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O&G > MENSTRUATION > Flashcards

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
Q

What occurs to the corpus luteum?

A

Lutenised theca cells continue to release Androstendioone

Granulosa cells continue convert this into Oestrogen

26
Q

What occurs to LH and FSH levels after ovulation?

Why?

A 
Decrease
There is no longer a dominant follicle/number of follicles to respond to LH and FSH
Oestrogen decreases (- feedback)
27
Q

How do the granulosa cells respond to low LH?

3 points

A

They increase the activity of an enzyme
This enzyme converts Cholesterol into Pregnenolone
Pregnelolone is the precursor for progesterone

28
Q

What happens as a result of progesterone release?

A

Negative feedback to HPO

Low levels of FSH and LH released

29
Q

As well as Progesterone, what else affects the HPO axis after ovulation?
What releases this?

A

Inhibin = negative feedback to HPO

Granulosa cells release it

30
Q

How does Progesterone and Inhibin affect oestrogen levels? What does this result in?

A

Decrease oestrogen levels (less FSH and LH)

Progesterone becomes the dominant hormone

31
Q

What does high Progesterone and low Oestrogen levels indicate?
2 points

A

Signals to the endometrium that ovulation has occurred

Endometrium can prepare for implantation of a fertilised egg

32
Q

Recall what occurs post ovulation (2)

A

Luteal phase and secretory phase

33
Q

What 2 things occur under the influence of progesterone at the beginning of the secretory phase?

A

Spiral arteries grow longer

Uterine glands secrete more mucus

34
Q

After day 15 post-ovulation, what occurs in regards to the ___ window?

A

The window for fertilisation starts to close

35
Q

What happens to the mucus after day 15 post ovulation?

Why does this happen?

A

It gets thicker

Becomes less hospitable for sperm

36
Q

What occurs to the corpus luteum during the secretory phase?
How does this affect hormone levels?
Why?

A

It becomes Corpus Albanians
Levels of progesterone and oestrogen decrease
It doesn’t secrete any hormones (it’s practically dead)

37
Q

What occurs to the spiral arteries after day 15 post ovulation? Why does this occur?

A

They collapse

Progesterone levels are at their lowest

38
Q

At the end of the secretory phase what occurs?

What does this lead to?

A

The functional layer of the endometrium starts to shed = menstruation = next cycle

39
Q

Describe the HPO feedback with
^ Oestrogen
v Oestrogen

A

^ Oestrogen = + feedback = ^ LH

v Oestrogen = - feedback = v LH

40
Q

Describe the HPO feedback with
^ Progesterone
v Progesterone

A

^ Progesterone = - feedback = v LH & v FSH

v Progesterone = + feedback = ^ LH & ^ FSH

41
Q

At what point of the cycle is the pt most likely to conceive?

A

Ovulation (fertile window)

Between days 10-14

42
Q

When is the patient least fertile during this cycle?

A

Menstruation

Days 1-7

43
Q

When does the thickening of the uterine lining occur? (what days in the whole cycle)

A

Days 17-28

O&G (1 decks)

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