The menstrual cycle is a term used to describe monthly events that occur
within a woman’s body in preparation for the possibility of pregnancy. Each month,
an egg is released from an ovary in a process called ovulation. At the same time,
the lining of the uterus thickens, ready for pregnancy. If fertilization does not
take place, the lining of the uterus is shed in menstrual bleeding and the cycle starts over.
An ovary contains hundreds of thousands of primary oocytes - immature eggs, or ova. Each of these is
enclosed in a structure called a follicle, and at this stage – a primordial follicle.
The menstrual cycle is under control of hormones secreted by the pituitary gland
and the ovaries. The pituitary itself is under control of the hypothalamus.
The hypothalamus produces a hormone called the gonadotropin-releasing hormone or GnRH. GnRH
stimulates the anterior lobe of the pituitary to secrete follicle-stimulating hormone (FSH).
FSH travels in the bloodstream to the ovaries and stimulates a group of follicles to grow. These
primordial follicles develop into primary follicles and then secondary follicles.
These secondary follicles produce a hormone named estrogen which acts to stimulate the growth of the
endometrium – the inner lining of the uterus. The secondary follicles compete with each other
and only one of them will survive and become a mature follicle, the rest atrophy and die.
The increasing level of estrogen also acts on the hypothalamus and the anterior pituitary
to increase the level of GnRH and induce the production of another hormone – luteinizing
hormone (LH). A surge in LH secretion triggers ovulation - the release of the egg from the
follicle and the ovary. The egg is then swept up by the fimbriae and taken into the uterine tube.
Fertilization by a spermatozoon, when it occurs, usually takes place in the
ampulla - the widest section of the fallopian tube. The fertilized egg immediately begins the
process of development while travelling toward the uterus. After 6 days it becomes a blastocyst and
is implanted into the endometrium of the uterus. Meanwhile, the left-over of the ruptured follicle
has become a corpus luteum which secretes progesterone. Progesterone further stimulates
uterine development making it a nutritious bed for the embryo in the event of pregnancy. In the
absence of pregnancy, the corpus luteum atrophies and progesterone level falls.
This leads to the breakdown of the endometrium, menstruation begins and the cycle starts over.