The Pathophysiology of Amenorrhea - Essay Example

"The Pathophysiology of Amenorrhea" is a great example of a paper on symptoms.
To effectively know the disease process involved in a case of a patient’s amenorrhea, several factors ought to be considered as part of the disease process, and for that matter pathophysiology of the disease. In this, the menstrual cycle easily come up as a possible factor in the disease process responsible for a patient’s amenorrhea (quote). As far as the menstrual cycle is concerned, there are target organs that are considered as part of the three physiologic phases of the menstrual cycle. These organs are the hypothalamus, pituitary, ovary and uterus, and they represent the follicular, ovulatory, and luteal phases of the menstrual cycle. Below is a brief discussion of how each of the phases places a role in the pathophysiology of the amenorrhea being experienced by the 30-year-old female patient who has 6 months of the condition.

Follicular phase

From the day of the first flow to the 13th day is considered the follicular phase of the cycle. The name follicular right merits the hormonal functions and activities that take place in the woman ahead of the onset of ovulation. For example, it is at this phase that the pituitary sets off the release of increased levels of follicle-stimulating hormones (FSH). The FSH subsequently recruits oocytes that set the pace for the next menstrual cycle to take place (quote). In line with the pathophysiology of amenorrhea, it would be noted that the hypothalamus plays a very significant role as part of the organ that regulates the activities that happen during the follicular phase. This is because it is actually this organ that releases gonadotropin-releasing hormone (GnRH) to kick start the follicular phase. Indeed as amenorrhea refers to the general situation where there is the total absence of menses, it can be expected that the effective functioning of the hypothalamus to set off the follicular phase could be considered an important component of the pathophysiology of the disease. This is because of the fact that the GnRH released by the hypothalamus is necessary for interacting with the anterior pituitary gland so as to stimulate the release of FSH to trigger communication with granulose cells, which are found around the oocytes (quote). As all these processes take place, the estrogen is aided to have a positive influence on LH secretion so that pituitary LH suppression will not be present. So where there is ineffective functioning of the hypothalamus, the suppression will happen, and the onset of menses will be negatively affected.

Ovulatory phase

The ovulatory phase is noted to take place right after the follicular phase. However, it may not be triggered until such time as 34 to 36 hours after there has been an LH surge or the E2 level has reached its peak (quote). This explains the dependence between the process of ovulating and the follicular phase, for which it can be said that the chances of successfully ovulating may be hampered if there is ineffective functioning of the organs responsible for carrying out the follicular phase. At the ovulatory phase, there is a rise in progesterone levels, which leads to the distensible nature of the follicular wall, which also triggers proteolytic enzyme activity (quote). Once the proteolytic enzyme activity has been affected, there is a rupture of the collagenous follicular wall, forcing the release of the ovum from the ovary through the uterus. At this stage, there are increases in the production of estrogen, progesterone and androgens from the corpus luteum. But the most important relation between the ovulatory phase and the pathophysiology of the amenorrhea is that menstruation starts partly as a result of an egg that has been released by the ovary during the ovulatory phase and the egg remains unfertilized. Even though a non-release of the egg could still guarantee menstruation, it is important to note that there are several hormonal processes other than the release of the egg that takes place at the ovulatory that are very important. Consequently, any problems with the ovulatory phase could mean that those other processes that have been talked about could not happen to offset menstrual flow in patients.