The Menstrual Cycle – Study Notes
1. Introduction to the Menstrual Cycle:
The menstrual cycle is a monthly process that prepares a woman's body for pregnancy. If
pregnancy does not occur, the uterus sheds its lining, leading to menstruation (period). The cycle
typically lasts 28 days, but can vary between 21 to 35 days. It involves the reproductive organs,
hormones, and ovaries.
2. Phases of the Menstrual Cycle:
The menstrual cycle is divided into four main phases, regulated by hormones:
a. Menstrual Phase (Days 1-5):
This phase begins on the first day of menstruation, which is the shedding of the
endometrial lining (the lining of the uterus).
Hormonal Levels: Both estrogen and progesterone are at their lowest.
Uterus: The endometrium breaks down, and blood and tissue are released through the
vagina.
b. Follicular Phase (Days 1-13):
This phase overlaps with the menstrual phase and lasts until ovulation.
Hormonal Changes: The hypothalamus releases GnRH (gonadotropin-releasing
hormone), which stimulates the pituitary gland to secrete FSH (follicle-stimulating
hormone). FSH stimulates the ovaries to develop follicles, each containing an egg.
Estrogen: The growing follicles produce estrogen, which causes the endometrial lining
to thicken in preparation for a potential pregnancy.
Ovulation Preparation: One follicle becomes dominant, while the others are reabsorbed.
c. Ovulation Phase (Day 14):
Ovulation occurs when a mature egg is released from the dominant follicle in the ovary.
This typically happens around Day 14 of the cycle (in a 28-day cycle).
Hormonal Surge: The rise in estrogen from the developing follicle triggers a surge in
LH (luteinizing hormone), which causes ovulation.
Egg Release: The mature egg is released from the ovary and travels down the fallopian
tube, where it may meet sperm and become fertilized.
Cervical Mucus: Around ovulation, the cervical mucus becomes clear, slippery, and
stretchy, facilitating sperm movement through the cervix.
d. Luteal Phase (Days 15-28):
After ovulation, the ruptured follicle forms the corpus luteum, which secretes
progesterone and a small amount of estrogen.
Hormonal Role: Progesterone helps maintain the thickened endometrium, making it
suitable for implantation if the egg is fertilized.
No Fertilization: If the egg is not fertilized, the corpus luteum disintegrates, leading to a
drop in progesterone and estrogen levels.
Endometrial Breakdown: Without the support of these hormones, the endometrial
lining starts to break down, and menstruation begins, signaling the start of the next cycle.
3. Hormonal Regulation of the Menstrual Cycle:
Hormones regulate the entire menstrual cycle in a coordinated way:
GnRH (Gonadotropin-Releasing Hormone): Secreted by the hypothalamus, it
stimulates the pituitary gland to release FSH and LH.
FSH (Follicle-Stimulating Hormone): Stimulates the ovaries to develop follicles.
LH (Luteinizing Hormone): Surge in LH triggers ovulation.
Estrogen: Produced by the growing follicles and later by the corpus luteum, estrogen
promotes the thickening of the endometrium.
Progesterone: Secreted by the corpus luteum, progesterone helps maintain the
endometrium in case of pregnancy.
4. Key Events in the Menstrual Cycle:
Day 1: First day of menstruation (bleeding).
Days 1-13: Follicular phase; the egg matures and estrogen increases, leading to
endometrial thickening.
Day 14: Ovulation occurs, and the egg is released.
Days 15-28: Luteal phase; the corpus luteum secretes progesterone to maintain the
endometrium.
End of Cycle: If no fertilization occurs, progesterone and estrogen levels drop, leading to
menstruation.
5. Variations in the Menstrual Cycle:
While the average menstrual cycle is 28 days, cycles can range from 21 to 35 days. A cycle that
is too long or too short, or irregular cycles, can indicate hormonal imbalances or health issues.
6. Disorders Related to the Menstrual Cycle:
Amenorrhea: The absence of menstruation. It can be primary (never having a period) or
secondary (a period that stops after having been normal).
Dysmenorrhea: Painful menstruation, often caused by prostaglandins, chemicals that
cause uterine contractions. It can lead to cramps.
Polycystic Ovary Syndrome (PCOS): A hormonal disorder causing irregular periods,
often due to imbalanced levels of LH and FSH.
Endometriosis: A condition where the tissue that normally lines the inside of the uterus
grows outside it, causing pain, heavy bleeding, and infertility.
Menorrhagia: Excessively heavy menstrual bleeding.
Premenstrual Syndrome (PMS): A group of symptoms that occur before menstruation,
including mood swings, irritability, fatigue, and bloating.
Premenstrual Dysphoric Disorder (PMDD): A severe form of PMS that includes
extreme mood swings and can affect daily functioning.
7. Fertilization and Pregnancy:
Fertilization: If the egg is fertilized by sperm, it will implant in the endometrial lining
and pregnancy begins. The body will produce hCG (human chorionic gonadotropin) to
maintain the corpus luteum and prevent menstruation.
Pregnancy Test: The presence of hCG in urine can confirm pregnancy, which prevents
the shedding of the uterine lining.
8. Menstrual Cycle Length:
Most women have a cycle between 21 and 35 days, with menstruation lasting about 3 to
7 days.
Cycle Length Variations: Stress, illness, and changes in weight or exercise habits can
affect cycle length.
Would you like a diagram showing the phases of the menstrual cycle or any additional details?
