Unit 3

REPRODUCTIVE SYSTEMS AND THE

MENSTRUAL CYCLE

Learning Objectives
By the end of this unit, the learner should be able to:
 Explain the importance of understanding the male and female reproductive systems
 Define the ovarian cycle, the menstrual (uterine) cycle and menstruation, the female
reproductive cycle, and hormones
 Describe the anatomy and physiology of female and male reproductive systems
 Describe the phases of the menstrual cycle and what occurs in each phase
 Explain how fertilization and implantation occur and when during the menstrual cycle
a woman can become pregnant.

Teaching Resources in this Unit

Handouts
External Female Reproductive Anatomy 42
Internal Female Reproductive Anatomy 42
Male Reproductive Anatomy 43

Unit Assessment
Quiz Questions 44
Quiz Questions Answer Key 48

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 Unit 3: Reproductive Systems and the Menstrual Cycle

Key Points
 Understanding the female reproductive cycle is essential for understanding how
pregnancy occurs and how family planning methods work to prevent it.
 The female reproductive cycle involves both the development of an egg in the
ovaries (oogenesis) and the preparation of the uterus to receive a fertilized ovum.
 Sperm can usually live up to 48 hours in the woman’s body.
 A woman is most likely to become pregnant if she has unprotected sex from 2 days
before ovulation to the day after ovulation.

3.1 Importance of Understanding Human Reproductive

Systems
It is essential that family planning providers understand the female and male reproductive
systems and female reproductive cycles in order to provide high quality family planning services.
To be able to help their clients make informed decisions about family planning methods,
instruct clients about how to use their chosen methods, and advise clients about managing side
effects, service providers need to understand how pregnancy occurs, when a woman can
become pregnant (her fertile time), and how contraceptive methods work. Another benefit of
understanding the reproductive cycles is a greater understanding of their roles in female fertility
problems and bleeding disorders.

3.2 Overview and Definitions

(Note: This section was adapted from Principles of Anatomy and Physiology, 7th edition, by
Gerard J Tortora and Sandra Reynolds Grabowski. Copyright 1993, HarperCollins College.
Reprinted with permission of John Wiley & Sons, Inc.)
During their reproductive years, non-pregnant females normally experience a cyclical series of
changes in the ovaries and uterus. Each cycle takes about a month and involves both oogenesis
(development of an ovum) and preparation of the uterus to receive a fertilized ovum. Hormones
control the events in these cycles.
The ovarian cycle is a series of events that are involved in the maturation of an ovum, or egg.
The menstrual (uterine) cycle is a series of changes in the endometrium (lining) of the uterus.
Each month, the endometrium is prepared for the potential arrival of a fertilized ovum that will
develop in the uterus. If an ovum is not fertilized, the outer portion of the endometrium sheds
off.
Menstruation is the shedding of the endometrium accompanied by bleeding. Menstruation
starts during puberty (at menarche) and stops permanently at menopause. It is also known as
“monthly bleeding,” a “period,” and menses.
The term female reproductive cycle refers to the ovarian and uterine cycles, the hormonal
changes that regulate them, and cyclical changes in the breasts and cervix.

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Male and female reproductive systems include all of the structures and organs involved in
fertilization and implantation.
Hormones are chemicals produced by glands and structures in the body. Hormones act as
chemical messengers to another body structure or gland. Hormones control the events in the
menstrual and ovarian cycles.
This unit focuses on the phases of the menstrual cycle, and includes events in the ovarian cycle
in the menstrual (uterine) cycle description.

3.3 The Female Reproductive System

(Note: To save space, illustrations of female and male anatomy are not included here but are
reprinted in the Handouts section at the end of this unit.)
External female reproductive anatomy
Structures of external female reproductive anatomy include:
• Pubic hair: Surrounds the female reproductive organs
• Clitoris: Sensitive ball of tissue creating sexual pleasure
• Labia majora (outer lips): Two folds of skin, 1 on either side of the vaginal opening, that
protect the female organs
• Labia minora (inner lips): Two folds of skin, inside the labia majora, that extend from the
clitoris
• Urethra: Opening where urine leaves the body
• Vaginal opening: Where a man’s penis is inserted during sex, and where blood flows out
during menstruation
• Anus: Where solid waste leaves the body.
Internal female reproductive anatomy
Primary structures and organs include:
• Uterus (womb): Reproductive organ where a fertilized ovum, or egg, grows and develops
into a foetus
• Fallopian tube: Each of the two tubes that link the ovaries to the uterus. An ovum travels
along one of these tubes once a month. Fertilization occurs in this tube.
• Ovary: Two reproductive glands where ova (eggs) develop and 1 is released each month
• Ovarian follicle: A hollow ball of cells that contains an immature ovum. Located in each
ovary
• Endrometrium: The lining of the uterus, which gradually thickens and then is shed during
menstruation
• Cervix: Lower portion of the uterus that extends into the upper vagina. It produces mucus.
• Vagina: Joins the outer sexual organs with the uterus.

3.4 The Male Reproductive System

The primary structures and organs of the male reproductive system include:
• Penis: Male sex organ made of spongy tissue

Unit 3: Reproductive Systems and the Menstrual Cycle 39

 • Urethra: Tube through which semen is released from the body. Urine is released through
the same tube.
• Seminal vesicles: Where sperm is mixed with semen
• Foreskin: Hood of skin covering the end of the penis
• Prostate: Organ that produces some of the fluid in semen
• Testicles: Organs that produce sperm
• Scrotum: Sack of thin, loose skin containing the testicles
• Vas deferens: Each of the 2 thin tubes that carry sperm from the testicles to the seminal
vesicles.

3.5 Phases of the Menstrual and Ovarian Cycles

By definition, the menstrual (or uterine) cycle begins with the first day of bleeding, which is
counted as day 1. The cycle ends just before the next menstrual period. Menstrual cycles
normally range from about 25 to 36 days. The description of the phases of the menstrual cycle
below assumes a cycle length of 28 days. However, only 10% to 15% of women have cycles that
are exactly 28 days.
The menstrual and ovarian cycles each have 3 phases:
Menstrual cycle
Days 1-5: Menstrual phase
• This phase is from first day of the menses to last day of bleeding (usually lasts from 3–5
days, up to 7 days).
• Bleeding occurs when there is no fertilization.
• Low levels of both progesterone and oestrogen make the blood vessels of the
endometrium constrict, cutting off blood flow to the uterine lining.
• The cells of the uterine lining start to die, and the lining sloughs off and causes bleeding.
• Two-thirds of the endometrial lining sheds during menses.
• During this time the ovaries are beginning the follicular stage (see below).
Days 6-14: Proliferative phase
• This phase is from cessation of menses to ovulation.
• Endometrial lining thickens in preparation for implantation of a fertilized ovum. Its
thickness doubles to about 4–6 mm.
• Uterine secreting glands increase in size and produce mucus.
• Uterine blood vessels begin to grow.
• Ovulation occurs in the ovaries at the end of this stage, usually around day 14, triggered by
a surge in luteinizing hormone (LH) from the anterior pituitary gland.
Days 15-28: Secretory phase
• This phase is from ovulation to the start of the next menses.
• Endometrial glands secrete mucus, which prepares the uterus to receive a fertilized ovum.
• The corpus luteum produces oestrogen, while the cells of the ovaries produce
progesterone.

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 • Endometrium continues to thicken.
Ovarian cycle:
While the uterus is proceeding through the 3 phases above, the ovaries pass through the
following phases:
• Follicular phase: (about 14 days): Between 3-30 follicles, each containing 1 ovum (egg),
begin to grow, with usually 1 reaching maturity while the others break down.
• Ovulatory phase (about 16-32 hours): The ovum is released from the follicle and enters the
Fallopian tube.
• Luteal phase (about 14 days): The ruptured follicle forms a structure called the corpus
luteum. The corpus luteum produces progesterone, which helps prepare the endometrium
for a fertilized egg.

3.6 Fertilization and Implantation

Once the egg is released from the ovary (ovulation), it can live for about 24 hours. Once sperm
move up the female reproductive tract (through the cervix and into the uterus) after
ejaculation, they can usually live for about 48 hours. Fertilization, when the egg joins with the
sperm and forms the oocyte, usually happens within 24 hours of intercourse. The fertilized
oocyte then implants into the endometrium by 5-7 days after fertilization.
Following implantation:
• The developing placental tissues secrete chorionic gonadotropine, a hormone that helps
maintain pregnancy, which maintains the corpus luteum.
• The corpus luteum of pregnancy, as this is now called, produces the oestrogens and
progesterone required to maintain the pregnancy until the placenta takes over this function.
If the ovum is not fertilized by a sperm, the corpus luteum regresses, levels of oestrogens and
progesterone drop off, the endometrium begins to slough off and pass through the vagina, and
menstruation begins the reproductive cycle again.

3.7 Fertile Days of the Menstrual Cycle

A woman's fertile days depend on ovulation as well as the life span of the egg and the sperm.
The egg and sperm are most likely to join, and pregnancy is most likely to occur, when
unprotected sexual intercourse takes place during the 2 days before ovulation or on the day of
ovulation. It is also possible a day or 2 after ovulation—although this is less likely.
Most women ovulate between 11 and 18 days after the first day of their last period. This is the
time when women are most fertile and most likely to get pregnant. But the time of ovulation
can be different from month to month and different between different women. Therefore, a
woman could potentially become pregnant if she has unprotected sex on most days of her
menstrual cycle.

Unit 3: Reproductive Systems and the Menstrual Cycle 41

 Reproductive Systems Teaching Resources

Handouts
External Female Reproductive Anatomy

Internal Female Reproductive Anatomy

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Male Reproductive Anatomy

Unit 3: Reproductive Systems and the Menstrual Cycle 43

Reproductive Systems Quiz Questions
Questions 1–9 : Indicate whether the following statements about the reproductive systems are
true or false by writing a “T” for true or an “F” for false in the space provided before each
statement.
___ 1. Proteins control the changes in the ovaries and uterus associated with the reproductive
cycle.
___ 2. The urethra is a tube through which semen is released from the body.
___ 3. The vas deferens are 2 thin tubes that carry sperm from the seminal vesicles to the
testicles.
___ 4. Fertilization occurs in the uterus.
___ 5. The menstrual cycle begins with the first day of bleeding.
___ 6. The majority of women have menstrual cycles that last 28 days.
___ 7. Blood pools in the uterus during the month and is released during the menstrual phase
of the menstrual cycle.
___ 8. During the proliferative phase of the menstrual cycle, endometrial glands secrete
mucus, which prepares the uterus to receive a fertilized ovum.
___ 9. Fertilization is most likely to occur when unprotected sexual intercourse happens during
the 2 days before ovulation or on the day of ovulation.

Questions 10–15 : Please fill in the blank spaces to complete the following sentences.
10. After ovulation, the ovum normally lives for ______________ (length of time) in the
reproductive tract.
11. After ejaculation, sperm normally survive _____________ (length of time) in the female
reproductive tract.
12. If an ovum is fertilized, it continues to travel down the _________________ toward the
______________.
13. A fertilized ovum implants into the _______________ about ______ days after fertilization.
14. At the end of the proliferative phase, ___________________ occurs in the ovaries.
15. The phases of the menstrual cycle, in the order in which they occur, are ________________,
_______________________, and ________________________.

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External Female Reproductive Anatomy Assessment
Label the major structures in this illustration:

1.
2. ____________
3. ____________

4. ____________
5. ____________

6. ____________

Unit 3: Reproductive Systems and the Menstrual Cycle 45

Internal Female Reproductive Anatomy Assessment
Label the major organs and structures in this illustration:

1. ____________
3. ____________

2. _________ 4. _______

5. ____________

6. ____________

7. ____________

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 Male Reproductive Anatomy Assessment
Label all the major reproductive structures and organs in this illustration:

4. ____________

5. ____________
1. 6. ____________
2.

3. 7. ____________

8. ____________

Unit 3: Reproductive Systems and the Menstrual Cycle 47

Reproductive Systems Quiz Questions Answer Key

F __ 1. Proteins control the changes in the ovaries and uterus associated with the reproductive
cycle.
T __ 2. The urethra is a tube through which semen is released from the body.
F __ 3. The vas deferens are 2 thin tubes that carry sperm from the seminal vesicles to the
testicles.
F __ 4. Fertilization occurs in the uterus.
T __ 5. The menstrual cycle begins with the first day of bleeding.
F __ 6. The majority of women have menstrual cycles that last 28 days.
F __ 7. Blood pools in the uterus during the month and is released during the menstrual phase
of the menstrual cycle.
F __ 8. During the proliferative phase of the menstrual cycle, endometrial glands secrete
mucus, which prepares the uterus to receive a fertilized ovum.
T __ 9. Fertilization is most likely to occur when unprotected sexual intercourse happens during
the 2 days before ovulation or on the day of ovulation.

10. After ovulation, the ovum normally lives for _____24 hours__ (length of time) in the
reproductive tract.
11. After ejaculation, sperm normally survive __2 days______ (length of time) in the female
reproductive tract.
12. If an ovum is fertilized, it continues to travel down the ___Fallopian tube__ toward the
___uterus_.
13. A fertilized ovum implants into the ___endometrium__ about __5-7__ days after
fertilization.
14. At the end of the proliferative phase, ovulation occurs in the ovaries.
15. The phases of the menstrual cycle, in the order in which they occur, are _menstrual phase_,
_proliferative phase____, and ___secretory phase___.

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Anatomy Assessment Answer Key
External female reproductive anatomy
1. clitoris
2. labia majora (outer lips)
3. urethra
4. vagina
5. labia minora (inner lips)
6. anus
Internal female reproductive anatomy
1. Fallopian tube
2. ovary
3. endometrium
4. uterus
5. ovarian follicle
6. cervix
7. vagina
Male reproductive anatomy
1. urethra
2. penis
3. foreskin
4. seminal vesicles
5. prostate
6. vas deferens
7. testicles
8. scrotum

Unit 3: Reproductive Systems and the Menstrual Cycle 49

 References

Ministry of Health. 2007. Malawi national reproductive health service delivery guidelines.
Lilongwe, Malawi: Ministry of Health.
Marieb, Elaine N. 2000. Essentials of human anatomy and physiology. 6th ed. San Francisco, CA:
Benjamin/Cummings.
Tortora, Gerard J. and Sandra Reynolds Grabowski. 1993. Principles of anatomy and physiology.
7th ed. New York, NY: HarperCollins College.
World Health Organization/Department of Reproductive Health and Research (WHO/RHR) and
Johns Hopkins Bloomberg School of Public Health/Center for Communications Programs (CCP),
Knowledge for Health Project. Family Planning: A global handbook for providers (2008 update).
Baltimore and Geneva: CCP and WHO/RHR.
http://info.k4health.org/globalhandbook/

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