The Menstrual Cycle: Ovarian and Uterine Phases, Mittelschmerz, and Clinical Correlates
The menstrual cycle is a highly regulated physiological process (average 28 days; range 24–38 days) governed by the hypothalamic-pituitary-gonadal axis. It consists of concurrent ovarian and uterine cycles. The ovarian cycle includes the follicular phase (days 1–14), ovulation (day ~14), and the luteal phase (14 days post-ovulation). The uterine cycle comprises the menstrual phase (days 1–5), proliferative phase (days 5–14), and secretory phase (days 14–28). Key hormonal regulators include GnRH, FSH, LH, estradiol, and progesterone. Physiological midcycle pain (mittelschmerz) occurs in >50% of premenopausal individuals. Abnormalities include dysmenorrhea, amenorrhea, abnormal uterine bleeding, premenstrual disorders, and anovulatory cycles (common in early post-menarche years).
The menstrual cycle is a highly regulated physiological process in which the coordinated release of hormones from the hypothalamus, pituitary gland, and ovaries produces a mature oocyte and prepares the endometrium for blastocyst implantation. The average cycle duration is 28 days (normal range 24–38 days), with day 1 defined as the first day of menstruation. Menstruation typically lasts 5 days with an average blood loss of 35–50 mL. The cycle encompasses simultaneous changes in the ovaries (ovarian cycle) and the uterus (uterine cycle), each divided into three distinct phases regulated by interdependent hormonal feedback mechanisms.
Introduction The menstrual cycle represents the integrated function of the female hypothalamic-pituitary-gonadal (HPG) axis. Understanding its normal physiology is essential for recognizing common abnormalities such…
Dr. Emmanuel Hirwa BAKUNDA is a Medical doctor and technology innovator dedicated to transforming medical education through digital solutions. With a clinical background in General pediatrics and child health, Dr. Bakunda combines frontline patient experience with a passion for health informatics and e-learning platforms.
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