PROBLEMS OF MENSTRUAL CYCLES
All women are born
females , however as we grow older, in this day and age this often changes
either due to developmental abnormalities or more recently due to personal preferences,
why and how this happens is not yet scientifically understood.
One hallmark of being a woman is a regular menstrual cycle.
Menstrual cycles start after the ovaries; the female sex
glands start maturing an egg each month. This stage is called menarche. A female baby in utero has thousands of immature
eggs called primordial follicles by the time the baby is born, only about 2ooo
are viable immature eggs are there.
PRIMORDIAL FOLLICLES(EGG BUDS) IN THE OVARY
20 WEEKS OF FOETAL LIFE......20 MILLION
AT BIRTH...2 MILLION
AT PUBERTY........500 THOUSAND
AT MENOPAUSE....FEW OR NONE
When these are finished we no
longer have a period. This is what is called menopause, after this time women do
not have a menstrual cycle and cannot get pregnant. It is only during the
fertile time of their lives that women can only get pregnant, that is when they
are having regular menses (periods).
Menstrual cycle is absolutely important for female development and
fertility. However it is often full of problems from menarche to menopause. In the next few posts I will discuss these
problems.
The first menstrual cycle women have is called Menarche and
it usually happens in the middle years at junior school. At the ages of 9 to 12
often delayed up to 15,this confirms the possibility of fertility in their future
life. This stage of their lives is
expressed as puberty. It usually starts first as the development of breast
buds, an odd pimple, pubic hair and the start of axillary hair, between the
ages of nine and fifteen. Once upon a
time mothers used to tell their daughters about this. Now generally this is all
discussed at school or on social media
between girls. In my time I was not
aware of this, one day when I started to have vaginal bleeding at school, I said
to a senior friend of mine that I have got TB (Tuberculosis). In those days TB
was very common, the only time we heard of bleeding was with TB (Tuberculoses
of the lungs). In the afternoon after I arrived home I discussed all this
with my mother , she explained all this to me in great detail including the
problems that can arise . I was not very
happy. I was in grade ten, in those days it used to be a very important year
for education. I did not ask it to happen now, could it not wait until summer vacation.
I was very lucky; I did not have my next period until the
summer vacation. This can often happen in the starting years of puberty
In our body we have
three main reproductive organs, a uterus, two fallopian tubes attached to it
and the two main sex organs lying on either side of the uterus and the ovaries.
The uterus is a hollow organ with a cavity which holds the baby as it develops.
It is the lining of the uterus which under goes changes during menstrual cycle.
The lower end of the uterus has a gate way, the cervix, this
opens in a tube called the vagina. Sounds simple, but it is most important, as
our genital tract is connected to the outside world through this tube. The menstrual blood flows to the outside
world, sperm enter the uterus through this to fertilize the egg to enable us to
make a baby. When the baby is ready, it
comes into the world through this tube screaming. We also have other covers for
our genital parts, these help us in protecting the genital tract from
infections.
One other very important structure is a
thin membrane with a small central hole for drainage. Many others organs in our body are involved
in female maturation (puberty and menstruation as already mentioned) fertility
and sexual activity. These organs are called endocrine glands. There secretions
work at distant organs. These are pituitary and Hypothalamus located in the
brain, Thyroid gland (located in the neck) and to some extent a gland called
adrenal. When a female baby is born after three or four days later they can
have a small vaginal bleeding, this in fact is a period. The infant’s uterus
was influenced by her mother’s hormones, when they are withdrawn after birth
and the baby has a small bleed. Many young mothers get very worried about this
but this is a very good sign that all the baby’s female organs are in good
form. The infant does not have another
bleed until menarche. It is received in
different cultures in different ways. In some cultures it is even celebrated.
For us women it often causes many problems during our life span. Generally women
have 450 periods during their life time. However we have to have them for our
development, fertility and pleasure (sexually). During pregnancy and after a
certain age called menopause, we do not have a period.
We do not clearly understand what starts the periods, the
ovary is a remarkable organ after a certain age it responds to a hormone FSH
(FOLLICULER STIMULTING HORMONE) when some of it’s premature follicles start to
grow. This comes from the pituitary controlled by the hypothalamus. When an egg
grows it in turn secretes another hormone called oestrogen. Only one follicle
continues to grow, the rest are demised. The oestrogen produced by what we call
the dominant follicle creates a surge for pituitary gland to release a hormone
called luteinising hormone (LH). This results in the release of the egg from
the growing follicle. This process is
called ovulation. This is what grows to be a baby.
During this time the lining of the
uterus is also thickened. After the egg is released, the empty shell of the follicle
becomes a yellow body called corpus luteum .
This secretes a second hormone called Progesterone this helps to mature
the lining of the uterus to receive the fertilized egg just in case it was
fertilized. Then the progesterone level remains increased to protect the egg.
If there is no egg the increased level of oestrogen suppresses the pituitary.
The levels of oestrogen and progesterone drop indicating the end of menstrual
cycle. Normal cycle is a reassuring sign that ovarian function is normal. The menstrual
blood is usually 40 mls; it consists of broken up endomentrial lining and
secretions from the vagina and cervix and is dark brown in colour.
During the menstrual cycle the broken up endomentrium
releases chemicals called prostaglandins and they are responsible for period
pains and cramps.
All these hormones when withdrawn cause the period and along
with prostaglandins cause many symptoms which we will discuss in the next
post.
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