Sie sind auf Seite 1von 3

Menstrual cycle is important

„ Normal vs abnormal
„ Very common consultations (>60%)
Menstrual cycle „ Important for the management of
infertility
„ Warning signs and symptoms of
cancer
Felix Wong 2006 „ Associated with other symptoms
„ Menopause

Key hormones for menstrual cycle Ovarian follicles


Follicular stimulating hormone

Luteinizing hormone

Produce E2 Produce both


E2 and P
Physiology of the menstrual cycle Physiology of the menstrual cycle
FSH
LH

Day 1-5: Menstruation Day 5-13: proliferative phase


E2

Pulses of GnRH stimulate FSH P

At the start of the cycle, secretions to induce follicular


the endometrium sheds development. Oestradiol
as its hormonal support levels reach their maximum,
a positive feedback effect on
disappears the hypothalamus and
pituitary cause LH surge,
followed by ovulation

Physiology of the menstrual cycle Normal


menstrual
cycle
Day 14-
14-28: Luteal/secretary phase

Corpus luteum develops from the


follicle., this produces oestradiol
and progesterone, to prepare the
endometrium for implantation of
the ovum. Without hormonal
support, the corpus luteum will
collapse, leading to endometrial
breakdown and menstruation
Normal menstruation Abnormal menstrual bleeding
„ Menarche before 16 „ Excessive menstruation (frequency
„ Menopause after 40-43 or volume)
„ Menstruation not more than 7 days • Heavy but regular – Menorrhagia
in length <though sometimes with • Irregular and often frequent –
polymenorrhoea
spotting x 1-2 days>
• Between menses – intermenstrual
„ Cycle length 21-40 days bleeding
„ No intermenstrual bleeding
„ Ovulation bleeding

Abnormal menstrual bleeding Abnormal menstrual bleeding


„ Too little bleeding „ Other variants and abnormalities
• Never starts – after 16 years this is • Traumatic - postcoital bleeding PCB
primary amenorrhoea • After cessation of menses – if > 1 year
• Ceases – If for 6+ months this is after, it is postmenopausal bleeding
secondary amenorrhoea • Occurs too early – before 8 years, this is
• Infrequent – Oligomenorrhoea precocious puberty
• While on hormones – breakthrough • Painful – dysmenorrhoea 1 or 2nd
bleeding • Preceded by cyclical symptoms –
Premenstrual syndrome (PMS)

Das könnte Ihnen auch gefallen