THE FEMALE REPRODUCTIVE CYCLE

What is the purpose of the cervical mucus during ovulation?

During ovulation, the cervix produces thin, clear, stretchy, slippery mucus that is designed to capture the man's sperm, nourish it, and help the sperm travel up through the cervix to meet the ovum for fertilization.

How many immature follicles does the ovary produce in response to FSH?

In response to FSH, the ovary produces five to 20 immature follicles, each of which houses an immature oocyte or egg.

What happens to the fallopian tubes during ovulation?

The distal ends of the fallopian tubes become active near the time of ovulation and create currents that help carry the ovum into the uterus.

Endometrial cycle

art of the female reproductive cycle that involves the cyclic growth and shedding of the uterine lining, regulated by hormones produced by the pituitary gland and the ovaries.

The nurse, while teaching a group of pregnant woman about the production of breast milk, describes colostrum and compares it with mature breast milk. Which information about colostrum would the nurse include in the description?

high maternal antibody content Colostrum is rich in maternal antibodies, especially IgA, which protects the newborn against enteric pathogens. Colostrum contains more minerals and protein but less sugar and fat than mature breast milk.

The endometrial (uterine) cycle occurs in

response to cyclic hormonal changes.

women are born with a single

supply of ova that are released from the ovaries gradually throughout the childbearing years

What is the Follicular Phase?

the Follicular Phase is the first phase of the ovarian cycle that starts on day 1 of the menstrual cycle and continues until ovulation, approximately 10 to 14 days later. It is named after the follicles in the ovary that grow and form a mature egg, with the goal of producing an ovum for fertilization.

How long does the ovum survive after ovulation?

the lifespan of the ovum is only about 24 hours after ovulation.

Menopause

the naturally occurring cessation of menstrual cycles, marking the end of the reproductive phase of a woman's life, usually occurring between the ages of 45 and 55.

A client is presenting with possible signs of menopause. The nurse recognizes that menopausal symptoms are related to:

vasomotor activities. Vasomotor symptoms are the most commonly reported during the menopausal transition. These include hot flashes, irregular menstrual cycles, sleep disruptions, forgetfulness, irritability, mood disturbances, decreased vaginal lubrication, night sweats, fatigue, vaginal atrophy, and depression.

It is important that couples who wish to practice natural forms of birth control understand that the mucus-secreting glands of the cervix can store live sperm for up to:

48 hours. The mucus-secreting glands of the cervix are capable of storing live sperm for 48 to 72 hours (2 to 3 days), enabling pregnancy to occur after intercourse has occurred 1 or 2 days before ovulation.

MENSTRUAL Phase

: (uterine changes...cycle days 1-6) Goal: shed the stratum functionalis layer of the endometrium Woman has bleeding (consists of 1-6 days) where she is shedding the stratum functionalis (functional layer) of the endometrium. If pregnancy did not occur during the last cycle, the progesterone and estrogen levels drop which causes the layer to shed.

: What is the relationship between the proliferative phase and the follicular phase of the ovarian cycle?

: The proliferative phase of the endometrial cycle corresponds to the follicular phase of the ovarian cycle. This phase depends on estrogen stimulation resulting from ovarian follicles, and it coincides with the follicular phase of the ovarian cycle.

What is the difference between the proliferative phase and secretory phase of the uterine cycle?

During the proliferative phase, the endometrium prepares for possible fertilization with pronounced growth, as the ovarian follicles are producing increased amounts of estrogen. The secretory phase, on the other hand, begins at the time of ovulation, and if the ovum is not fertilized, the corpus luteum degenerates, and hormone levels fall, ultimately resulting in menstruation.

Ovarian Cycles:

Follicular (occurs during the menstrual and proliferative phase), Ovulation, Luteal Pha

What are follicular cells?

Follicular cells are the cells that surround and nourish the developing ovum in the ovary.

A nurse is teaching a group of adolescent girls about the menstrual cycle. The nurse would integrate information about which hormones as being predominant during the cycle? Select all that apply.

LH GnRH FSH The predominant hormones involved in the menstrual cycle are gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and prostaglandins. Testosterone and prolactin do have a role in the female reproductive system are not considered predominant hormones for the menstrual cycle.

what is the role of luteinizing hormone (LH) in the follicular phase?

LH from the anterior pituitary gland surges during the follicular phase, affecting the final development and subsequent rupture of the mature follicle that releases the ovum during ovulation.

Uterine Cycles

Menstrual & Proliferative (both occur during the follicular phase), Secretory Phase

Cycle Day: 1-13: First Part of the Menstrual Cycle

Menstrual (Cycle days 1-6) Follicular Phase (Cycle days 7-13) Proliferative Phase (Cycle days 7-14)

It is important that a nurse recognizes there are cultural differences that will have an influence on the care of the client. Some cultures practice female circumcision, which involves the removal of the:

clitoris Some cultures practice female circumcision, which involves the removal of the clitoris. It is important for the nurse to remain open-minded and nonjudgmental with all clients.

A client is returning with a third vaginal infection within a six-month period. During the health assessment, the nurse should ask about the client's use of which products? Select all that apply.

douches,deodorants Antibiotic therapy, douching, perineal hygiene sprays, and deodorants upset the acid balance within the vaginal environment and can predispose women to infections. The vagina depends on its acidic environment to protect it against ascending infections.

Luteal Phase A significant increase in temperature, usually 0.5° to 1°F, is generally seen within a day or two after ovulation has occurred; the temperature remains

elevated until 3 days before the onset on the next menstruation.This rise in temperature can be plotted on a graph and gives an indication of when ovulation has occurred.

Which hormone would the nurse explain as being primarily responsible for maturation of the ovarian follicle?

follicle-stimulating hormone Follicle-stimulating hormone is primarily responsible for the maturation of the ovarian follicle. Luteinizing hormone is required for the final maturation of preovulatory follicles and luteinization of the ruptured follicle. Gonadotropin-releasing hormone induces the release of follicle stimulating hormone and luteinizing hormone to assist with ovulation. Estrogen is crucial for the development and maturation of the follicle and induces proliferation of the endometrial glands.

A nurse is obtaining a health history from a female client who reports that she started menstruating at age 11 years. The nurse would document this as:

menarche, age 11. Menarche refers to the start of menstruation, which in this case would be at age 11 years. Thelarche refers to the development of breast buds; adrenarche refers to the appearance of pubic and then axillary hair and subsequent growth spurt. Mensis is a general term referring to menstruation.

A young mother is expressing frustration of not being able to breastfeed her infant. A potential cause could be the lack of the hormone:

prolactin The hormone prolactin is responsible for the stimulation of milk production. Oxytocin is responsible for uterine contractions during labor. Luteinizing hormone and estrogen are important hormones responsible for the monthly cycles.

. In the absence of fertilization, the corpus luteum begins to

the corpus luteum begins to degenerate and consequently ovarian hormone levels decrease. As estrogen and progesterone levels decrease, the endometrium undergoes involution. FSH and LH are generally at their lowest levels during the luteal phase and highest during the follicular phase.

A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate?

"Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." Information about the efficacy of herbal therapies is largely anecdotal. Research to validate the efficacy, safety, and potential harmful effects of herbal therapies is lacking. Until recently, hormone replacement therapy was the mainstay of treatment, but in light of the results of the Women's Health Initiative trial, it has become controversial. Telling the woman that her symptoms are not severe enough is demeaning and inappropriate: the woman's symptoms are significant to her, regardless of what the nurse may think.

: How does basal body temperature change during ovulation?

Basal body temperature typically rises slightly during ovulation, which can be used to track the timing of ovulation for fertility purposes.

The luteal phase begins at

Begins when the egg is releases from the ovary another words ovulation.The corpus luteum forms which developed from the Graaifan follicle that released the ovum. The corpus luteum acts as a temporary endocrine structure that secretes progesterone and estrogen. Progesterone prepares the endometrium for implantation of the embryo, if the ovum is fertilized.

What happens to the follicles during the follicular phase?

During the follicular phase, the follicles in the ovary grow and develop under the influence of FSH, with one follicle eventually becoming the dominant follicle that will mature fully and release an ovum during ovulation

what happens during the ischemic phase of the menstrual cycle if fertilization does not occur?

During the ischemic phase, estrogen and progesterone levels drop sharply as the corpus luteum starts to degenerate. Changes in the endometrium occur with spasm of the arterioles, resulting in ischemia of the basal layer. The ischemia leads to shedding of the endometrium down to the basal layer, and menstrual flow begins.

What is ovulation and what triggers it?

Ovulation is the process in which a mature follicle in the ovary ruptures and releases a mature oocyte or egg. The surge in LH triggers the final development and rupture of the mature follicle, leading to ovulation.

What are some symptoms of ovulation?

Ovulation symptoms include vaginal spotting, an increase in vaginal discharge giving the woman a "feeling of wetness," increased libido leading to more desire to be intimate, a slight rise in basal body temperature, and lower abdominal cramping.

When does ovulation typically occur during the ovarian cycle?

Ovulation typically occurs approximately 10 to 12 hours after the LH peak and 24 to 36 hours after estrogen levels peak during the ovarian cycle.

What hormone prompts the pituitary gland to release follicle-stimulating hormone (FSH)?

The hypothalamus prompts the pituitary gland to release follicle-stimulating hormone (FSH) during the follicular phase of the ovarian cycle.

What is the role of the maturing follicular cells in the follicular phase?

The maturing follicular cells secrete increasing levels of estrogen, which induce proliferation of the endometrium and myometrium, supporting an implanted ovum if pregnancy occurs.

The nurse discusses measures to prevent infection of the reproductive tract with a client. The nurse determines that the client has understood the information when the client identifies which component as helping to protect against vaginal infections?

acidic environment An acidic environment helps protect against ascending infections in the vagina. The client should be cautioned against using douches, hygiene sprays, or deodorants that might upset the acid balance. Rugae allow for extreme dilation of the vaginal canal during labor and birth. Menstrual flow and ovulation play no role in the prevention of vaginal infections.

The nurse provides client education regarding the uterine corpus. Which part may fluctuate with changes of hormonal levels in the absence of pregnancy?

endometrium The corpus, or main body of the uterus, undergoes cyclic changes as the result of changing levels of hormones secreted by the ovaries, in preparation of a pregnancy. When fertilization does not occur, most of the endometrium is shed, and the monthly period occurs.

After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle?

follicular phase The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase. The proliferative, secretory, and ischemic phases occur in the endometrial cycle.

A nurse is teaching a client about the reproductive system and the hormones involved. The nurse would include which structures as the source of these hormones? Select all that apply.

ovaries pituitary hypothalamus The reproductive cycle is influenced and controlled by hormones secreted by the ovaries, hypothalamus, and pituitary gland. The placenta secretes a temporary hormone that assists with maintaining pregnancy. The uterus does not secrete hormones.

However, if fertilization occurs the fetus will start to

produce HcG Human chorionic gonadotropin (hence what a pregnancy test picks up) and this will prevent the corpus luteum from dying. So, until the placenta becomes fully functional, the corpus luteum will help maintain steady levels of progesterone and estrogen to maintain the endometrium for the fetus. The placenta will take over will progesterone and estrogen production at approximately 8 weeks.

The four phases of the endometrial cycle are the

proliferative phase, secretory phase, ischemic phase, and menstrual phase.

Role of Progesterone:

stimulates estrogen production allows the endometrium to receive the fertilized ovum for implantation stops production of LH and FSH (so possible pregnancy can be maintained) and estrogen inhibits the hypothalamus from releasing GnRH (hence new reproductive cycle....if the ovum is fertilize you want to prevent another menstrual cycle from occuring so pregnancy can occur). This will help prevent the hypothalamus from releasing GnRH which will prevent LH and FSH from being secreted in case fertilization has occurred

What happens if the ovum does not meet a sperm within 24 hours?

If the ovum does not meet a sperm within 24 hours after ovulation, it will die

After a reproductive class at the local school, the public health nurse realizes more training is needed when the class identifies the layers of the uterus to include:

epimetrium. The three layers of the uterus are the endometrium, myometrium, and serosa. The epimetrium is not a layer of the uterus.

Corpus luteum stays in place for about

14 days and if fertilization hasn't occurred it disintegrates. It will turn into the corpus albicans. When the corpus luteum dies, estrogen and progesterone will decrease and this leads to a new reproductive cycle..the hypothalamus will release GnRH which will cause the anterior pituitary gland to release FSH and LH and the woman will shed the uterine lining and new follicle will be stimulated to produce a new egg etc.

Regardless of the length of a woman's menstrual cycle, ovulation usually occurs around

14 days before the start of her next period. So, if a woman has a 28-day cycle, ovulation will occur around day 14, but if she has a longer cycle, such as a 120-day cycle, ovulation will still occur around 14 days before the start of her period.

Typical menstrual cycle is

28 days

Female reproductive cycle

A complex process that includes the ovarian cycle, the endometrial (uterine) cycle, the hormonal changes that regulate them, and the cyclical changes in the breasts that prepare the body for fertilization.

When teaching a group of adolescents about the menstrual cycle, the nurse describes the ovarian and endometrial cycles. Which phase(s) would the nurse explain as part of the ovarian cycle? Select all that apply.

Luteal phase Follicular phase The ovarian cycle consists of three phases: the follicular phase, ovulation, and the luteal phase. The four phases of the endometrial cycle are the proliferative phase, secretory phase, ischemic phase, and menstrual phase.

A nurse is conducting a presentation for a group of parents of a local middle school. When describing puberty in girls, which event would the nurse identify as typically occurring last?

Menstruation Pubertal events preceding the first menses have an orderly progression: thelarche, the development of breast buds; adrenarche, the appearance of pubic and then axillary hair followed by a growth spurt; and menarche (occurring about 2 years after the start of breast development).

What is mittelschmerz?

Mittelschmerz is a German term that means "middle pain" and refers to a pain felt on one side of the abdomen around the time the egg is released during ovulation.About one in five women can feel mittelschmerz around the time of ovulation.

Ovulation

The mid-point of the 28-day menstrual cycle that occurs on day 14, during which the ovum is released from the ovary and travels towards the uterus.

Menstruation

The monthly shedding of the uterine lining that marks the beginning and end of the monthly cycle in the female reproductive system. Absence of fertilization results in menstruation.

What is the ovarian cycle?

The ovarian cycle is the process in the female reproductive system that involves the maturation and release of an egg from the ovary each month. It consists of three phases: the follicular phase, ovulation, and the luteal phase.

what initiates the follicular phase of the ovarian cycle?

hypothalamus is the initiator of this phase. Increasing levels of estrogen secreted from the maturing follicular cells and the continued growth of the dominant follicle cell induce proliferation of the endometrium and myometrium

A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs:

in the fallopian tubes. Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development.

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries?

secreting estrogen and progesterone The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.

Summary of Menstrual Cycle Hormones

• LH rises and stimulates the follicle to produce estrogen. • As estrogen is produced by the follicle, estrogen levels rise, inhibiting the output of LH. • Ovulation occurs after an LH surge damages the estrogen-producing cells, resulting in a decline in estrogen. • The LH surge results in establishment of the corpus luteum, which produces estrogen and progesterone. • Estrogen and progesterone levels rise, suppressing LH output. • Lack of LH promotes degeneration of the corpus luteum. • Cessation of the corpus luteum means a decline in estrogen and progesterone output. • The decline of the ovarian hormones ends their negative effect on the secretion of LH. • LH is secreted, and the menstrual cycle begins again.

What is the cause of lower abdominal cramping during ovulation?

Lower abdominal cramping during ovulation is caused by the rupture of the mature follicle in the ovary and the release of the mature oocyte

Ovarian cycle

Part of the female reproductive cycle that involves the growth and release of an egg from the ovaries during each menstrual cycle, regulated by hormones produced by the pituitary gland and the ovaries

follicular phase of ovarian cycle

The first phase of the ovarian cycle that occurs from cycle day 1 to 13 and includes changes in the ovary, while simultaneously the uterus goes through changes during the menstrual phase (cycle days 1-6) and proliferative phase (cycle days 7-14).

how long does the follicular phase last?

The follicular phase typically lasts for approximately 10 to 14 days, but its duration can vary due to variations in follicular development.These variations account for the differences in menstrual cycle lengths

How many follicles does the ovary raise monthly, and how many usually mature to reach ovulation?

The ovary raises many follicles monthly, but usually only one follicle matures to reach ovulation.

Two structures that play a vital role in the woman's reproductive cycle:

ovary & Uterus (they work together) Each structure has three cycles (and these cycles correspond with each other)

A nurse is reviewing the medical record of a woman who has given birth vaginally. The record reveals that the client required a right mediolateral episiotomy during birth. When assessing the client, the nurse would inspect which area to evaluate the status of the episiotomy?

perineum The perineum is the most posterior part of the external female reproductive organs. This external region is located between the vulva and the anus. It is made up of skin, muscle, and fascia. Incising the perineum area to provide more space for the presenting part is called an episiotomy. An episiotomy does not involve the clitoris, vestibule, or labia.

What happens at ovulation during the ovarian cycle?

At ovulation, a mature follicle ruptures in response to a surge of LH from the pituitary gland, releasing a mature oocyte.

A nurse is conducting a health education class for a group of female high school students about the female reproductive system. The nurse determines that the teaching was successful when the students identify which structure(s) as part of the external female reproductive system? Select all that apply.

Perineum Vestibule Mons pubis The external female reproductive organs collectively are called the vulva (which means "covering" in Latin). It encompasses both sets of labia (majora and minora), the head of the clitoris, the opening of the urethra, and the opening of the vagina. The structures that make up the vulva include the mons pubis, the labia majora and minora, the clitoris and prepuce, the structures within the vestibule, and the perineum. The ovaries and vagina are internal genitalia.

: What is the role of the endometrium in the follicular phase?

the endometrium thickens and proliferates during the follicular phase, in preparation for the potential implantation of an ovum if pregnancy occurs

How long does cervical mucus remain optimal for sperm survival during ovulation?

Cervical mucus remains optimal for sperm survival and transport for around 3 to 5 days during ovulation.

What happens during the secretory phase of the endometrial cycle?

Under the influence of progesterone released by the corpus luteum after ovulation, the endometrium becomes thickened and more vascular and glandular, in preparation for implantation if it is to occur. This phase typically lasts from day 15 (after ovulation) to day 28 and coincides with the luteal phase of the ovarian cycle. In the absence of fertilization, the corpus luteum begins to degenerate, and the endometrium undergoes involution.

A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important?

genetics Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important.

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation?

progesterone After the follicle ruptures as it releases the egg, it closes and forms a corpus luteum. The corpus luteum secretes increasing amounts of progesterone and estrogen, which interact with the endometrium to prepare it for implantation. The corpus luteum does not secrete prolactin, testosterone, or luteinizing hormone.

During a prenatal visit, a pregnant woman tells the nurse, "I have had to buy some new bras because my breasts are getting bigger. I know this is supposed to happen, but what is going on in my body?" Which response by the nurse would be appropriate?

"Your hormones are causing the glands in your breasts to grow." During pregnancy, placental estrogen and progesterone stimulate the development of the mammary glands. Because of this hormonal activity, the breasts may double in size during pregnancy in preparation for milk production. At the same time, glandular tissue replaces the adipose tissue of the breasts. Following childbirth and the expulsion of the placenta, levels of placental hormones (progesterone and lactogen) fall rapidly, and the action of prolactin (milk-producing hormone) is no longer inhibited. Prolactin stimulates the production of milk within a few days after child birth, but in the interim, dark yellow fluid called colostrum is secreted. The substances in breast milk are not present until breast milk is produced.

What is the role of estrogen in the proliferative phase?

The proliferative phase depends on estrogen stimulation resulting from ovarian follicles, which leads to enlargement of the endometrial glands and the increase in thickness of the endometrium

What is the proliferative phase of the endometrial cycle and when does it occur?

The proliferative phase is the phase of the endometrial cycle that corresponds to the follicular phase of the ovarian cycle, during which the endometrial glands enlarge and the endometrium increases in thickness from 0.5 to 5 mm in preparation for implantation of the fertilized ovum. This phase starts on about day 5 of the menstrual cycle and lasts until the time of ovulation.

luteal phase

The second phase of the ovarian cycle that occurs from cycle days 15-28 and involves changes in the ovary, while simultaneously the uterus goes through changes during the secretory phase (cycle days 15-28).

What happens during the menstrual phase of the menstrual cycle?

The spiral arteries rupture, releasing blood into the uterus, and the thickened endometrial lining sloughs away from the uterine wall and passes out through the vagina. This marks the end of one menstrual cycle and the start of a new one. Menstrual bleeding usually lasts 3 to 7 days and averages 1 oz or a range of approximately 2/3 to 2 2/3 oz in volume per cycle.

What hormone surge triggers ovulation during the ovarian cycle?

The surge of luteinizing hormone (LH) from the pituitary gland triggers ovulation during the ovarian cycle.