The Internal Organs

The largest organ in the female reproductive system is the uterus. Most of the time it is relatively small, about the size of your fist. In a normal pregnancy, the fetus develops within the uterus, stretching it to many times its normal size. Visit the pregnancy .

On both sides of the uterus are pouches called ovaries. The ovaries contain unfertilized eggs or ova. When one of these ova (called an ovum) unites with a man's sperm, it is fertilized and may eventually produce a child.

A girl's ovaries begin releasing ova at puberty prompting the start of her menstrual cycles.

When the ovaries stop producing ova, a woman has reached menopause. Tubes attached to the ovaries called Fallopian tubes allowing the ovum to travel to the uterus.

The vagina connects the uterus to the outside of the body. This passage has several important functions for women:

The connection between the uterus and the vagina is called the cervix. This is a narrow opening, which helps protect the uterus from outside contaminants.

The Menstrual Cycle

Changes in a woman's hormones that happen every month direct her body to release a tiny egg or ovum. The different stages in the production of this ovum are used to describe a woman's menstrual cycle. On average, the body produces an ovum once every 28 days and this is the average length of a menstrual cycle. Some women have longer or shorter cycles.

Women usually begin having periods in their early teens, but a woman's periods can start as early as age 9 or as late as 16 or 17. Having a period means that a woman's menstrual cycles have begun and that she can become pregnant if the ovum she releases combines with a man's sperm.

Changes of the Menstrual Cycle

Sometimes a woman's cycles are irregular, which means they come at a different time every month. This is particularly common for teenagers, however most women miss a period or experience other variations in their cycle at some point in their lives. You might miss a period because:

·         you are pregnant

·         your body is still maturing

·         you are under stress at work, home or school

·         you are approaching menopause

·         you've been exercising vigorously

·         you've lost a lot of weight in a short period of time

·         you have a hormone disorder

Although some of these changes are part of a woman's natural life cycle it is always wise to discuss changes in your menstrual cycle with your doctor.

The Stages of the Menstrual Cycle

Two important hormones govern the menstrual cycle:

·         Estrogen

·         Progesterone

Hormones are chemical messengers, which the body uses to send instructions from one part of the body to another. The levels of estrogen and progesterone signal the changes that happen during the menstrual cycle. It is important to remember that these hormones also influence other parts of the body. For example, estrogen helps a woman retain calcium in her bones. The influence of these hormones is also thought to cause many of the symptoms of premenstrual syndrome.

A woman's menstrual cycle is said to begin on the first day of her bleeding. A woman's menstrual cycle only occurs if she is not pregnant.

Day 1

·         estrogen and progesterone levels are at their lowest level

·         the inner lining of the uterus, or endometrium is discharged as menstrual blood

·         the unfertilized ovum produced in the last cycle is also discharged

Day 2-12

·         menstruation continues for three to six days for most women

·         when menstruation begins, a new ovum begins to mature in the ovaries

·         the sac around the maturing ovum produces estrogen, increasing the levels in the body

·         increasing estrogen levels prompt the uterine lining to thicken beginning around day nine. If a woman becomes pregnant this nutrient-rich lining supports the developing embryo.

Ovulation

·         estrogen levels peek

·         around Day 14 the sac containing the mature ovum, splits open releasing it from the ovary
This is called ovulation. Some women feel a slight pain when this occurs. This is called a mittelschmerz. Some women also have spotting (light bleeding) at this time.

·         the endometrium continues to thicken

Days 15-22

·         the empty sac left in the ovary begins to produce both estrogen and progesterone 
This sac is called the corpus leuteum.

·         the uterine lining continues to thicken thanks to estrogen produced in the ovary

·         the ovum travels from the ovary down the fallopian tube
If the egg is going to be fertilized it is likely to happen now. When a fertilized egg reaches the uterus, high levels of estrogen and progesterone signal the uterine lining to allow it to implant on the wall of the uterus.

Day 22 - Day 1 of next cycle

·         around this time the corpus luteum stops producing estrogen and progesterone
If the egg has not been fertilized, levels of both estrogen and progesterone will begin to drop.

·         blood vessels in the uterine wall contract and spasm due to the lack of estrogen and progesterone

·         the uterine lining is shed as menstrual blood beginning the first day of the new cycle

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is a poorly defined condition used to describe symptoms, which occur after ovulation and before a woman's period. They are usually most intense in the week just before a woman's period when the levels of estrogen and progesterone are the lowest. Symptoms include:

·         abdominal bloating

·         irritability

·         mood swings

·         headache

·         weight gain

·         fatigue

·         food cravings

·         tension

·         breast swelling

·         backache

Many women experience some of these symptoms.

Some illnesses may become worse during the two weeks before a woman's period. This is known as 'menstrual magnification.' Illnesses where this occurs include:

·         depression

·         migraine headaches

·         seizure disorders

·         irritable bowel syndrome

·         asthma

·         chronic fatigue syndrome

·         allergies

These conditions should be ruled out before a diagnosis of PMS is made. If PMS-like symptoms occur outside of the two-weeks before your period, you doctor should check for other illnesses.

Treatment

Changes in a woman's diet and lifestyle may help relieve the symptoms of PMS. Here are some things that research has shown may improve PMS symptoms:

·         aerobic exercise

·         a complex carbohydrate diet that involves whole grains like brown flour and rice

·         vitamin supplements of calcium, magnesium and/or vitamin E

Other changes in a woman's diet may help, such as eating more fruits and vegetables or eating less:

·         fat

·         sugar

·         salt

·         caffeine

·         alcohol

Some women have found herbs such as evening primrose oil or chasteberry helpful.

For women with serious symptoms, particularly mood changes, a group of antidepressant drugs known as SSRIs may be useful.

Birth-control pills are sometimes prescribed to treat PMS to increase hormone levels. This is for women with primarily physical symptoms. There is little evidence to support this approach.

 More About Periods

Menstrual periods usually last from three to five days, but periods as short as two days or as long as seven may be normal for you. Menstrual flow is usually heaviest in the first two days. It is not unusual for menstrual fluid to contain small clots.

Most women have some occasional pain or discomfort during their period. Typical symptoms include:

·         cramps

·         backache

·         headache

·         nausea

·         fatigue

·         diarrhea