SOURCE AND CHARACTER OF MENSTRUAL CHANGES 



However, the presence of the ovaries seems necessary for the performance 

 of the menstrual function; for women do not menstruate when both ovaries 

 have been removed by operation. (See page 432 for a discussion of the 

 functional effects of removal of the ovary.) 



Source and Character of Menstrual Changes. The menstrual periods 

 usually occur at intervals of a lunar month, the duration of each being from 

 three to six days. In some women the intervals are so short as three weeks 

 or even less; while in others they are longer than a month. The periodical 

 return is usually attended by pains in the loins, a sense of fatigue in the 

 lower limbs, and other symptoms, which vary extremely in different individuals. 



The menstrual discharge is a thin sanguineous fluid, and consists of blood, 

 epithelium, and mucus from the uterus and vagina. The menstrual flow is 

 preceded by a general engorgement of all the pelvic organs with blood. The 

 cervix and vagina become darker in color and softer in texture, and the quantity 

 of mucus secreted by the glands of the cervix and body is increased. The 

 uterine mucous membrane is swollen and the glands are enlarged. The dis- 

 charge of blood, the source of which is the mucous membrane of the body 

 of the uterus, is probably associated with uterine contractions. There is 

 great difference of opinion as to whether or not any of the uterine mucous 

 membrane is normally shed during the process of menstruation. John 

 Williams believes that the whole of the mucous membrane of the body of 

 the uterus is thrown off at each monthly period, forming a true decidua men- 

 strualis, figure 496, while Moricke and others believe that the mucous mem- 

 brane remains intact. Leopold believes that red blood-corpuscles escape 

 from the congested capillaries and undermine the superficial epithelium, and 

 that in this way the superficial layer of the mucous membrane is eroded and 

 subsequently regenerated. There is a period of regeneration followed by a 

 period of rest before the next repetition. Minot distributes the variations in 

 time as follows : 



Tumefaction 5 da 7 s 



Menstrual discharge 4 



Restoration of mucosa 7 



Period of rest 12 



The menstrual period is often accompanied by profound disturbances in 

 other parts of the body, especially of the vascular and of the nervous systems 

 and of the nutritive processes. 



Corpus Luteum. Immediately before, as well as subsequent to, the rupture 

 of a Graafian follicle and the escape of its ovum, changes ensue in the interior 

 of the follicle, which result in the production of a yellowish mass, termed a 

 Corpus luteum. 



When fully formed, the corpus luteum of mammals is a roundish solid 

 body, of a yellowish or orange color, and composed of a number of lobules, 



44 



