Comparative Analysis Of The Uterine Menstrual Cycle And The Hematological Indices Of Students In The University Of Benin
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.
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).
Objective of the Study
The broad objective of the study is to make a comparative analysis of the uterine menstrual cycle and the hematological indices of students during different phases of menstrual cycle.
Specifically the study will;
- Compare the Hematological parameters during different phases of menstrual cycle
- Compare the Differential leucocyte count during different phases of menstrual cycle
- Compare the Serum electrolyte levels during different phases of menstrual cycle
Significance of the Study
Menstrual disorders like delayed or early menarche, premenstrual symptoms and dysmenorrhoea create a great anxiety among adolescent girls and their families, thus it is of enormous significant to know the age at menarche for girls‘ clinical evaluation, education and identification of deviations from normal. Investigating the age of menarche and menstrual problems among adolescent is also important so as to provide health planners and caregivers with fundamental data necessary for interventions. The 6 knowledge of age at menarche in a given population is a pressing need of the society as no law about the age at marriage, consensual sex, abortion, family planning, rape and other aspects of female reproductive life can be made without it. With emergence of acquired immune deficiency syndrome as one of major threat to mankind and teenage pregnancies as one of the major social problems, an urgent need is felt, in developed as well as developing countries to make the adolescents aware of it.
Conclusion and Recommendation
With respect to hematological parameters, hormonal changes and nutrition play a major role. In
the present study we found decreased RBC count which increases rouleaux formation thus increasing ESR in the menstrual phase. The cyclical changes in the electrolytes supports the claim of many women that they suffer changes in fluid and electrolyte balance in the premenstrual days. Moreover, these changes may have significance in terms of the normal reference interval, hence necessitate small but significant alterations to the normal reference interval for calcium, magnesium and sodium in menstruating women.
Based on the findings of the present study, the following recommendations are made:
- Further studies should be conducted to determine age at menarche among other ethnic groups in Nigeria.
- Further studies should investigate the associations of childhood/adolescent adiposity and early menarche on disease throughout life.
- More studies should are needed to investigate the association between birth weight and age at onset of menarche.
- Preventive and treatment strategies for premenstrual disorders are strongly recommended.
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