The Physiology of Menstruation

  • Roger P. Smith


Only humans, closely related primates, some species of bats, and elephant shrews visibly menstruate. The processes that drive the monthly maturation, slough, and renewal of the endometrium that results in menses are ultimately orchestrated by a complex interaction of hormones, tissues, and molecular signaling, all designed to ensure the possibility of securing a pregnancy should a timely mating occur. Menstrual pain and excessive menstrual bleeding are both extremes of a normal continuum. Understanding their development requires a familiarity with the processes that create the normal menstrual cycle. This discussion will focus primarily on the uterus, leaving many of nuances of the complex interactions of the hypothalamus, pituitary, and ovary to others.


Physiology Pituitary Hypothalamus Ovary Follicle stimulating hormone (FSH) Luteinizing hormone (LH) Endometrium Prostaglandin Ovulation Anatomy 

Additional Resources

  1. For excellent images and an overview of the anatomy of the female reproductive organs:Google Scholar
  2. Smith RP, Turek P. The Netter Collection of medical illustrations: reproductive system. Philadelphia, PA: Elsevier—Global Medicine Group; 2011.Google Scholar
  3. For a review of the structure and functions of FSH and LH:Google Scholar
  4. Padmanabhan V, Karsch FJ, Lee JS. Hypothalamic, pituitary and gonadal regulation of FSH. Reprod Suppl. 2002;59:67–82.PubMedGoogle Scholar
  5. Pierce JG, Parsons TF. Glycoprotein hormones: structure and function. Annu Rev Biochem. 1981;50(1):465–95. Scholar
  6. An excellent overview of the role of prostaglandins in menstruation can be found at:Google Scholar
  7. Drife JO, Calder AA, editors. Prostaglandins and the uterus. London: Springer-Verlag; 1992.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Roger P. Smith
    • 1
  1. 1.Florida Atlantic UniversityBoca RatonUSA

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