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|An extra long or extra short period can be caused when the shell that once housed the egg (called the corpus luteum) swells in size and throws off the hormone chain.|
28 day cycle.
Proliferative Phase. During first 14 days after menstruation (3-5 days) under oestrogenic stimulation, produced by effect of FSH on the ovarian Graafian follicle (granulosa cells) the endometrium exhibits proliferation of both narrow round tubular glands and compact stroma which develops from the outer one-third of the endometrium. Mitoses seen in both glands and stroma. Oedema develops in stroma.
Secretory Phase Following ovulation, mediated by pituitary LH and a further surge of FSH, the ovarian graafian follicle is transformed into a Corpus Luteum which continues to secrete oestrogen but also progesterone.
Early Secretory Phase Day 17-20, Endometrial glands enlarge and lining cells develop subnuclear vacuolation (glycogen rich), Stromal oedema+. No mitoses.
Late Secretory Phase Day 21-27. Secretion in lumens of glands which now become enlarged and tortuous. Stromal oedema++. Increased tortuosity of stromal vessels. Stromal cells become enlarged and rounded and is complete by Day 27. Endometrium now prepared for implantation of fertilised ovum. In the absence of pregnancy, stroma is infiltrated by acute inflammatory cells and granular cells. Corpus Luteum in ovary degenerates, progresterone and oestrogen level drops and the luminal two-thirds of the endometrium desintegrates and is cast off (Menstruation) with haemorrhage.
Pregnancy Following fertilisation and implantation of the ovum in the endometrium (about 4-5 days after ovulation) the Corpus Luteum continues to secrete oestrogen and progesterone with increased decidualistion of stroma and glandular secretion. Arias-stella change - marked hypersecretory state of glands.
Combined Oestrogen/Progesterone Little oestrogen stimulation, mainly progesterone effect. Decidual change and glandular atrophy. Some side effects mainly with long-term use.
Endometrial Polyps Common in perimenopausal and menopausal endometrium. May be sessile or pedunculated up to about 3 cms. in diameter. Usually associated with inappropriate reaction of part of the endometrium of oestrogenic stimulation.
Endometriosis Endometrial glands and stroma outside of the uterus e.g. in ovaries, fallopian tubes, pouch of Douglas, mesentery, gastrointestinal tract, skin, scars etc.
Cause Unknown (1) ? Implantation from retrograde menstruation.
(2) Metaplasia of peritoneal serosa.
Regresses following menopause.