Menstrual Cycle

Question 1

Average age of menarche in US is?

Answer 1

12-13

Question 2

Normal Menstrual Cycle

Answer 2

21-45 day cycles

Question 3

How many days is normal for Flow?

Answer 3

up to 7 days (average 3-5)

Question 4

What is the normal amount?

Answer 4

up to 80ml/period (1tsp = 5ml)

Question 5

What are the cycle phases and average days of each stage?

Answer 5

Menses (day 1), 
follicular phase “proliferatory”, 
ovulation (day 14), 
luteal phase “secretory”, 
menses (day 30)

Question 6

Practice drawing out the cycle in 15 seconds

Answer 6

(Insert image)

Question 7

What hormones are responsible for the menstraul cycle and where are they secreted/ where do they stimulate?

Answer 7

GnRH (hypothalamus) -> FSH/LH (anterior pituitary) -> estrogen/progesterone (ovary)

LH: androgens, progesterone, ovulation
FSH: estrogen (E2)

Question 8

What are the effects of estrogen on the reproductive organs (5)? What other effects?

Answer 8

• endometrial proliferation
• myometrial cell growth
• vaginal cornification
• reduced vaginal pH (more acidic)
• increased cervical mucus pH (more basic/ supportive of sperm)
• breast, fat, skin, bone, brain
• feedback loop on hypothalamic-pituitary

Question 9

What are the effects of progesterone on reproductive organs (3)?

Answer 9

• endometrial secretory changes (counteract estrogen)
• decreased pH of cervical mucus (more acidic)
• helps to maintain pregnancy
• breast, uterine and tubal muscle activity
• thermogenesis effect (increase in basal temperature)

Question 10

Signs and symptoms of ovulation?

Answer 10

• mittelschmertz (ovulation year pain)
• cervical mucus changes
• basal body temperature rises after ovulation
• regular monthly periods
• LH spike (urine ovulation predictor kits)
• PMS
• serum progesterone (day 21)

Question 11

What happens when estrogen is in excess (6)?

Answer 11

• dysmenorrhea
• nausea
• edema
• enlarged uterus, uterine fibroids
• fibrocystic breast changes
• menorrhagia (heavy bleeding)

Question 12

What happens with estrogen deficiency (2)?

Answer 12

• scant menses

- mid cycle spotting

Question 13

What happens when progesterone is in excess (8)?

Answer 13

• edema
• bloating
• headache
• depression
• weight gain
• fatigue
• HTN
• varicose veins

Question 14

What happens with progesterone deficiency (5)?

Answer 14

• symptoms similar to those with anovulatory cycle, endometriosis, adenomyosis,endometrial hyperplasia
• prolonged menses
• heavy menses
• severe cramps
• luteal spotting, break through bleeding