Menstrual cycle

it include detail about menstural cycle and its phase. cultural belief and management related with menstrual problem. it also include menopouse and its feature & management

1. DR.BIJAY KUMAR SAH MBBS(BANGLADESH)

2. MESTRUATION The periodic sheding of blood,damaged tissue of endometrium and unfertilized ova per vagina is called menstruation. MENSTRUAL CYCLE:- The monthly rhythmic changes in the rates of secretion of female hormones and corresponding changes in the ovaries and sexual organs as well is known as menstrual cycle.Average-28 1 days(normal)

3. HORMONAL CONTROL OF MENSTRUTION Progesteron release

4. PHASES OF MESTRUAL CYCLE It have 3 phases:- 1)proliferative phase-10 days (5 th to 14 th day) 2) Secretory phase-14 days (15 th to 28 th day) 3)menstrual phase-4 days (1 st to 4 th day)

5. 1)PROLIFERATIVE OR ESTROGENIC PHASE:- Under the influence of estrogen the uterine stroma and epithelial cell proliferate rapidly so the endometrium increase in thickness about 3-4 mm.

6. 2)SECRETORY PHASE:- Under influence of estrogen & progesterone. a)Estrogen cause slight additional proliferation of endometrium . b) progesteron causes marked swelling and secretory change like- i )The uterine glands & blood vessels become large and tortuous. ii)The cell cytoplasm contain secretory granule rich in lipid & glycogen. The thickness becomes 5-6 mm.

7. 3)MENSTRUAL PHASE:- No influence of estrogen & progesteron In this phase the estrogen(vasodilator) & progesteron sharply decrease and some vasoconstrictor release causes tortuous blood vessel spasm and necrosis of endometrium hence the periodic sheding of blood,damaged tissue of endometrium and unfertilized ova per vagina is called menstruation.

8. COMPOSITION OF MENSTRUAL BLOOD Volume:-30-50 ml Stratum compactum and spongiosum of endometrium Mucous Unfertilised ovum Leucocytes Fibrinolysin Some chemical substance like glycogen

9. NATURE OF MENSTRUAL BLOOD Liquid,pale,reddish brown in color. Fishy smell. Never clot due to absence of cloting factor and presence of fibrinolysin which act as anticoagulant. ARTIFICIAL MENOPAUSE:- Permanent cessation of ovarian function done by artificial means like surgical removal of ovaries or by radiation is called artificial menopause.

10. Cultural belief on menstruation:- There is wrose belief in society about menstruation that it is a period in which female are crushed by god and they should be kept separately and they are not allowed to do any household work or pray for god.Even during that time they can’t spend time with there husband. During this period they are even neglated by their family members.

11. How can be cultural belief can be improved? This belief can be improved by following ways:- 1)proper health education about menstrution and its process. 2) counceling of the people by personal discussion,family discussion, group discussion.

12. CARE DURING MENSTRURAL PERIOD 1)Maintain of personal hygiene by- a)proper and regualar bathing. b)use of sanitory pad and frequent changing as it got much soaked. 2) Maintaine of nutrition 3)Proper rest 4)Emotional and psycological support from the family member(mainly mother) and society

13. MENOPAUSE Permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity is called menopause. Age of menopause:-45-55 yrs, average 50 yrs. some of the factor may cause early menopause like:-cigarette smoking and severe malnutrition.

14. MENSTRUATION PATTERN PRIOR TO MENOPAUSE Abrupt cessation of menstruation(rare). Gradual decrease in both amount and duration.it may be spoting or delayed and ultimately lead to cessation. Irregular with or without excessive bleeding.One should exclude genital malignancy prior to daclare it as the usual premenopausal pattern.

15. MENOPAUSAL SYMPTOMS Hot flush with excessive sweating. Palpitation. Weakness and fatigue. Urogenital atrophy may leads to dyspareunia ( painfull sexual intercourse). Psycological changes like – depression,anxity,decrease sexual desire,headache,insomnia,irritability , mood swing,dementia and inability to concentrate.

16. MENOPAUSAL SYMPTOMS CONT. Skin and hair:- thining,loss of elasticity and wrinkling of skin. Loss of axillary and pubic hair. Cardiovascular changes:-increase risks of hypertenson and atherosclerosis. Bone metabolism:-may lead to osteoporosis and fracture due to decrease in osteoblastic activity.

17. Diagnosis of menopause Cessation of menstruation for consecutuive 12 months without any other pathology. Appearance of menopausal symptoms Vaginal cytology-showing maturation index(feature of low oestrogen ) Low serum FSH & LH

18. TREATMENT OF MENOPAUSAL SYMPTOM Proper counselling Nutritious diet-diet rich of calcium and protein. Supplementary calcium-1 to 1.5 gm calcium reduce osteoporosis & fracture. Vitamin D supplementation. Cessation of smoking and alcohol. HORMONE REPLACEMENT THERAPY- oestrogen replacement.

19. THANK YOU GOD BLESS YOU