The school nurse is teaching a group of middle-school students about the female reproductive system. Which statement by a student most accurately describes the reason menstruation begins?
1. "Your uterus starts to contract, and this causes the lining to come out, which is your period."
2. "Your brain sends a signal that there is enough estrogen and progesterone. Then these hormone levels drop, and you get your period."
3. "You have to have your period every 28 days to be normal."
4. "You get your period when you ovulate."
Correct Answer: 2
Rationale 1: Uterine contractions do not cause menstruation.
Rationale 2: Menstruation begins when high progesterone and estrogen levels in the final third of the uterine cycle provide negative feedback to shut off GnHR, LH, and FSH. This causes estrogen and progesterone levels to drop sharply, which causes the endometrium to be shed.
Rationale 3: A normal menstrual cycle can vary from 22 to 35 days and still be considered normal.
Rationale 4: Menstruation does not occur with ovulation.
Global Rationale: Menstruation begins when high progesterone and estrogen levels in the final third of the uterine cycle provide negative feedback to shut off GnHR, LH, and FSH. This causes estrogen and progesterone levels to drop sharply, which causes the endometrium to be shed. Uterine contractions do not cause menstruation. A normal menstrual cycle can vary from 22 to 35 days and still be considered normal. Menstruation does not occur with ovulation.
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