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GOSH > Menstrual cycle > Flashcards

Menstrual cycle Flashcards

1
Q

What is the purpose of the menstrual cycle?

A

generate oocyte

facilitate fertilisation

optimise endometrium for implantation

protect developing embryo

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2
Q

On what day does ovulation occur?

A

14

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3
Q

On what days does the follicular phase take place? (thinking about the cycle from the follicular perspective)

A

1-14

follicle generation takes place

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4
Q

On what days does the luteal phase take place?

thinking about the cycle from the follicular perspective

A

14-28

formation and degradation of corpus luteum takes place

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5
Q

What are days 1-5 of the menstrual cycle known as (from an endometrial perspective)?

A

Menstrual phase

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6
Q

What are days 5-14 of the menstrual cycle known as (from an endometrial perspective)?

A

Proliferative phase

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7
Q

What are days 14-28 of the menstrual cycle known as (from an endometrial perspective)?

A

secretory phase

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8
Q

What are the prominent hormones produced in follicular phase?

A

FSH - pituitary

oestrogen - ovary

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9
Q

What are the prominent hormones produced in luteal phase?

A

LH - pituitary

progesterone - ovary

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10
Q

What does HPO stand for?

A

hypothalamo-pituitary-ovarian

axis

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11
Q

What is the main oestrogen that is important during 1)reproduction, 2) pregnancy and 3) post menopause?

A

1) estradial (E2)
2) E3
3) E1

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12
Q

What are the different ways the cycle can be broken down in to phases?

A 
From the follicular perspective:
follicular phase (days 1-14)
luteal phase (days 14-28)
From the endometrial perspective:
menstrual phase (days 1-5)
Proliferative phase (days 5-14)
Secretory phase (days 14-28)
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13
Q

How is the menstrual cycle controlled?

A

Hypothalamo-pituitary-ovarian axis

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14
Q

What hormone, important to the menstrual cycle, is released by the hypothalamus?

A

GnRH

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15
Q

What hormones, important to the menstrual cycle, are released by the anterior pituitary?

A

FSH and LH

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16
Q

How does the GnRH effect the menstrual cycle?

A

stimulates anterior pituitary gland to produce FSH and LH

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17
Q

How do FSH and LH effect the menstrual cycle?

A

stimulate ovary to produce oestrogen

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18
Q

How does oestrogen effect the hypothalamus and the anterior pituitary gland? What is the exception to this?

A

negative feedback, causes reduced release of GnRH, FSH and LH

On day 14 (ovulation), very high levels of E2, which cause v. high levels of LH (triggering ovulation)

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19
Q

What is important about the way GnRH is released?

A

Hourly pulses - v. important

20
Q

How is GnRh transported to pituitary?

A

hypophyseal portal blood system

21
Q

What can cause alteration of GnRH secretion?

A 
bereavement
anxiety
time zone
day/night duty
exercise
weight loss/gain
22
Q

What factors can alter the menstrual cycle?

A 
bereavement
anxiety
time zone
day/night duty
exercise
weight loss/gain
23
Q

What hormone, important in reproduction (but especially birth), is produced in the posterior pituitary gland?

A

oxytocin

24
Q

What cells in the anterior pituitary gland produce FSH and LH?

A

basophils

25
Q

What does FSH do in the menstrual cycle?

A

Stimulates follicular activity - promotes estradiol (oestrogen) production from granulose cells

26
Q

What does LH do in the menstrual cycle?

A

triggers release of egg from dominant follicle

promotes development of corpus luteum and production of progesterone

27
Q

What happens when oestrogen levels peak on day 14/mid-cycle?

A

High E2 levels = surge in LH = ovulation

28
Q

What happens to the follicle in the menstrual cycle?

A

develops and matures in ovary, released during ovulation,
becomes corpus luteum
degenerates if not fertilised

1) primordial follicle
2) primary/preantral follicle
3) secondary/antral follicle
4) preovulatory follicle
5) ovulation

29
Q

What happens to the corpus luteum post-ovulation, if no fertilisation has taken place?

A

degenerates/fibroses to become corpus albicans

30
Q

What is the endometrium?

A

Lining of uterus

31
Q

What happens to the endometrium in the proliferative phase? What hormone causes this?

A

Endometrium thickens (by ovulation 2-3mm thick)
Increase stroll cells
Increased glands, blood cells

E2

32
Q

Roughly how thick is the endometrium by ovulation?

A

2-3mm

33
Q

What happens to endometrium in secretory phase? Which hormone is dominant?

A

Increased secretion
Increased lipid and glycogen
Increased blood supply

Endometrium 4-6mm thick

OPTIMAL CONDITIONS FOR IMPLANTATION OF FERTILISED EGG: STABLE, VASCULAR AND NUTRIENT-RICH

Progesterone

34
Q

Roughly how thick is the endometrium during secretory phase?

A

4-6mm

35
Q

What occurs in menstruation?

A

LH levels fall

Corpus lutes collapses

progesterone withdrawal = menstruation begins

vasodilation

necrotic outer layers of endometrium separate from uterus

separated tissue and blood initiate uterine contractions

expel contents

36
Q

How does a follicle reach the fallopian tube?

A

released by ovary, collected by fallopian tube by chemotaxis

37
Q

Where is mucus produced?

A

cervix - columnar glands

38
Q

What is the consistency of cervical mucus around ovulation? How does this facilitate conception?

A

Stringy and runny (spinnbarkeit)

Facilitates sperm access during ovulation - the consistency changes after this, to prevent infection

39
Q

What is the consistency of cervical mucus in the luteal phase? How does this facilitate pregnancy?

A

Tenacious and inelastic

prevents microbial ingress - protects developing embryo

critical to pregnancy - mucus plug

40
Q

How can a malformed mucus plug effect pregnancy? What can cause this?

A

Can lead to miscarriage and pre-term birth

surgery or other problem that has damaged endothelial lining of cervix

41
Q

Between what days are you at most risk of getting pregnant?

A

7-21

Actually a very wide period of time where risk of pregnancy is high.

RHYTHM METHOD OF CONTRACEPTION DOES NOT WORK

42
Q

What does the combined oral contraceptive contain?

A

Estradiol

Progestogen (synthetic progesterone)

43
Q

how does the COCP effect the menstrual cycle to prevent pregnancy?

A

Steady (but higher) levels of oestrogen and progesterone

inhibit GnRH/FSH/LH

prevent ovulation
thin endometrium
tenacious mucus

44
Q

When is the worst time to forget to take pill?

A

at the beginning or end of 3 week cycle - extends time with no cover, therefore time for GnRH/FSH/LH levels to rise again

45
Q

How are eggs collected in IVF?

A

Superovulation

46
Q

How is super ovulation induced in IVF?

A

daily injections of recombinant FSH

GOSH (33 decks)

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