Preservation of menstrual function in adolescent and young females

Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...

The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.

The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle.  At puberty, GnRH secretion increases in both frequency and...

The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
The menstrual phase occurs from days 1 to 5 and involves the shedding of the stratum functionalis, as a uterine...

The uterine cycle begins with the menstrual phase, which is considered day one of the cycle and typically lasts about five days. This phase is characterized by the degeneration and shedding of the stratum functionalis, the functional layer of the endometrium.
When fertilization does not occur, the corpus luteum deteriorates, causing a significant drop in the levels of estrogen and progesterone in the body. This hormonal decrease triggers the release of prostaglandins, which cause the uterine...

The secretory phase of the menstrual cycle, spanning from day 14 to 28 in a typical 28-day cycle, is a period of significant physiological changes in the female reproductive system. This phase commences immediately after ovulation and is characterized by the preparation of the endometrium for potential embryo implantation.
Following ovulation, the corpus luteum, a temporary endocrine structure, produces progesterone and estrogens. These hormones stimulate the growth and coiling of endometrial...