The Physiology of the Menstrual Cycle

Question 1

List the components of the reproductive system(organs glands)

Answer 1

Ovary
– Oviduct (Uterine tubes=Fallopian tubes)
– Uterus (Nourishment of the developing
embryo and fetus)
Accessory glands
Copulatory organ and parturition
– vagina
Vulva
Mammary glands

Question 2

What are the functions of the ovary

Answer 2

Oocyte release
– Menstruation
– Reproduction

Hormone production causing Female phenotype

Question 3

how many eggs before birth

Answer 3

7 million

Question 4

how many eggs during menopause

Answer 4

0

Question 5

how many eggs at first period

Answer 5

0.5 million

Question 6

Outline 7 steps of normal follicle development

Answer 6

1.primary follicle 2. growing follicle 3.mature follicle 4.ovulation 5.empty follicle 6. corpus luteum 7.corpus luteum regresses

Question 7

why is LH low during follicular phase of menstrual cycle even though GnRH is being secreted

Answer 7

Low concentration of oestrogen inhibits LH secretion from the anterior pituitary. oestrogen is produced by developing follicle cells

Question 8

FSH is secreted in when oestrogen is low or high

Answer 8

low

Question 9

As follicle develop in follicular stage what happens to estrogen conc

Answer 9

it rises

Question 10

What are periphial effects of estrogen in women

Answer 10

bone and muscle growth endometrial growth, maintains breast and female secondary characteristics

Question 11

after 10 daYS OF MENSTRUAL CYCLE WHAT effect does estrogen have on lh

Answer 11

positive feedback

Question 12

explain oestrogen effect on lh at differing concentrations

Answer 12

low oestrogen concentration negative feedback inhibits lh, at high conc of oestrogen positive feedback lh increases

Question 13

how long is follicular phase

Answer 13

1-10 days

Question 14

What does massive spike in LH around day 14 do

Answer 14

triggers ovulation in most mature follicle

Question 15

After ovulation what happens to LH GNRH

Answer 15

all drop

Question 16

days 11-14 of menstrual cycle are called

Answer 16

Ovulatory phase: Days 11-14

Question 17

before ovulation what do the fimbrae do

Answer 17

Shortly before the ovulation
fimbriae begin to sweep over
the surface of ovaries

Question 18

in the luteal phase what three hormones does the corpus luteum secrete

Answer 18

inhibin progesterone oestrogen

Question 19

iS INHIBIN PRESENT IN FOLLICULAR PHASE

Answer 19

No only after ovulation secreted by corpus luteum

Question 20

describe progesterone levels during menstrual cycle

Answer 20

Progesterone rises during luteal phase. low level beforehand

Question 21

What does inhibin do and why

Answer 21

negative feedback inhibit fsh, at luteal phase no maturation of folllicles needed yet

Question 22

how is GNRH release inhibited by hormones in luteal phase

Answer 22

rising progesterone from corpus luteum and falling oestrogen

Question 23

what does progesterone do

Answer 23

inhibit gnrh causing fsh and lh to fall and stimulate endometrial growth to allow implantation

Question 24

What causes progesterone inhibin to eventually decrease in luteal phase

Answer 24

they are secreted by the corpus luteum which eventually deteriorates allowing GNRH secretion to increase and therefore fsh and lh and a new cycle

Question 25

What is the function of the uterus

Answer 25

provides environment for egg implantation, and nourishment of the embryo and fetus during pregnancy protection of fetus and expelling fetus. to transport sperm to uterine tubes

Question 26

What happens menstrual phase day 1-5 of to the uterine wall

Answer 26

The functional layer of the endometrium becomes detached from the uterine wall, resulting in bleeding (menses).

Question 27

Describe what happens to uterine wall Proliferativa phase | D 6 – 14

Answer 27

Endometrium begins to proliferate and thicken, tubular glands and spiral arteries form.

Question 28

Describe what happens to uterine wall in Late Proliferative | Ovulatory D13-14

Answer 28

The glands are long and tortuous due to active growth. Stroma is gradually becoming oedematous.

Question 29

describe what happens in Secretory phase | (D 15 – 22) in uterine walls

Answer 29

``` Enlargement of glands which begin secreting mucus and glycogen in preparation for implantation of the fertilized ovum. Increased fluid (oedema) in the stroma ``` rising progesterone level

Question 30

what are the three segments of the uterine tube

Answer 30

infundibulum contains fimbrae, | ampulla and isthmus

Question 31

Describe organistation of uterine tube layers

Answer 31

tunic serosa on outside, then tunic muscularis, then tunicsubmucosa then tunic mucosa inside

Question 32

What threev things cause female infertility

Answer 32

anovulation, issue with egg transport, issue with implantation

Question 33

what are the causes of anovulation

Answer 33

PCOS, hypothalamic dysfunction, pituitary dysfunction, thyroid dysfunction, ovarian faliure

Question 34

The most common causes of ovulatory | dysfunction

Answer 34

``` Polycystic ovary syndrome (PCOS) (70%) 2) Hypothalamic amenorrhea (10%) 3) Hyperprolactinemia (10%) 4) Premature ovarian failure (10%) ```

Question 35

How can you treat PCOS

Answer 35

Life style intervention: Weight loss Ø Restores ovulation Ø Achieves spontaneous pregnancy Ø Medical treatment with ovulation induction drugs

Question 36

How is Clomiphene citrate treat infertility

Answer 36

First line treatment Clomiphene citrate stimulates endogenous FSH production. FSH stimulates ovulation

Question 37

Laparoscopic ovarian drilling, treat what

Answer 37

PCOS

Question 38

how do you treat hyperprolactinemia

Answer 38

Dopamine-agonist drugs are the treatment of choice

Question 39

Describe what can happen to the actual uterine tube

Answer 39

can be inflamed

Question 40

What are the uterine factors that can cause infertility

Answer 40

polyps, fibroids, endometriosis, uterine abnormality

Question 41

define ovarian reserve

Answer 41

The number and quality of the follicles left in the ovary at any given time. • An accurate measure of the quantitative OR would involve the counting of all follicles present in both ovaries

Question 42

how do you calculate ovarian reserve

Answer 42

antral follicle count, done looking at ultrasound(subjective), can look at amh concentration. both arent that clinically reliable. age may be the best indicator

Question 43

do women with spontaneously regular cycles have ovulation problem

Answer 43

no