T1 - Menstrual Cycle (Josh) Flashcards
What are the phases of the Endometrial Cycle?
Proliferation
Secretory
Ischemic
Menstrual
Endometrial Cycle is influenced by which mechanism?
Hypothalmic-Pituitary-Ovarian Axis feedback mechanism
What are the hormones during the Endometrial Cycle?
Estrogen
Progesterone
Which phase of Endometrial Cycle?
A significant rich layer of myometrium and blood vessels develops to cover the endometrial cavity.
Proliferative Phase
Which phase of Endometrial Cycle?
characterized by a deepening and maturing of the succulent layer of endometrium for implantation.
Secretory Phase
Which phase of Endometrial Cycle?
First day of menstral cycle is day 1
Shedding of functional 2/3 of endometrium
Ischemic Phase
The Proliferative Phase correlates w/ which phase of the Ovarian Cycle?
Follicular Phase
The Proliferative Phase depends on the dominance of which hormone?
estrogen
which is stimulated from ovarian follicles
Can the Proliferative Phase adequately support life?
no
cannot adequately support an implanted ovum
Which phase creates the layer than supports the developing zygote?
Secretory phase
During the Secretory Phase, the corpus luteum produces which hormone?
Progesterone
What happens during the secretory phase if pregnancy does NOT occur?
corpus luteum regresses
ischemia of endometrium develops and cyclic menstrual bleeding begins
What are the phases of the Ovarian Cycle?
Follicular Phase (Pre-ovulatory)
Ovulation
Luteal (Post-ovulatory)
Toward the end of the normal menstrual cycle, what happens to blood levels of ovarian hormones (estrogen and progesterone)?
decline
*** these low levels trigger the hypothalamus to begin a new ovarian cycle by secreting GnRH
When the hypothalamus releases Gonadotropin-releasing Hormone (GnRH), where does it go?
to the anterior pituitary to stimulate the release of LH and FSH, which go to the ovary
During the Follicular Phase, which hormone is dominant?
FSH
***stimulates the development of ovarian graffian follicles
***one of these follicles develops into a mature ova
***surge of LH causes this mature ova to be released from ovary
What does the surge of LH do?
causes the mature ova to be released from ovary
Why would the developing follicles produce estrogen and progesterone in large amounts?
these hormones prepare the endometrial lining of the uterus for implantation of a zygote
When does ovulation occur?
14 + or - 2 days before next menstrual flow
What sparks ovulation?
marked surge of LH and a smaller peak of estrogen
***when these hormones peak, ovulation occurs within 24-36 hrs
Clinical signs of Ovulation
BBT: sharp increase in body temperature.
Vaginal mucus becomes thin and stretchable (spinnbarkeit).
Cervical mucus Ph changes from acidic…to more alkaline.
Mittelschmerz a subjective feeling of slight abdominal discomfort.
Progesterone plasma level increases to about 3 mg/mL (about 3 days post ovulation)
During the Luteal Phase, the corpus luteum secretes lots of Estrogen and Progesterone.
Which is dominant?
Progesterone
***peak about 8-10 days after ovulation, about the time a fertilized ovum would be implanted in the endometrium if pregnancy has occuredd
Avg menstrual cycle is — days.
28
Menstrual flow normally lasts –
4-7 days
Therapeutic mgmt for Dysmenorrhea during menstruation?
Mild analgesics
Hormonal therapy (birth control)
Heating pad on abdomen
Rest and mild exercises
**note: birth control is best unless trying to get pregnant
Oral contraceptives may — menstrual flow.
IUDs may — menstrual flow.
decrease
increase
S/S of Premenstrual Syndrome (PMS)
HA
Bloating
Tenderness and swelling of breasts
Food cravings
Depression
Irritability
— is an early sign of pregnancy or can be a symptom of menopause or some pathology.
Primary Amenorrhea
When is menopause diagnosed?
1 year after last menstrual period
What is the transition period during which ovarian function and hormone production decline?
Climacteric
What type of amenorrhea is this?
reflects a problem in the central hypothalamic-pituitary axis so that hormone production is inadequate.
Hypoganoadotrophic Amenorrhea
**May also be related to stress or inappropriate body fat to lean ratio.
Treatment for Dysfunctional Uterine Bleeding
Estrogen Therapy
Danazol (synthetic testosterone)
— is tissue resembling endometrial tissue, but located OUTSIDE the endometrium in the pelvis.
Endometriosis
***painful
Treatment for Endometriosis
Pain mgmt
Hormonal antagonist to suppress endogenous estrogen/GnRH/FSH/LH
Surgical intervention (TAHBSO)
What triggers the Ovarian/Hypothalamus/Pituitary feedback mechanism?
Low blood levels of estrogen trigger the hypothalamus to start the menstrual cycle all over again.
Hypothalamus secretes GnRH –>
stimulates the pituitary gland –>
Anterior Pituitary secretes FSH and LH –>
stimulates a primary follicle on the ovary to begin maturing.
Anterior Pituitary Hormones:
— causes the primary follicle to mature.
— surge causes the follicle to be released from surface of ovum.
FSH
LH
After ovulation, what is the follicle crater called? q
corpus luteum
What is the function of the Corpus Luteum?
secretes copious amonts of estrogen and progesterone (progesterone is dominant)
The Follicular Phase of the ovarian cycle corresponds with which phase of the endometrial cycle?
Proliferative
***both are preovulatory
What hormone is dominant in the preovulatory stage (Follicular and Proliferative)?
Estrogen
The —- phase of the ovarian cycle and the secretory phase of the endometrial cycle occur simultaneously.
Luteal
What hormone is dominant in the secretory phase?
progesterone
Which stage of the endometrial cycle can support an implanted zygote?
secretory
In what three places is the hormone estrogen produced?
Ovarian follicle
Corpus Luteum
Placenta
Ovulation occurs at the end of which phases?
Proliferative (Endometrial Cycle)
Follicular (Ovarian Cycle)
Amenorrhea:
Which circumstances should be evaluated?
1) absence of both menarche and secondary sexual characteristics by age 14
2) absence of menarche by age 16
3) 3 to 6 mth absence of menses after a period of menstruation
Secondary Dysmenorrhea
acquired menstrual pain that develops later in life than primary dysmenorrhea, typically after age 25
What are S/E of Danazol (synthetic testosterone)?
masculinizing traits (weight gain, edema, decreased breast size, oily skin, hirsutism, deep voice)
amenorrhea
hot flashes
vaginal dryness
insomnia
decreased libido
migraine
dizziness
fatigue
depression
Danazol is contraindicated in whom?
liver disease
***use w/ caution with cardiac and renal disease
***used less frequently b/c of side effects
