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Old 01-25-2012
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Question I don't understand the concept of anovulation and its effects

hey guys
can you help me understand the logic behind ANOVULATION leading to DUB. or any kind of lengthening or shortening of menstrual cycles. and also how anovulation causes endometrial proliferation??

(i get it if progesterone is low..
but like we find in teens .. that hormones are normal but there is anovulation?? there was a question in uworld with normal hormones but anovulation.. leading to shortened cycles etc)
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Old 01-25-2012
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unopposed estrogen causes anovulation in DUB.

too much estrogen drives negative feedback of the gonadotropes (LH, FSH).

with no LH spike, there cannot be ovulation.
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Old 01-25-2012
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but why does anovulation cause shortened or prolonged menstrual cycles??
( i get the prolonged part.. why shortened?)
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Quote:
Originally Posted by mbbs2010 View Post
but why does anovulation cause shortened or prolonged menstrual cycles??
( i get the prolonged part.. why shortened?)
i have no idea lol
good question.
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Old 01-25-2012
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Quote:
Originally Posted by mbbs2010 View Post
hey guys
can you help me understand the logic behind ANOVULATION leading to DUB. or any kind of lengthening or shortening of menstrual cycles. and also how anovulation causes endometrial proliferation??
no ovulation means no corpus luteum. No corpus luteum means no progesterone. No progesterone means that unopposed estrogen will continue to cause endometrial proliferation and there will be no degeneration of glandular structures as normally occurs during menstruation.



Quote:
Originally Posted by mbbs2010 View Post
(i get it if progesterone is low..
but like we find in teens .. that hormones are normal but there is anovulation?? there was a question in uworld with normal hormones but anovulation.. leading to shortened cycles etc)
Quote:
Originally Posted by mbbs2010 View Post
but why does anovulation cause shortened or prolonged menstrual cycles??

( i get the prolonged part.. why shortened?)
Patients with dysfunctional uterine bleeding (DUB) have lost cyclic endometrial stimulation that arises from the ovulatory cycle. As a result, these patients have constant, noncycling estrogen levels that stimulate endometrial growth. Proliferation without periodic shedding causes the endometrium to outgrow its blood supply. The tissue breaks down and sloughs from the uterus. Subsequent healing of the endometrium is irregular and dyssynchronous.

Chronic stimulation by low levels of estrogen will result in infrequent, light DUB. Chronic stimulation from higher levels of estrogen will lead to episodes of frequent, heavy bleeding.

All depends on the levels of estrogen present in that specific time frame.
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