1. Sexual Reproduction in the Human (Extended Study)

2. Learning objectives Outline the stages in the menstrual cycle Discuss the role of hormones in the menstrual cycle Discuss the Cause/Prevention/Treatment for fibroids or for endometriosis

3. Menstrual Cycle

4. Hormonal control in the menstrual cycle Four hormones involved:  FSH (Follicle Stimulating Hormone)  Oestrogen  LH (Luteinising Hormone)  Progesterone Each hormone causes the production of the hormone following it and inhibits the hormone preceding it

5. FSH – Follicle Stimulating Hormone Produced by pituitary gland Produced early in the cycle (days 1-5) Stimulates a few potential eggs to develop, surrounded by graafian follicles Only one usually survives Sometimes used in fertility treatments to stimulate ovaries to produce eggs – often lots of eggs develop. This explains some multiple births Each graafian folllicle then produces oestrogen

7. Oestrogen Produced by the graafian follicle in the ovary Produced from days 5 -14 Causes the endometrium to develop Inhibits FSH ensuring no further eggs develop (useful in contraceptive pill) High levels of oestrogen just before day 14 stimulate release of LH

9. LH - Luteinising Hormone Produced by the pituitary gland Produced on day 14 Causes ovulation Causes the remains of graafian follicle to develop into corpus luteum Corpus luteum makes final hormone in the cycle progesterone (along with small amounts of oestrogen)

11. Progesterone Produced by the Corpus Luteum in the ovary Produced from days 14-28 Maintains structure of endometrium Inhibits FSH to stop further eggs developing Inhibits LH to stop further ovulation and pregnancies Prevents contractions of the uterus

14. Learning Check List the four hormones involved in the menstrual cycle In each case state where it is produced Give a function for each hormone

15. Events when pregnancy does not occur

16. Menstrual disorder (Fibroids) Fibroids are tumours of the uterus They are the result of the overproduction of cells They do not invade other tissues and do not spread (benign)

17. Slow growing and range from the size of a pea to the size of a melon Common between ages of 35 and 45 Small fibroids often produce no symptoms As they enlarge they produce heavy and prolonged menstrual bleeding (this can lead to anaemia, pain, miscarriage or infertility) Menstrual disorder (Fibroids)

18. Cause Cause is uncertain May be an abnormal response to oestrogen Can occur in women taking the contraceptive pill

19. Prevention and treatment Small fibroids require no treatment just monitoring to check their growth Large fibroids can be removed by surgery If many large fibroids are present a Hysterectomy may be necessary. This is where the uterus is removed

20. Menstrual disorder (Endometriosis) Growth of endometrial cells outside the uterus (often in fallopian tube) Normally endometrium is shed each month in the menstrual cycle. In endometriosis misplaced endometrium is unable to exit the body Results in internal bleeding, inflammation of surrounding area and pain Formation of scar tissue may result If in the fallopian tube this can interfere with the passage of eggs to the uterus (infertility)

21. Cause Exact cause remains unknown Several theories (response to excess oestrogen creation)

22. Prevention and treatment No known cure Hysterectomy (removal of uterus) - no guarantee that symptoms will disappear Medication can be taken to interfere with hormones resulting in a reduction or elimination of menstrual flow

23. Syllabus

24. Depth of treatment Detailed study of the menstrual cycle and hormonal control

25. Contemporary issues and technology Menstrual disorders  one example of a menstrual disorder from the following: endometriosis and fibroids  one possible cause, prevention and treatment