G

y Menstrual phase: 0-3 days

Proliferative phase: 3-14 days Secretory phase: 14-20 days Preparation for implantation: 21-26 days Endometrial breakdown: 24-28 days

Follicular or proliferative phase Endocrine: Rising LH, with mid-cycle peak; Falling FSH, with a small mid-cycle rise; Rising oestrogen, with a pre-ovulatory peak; Rise in progesterone at mid-cycle.

Endometrium:

Proliferation of glandular, stromal and luminal epithelium; Proliferation of vascular elements: spiral arterioles.

Breast: Epithelial proliferation; Ductal epithelial sprouting. Luteal or secretory phase Endocrine: Declining LH after mid-cycle peak; Declining FSH after mid-cycle peak, rising at the end; Oestrogen peak in mid-cycle, decreasing by the end; Increasing progesterone, declining by the end.

Endometrium:

Early: elongation; filling of lumina with glycogen-rich secretions; coiling of spiral arterioles.

Late: saw tooth glands; stromal oedema caused by fluid accumulation in the extracellular matrix.

Breast: Secretory changes; Ductal dilatation.

Functions of the Fallopian tubes

Pickup of the ovum g

Transport of gametes e'

Transport of the early embryo y s mm e 3

Menstruation is caused by withdrawal of ovarian steroid support from the decidualised endometrium. Spiral arteriolar vasospasm causes endometrial ischaemia. Lysosomal enzyme release ensues. Shedding of the decidua func-tionalis of the endometrium occurs. Control of menstrual bleeding is achieved by platelet plug formation, prostaglandins ( PGE2, PGF2a) and endometrial repair.

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