Hormones and The Menstrual Cycle: Discussion Guide
Hormones and The Menstrual Cycle: Discussion Guide
Hormones and The Menstrual Cycle: Discussion Guide
Graduate School
Master of Arts in Nursing
Maternal and Child Health
Prepared by John Ryan Borja, RN, LPT, MAED and Thea Micah Q. Toledo, RN
Discussion Guide
Menstruation
Follicular phase
The follicular phase starts on the first day of menstruation and ends
with ovulation. Prompted by the hypothalamus, the pituitary gland releases
follicle-stimulating hormone (FSH). This hormone stimulates the ovary to
produce around five to 20 follicles (tiny nodules or cysts), which bead on
the surface.
Each follicle houses an immature egg. Usually, only one follicle will
mature into an egg, while the others die. This can occur around day 10 of
a 28-day cycle. The growth of the follicles stimulates the lining of the uterus
to thicken in preparation for a possible pregnancy.
Ovulation
During the follicular phase, the developing follicle causes a rise in the
level of estrogen. The hypothalamus in the brain recognizes these rising
levels and releases a chemical called gonadotrophin-releasing hormone
(GnRH). This hormone prompts the pituitary gland to produce raised levels
of luteinizing hormone (LH) and FSH.
Within two days, ovulation is triggered by the high levels of LH. The
egg is funnelled into the fallopian tube and toward the uterus by waves of
small, hair-like projections. The life span of the typical egg is only around 24
hours. Unless it meets a sperm during this time, it will die.
LUTEAL PHASE
During ovulation, the egg bursts from its follicle, but the ruptured
follicle stays on the surface of the ovary. For the next two weeks or so, the
follicle transforms into a structure known as the corpus luteum. This structure
starts releasing progesterone, along with small amounts of estrogen. This
combination of hormones maintains the thickened lining of the uterus,
waiting for a fertilized egg to stick (implant).
If pregnancy does not occur, the corpus luteum withers and dies,
usually around day 22 in a 28-day cycle. The drop in progesterone levels
causes the lining of the uterus to fall away. This is known as menstruation.
The cycle then repeats.
DYSMENORRHOEA
o It is thought that the uterus is prompted by certain hormones to
squeeze harder than necessary to dislodge its lining. Treatment
options include pain-relieving medication and the oral
contraceptive pill
HEAVY MENSTRUAL BLEEDING
o Also referred to as menorrhagia. If left untreated, this can cause
anaemia. Treatment options include oral contraceptives and a
hormonal intrauterine device (IUD) to regulate the flow
AMENORRHEA
o This is considered abnormal, except during pre-puberty, pregnancy,
lactation and postmenopause. Possible causes include low or high
body weight and excessive exercise.
MENOPAUSE
Menopause is a natural process that marks the end of the menstrual cycles.
It's diagnosed after months without a menstrual period.
SYMPTOMS
MANAGEMENT OF MENOPAUSE
The Three Delays Model identifies three groups of factors which may stop
women and girls accessing the maternal health care they need:
Financial implications
SOLUTIONS:
SOLUTIONS:
Training local midwives who will remain in rural areas when qualified,
training nurses, doctors and healthcare professionals to provide safe births
now and for future generations. Ensuring health centres are suitably
equipped to provide safe deliveries and improving referral systems
between health centres and hospitals.
THE MILLENNIUM DEVELOPMENT GOALS
Target 5.A: Reduce by three quarters, between 1990 and 2015, the
maternal mortality ratio.