Thefemalemenstrualcyclemaderidiculouslysimple

byMichaelTurner
Quickfactsandfigures

dayofovulation?day14
whatcausesovulation?theLHsurge
whatcausestheLHsurge?
1.aburstofestrogenproductionfromthefollicleonday12,AND
2.theswitchofestrogenfromNEGtoPOSfeedbackonLHproductn
whenisprogesteronehighest?Day21fromproductnbycorpusluteum
whenisestrogenhighest?Day12aburstsecretedbythefolliclecausestheLHsurge
estrogen:buildsuptheuterinelining(grownsthelawn)
progesterone:maintainstheuterinelining(watersthelawn)

Overview:what'sthepointofit?
Thebasicideaisthateverymonththefemalebodydoes2things:
1)Offersanopportunitytoreproducebyreleasingamatureeggintothefallopiantube
2)Preparesitselfforapossiblepregnancybycreatingaenvironmentwhereafertilizedeggcoulddevelop.
Thisenvironmentisathicklayerofbloodandnutrientsintheuterus.
Releasingamatureegg,andbuildingupathickuterinelining("endometrium")inwhichitcoulddevelop,arenottasks
whichareaccomplishedquicklyandeasily.Rather,thebodymustworkoveraperiodoftimetoaccomplishthesegoals,and
thisworkisinitiatedandcarriedoutbytheactionofcertainhormones.

Overview:the2keystounderstandingthecycle
1)Estrogenandprogesteronehavetwoeffectsinthemenstrualcycle:
A)Theyactontheuterustocausethebuildingupandmaintanenceoftheendometrium(thebloodandnutrientlining)
Theendometriumwillneverbuilduponitsown.Thebloodandvasculatureonly
sticktothewallandbuildupwhenestrogenandprogesteroneactonthecellsoftheuterus.

B)TheyinhibittheproductionofGnrHandFSH/LH("negativefeedback")

Theeffectofthisinhibitionisthatfolliculargrowthanddevelopmentisseverlylimited.

2)Thecentral,andmysterious,eventofthewholecycleistheswitchofestrogenfromNEGATIVEtoPOSITIVE
feedbackonthereleaseofLHandFSH(days1214)
thesurgeinLHlevelsiswhatcausesthefollicletoruptureandreleasethematureegg(thisreleaseiscalled
"ovulation").Thus,itissaidthattheLHsurgecausesovulation.
thisisoneoftheonlyexamplesofpositivefeedbackintheentirebody.(FYIanotheroneistherelationship
betweenstimulationandsexualarousal.Moreonthatlater.(makesyouwanttoreadahead,eh!?)

Descriptionofphase1:thefolliculardevelopmentstage(days112)
Itallbeginswhenthebraindecidesit'stimetostartmaturingsomeeggssothattheywillbereadytogetreleased(and
hopefullyfertilized!)soon.Sothehypothalmussendsasignal(GnRH)totheanteriorpituitarythatsays"Releasethe
FollicularStimulatingH'oneandtheLeutinizingH'onesothatwecanstartdevelopinganegg!"
TheAnteriorpituitaryreplies"Yessir!"anditreleasestheFSHandLHjustasitwascommanded.TheFSHandLHthen
traveltotheovariesandcausethefolliclestostartmaturing.
Asthefolliclesstartmaturing,theybegintoreleaseestrogen.Oneofestrogen'sjobsistogototheuterusandtobuildupthe
endometrium..Whydoesitmakesensethatmaturingfollicleswouldproduceestrogen?B/cbyreleasingestrogen(and
thuscausingtheendometriumtobuildup),thematuringfolliclesarepreparing,inadvance,ahomeforthemselvesinthe
eventthatoneofthemgetsfertilizedandneedsaplacetoimplant.
So,undertheinfluenceofestrogenproducedbymaturingfollicles,theendometriumbeginstobuildup.
Oneweekintothisprocessoffollicularmaturation,onefollicleisannointedas"TheChosenFollicle".Alltheotherfollicles
thathadbeendevelopingundertheinfluenceofFSHandLHwitheraway,leavingjustTheChosenOnetoluxuriateinthe
bathofhormones.Ahhh..
AstheChosenFolliclematures,itproducesmoreandmoreestrogen.Nowweseeinactiontheotherroleofestrogen.
Estrogen,inadditiontobuildinguptheendometrium,actsonthehypothalmustoinhibitthereleaseofGnrh,andonthe
anteriorpituitarytoinhibitthereleaseofFSHandLH
WhatsthepointofinhibitingFSHandLH?
shortanswer:B/cyoudon'twantawholenewroundoffollicularmaturationtostart.

explanation:RememberFSHandLHstimulateabunchoffolliclestostartmaturing.Butyouhavealready
donethis!YouhaveALREADYmaturedabunchoffollicles,andyouhaveALREADYselectedtheoneChosenFollicle
forthemonth.Sowhykeepstimulatingmoretodevelop?Itsawasteofenergyandfollicles..Soitstimetoturndown
theFSHandLHlevels.Youallowonlyatricklejustenoughtokeep"TheChosenFollicle"developing,butnotenoughto
startawholenewroundoffolliclematuration.

Phase2:thereleaseofamatureeggfromthefollicle(aka"ovulation")(days1214)
AstheChosenFolliclematures,theeggwithinnearsthepointofbeingreleasedintothedeep,darkworldofthefallopian
tube.Justbeforethemomentoffullmaturityarrives,anditistimetobereleasedintothefallopiantube,something
mysteriousandamazingoccurs.dadadadum..
Suddenly,theestrogenbeingreleasedfromthematuringfollicle

switches

fromNegativetoPositivefeedbackonGnRHand
FSH/LH!!Uhoh!!EstrogenandFSH/LHbecomelockedinawonderful,sensual,POSITIVEfeedbackloopeach
stimulatingtheothertowardhigherlevelsofarousal(andyouthoughtthistopicwasboring!)
Thealmostfullymaturefolliclereleasesestrogen,whichnowstimulatesthereleaseofFSH/LH,whichstimulatesfurther
maturationofthefollicle,whichcausesittoreleaseevenmoreestrogen.

Theyarelockedinaspiralofmutualstimulation.(AsAustinPowerswouldsay:YEAHBABY!!)FSH,LH,andestrogen
levelsallsurgetogether.(gggrrrrrrrrrr)
Theclimax,Imeantheculmination,occurswhentheactionofextremelyhighlevelsofLH(the"LHsurge")finallycauses
thefollicletoruptureandreleasethematureegg.Thus,itissaidthat"theLHsurgecausesovulation".TheLHsurgeALSO
causestheremainingrupturedfolliclecellstoorganizeintothecorpusluteum.

Phase3:theactionofthecorpusluteumtomaintaintheendometrium(aka"TheLutealPhase")
(days1523)
Oncetheegghasbeenreleased,itbeginsitsslowjourneydownoneofthefallopiantubes(eitherRorL)towardstheuterus.
Outofthewholemonth,thisistheonlywindowoftimeinwhichawomancanbecomepregnant!!
Astheeggmakesitsjourney,itisimperativethattheuterineliningcontiuetobemaintained(sinceaconceptioncould
happenatanytime).Buthowcanthisbedone,nowthatthefolliclehasrupturedandstoppedproducingestrogen?.
Theansweristheactionofthecorpusluteum!
RememberthattheLHsurgealsocausestheleftoverrupturedfolliclecellstoorganizeintothecorpusluteum(orC.L.)Once
theC.L.isformed,itstartspumpingoutestrogen,andespeciallyprogesterone(anewplayeronthestage).Bothoftheseact
tomaintaintheuterinelining.

Nowthatovulationhasocurred,estrogenswitchesbacktoitsnormalstateofinhibitngGnRHandFSH/LHrelease(soas
NOTtotriggeranewroundoffollicularmaturationWhoneedsnewfollicles?Wejustreleasedoneandwerestillwaiting
toseewhathappenstoit).Progesteronejoinsthefrayandalsoactsw/negfeedbackonGnRhandFSH,LH.
Sonowthewholebodywaitsexpectantlywilltheeggbefertilized??!!Willthelittlespermiesurvivetherigorsofthe
vaginalcanalandfinditswaytothemothership??!!

Iftheeggisfertilized(Yipee!)>Implantationandmaintanenceofendometrium
Iftheeggisfertilized,thenewlyformedthingyiscalleda"zygote".Thezygoteimmediatelystartsdividing,andwhenit
reachestheuterus,itimplantsintheendometrium.Nowthethingyhasenoughcellsthatitgetsanewnamea"blastocyst".
CellsontheouterlayeroftheblastocystsecreteaH'onecalled"humanchorionicgonadotropin(HCG),whichactstokeep
thecorpusluteumfunctional.WhocaresaboutkeepingtheC.L.functional?AfunctionalC.L.secretesestrogenand
progesterone.Estrogenandprogesteronekeeptheendometriumfromsloughing.Whydowecareaboutkeepingthe
endometriumfromsloughing?Well,nowthatourlittleblastocystissnuggledsafelyintotheendometrium,thelastthing
wewouldwanttohappenisfortheendometriumtosloughoffandcarryhimaway.Thatwouldbeterrible!(FYIthisis
howRU486causesanabortion).
HighlevelsofestrogenandprogesteronealsoacttoinhibitproductnofGnRHandLSH/FH.Thismakessense;sinceyouare
alreadypregnant,youdon'twanttowasteenergyorriskanotherpregnancybymaturinganewroundoffollicles.
Overtime,thecorpusluteumslowlybegiunstodieout,anditsestrogenandprogesteronesecretingfunctionistakenoverby
theouterlayerofcellsoftheblastocyst.
Astheembryogrowsanddevelopesintheuterus,somepartofitmustcontinuallyproduceestrogenandprogesteronesothat
theuterineliningneccessaryforgrowthismaintained.(rememberifestrogenandprogesteronelevelseverdrop,the
endometriumwillimmediatelystartsloughing!)

IftheeggisNOTfertilized>sloughingoffoftheendometrium("Menstruation")
Herestheflow:Iftheeggisnotfertilized,itdoesn'timplant,itdoesn'tdevelopeintoablastocyst,anditdoesn'tsecrete
HCG.IntheabsenceofHCG,thecorpusluteumsoondeteriorates.
Asthecorpusluteumdeteriorates,estrogenandprogesteronelevelsfalloff.Fallingestrogenandprogesteronelevelscause2
things:
1)theendometriumisnolongermaintainedandthereforeitbeginstosloughoff.
Thissloughingoffoccursoveraperiodofafewdays,duringwhichtimethebloodandcellsofthelining

flowoutofthevagina.Thissloughingoffperiodoftimeiscalled"menstruation"
2)thenegativefeedbackonGnrHandFSH/LHproductionsubsides.
This,bydefinition,meansthatthelevelsofGnRHandFSH/LHbegintorise.Astheydo,theystartto
stimulatethematurationofawholenewroundoffollicles.Thus,thecyclebeginsagain.Thelasteggfailedto
befertilized;soitistimetomatureanotherbatchoffollicles,pickaChosenOne,andseeifthereisn'tbetter
luckwiththenextegg.
THEEND

note:Althoughthestagesdiscussedabovealwaysoccurintheordergiven,thetimeframeoverwhichthecycleisspread
variesfromwomantowoman.Somehavearelativelycontractedcycleiswhicheachstageisreachedquickerthannormal;
whileforothersthereverseistrue.

ThoughtQuestionsandscenarios
acommonpregnancyvariation:thezygoteimplantsinthewrongplace(calledan"ectopicpregnancy").Thewrongplace
isusuallythewallofthefallopiantube(a"tubalpregnancy").(Basicallythepoorlittlezygotegotstuckonthewallofthe
fallopiantubebeforeithadachancetogetallthewaydowntotheuterus).Ectopicpregnanciesusuallyendinspontaneous
abortions.
Howdoesahomepregnancytestwork?
Homepregnancytestslookforthepresenceofhumanchorionicgonadotropin(HCG)IfHCGispresent,thatmeansthata
blastocystimplantedintheuterinewallissecretingit.Iotherwords,thatmeansthatyouarepregnant!
Howdoesthebirthcontrolpillwork?
ThebirthcontrolpillissimplyaveryhighdoseofsyntheticH'onesthatresemblethestructureofestrogenandprogesterone.
Thus,whenyoutakethepill,youbodyfeelshighlevelsofestrogenandprogesterone.
Highlevelsofestrogenandprogesteronedo2things,onlyoneofwhichisthedesiredeffectofthepilluser:
1)theuterineliningismaintainedathighlevels(asifyouwereinthelutealphase,orinthephaseofblastocyst
implantation).
(sincetheuterineliningisbeingmaintained,insteadofsloughingoff,thisiswhyyoudonthaveyour
periodwhenyoureonthepill)
***2)theproductionofGnRHandFSH/LHisinhibited****(b/cestrogenhasnegfeedbackonthese)
thisisthedesiredeffectofthepilluser!
ThejobofFSHandLHistostimulatethematurationofagroupoffollicles.Thus,ifnoFSHandLH

arepresent,nofolliclesmature,nomatureeggisreleasedintothefallopiantube,andnopregnancy
canocurr.
Howdoesnaturalplanningasabirthcontrolmethodwork?
Naturalplanningworksbymappingaparticularwoman'scycle,andthenavoidingsexforthewindowoftimejustbefore
ovulation(incaseitcomesearlythatmonth),andjustafter.(Aswelearned,theperiodoftimejustafterovulationistheonly
timewhenpregnancycanoccur).
Wealsolearnedsomethingelsecool.Ifyoudonotwanttogetpregnant,whenisthesafesttimetohavesex?
answer:rightaftermenstruation,b/cthisiswhenawholenewroundoffolliclesisjuststartingtodevelop,andthus
ovulationisatthefarthestpointinthefuture.