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COMPARATIVE
ANALYSIS OF THE UTERINE MENSTRUAL CYCLE AND THE HEMATOLOGICAL INDICES OF
STUDENTS
ABSTRACT
The
menstrual cycle is affected by so many various factors e.g. stress and changes
in diet and iron. Several other studies showed no significant changes in
Hemoglobin Concentration and RBC Count during various phases of menstrual
cycle, Twenty student with normal menstrual cycle where used as the study
subject. The three phase of the uterine cycle was studied and the hematologic
indices analysed. We tried to make a comparative analysis on Hemoglobinand Red
Blood Cell Count which showed no significant increase from Menstrual Phase (MP)
to Secretory Phase (SP), which is in agreement with the earlier reports.
Hemoglobinconcentration may increase from menstrual phase to secretory phase
due to increase in erythropoiesis to compensate for the blood loss during
menses. There was a pronounced tendency towards an increase in Hband RBC Count
from the early menstrual phase until the post- ovulatory period, with a
subsequent decrease towards the end of the cycle. Form the analysis we deduced
that the menstrual cycle had no deleterious effect on the hematologic indices.
CHAPTER ONE
1.0
INTRODUCTION
The
menstrual cycle is the cycle of natural changes that occurs in the uterus and
ovary as an essential part of making sexual reproduction possible (Lentzet al.,
2012). Its timing is governed by endogenous (internal) biological cycles. The
menstrual cycle is essential for the production of eggs, and for the
preparation of the uterus for pregnancy (Lentz et al., 2012). The cycle occurs only in fertile female
humans and other female primates. In human females, the menstrual cycle occurs
repeatedly between the ages of menarch, when cycling begins, until menopause,
when it ends.
In humans,
the length of a menstrual cycle varies greatly among women (ranging from 21 to
35 days), with 28 days designated as the average length (AHYPERLINK
"http://en.wikipedia.org/wiki/Menstrual_cycle" \l
"cite_note-Widmaier-3"nderson et al., 2003). Each cycle can be
divided into three phases based on events in the ovary (ovarian cycle) or in
the uterus (uterine cycle) (Anderson et al., 2003). The ovarian cycle consists
of the follicular phase, ovulation and luteal phase whereas the uterine cycle
is divided into menstruation, proliferative phase, and secretory phase. Both
cycles are controlled by the endocrine system and the normal hormonal changes
that occur can be interfered with using hormonal contraception to prevent
reproduction (Klumpetet al., 2013).
By
convention, the length of an individual menstrual cycle in days is counted
starting with the first day of menstrual bleeding. Stimulated by gradually
increasing amounts of estrogen in the follicular phase, discharges of blood
(menses) slow then stop, and the lining of the uterus thickens. Follicles in
the ovary begin developing under the influence of a complex interplay of
hormones, and after several days one or occasionally two become dominant
(non-dominant follicles atrophy and die). Approximately mid-cycle, 24–36 hours
after the Luteinizing Hormone(LH) surges, the dominant follicle releases an
ovum or egg in an event called ovulation. After ovulation, the egg only lives
for 24 hours or less without fertilization while the remains of the dominant
follicle in the ovary become a corpus luteum; this body has a primary function
of producing large amounts of progesterone. Under the influence of
progesterone, the endometrium (uterine lining) changes to prepare for potential
implantation of an embryo to establish a pregnancy. If implantation does not
occur within approximately two weeks, the corpus luteum will involute, causing
sharp drops in levels of both progesterone and estrogen. The hormone drop
causes the uterus to shed its lining and egg in a process termed menstruation
(Klumpetet al., 2013).
The
menstrual cycle is characterized by cyclical fluctuations in the levels of FSH,
LH, estrogen and progesterone The hormones are known to have an effect on
oxygen carrying capacity, immune response, bleeding and also changes in serum
electrolyte which may be responsible for variable physical, psychological
symptoms and autonomic changes. It is suggested that stressful situations
during ovulatory periods and menstruation may cause increased 17-hydroxy
corticosterone levels with resulting eosinopenia (Feuring M et al., 2002).
Platelet function is periodically altered during the ovarian cycle due to the
influence of progesterone and estrogen on Von Willebrand factor concentrations
(Sioba´net al., 2004). Ovarian hormones influence almost all the systems of the
body.
They are
known to alter the immune system like depression of the suppressor T cell
activity Human & animal studies suggest that there is a change in the
distribution of immune cells during different phases of menstrual cycle
(Pehlivanogluet al., 2001). 5–20% of women reporting severe dysmenorrhea
(painful menstruation) which may be associated with reproductive morbidities
like infection (Sioba´net al., 2004), thus estimation of leucocyte count is an
important tool. Females have more asthma throughout the reproductive years.
Female sex steroids are pro-inflammatory and will increase the susceptibility
to atopy(Sioba´net al., 2004).
In developing
countries, abnormal uterine bleeding appears to affect about 5–15% of women of
reproductive age. It is a major cause of gynecological morbidity, affecting up
to one in five women some point during their reproductive life span
Reproductive-aged women of about 9-14% have blood loss that exceeds 80 ml
(Rajneeet al., 2010) and prolonged and excessive bleeding may provoke or
exacerbate anaemia and in a certain percentage of cases, may eventually be life
threatening if left untreated, thus there arises a need to estimate
Haemoglobin, Red Blood Cell count and ESR during the menstrual cycle. The lack
of awareness about the potential importance of reducing menstrual flow when
women are anaemic and lack of knowledge among women about treatment
alternatives is of some concern. The maintenance of different blood corpuscles
at normal levels during the menstrual cycle is necessary. Therefore, in the
present study, haematological modulation in the different phases of menstrual
cycle was studied. (Silverthornet al., 2013 and Sherwood et al., 2013).
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