Author: Akau B. Z. What is the Menstrual Cycle? The menstrual cycle is a cyclical pattern of physiological changes in the ovaries, uterus, and other sexual structures that occur from the start of one menstrual cycle to the beginning of the next. Its duration is approximately 28 days (ranges 21 – 35 ). It starts with removing the endometrium and releasing FSH (follicle-stimulating hormone) by the anterior pituitary. The menstrual cycle depends on: Complex interaction and interplay of neuroendocrine systems from the hypothalamus to the pituitary, the ovaries, and the end organs. The hypothalamus itself is under the influence of the CNS and environmental stimuli. Chemical messengers – endocrine and paracrine. End organ response. Outcome of pregnancy or menstruation. The hypothalamus-pituitary-ovarian axis controls the required physiologic changes of the menstrual cycle that occur both in the ovaries and the uterus. The hypothalamic-pituitary-ovarian axis, ovarian cyc...