Module 1

Question 1

Menstrual cycle is a reflection of cyclic release

of hormones on the _____________ -___________-___________ AXIS

Answer 1

Hypothalmic-Pituitary-Ovarian (HPO)

Question 2

GnRH is secreted by the ___________ which…
Stimulates cells in the __________ to make…
____ and ____ which…
Act on the ________

Answer 2

hypothalamus
anterior pituitary
FSH and LH
ovaries

Question 3

In your brain, link FSH to ___________ and LH to _____________.

Answer 3

estrogen; ovulation

Question 4

Menstrual cycle phases:
Ovarian cycle-3 phases:____, _____, _____

Uterine cycle-3 phases:____, _____, _____

A) Luteal phase
B) Ovulatory phase
C) Menstrual phase
D) Follicular phase
E) Secretory phase
F) Proliferative phase

Answer 4

Ovarian cycle-3 phases: D, B, A
Follicular phase
Ovulatory phase
Luteal phase

 Uterine cycle-3 phases: F, E, C
Proliferative phase
Secretory phase
Menstrual phase

Question 5

Follicular Phase
– From start of _______ (day ____of cycle) to just before
___________.
– ___ to ____ days in length (Is this variable from woman to woman?)

Answer 5

menses (day 1 of cycle); ovulation

10 to 17 days in length; yes, it’s variable

Question 6

Follicular Phase:

Early in the cycle (days ___to ___) multiple follicles are growing and and estrogen levels _____.

Answer 6

days 1 to 5;

rise

Question 7

Follicular Phase:
In the _____-________ phase, competition is occuring to become dominant ______________ - one ________ becomes dominant on day ____. Other follicles give up and undergo ________.

Answer 7

mid-follicular; follicle; follicle, 7.

atresia

Question 8

Mid-Follicular Phase:
__________ levels of estrogen act on the
hypothalamus and anterior pituitary to inhibit
________ and _____ secretion in a
CLASSIC __________ FEEDBACK LOOP

Answer 8

Moderate; FSH and LH;

Negative

Question 9

Follicular Phase:
 Day___ through ______ of follicular
phase…dominant follicle continuing to mature
and produce _____ levels of estrogen…which…
Eventually stimulate _____ and _____ in a
CLASSIC ____________ FEEDBACK LOOP.
This leads to the ___________-inducing LH surge
End of follicular phase: follicle _____ on surface of
_________.

Answer 9

7 through end; high levels of estrogen;
FSH and LH; Positive
ovulation-inducing LH surge;

End of phase: follicle bulges on surface of ovary

Question 10

Ovulatory Phase:
– \_\_\_ surge then…
– \_\_\_\_\_\_\_ protrudes, \_\_\_\_\_\_\_\_\_\_\_\_
ruptures and \_\_\_\_\_\_\_\_\_ is
extruded…
– \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_!!

Answer 10

LH surge then…
follicle protrudes, vesicle ruptures, and oocyte is extruded…

OVULATION!!

Question 11

Luteal Phase:
– Begins with \_\_\_\_\_\_\_\_ and ends
when \_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_\_\_.
– Luteal phase lasts \_\_\_\_ days
(generally (does/does not) vary!)
– After ovulation, walls of dominant
follicle \_\_\_\_\_\_\_\_\_\_ inward
– This follicle undergoes changes to
form the \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_- \_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 11

ovulation; when new cycle starts;
14 days; does not vary;
collapse;
corpus luteum (CL) - “yellow body”

Question 12

Luteal Phase:
Corpus luteum (CL) produces large amounts
of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
 This \_\_\_\_\_\_\_\_\_\_the growth of
new follicles
 \_\_\_\_\_\_\_\_\_\_\_\_ causes an
\_\_\_\_\_\_\_\_\_\_\_ in basal body
temperature

Answer 12

progesterone;
suppresses;
Progesterone; elevation

Question 13

Ovulation predictor kits are measuring the ____ surge, which is ____ ovulation.
The measurement of basal body temperature is an indicator of ____________, which is ______ ovulation.

Answer 13

LH; pre-ovulation;

progesterone; post-ovulation

Question 14

Luteal Phase:
If conception doesn’t occur, the CL
rapidly regresses\_\_\_ to\_\_\_days after
ovulation…
 Declining CL results in decreasing
\_\_\_\_\_\_\_\_\_\_\_ levels…
 and \_\_\_\_\_\_\_\_\_\_\_ begins

Answer 14

9 to 11 days after ovulation;
decreasing progesterone levels;
menstruation begins

Question 15

T/F: The proliferative phase is a progesterone dominant phase.

Answer 15

False. It is an estrogen dominant phase.

Question 16

Proliferative phase:
- cycle days ____ through ____
– Increasing plasma __________levels
– Proliferation of __________ glands and ________
– Endometrium ___________ and ______________
– Endocervical glands, stimulated by _________,
produce thin, clear mucus to _________ ________,
facilitate ________ __________ and ___________
– Changes to help a woman _____ ___________

Answer 16

5 through 14;
estrogen;
endometrial glands and stroma;
thickens and regenerates;
estrogen; lubricate vagina, facilitate sperm capture and transport;
GET PREGNANT

Question 17

The secretory phase is a _________________ dominant phase.

Answer 17

progesterone

Question 18

Secretory phase:
- cycle days ___ through ___
– Progestational phase…____________ acts on
__________-primed endometrium
– Endometrium _________ and ___________ glycogen,
mucus and other substances
– Cervical mucus is _______ and ________
Changes to help a woman ________ ___________

Answer 18

days 14 through 28;
progesterone; estrogen-primed endometrium;
cervical mucus is thick and sticky;
STAY PREGNANT

Question 19

T/F: The uterus is quiet during the secretory phase.

Answer 19

True, no cramping or contractions to help sustain pregnancy if it occurred.

Question 20

Menstrual phase:
- cycle days \_\_\_ to \_\_\_\_
– Degeneration of \_\_\_\_\_\_\_\_\_\_\_ lining
– Sloughing…\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
– Constriction of \_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_…decreased
blood flow and oxygenation to
endometrium

Answer 20

cycle days 1 to 5;
endometrial;
menstrual flow
spiral arterioles

Question 21

_________________ is painful menses: cramping,

backache, abdominal pain

Answer 21

Dysmenorrhea

Question 22

Primary dysmenorrhea is a diagnosis of ____________ with no evident ____________.

Answer 22

exclusion; no evident pathology

Question 23

Primary dysmenorrhea usually manifests _________ in a woman’s menstrual history.

Answer 23

early

Question 24

Primary dysmenorrhea is associated with __________ cycles.

Answer 24

ovulatory

Question 25

____________ released during the early menstrual phase cause uterine contractions, leading to _________ which causes pain.

Answer 25

Prostaglandins; hypoxia

Question 26

Dysmenorrhea:
ONSET: usually _______ __________ or at the same time as ___________ _____________.
LOCATION: Usually _____________ _________ and ______ _________, may radiate to __________ ______
MAY ALSO AFFECT: _____ system, causing _______ , ___________, and _________

Answer 26

right before or at the same time as menstrual bleeding;
Usually suprapubic area and lower back, may radiate to inner thighs ;
GI system, Nausea, vomiting, and diarrhea.

Question 27

What dx testing is done for dysmenorrhea?

Answer 27

None

Question 28

Treatment for dysmennorhea?

Answer 28

NSAIDS, combined hormonal contraceptives

Question 29

PMS/PMDD begins at or soon after ________.

Answer 29

ovulation

Question 30

PMS/PMDD is worst during _____________ phase.

Answer 30

luteal

Question 31

Lifestyle approaches for PMS/PMDD: ___________;
reduce ___________, __________, and _______
increase ___________ __________

Answer 31

Lifestyle approaches: exercise;
reduce caffeine, sodium, and alcohol;
increase complex CHO

Question 32

Treatments for PMS/PMDD:
Supplements/herbs: __________, ___________, ________
○ Physical symptom treatment: ______, ___________
○ Mood symptom treatment: _____________

Answer 32

Supplements/herbs: calcium, magnesium, chasteberry
○ Physical symptom treatment: OCPs, NSAIDs
○ Mood symptom treatment: SSRIs

Question 33

When using intermittent dosing with SSRI’s for PMS/PMDD you should choose those with a _________ half-life, such as __________ or __________.

Answer 33

long half-life;

Prozac or Zoloft