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Normal menstrual blood continues for 2-7 days, with a cycle length range 21-35
days with average 28 days. The amount of menstrual blood about 30- 50 cc, if
exceeds 80 cc its considered as menorrhagia. Menorrhagia also considered if the
duration of bleeding exceeds 7 days. Cycle length greater than 35 days is
considered as oligomenorrhae while cycle length shorter than 21 days is considered
as poly- menorhhaea. Duration of periods less than 2 days is considered as hypo-
menorrhae.
Menstruation occurs as a consequence of hormonal interaction between
hypothalamus and the pituitary (Hypothalamo-pituitary axis), pituitary and ovarian
axis, lastly the effect of these axis on the uterus.
Ovulation (release of the ovum )occurs after 34-36 hours after LH surge.
Life span of the released ovum (secondary oocyte) is 24 hours.
Time since ovulation till the next cycle is a constant 14 days.
So the ovary during the ovulation cycle may be classified into a follicular phase
where the primordial follicle under the effect of FSH and the granulose secrete
increasing amount of E2 and inhibin hormone. Stage of ovulation during which E2
reach up to 200 pg/ml for 24-48 hours followed by LH Surge and peak and 36
hours after the surge to release the ovum.
Fig 5
After ovulation is the lutinizing phase during which the corpus lutetium formation
proliferation, vascularization , maturation, and finally regression take place. The
life span of the corpus lutium in non pregnant woman is 12-14 days.
Progesterone hormone reach a peak 8 days post LH surge.
Fi 6 the ovary shows growth of follicles ovulation and formation of corpus luteum