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MENSTRUATION Flashcards

1
Q

What 2 sections could the menstruation cycle be split into?

A

Pre-ovulation

Post-ovulation

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2
Q

What are the 2 main cycles in the menstruation cycle?

A

Ovarian and Uterine

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3
Q

What are the 2 phases of the Ovarian cycle?

A

Follicular phase
Ovulation
Luteal phase

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4
Q

What are the 3 phases of the Uterine cycle?

A

Period
Proliferative
Ovulation
Secretory

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5
Q

How long does a full cycle, on average, take?

A

28-35 days

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6
Q

On average, how long does a period last?

A

~ 5 days

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7
Q

What occurs during the ovarian cycle in 1 sentence

A

Development of the follicles leading up to ovulation

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8
Q

What occurs in the Uterine cycle in one sentence

A

Functional endometrium thickens, there is a rise in Progesterone levels

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9
Q

What happens during the ‘period’ phase of the menstrual cycle?
2 points

A

The endometrial lining is shed from the previous cycle

FSH levels increase (follicles grow)

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10
Q

What 5 things occur during the Proliferative phase?

A
  • ^ Oestrogen levels
  • Endometrium thickens
  • Growth of endometrial glands
  • Spiral arteries emerge
  • Cervical mucus is more hospitable towards sperm
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11
Q

Why does all the proliferative phase occur?

A

To optimise the chance of fertilisation

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12
Q

What induces the start of the Proliferative phase?

A

GnRH is released from the hypothalamus to the anterior pituitary gland in pulses

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13
Q

What happens if GnRH is released constantly?

2 points

A

GnRH receptors are desensitised

Less LH and FSH released

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14
Q

What 2 hormones are released once GnRH reaches the A.P.G.?

A

LH

FSH

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15
Q

What is the relationship between the hypothalamus, APG and ovaries called?

A

Hypothalamo-pituitary ovarian axis (HPO)

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16
Q

In the first 10 days of the Follicular phase, what happens to the Theca cells?
(2 points)

A

Develop LH receptors, LH can bind to them

They release Androstendione

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17
Q

In the first 10 days of the Follicular phase, what happens to the Granulosa cells?
(2 points)

A

Develop FSH receptors, FSH binds to them

Aromatase is released

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18
Q

What happens between Aromatase and Androstendione?

What does this eventually become?

A

Aromatase converts Androstendione into 17B-Estradiol

Oestrogen

19
Q

What occurs to the granulosa cells during days 10-12?

A

They also develop LH receptors

20
Q

Why is it important that Granulosa cells also have LH receptors?

A

There’s more androstendione to convert into Oestrogen

21
Q

During days 10-12 describe the changes in hormone levels

A

High FSH, equal levels of LH and Oestrogen (period)
Spike of FSH and LH
Steady increase of Oestrogen

22
Q

What happens when Oestrogen levels have reached the ‘threshold’?
4 points

A
  • feedback system to APG
    Less FSH release
    Follicles stop growing and die
    Follicle with most FSH = Dominant follicle
23
Q

What occurs to the Follicle between days 12-14?

5 points

A 
The dominant follicle continues to bind to FSH and LH
There are increasing levels of Oestrogen
\+ feedback to HPO
Surge in LH and FSH
Ovulation (release of oocyte)
24
Q

What are the remnants of the ovarian follicle made of?

What’s this called?

A

Lutenised Theca and Granulosa cells

Corpus Luteum

25
What occurs to the corpus luteum?
Lutenised theca cells continue to release Androstendioone | Granulosa cells continue convert this into Oestrogen
26
What occurs to LH and FSH levels after ovulation? | Why?
``` Decrease There is no longer a dominant follicle/number of follicles to respond to LH and FSH Oestrogen decreases (- feedback) ```
27
How do the granulosa cells respond to low LH? | 3 points
They increase the activity of an enzyme This enzyme converts Cholesterol into Pregnenolone Pregnelolone is the precursor for progesterone
28
What happens as a result of progesterone release?
Negative feedback to HPO | Low levels of FSH and LH released
29
As well as Progesterone, what else affects the HPO axis after ovulation? What releases this?
Inhibin = negative feedback to HPO | Granulosa cells release it
30
How does Progesterone and Inhibin affect oestrogen levels? What does this result in?
Decrease oestrogen levels (less FSH and LH) | Progesterone becomes the dominant hormone
31
What does high Progesterone and low Oestrogen levels indicate? 2 points
Signals to the endometrium that ovulation has occurred | Endometrium can prepare for implantation of a fertilised egg
32
Recall what occurs post ovulation (2)
Luteal phase and secretory phase
33
What 2 things occur under the influence of progesterone at the beginning of the secretory phase?
Spiral arteries grow longer | Uterine glands secrete more mucus
34
After day 15 post-ovulation, what occurs in regards to the ___ window?
The window for fertilisation starts to close
35
What happens to the mucus after day 15 post ovulation? | Why does this happen?
It gets thicker | Becomes less hospitable for sperm
36
What occurs to the corpus luteum during the secretory phase? How does this affect hormone levels? Why?
It becomes Corpus Albanians Levels of progesterone and oestrogen decrease It doesn't secrete any hormones (it's practically dead)
37
What occurs to the spiral arteries after day 15 post ovulation? Why does this occur?
They collapse | Progesterone levels are at their lowest
38
At the end of the secretory phase what occurs? | What does this lead to?
The functional layer of the endometrium starts to shed = menstruation = next cycle
39
Describe the HPO feedback with ^ Oestrogen v Oestrogen
^ Oestrogen = + feedback = ^ LH | v Oestrogen = - feedback = v LH
40
Describe the HPO feedback with ^ Progesterone v Progesterone
^ Progesterone = - feedback = v LH & v FSH | v Progesterone = + feedback = ^ LH & ^ FSH
41
At what point of the cycle is the pt most likely to conceive?
Ovulation (fertile window) | Between days 10-14
42
When is the patient least fertile during this cycle?
Menstruation | Days 1-7
43
When does the thickening of the uterine lining occur? (what days in the whole cycle)
Days 17-28

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