Training of Roma Health Mediators in Reproductive Health

lining like a pillow. If the girl/woman has had sex in the last few days before she
ovulates, by the time the egg arrives in the fallopian tube, there may be some sperm
waiting to unite with the egg. If the arriving egg is united with the sperm (called
fertilization), the egg travels to the uterus, and attaches to the lining of the uterus
(implantation) and remains there for the next nine months, growing into a baby. If the
egg is not fertilized, then the uterus does not need the thick lining it has made to protect
the egg. The lining is shed, along with some blood and the unfertilized egg. All of this
flows through the cervix and then out of the vagina. This flow of blood is called the
“period” or menstruation.
Ovulation is the release of a ripe egg from one of the ovaries once a month. This egg is
picked up by the broad, funnel-shaped end of the Fallopian tube and starts moving in
the tube towards the womb. A woman can become pregnant only if: 1) she ovulates,
and 2) the released egg is fertilized by a sperm after sexual intercourse with a man.
Usually only one egg is released during ovulation. Sometimes, however, two eggs are
released at the same time. If this happens and both are fertilized, twins will be born.
Menstruation happens every month. When an egg ripens in the ovary, the inner lining
of the uterus (womb) starts becoming thick and spongy (due to increased blood-supply)
as it prepares to receive the fertilized egg. However, after ovulation, if the egg does not
get fertilized, it dies. The uterus is “disappointed” that the “expected guest” will not
come this month. So it sheds its inner lining and blood, which comes out of the
woman’s body through vagina as menstrual flow.
This cycle is repeated every month. The period of time between a menstruation and the
next one is called the menstrual cycle, with all these events taking place repeatedly.
The length of the menstrual cycle varies from 21-40 days. The average length of the
cycle is 28 days.
Menstruation begins at puberty and continues until menopause around age 45 to 50
years. Then it stops forever because the ovarian function stops at that stage.
Any bleeding from the vagina after menopause could be a sign of dangerous disease
like cancer or a tumor of the uterus and should not be ignored.
Fertilization takes place when a male sperm cell meets the female egg.
Millions of sperm cells are deposited in the vagina during sexual intercourse. After the
male ejaculates (“comes”) in the vagina, ejaculated sperm swim up through the cervix
into the uterus, and reach the Fallopian tubes seeking an egg. If a mature egg is present,
fertilization can take place. Although thousands of sperm may be present, only one
sperm cell can penetrate the egg. Sperm can fertilize an egg up to seven days after
intercourse. The fertilized egg moves from the Fallopian tube into the uterus (womb)
where it will grow.
Implantation occurs when the fertilized egg attaches to the lining of the uterus. When
this happens, the lining remains throughout pregnancy, so menstruation stops.
When the fertilized egg attaches to the lining of the uterus, a thick and spongy organ
called the placenta is formed. One side of the placenta is attached to the inside wall of
the womb. The other side is attached to the umbilical cord, which connects the
placenta to the growing baby, called the “fetus”. He/she gets blood supply from the
mother's body through the placenta. A bag of water surrounds the fetus and protects it
from jerks, bumps and external injuries.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 3: Human Reproduction