Tag Archives: ovulation

Menstruation

The endometrium is under the influence of sex steroids that circulate in females of reproductive age. Sequential exposure to oestrogen and progesterone will result in cellular proliferation and differentiation, in preparation for the implantation of an embryo in the event of pregnancy, followed by regular bleeding in response to progesterone withdrawal if the corpus luteum regresses. During the ovarian follicular phase, the endometrium undergoes proliferation (the ‘proliferative phase’); during the ovarian luteal phase, it has its ‘secretory phase’. Decidualization, an irreversible process  that develop a specialized glandular endometrium, and apoptosis arise when there is no embryo implantation. Menstruation (day 1) is the shedding of the ‘dead’ endometrium and ceases as the endometrium regenerates (which normally happens by day 5–6 of the cycle).

The endometrium is composed of two layers, the uppermost of which is shed during menstruation. A fall in current levels of oestrogen and progesterone for about 2 weeks after ovulation leads to reduce of tissue fluid, vasoconstriction of spiral arterioles and distal ischaemia. This results in tissue breakdown, and loss of the upper layer along with bleeding from fragments of the remaining arterioles is seen as menstrual bleeding. Enhanced fibrinolysis reduces clotting.

The effects of oestrogen and progesterone on the endometrium can be reproduced artificially, for example in patients taking the combined oral contraceptive pill or hormone replacement therapy who experience a withdrawal bleed during their pill free week each month.

Vaginal bleeding will cease after 5–10 days as arterioles vasoconstrict and the endometrium begins to regenerate. Haemostasis in the uterine endometrium is different from haemostasis elsewhere in the body as it does not involve the processes of clot formation and fibrosis.

In rare cases, the tissue breakdown and vasoconstriction does not occur correctly and the endometrium may develop scarring which goes on to inhibit its function. This is known as ‘Asherman’s syndrome’. The endocrine influences in menstruation are clear. However, the paracrine mediators less so. Prostaglandin F2a, endothelin-1 and platelet activating factor (PAF) are vasoconstrictors which are produced within the endometrium and are thought likely to be involved in vessel constriction, both initiating and controlling menstruation. They may be balanced by the effect of vasodilator agents, such as prostaglandin E2, prostacyclin (PGI) and nitric oxide (NO), which are also produced by the endometrium. There is a research shows that progesterone withdrawal increases endometrial prostaglandin (PG) synthesis and reduces PG metabolism. The COX-2 enzyme and chemokines are involved in PG synthesis and this is likely to be the target of non-steroidal anti-inflammatory agents used for the treatment of heavy and painful periods.

Endometrial repair involves both glandular and stromal regeneration and angiogenesis to reconstitute the endometrial vasculature. VEGF and fibroblast growth factor (FGF) are found within the endometrium and both are powerful angiogenic agents. Epidermal growth factor (EGF) appears to be responsible for mediation of oestrogen-induced glandular and stromal regeneration. Other growth factors, such as transforming growth factors (TGFs) and IGFs, and the interleukins may also be important.

Greater understanding of mediators of menstruation is important in the search for medications to control heavy and painful periods. Mefenamic acid is a PG synthetase inhibitor which is widely used as a treatment for heavy menstrual bleeding. It is believed to act by increasing the ratio of the vasoconstrictor PGF2a to the vasodilator PGE2. Mefenamic acid reduces menstrual loss by a mean value of 20–25 per cent in women with very heavy bleeding, and further more effective agents are still being sought.

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Birth control and breastfeeding

The first ovulation after childbirth comes in a different period in very woman. There is no general rule when will ovulation happen but it is a well known fact that breastfeeding plays an important role in this process. If the mother is breastfeeding her baby, the first menstrual cycle should occur in around six months. Otherwise, ovulation usually occurs between four and six weeks after childbirth. But, the fact is that the menstrual cycle occurs just two weeks after ovulation so chances are that you can be fertile right after childbirth without being aware of that fact.

Those who believe that breastfeeding is a safe method of preventing pregnancy are not playing safe. It is a well known fact that during breastfeeding, the mother’s brain secretes a hormone called prolactin which is responsible for milk production. The bigger the amount of this hormone in the system the later you can expect ovulation. However, even a small break between breastfeeding that last more than 5 hours may be just enough to reduce the level of prolactin and the ovulation process can begin. This is why even mothers who are breastfeeding should start thinking about birth control.

In these cases, birth control pills are not recommended because the estrogen that they contain can stop the production of milk. Furthermore, these hormones can be transferred to the child through the milk. The high amount of estrogen that is usually found in these pills can cause negative effects in the child’s development. After childbirth, natural birth control methods are not that effective. The menstrual cycle after childbirth should stabilize after a while.

Between the 6th and 8th week after childbirth you can use an intrauterine device. This is the period when the uterus gets back to its natural form. Besides that you should wait for the vaginal discharge to stop in order to avoid infections. The biggest advantage of using intrauterine devices is the fact that the woman shouldn’t worry about pregnancy in the next 5 years. Of course, side effects are always present and things such as injuries during insertion, losing the IUDs and changing its position are possible. Some women can also experience bleeding. There are certain IUDs that can decrease the intensity and duration of bleeding during the menstrual cycle.

So-called mini pills and three-month injections don’t contain estrogen (they only contain gestagen) and they are another good birth control option during breastfeeding period. These pills don’t stop milk production and flow which makes them perfect for breastfeeding mums. The hormones can reach the baby’s body through the milk but experts claim that the hormones used in these pills are harmless. The only disadvantage of these pills is that they need to be consumed every day at the same time. The three-month injections are better because they are used once in three months. But, they contain more gestagen.

Finally, you can always try the traditional barrier methods like using condoms or a diaphragm. These methods are perfectly safe for breastfeeding mothers.

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Improve your fertility in a natural way

A lot of couples today have problems conceiving a child. Couples who try to conceive for a longer period, become depressed and frustrated because no matter how hard they try that can’t succeed. This situation can even lead to problems in the relationship.

Luckily there are some things that can help every person when it comes to conceiving. The good news is that all these things are natural and easy to perform.

First of all, your partner and you should quit smoking. There are numerous studies that have proven that smokers have lower sperm quality and less sperm in general. Smoking affects women too. Women smokers have bigger chances to become infertile. When it comes to fertility therapies, smokers have to follow therapies with more medications than non-smokers. Even passive smoking can be very bad for your health and that’s why both partners must stay away from tobacco. No matter when you have started smoking, you should know that once you quit smoking your health will start to improve. So, stay away from cigarettes and you will conceive much faster.

Many people don’t see the connection between their diet and conceiving. The truth is that food is really important in this process. It is a known fact that many couples who don’t eat properly have troubles conceiving a baby. Many people are not aware that their diet is wrong because they don’t feel bad. However you should be sure that there are plenty of fruits and vegetables in your diet. These products act as antioxidants which are especially important in our body’s fight against free radicals. Besides that, men should consume more vitamin E and C, vitamins that increase the number of sperm cells and their flexibility. When we talk about women, those women who are overweight should consider losing some pounds because obesity could be a serious problem in this process. Every few pounds that you lose will increase the chance of conceiving.

Don’t forget to relax. Stress is becoming number one factor for appearance of all kind of diseases and it also affects fertility in a negative way. Find a way to relieve stress. Learn how to cope with stress and use some relaxation methods.

According to some experts having sex at least three times a week is the perfect routine if you want to get pregnant. Ovulation can vary and that’s why It is sometimes hard to tell when is the best time for conceiving. If you practice sex at least three times a week you will be sure that you won’t miss that period.

If you are taking some medications make sure that they don’t affect your fertility. The only logical thing to do in such cases is to replace one medication with another and see the results. Try to see if there are some alternatives that include zinc and folic acid in them.

Having a good night sleep is another proven way to increase chances of pregnancy. So make sure you get enough sleep during the night and occasionally take a nap during the day.