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The human body · Human reproduction

The menstrual cycle

Before you start, make sure you know: The cell, the unit of living things (Grade 6 Science (middle school))

Hormones are chemical messengers made by glands of the endocrine system. They travel in the blood and change how distant organs work. In the menstrual cycle, hormones from the pituitary gland and the ovaries coordinate the ovary and the uterus.

Maya's health teacher at her middle school hands out a calendar and asks: "Why does the body repeat the same changes about once a month, and how can you track them?" From menarche (the first period) to menopause, the female reproductive system repeats the same sequence of changes month after month. This is the menstrual cycle: its purpose is to prepare an egg and a possible place for it to implant.

The phases of the cycle

Although only a few days of bleeding each month are visible from the outside, simultaneous and continuous changes are taking place inside the body in two organs at once: what stages do the ovary and the uterus go through in parallel?

The first day of menstrual bleeding is day 1. The ovarian cycle comprises the follicular phase, ovulation and the luteal phase; the uterine cycle comprises menstruation, proliferation of the endometrium and the secretory phase. The two are coordinated, but they describe different organs.

Conceptual diagram comparing the phases of the ovarian cycle and the uterine cycle side by side. Ovary: follicular phase →ovulation → luteal phase Uterus: menstruation → proliferation→ secretory phase

Reading the endometrium graph

Menarche is the first menstrual period. It usually happens during puberty, around ages 9 to 15, and shows that the reproductive system has matured enough to start cycling. Cycles are not all exactly 28 days: lengths vary from person to person and from cycle to cycle. Menstruation is the first part of the cycle, not something separate from it. During pregnancy the cycles pause, because ovulation and menstruation do not happen.

The endometrium (the lining of the uterus) is thin during menstruation and thickens steadily during the proliferative phase, from about day 5 until ovulation. After ovulation it keeps thickening and becomes more secretory, reaching its maximum from about day 15 to day 25. It thickens so it can nourish an embryo if fertilization happens.

Graph of endometrium thickness over a 28-day cycle: thin at days 1 to 5, thickening until day 14, thickest from day 15 to 25, then falling at the end. Menstruation Proliferative phase Secretory phase Endometrium shed (days 25-28) Ovulation (day 14) Days of the cycle (1 to 28) Thickness
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Name the phases of the menstrual cycle and state, in one sentence, what happens in each of them.

Name the phases of the menstrual cycle and state, in one sentence, what happens in each of them.

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The diagram represents the $28$ days of a menstrual cycle: the curve shows the thickness of the endometrium and four moments are marked with letters. Write down what…

The diagram represents the $28$ days of a menstrual cycle: the curve shows the thickness of the endometrium and four moments are marked with letters. Write down what happens or what each letter (A, B, C, and D) represents, and put these four moments in order throughout the cycle.

1 7 14 21 28 days A B C D
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State whether these statements are true or false and justify your answer: a) all women have cycles of exactly $28$ days; b) menstruation is part of the menstrual cycle;…

State whether these statements are true or false and justify your answer: a) all women have cycles of exactly $28$ days; b) menstruation is part of the menstrual cycle; c) during pregnancy the menstrual cycles continue.

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Explain what menarche is, at what stage of life it occurs, and what it indicates about the maturation of the reproductive system.

Explain what menarche is, at what stage of life it occurs, and what it indicates about the maturation of the reproductive system.

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In the menstrual cycle graph, the curve represents the thickness of the endometrium over the $28$ days. Describe how this thickness changes during the cycle, relate…

In the menstrual cycle graph, the curve represents the thickness of the endometrium over the $28$ days. Describe how this thickness changes during the cycle, relate these changes to the time of ovulation, and reason why the endometrium thickens before a possible fertilization.

bleeding thickness of the endometrium ovulation 1 7 14 21 28 days
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Ovulation and the endometrium

Ovulation releases an oocyte, commonly called an egg, from the ovary. It can be fertilized for approximately 12–24 hours; sperm can survive for up to about five days in the reproductive system. For this reason, sexual intercourse before ovulation can also result in pregnancy.

Female reproductive system in front view: an ovary releases an oocyte that is picked up by the fimbriae of the Fallopian tube and moves towards the uterus, whose endometrium is preparing for a possible implantation. Fallopian tube Possible fertilization Uterus Endometrium Oocyte Ovary Ovary

If pregnancy does not occur, the corpus luteum degenerates, progesterone and estrogen levels fall and part of the endometrium is shed: this is menstruation. Menstrual blood comes mainly from the lining of the uterus, not from the egg.

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Explain what ovulation is, in which organ it takes place, and at what point in the menstrual cycle it usually occurs.

Explain what ovulation is, in which organ it takes place, and at what point in the menstrual cycle it usually occurs.

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Explain what the endometrium is, in which organ it is found, and why its thickness changes throughout the cycle.

Explain what the endometrium is, in which organ it is found, and why its thickness changes throughout the cycle.

Solve
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Explain what menstruation is, what is shed during it, and what its arrival indicates regarding whether or not a pregnancy has occurred in that cycle.

Explain what menstruation is, what is shed during it, and what its arrival indicates regarding whether or not a pregnancy has occurred in that cycle.

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For centuries, there has been a myth that menstrual blood is a "toxic" substance or a periodic waste product through which the female body "purifies itself and…

For centuries, there has been a myth that menstrual blood is a "toxic" substance or a periodic waste product through which the female body "purifies itself and eliminates accumulated impurities."

  1. a) Refute this myth by detailing what tissues, cells, and fluids truly make up the menstrual flow and what the exact physiological cause is for its shedding.
  2. b) During the nine months of pregnancy, menstruation does not occur. Use this fact to explain why the hypothesis of "periodic toxin purification" lacks any biological foundation and explain what function the endometrium performs if embryo implantation occurs.
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The hormones that regulate the cycle

The ovary and the uterus are physically separate and carry out different tasks, yet they synchronize their changes perfectly month after month: how do these organs communicate at a distance to coordinate their cycles?

The pituitary gland releases FSH, which promotes the maturation of the follicle, and LH, whose sudden surge triggers ovulation. The follicle produces estrogen, which promotes the proliferation of the endometrium. After ovulation, the corpus luteum mainly produces progesterone, which prepares and maintains the secretory endometrium.

Pituitary–ovary–uterus axis: before ovulation, FSH makes the follicle mature, which releases estrogen and thickens the endometrium; after the LH surge ovulation occurs and the corpus luteum releases progesterone, which prepares the secretory endometrium. Before ovulation After ovulation Pituitary gland FSH LH surge Follicle Ovulation Corpus luteum Estrogen Progesterone Proliferative endometrium Secretory endometrium
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Explain what estrogens and progesterone are, which organ produces them, and which organs have their function altered by them.

Explain what estrogens and progesterone are, which organ produces them, and which organs have their function altered by them.

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The menstrual cycle repeats time and time again for around forty years of a woman's life. Explain why it is said to be "cyclic", which hormones regulate it (estrogens…

The menstrual cycle repeats time and time again for around forty years of a woman's life. Explain why it is said to be "cyclic", which hormones regulate it (estrogens and progesterone) and which organs produce them, indicating in general terms what each one triggers in the ovary or in the uterus.

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During pregnancy there is no menstruation. Explain why, relating it to the function of the endometrium and to the hormones that maintain it during gestation.

During pregnancy there is no menstruation. Explain why, relating it to the function of the endometrium and to the hormones that maintain it during gestation.

Solve
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Toward the end of the luteal phase (days 25 to 28 of a typical cycle), if fertilization has not occurred, the corpus luteum degenerates and progesterone and estrogen…

Toward the end of the luteal phase (days 25 to 28 of a typical cycle), if fertilization has not occurred, the corpus luteum degenerates and progesterone and estrogen levels plummet.

  1. a) Knowing that progesterone is the hormone responsible for keeping the endometrium thickened and vascularized, predict the consequence that this sharp hormonal drop will have on the inner wall of the uterus and explain how menstruation originates.
  2. b) Someone argues that "menstruation occurs because at that moment sex hormones reach their highest level to push the tissues outward". Justify with reasons whether this statement is true or false based on the actual hormone levels.
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The fertile window and the limits of the calendar

The fertile window covers approximately the five days before ovulation and the day of ovulation, because sperm can survive for several days and the oocyte lives about 12–24 hours. It is not possible to identify days with no risk of pregnancy using a calendar alone.

The luteal phase (ovulation to the next period) lasts about 14 days. So ovulation happens about 14 days before the next period: ovulation day = cycle length − 14. In a 30-day cycle, ovulation is around day 16, not in the middle. The fertile days are the day of ovulation and the days just before it. In the simplified model we use here, we count the day of ovulation and the two days before it; the real fertile window is longer (up to five days before).

Tracking your own cycle (start date, length, symptoms) helps you see how regular it is. Regular cycles are a sign of health, because they show the brain, ovaries, and uterus are communicating. Stress, long trips, eating disorders, or too little food can pause periods, so a doctor asks about changes. During intensive breastfeeding, hormones often stop ovulation for a while, which saves the mother's energy for the baby. But ovulation comes before the first period, so pregnancy is possible before the period returns.

Timeline of seven days around ovulation: sperm survive several days before and the oocyte about 12 to 24 hours after; a calendar neither predicts reliably nor protects against STIs. Fertile window Ovulation Sperm: survive several days Viable oocyte: 12–24 h −5 −4 −3 −2 −1 0 +1 Days relative to ovulation Calendar ≠ reliable prediction nor protection against STIs
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In a $28$-day cycle, ovulation occurs about $14$ days before the end of the cycle, and the most fertile days are the day of ovulation and the two preceding days. If a…

In a $28$-day cycle, ovulation occurs about $14$ days before the end of the cycle, and the most fertile days are the day of ovulation and the two preceding days. If a girl gets her period on the 6th of a month and her cycle lasts $28$ days, calculate around which day her ovulation will take place and which three days of the month would be, approximately, the most fertile.

Solve
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A girl has regular $32$-day cycles. Knowing that about $14$ days pass from ovulation to the next menstruation, estimate around which day of the cycle she ovulates and…

A girl has regular $32$-day cycles. Knowing that about $14$ days pass from ovulation to the next menstruation, estimate around which day of the cycle she ovulates and explain why it does not happen exactly in the middle.

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Explain the relationship between ovulation and the fertile days: why, if the cycle lasts about four weeks, the probability of pregnancy is concentrated in just a few…

Explain the relationship between ovulation and the fertile days: why, if the cycle lasts about four weeks, the probability of pregnancy is concentrated in just a few days.

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Intense stress, long trips, or eating disorders can make the menstrual period temporarily disappear. Explain what the body needs to maintain regular cycles, and why…

Intense stress, long trips, or eating disorders can make the menstrual period temporarily disappear. Explain what the body needs to maintain regular cycles, and why doctors consider the period a "sign of health".

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Explain what information a girl can record about her cycle (dates, duration, symptoms) and what use knowing the regularity of her own cycle has for her health.

Explain what information a girl can record about her cycle (dates, duration, symptoms) and what use knowing the regularity of her own cycle has for her health.

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An informational leaflet claims: "Since the human egg only survives about 24 hours after ovulation, a person with regular 28-day cycles can only become pregnant if they…

An informational leaflet claims: "Since the human egg only survives about 24 hours after ovulation, a person with regular 28-day cycles can only become pregnant if they have sexual intercourse on day 14 of the cycle."

  1. a) Refute this claim taking into account that sperm can remain viable in the female reproductive system for 3 to 5 days, and define the days of the cycle that make up the actual "fertile window".
  2. b) If this person's period began on May 4, predict within which date range of that month there is a high probability of fertilization if they have unprotected sex, and justify your answer.
Solve
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Emma has irregular menstrual cycles whose duration varies between 26 and 34 days. In humans, the luteal phase (the time elapsed between ovulation and the start of the…

Emma has irregular menstrual cycles whose duration varies between 26 and 34 days. In humans, the luteal phase (the time elapsed between ovulation and the start of the next menstruation) is remarkably constant and always lasts about 14 days, whereas the phase prior to ovulation is responsible for the variations.

  1. a) Calculate between which days of her cycle (counting day 1 as the first day of bleeding) ovulation can actually occur in Emma.
  2. b) Justify why the method of trying to predict fertile days by simply counting 14 days from the start of the last menstruation is very unreliable and carries a high risk of unintended pregnancy.
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There is a popular belief that a mother who continuously breastfeeds her baby cannot become pregnant as long as her period has not returned. a) Justify, from an…

There is a popular belief that a mother who continuously breastfeeds her baby cannot become pregnant as long as her period has not returned.

  1. a) Justify, from an evolutionary and offspring-survival perspective, the biological advantage for mammals of intensive breastfeeding temporarily inhibiting ovulation.
  2. b) Refute the described popular belief with biological arguments: explain the temporal relationship between ovulation and menstruation, and reason why a breastfeeding woman can conceive without having had her first period after childbirth yet.
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A couple wishes to have a baby. The woman has regular 32-day cycles and her last period started on March 2. Her partner checks a website and suggests: "Since ovulation…

A couple wishes to have a baby. The woman has regular 32-day cycles and her last period started on March 2. Her partner checks a website and suggests: "Since ovulation happens around the middle of the cycle, our most fertile day will be day 17 (March 18), so we will only have intercourse on March 18 and 19."

  1. a) Knowing that the luteal phase lasts a fixed 14 days (from ovulation to the next period), calculate on which day of the cycle and on what exact date in March ovulation will actually occur.
  2. b) Considering that sperm can live up to 4 days in the female genital tract and the ovum about 24 hours, determine the woman's fertile window in March and explain whether her partner's proposed plan has a high probability of success or if they should modify it.
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Summary

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