Menstruation and Ovulation

Question 1

Name the two phases of Ovulation and the length of each

Answer 1

Follicular phase - 14 days average (but changes person to person)
Luteal phase - 14 days (fixed)

Question 2

What happens in the follicular phase

Answer 2

Menstruation 
Increase in LH, FSH and Oestrogen 
Increase in FSH and LH triggers: completion of 1st meiotic division to form secondary follicle 
Oestrogen:
Stimulates thickening of endometrium
Thinning of cervical mucus

Question 3

In the follicular phase LH and FSH do what?

Answer 3

Increase in FSH and LH triggers: completion of 1st meiotic division to form secondary follicle 
LH surge (triggered by oestrogen/positive feedback) - causes ovulation

Question 4

In the follicular phase what is the role of oestrogen?

Answer 4

Stimulates thickening of endometrium
Thinning of cervical mucus
Switches control of LH and FSH to positive feedback

Question 5

What triggers ovulation

Answer 5

LH surge

12-36 hours after surge ovulation occurs

Question 6

During which phase does ovulation occur?

Answer 6

Follicular

Question 7

How long does the luteal phase last?

Answer 7

14 days

Question 8

Describe the hormonal changes in the luteal phase

Answer 8

LH, FSH and oestrogen fall

Increase in the production of progesterone

Question 9

What is progesterone produced by?

Answer 9

Corpus Luteum (which develops from leftover follicular cells)

Question 10

What happens in the follicular phase if fertilisation doesn’t occur?

Answer 10

Corpus luteum degenerates and reduction in progesterone which triggers menstruation

Question 11

What happens in the follicular phase if fertilisation occurs?

Answer 11

Embryo produces hCG which stimulates maintenance of corpus luteum and therefore maintenance of a viable endometrium

Question 12

Describe a normal menstrual cycle

Answer 12

21-35 days
Menstruation lasting 4-6 days
No inter-menstrual bleeding/post-coital bleeding
No passage of excessive amounts of blood/clots

Question 13

Define Menorrhagia

Answer 13

Prolonged heavy bleeding - loss of >80mls

Question 14

Define Dysmenorrhea

Answer 14

Painful periods

Question 15

Define Polymenorrhea

Answer 15

Menstrual cycle lasting <21 days

Question 16

Define Oligomenorrhea

Answer 16

Cycle lasting >35 days

Question 17

Define Amenorrhea

Answer 17

Absence of period >6 months (can be primary or secondary)

Question 18

List causes of Primary amenorrhea (5)

Answer 18

Imperforate hymen
Turners syndrome 45XO
Testicular feminization (female phenotype, male genotype)
Anorexia, excessive exercise

Question 19

Define primary amenorrhea

Answer 19

Failure to start periods by age 16

Question 20

List causes of secondary amenorrhea (6)

Answer 20

Pregnancy
Menopause
Polycystic Ovarian Syndrome
Drug induced: withdrawal from contraception, steroids, recreational drug use
Genetic disorders: Kallmans syndrome, Turners syndrome, Prader Willi
Systemic disease: thyroid dysfunction, renal railure, pituitary disease and haemochromatosis

Question 21

Define secondary amenorrhea

Answer 21

Loss of menstruation for 6 months after periods were previously established