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).