OB Female Physiology : The Menstrual Cycle

Dysfunctional Uterine Bleeding (DUB)

Vaginal bleeding not related to menses or endometrial pathology

Amenorrhea

Absence or menstruation

primary amenorrhea

Menarche is delayed beyond 18 years of age

Secondary amenorrhea

cessation of uterine bleeding occurs in women who previously menstruated

Mittelschmerz

Dull ache mid cycle on either side of lower abdomen

Memometrorrhagia

Bleeding that irregular in both frequency and volume

Metorrhagia

Irregular frequent bleeding

Hypomenorrhea

Abnormally small amounts of menstrual bleeding

Hypermenorrhea

excessive volume during cyclic menstrual bleeding

Dysmenorrhea

Painful periods often associated with endometriosis

Menorrhagia

Abnormally heavy or long periods often associated with fibroids

Oligomenorrhea

Prolonged periods over 35 days, associated with PCOS

Polymenorrhea

Period cycles less than 21 days

Tamoxifen

Hormone replacement therapy drug

Less than 5mm

Post menopausal patients not on HRT should have this endometrial thickness

Postmenopausal patients on HRT should have a normal endometrial thickness of up to

8mm

1-5

Day of cycle for menses

1-5

Day of cycle for follicular phase

FSH and Estrogen

Dominant hormones in menses and follicular phase

6-14

Day of cycle for proliferative

FSH and Estrogen

Dominant hormones in proliferative phase

14

Day of ovulation

LH

Dominant hormone for ovulation

15-28

Average length of the secretory and Luteal phase

Homogenous hyperechoic

Appearance of uterine in secretory phase

Hypoechoic

Early proliferative appearance

Tri layered

Late proliferative appearance

Thin

Menses sono appearance

1-4 mm

Endo thickness in menses

4-8 mm

Endo thickness in proliferative

8-16 mm

Endo thickness in secretory phase

Menses

Late proliferative

Secretory phase

Secretory

Endometrium is thickest in what phase

Menses, Proliferative,Secretory

Order of Uterine Phase

Follicular, Ovulation, Luteal

Order of Ovarian Phase

Ovulation

Proliferative phase ends at

10 days

Proliferative phase lasts about

Proliferative

Regeneration and proliferation of endometrium stimulated by estrogen

The superficial layer

What layer is shed during menstruation

Catabolic

Menstruation can be described as this process if implantation has not occurred

Progesterone

Corpus Luteum secretes

Ovulation

Theca Cells peak during this phase with the LH

Corpus Luteum

Also described as the ring of fire

Low resistive flow

The corpus Luteum is vital and therefore has

hCG

The corpus Luteum atrophies/ regresses and becomes the corpus Albicans with the absence of

Corpus Luteum

Fatty yellowish cell type

Ovulation

Free fluid in the posterior cup de sac is normal during what phase

24-36 hours after surge

Surge of LH causes rupture of follicular membrane within

11mm or 1.1cm

Ovulation typically occurs with follicles greater than

Greater than 3cm

Considered a cyst

Graafian

Dominant follicle measuring up to 10 mm during the follicular phase

Luteinizing Hormone (LH)

Stimulates maturation of follicle and is responsible for Graafian rupture

Estrogen

Theca Cells produce

Infundibulum, Ampulla, Isthmus, Interstitial

Outer to inner

28 days

Average menstrual cycle

Come from the ovary

FSH affects the ovary but does NOT

Hypothalamus

Produces gonadotropic releasing hormone (GnRH)

FSH and LH

The process of the hypothalamus producing GnRH allows the Pituitary Gland to secrete what