For each description of a phase in the menstrual cycle A–E, select the most appropriate option for the following list of days.
1. Day 0.
2. Day 4.
3. Day 7.
4. Day 14.
5. Day 21.
6. Day 27
- Vaginal secretions are at their most fluid; the endometrium has regenerated but is not yet optimal for implantation.
- The endometrium has undergone ischaemic necrosis (death due to lack of blood flow) and external discharge has been noted.
- The level of luteinizing hormone is around its peak, the level of oestradiol is medium, and that of progesterone relatively low.
- The menstrual discharge has just ended.
- The level of progesterone is around its peak.
Medicine
A. Option 4 Day 14. This is the middle of the cycle, when ovulation is just occurring; fluid vaginal secretions favour passage of spermatozoa; if the ovum is fertilized it will be ready to implant in about a week when the endometrium will be at its most receptive.
B. Option 1 Day 0. The menstrual cycle is timed from when the patient first notices the menstrual discharge.
C. Option 4 Day 14. The sudden peaking of the level of luteinizing hormone initiates ovulation; at this stage the level of oestradiol is falling from its initial peak in the proliferative phase; the level of progesterone is about to start rising steeply.
D. Option 2 Day 4. The menstrual discharge lasts around four days on average.
E. Option 5 Day 21. At this stage progesterone is having its maximal effect and the endometrium is at its most receptive; in the absence of a fertilized ovum the progesterone level will fall leading to menstruation; if an ovum implants, the gonadotrophic hormone it produces will stimulate the corpus luteum to maintain and increase secretion of proges-terone so maintaining the endometrium and the pregnancy.
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