: Susan Straindring.

2. Textbook of clinical embryology: Vishram Singh.

3. Textbook of human embryology: Yogesh Sontakke.

4. Textbook of human embryology: I. B. Singh.

5. Difiore’s atlas of Histology.

THANK YOU