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    Wednesday, August 31, 2016

    What Is Normal Menstrual Cycle?

    The menstrual cycle is a cycle that occur in a woman's body to prepare for a possible pregnancy. Every month, the ovaries secrete the egg is called ovulation or fertile period. At the same time, hormonal changes also prepares the uterus for pregnancy. If the time of ovulation, the egg is not fertilized, the lining of the uterus will shed out through the vagina is called menstruation.

    In women, the menstrual cycle occurred on average about 28 days, although it is generally applicable, but not all women have the same menstrual cycle, sometimes cycles occur every 21 days to 30 days. Typically, the average menstrual occurred five days, sometimes menstruation can also occur about 2 days to 7 days later than 15 days. If the blood out of more than 15 days then it includes a blood disease. Generally, due to menstrual blood loss was 10ml to 80ml per day but usually with an average of 35ml per day.

    As to whether the normal menstrual cycle?

    The menstrual cycle, which is calculated from the first day of the last menstrual period until the first day of next menstruation, is not the same in every woman. Menstruation will last for 2-7 days with a cycle of 21-35 days. With a broader definition, menstruation "normal" in every person is different. Therefore, you can consult a doctor if your menstrual perceived not as usual.

    Some important things that need your attention on your menstrual cycle:
    • Date: Make a note of the date you started and cessation of menstruation. Whether longer or shorter than usual.
    • Number of menstruation: Notice how many times a day you should replace the pads, whether more or less frequently than usual.
    • Abnormal Bleeding: Do you often experience brownish spots between menstrual periods
    • Pain: Do you feel pain during menstruation heavier than usual.

    The cause of menstrual cycle disruption

    • Pregnancy or breast-feeding
    • Eating disorders, extreme dieting, weight loss is significant, or excessive exercise
    • Polycystic ovary syndrome (PCOS)
    • Premature ovarian failure
    • Infection of the reproductive organs
    • Myoma uteri

    Hormonal system that affects the menstrual cycle are:
    • RH FSH (follicle stimulating hormone releasing hormone) which issued the hypothalamus to stimulate the pituitary secrete FSH
    • LH-RH (luteinizing hormone releasing hormone) which issued the hypothalamus to stimulate the pituitary secrete LH
    • PIH (prolactine inhibiting hormone) which inhibit the pituitary to secrete prolactin
    In each menstrual cycle, FSH released by the pituitary stimulates the development of follicles in the ovaries (ovarian). In general, only one follicle which aroused but can progress can be more than one, and the follicle develops into the follicle de graaf makes estrogen.

    This estrogen suppresses the production of FSH, so the pituitary secretes hormones namely LH second. LH and FSH hormone production is under the influence of hypothalamic releasing hormones distributed to the pituitary.

    Channeling RH is affected by the feedback mechanism of estrogen on the hypothalamus. Production of gonadotropin hormone (FSH and LH) that will either cause the maturation of follicles de graaf containing estrogen.

    Estrogen affects the growth of the endometrium. Under the influence of LH, follicle de graaf become ripe until ovulation occurs. After ovulation, the corpus rubrum formed which will become the corpus luteum, under the influence of hormones LH and LTH (luteotrophic hormones, a hormone gonadotropic).

    The corpus luteum produces progesterone, which can affect the growth of the endometrial glands. If there is no fertilization, the corpus luteum degenerates and resulted in decreased levels of estrogen and progesterone. Decreased levels of this hormone cause degeneration, haemorrhage, and the release of the endometrium. This process is called menstruation or menstruation. If there is a conception in the time of ovulation, the corpus luteum is maintained.

    In each cycle, there are 3 main periods:
    1. Menstrual period that lasts for 2-8 days: At the time of the endometrium (lining of the uterus) is released causing bleeding and ovarian hormones are in the lowest levels
    2. Proliferation period of blood stopped menstruating until day 14: After menstruation ends, begins a proliferative phase in which there is a growth of the decidua functionalist to prepare the uterus for the attachment of the fetus. In this phase endometrium grows back. Between day 12 to 14 may occur release of eggs from the ovaries (called ovulation)
    3. Secretion period: Secretion period is the period after ovulation. The hormone progesterone is issued and affect the growth of the endometrium to make the condition of the uterus is ready for implantation (attachment of the fetus to the uterus)

    Ovarian Cycle:
    1. The follicular phase: In this phase of reproductive hormones work mature egg cells are derived from one follicle then matured in mid-cycle and is ready for the process of ovulation (egg expenditure from the ovary). The average time in human follicular phase ranges from 10-14 days, and variability affects the overall length of the menstrual cycle
    2. Luteal phase. The luteal phase is the phase of ovulation to menstruation with an average term of 14 days
    Hormonal cycle and its relationship with ovarian and uterine cycles in the normal menstrual cycle:
    • Every beginning of the menstrual cycle, the hormone levels of gonadotropins (FSH, LH) is at a low level and has been declining since the end of the luteal phase of the previous cycle
    • FSH hormone from the hypothalamus slowly increased after the end of the corpus luteum and follicle growth begins in the follicular phase. This is the trigger for the growth of the endometrial lining
    • Increased levels of estrogen cause a negative feedback on the pituitary FSH expenditure. LH then declined as a result of increased levels of estradiol, but at the end of the follicular phase LH hormone levels increased dramatically (biphasic response)
    • At the end of the follicular phase, FSH stimulates receptors (receivers) LH hormone contained in granulosa cells, and stimulation of the hormone LH, progesterone exit
    • After stimulation by the hormone estrogen, which causes the pituitary LH triggers ovulation which appear 24-36 hours later. Ovulation is a marker of the phase transition from proliferation to secretion phase, from follicular to luteal
    • Kedar estrogen decline at the start of the luteal phase just before ovulation until the middle phase, and then increased again due to the secretion of the corpus luteum
    • Progesterone increases after ovulation and can be a marker that ovulation has occurred
    • Both estrogen and progesterone rise during the life of the corpus luteum and kemuadian decreased to prepare for the next cycle.
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