Menstruation: 10 Quick Facts:
- Menstruation or periods is the monthly shedding of the uterine lining in women that lasts for about 3 to 5 days on an average.
- Longer menstrual cycles are common for the first few years after menstruation begins. It usually shortens and becomes more regular with age.
- Period flow varies amongst women ranging from light, moderate to heavy.
- Periods usually start between age 11 and 14 and continue until menopause (between ages 45 and 55).
- While tracking your Menstrual cycle, the first day of bleeding is considered the first day of your cycle.
- Average menstrual cycle is 28 days long. However, cycles may vary anywhere from 21 to 35 days in adults and from 21 to 45 days in young teens.
- Women with shorter or longer cycles than average may ovulate before or after day 14.
- Common problems associated with periods include abnormal bleeding, dysmenorrhea (painful period), and amenorrhea (no period).
- A normal cycle is an indication of good health, see your doctor for any abnormalities in your period.
- Personal hygiene is very important during periods; therefore, doctors suggest that women change the pad/tampon about every 4 to 8 hours.
What is Menstruation?
Aunt Flow, Menses, Period or Menstruation is a monthly event in the life of woman in her reproductive age. Menstruation constitutes the normal vaginal bleeding that occurs every month accompanied by some signs and symptoms. A woman’s body prepares itself for pregnancy every month. Of the two ovaries, one releases an egg (called ovulation) and alongside hormonal changes prepare the uterus for pregnancy. If ovulation is not accompanied by fertilization of the egg by a sperm, pregnancy doesn’t occur. Consequently, the lining of the uterus, or the womb, is removed through the vagina. This is the menstrual period. The menstrual blood consists of both tissue and blood from inside the uterus.
On an average, menstruation typically starts in girls between ages of 11 and 14 and continue till the woman hits menopause between the age 45 and 55. Menstrual bleeding usually last from 3 to 5 days. In early teens, the bleeding may be between 2 to 7 days but it usually shortens with age.
Besides vaginal bleeding, women may experience certain symptoms along their cycle such as
- Lower back pain
- Mood swings and irritability
- Bloated and sore breasts
- Abdominal Bloating
- Abdominal or pelvic cramping
- Food cravings
- Fatigue and Headache
Other than these, a woman may also experience Premenstrual syndrome or PMS before the start of the period. These include a group of both emotional as well as physical symptoms.
What Does a Typical/Normal Menstrual Cycle Look Like?
The menstrual cycle is the monthly course driven by changes in hormone secretion in the female body. The rise and fall in the level of hormones – estrogen, progesterone, and testosterone, stimulate the release an egg from an ovary, thicken the lining of the uterus to sustain a pregnancy, and then cause the uterus to shed this lining (through menstruation) if there is no pregnancy. The average menstrual cycle is 28 days or four weeks long but it may vary between women and from month to month. While in young teens, the menstrual cycle can range from 21 to 45 days, in adults, it is anywhere from 21 to 35 days.
|Day 1||First day of bleeding||Happens after the hormonal levels drop at the end of the last cycle. This signals the breakdown of uterine lining causing shedding of blood and tissues through the vagina.
Bleeding continues for about 5 days
|Day 5||End of Bleeding
Preparation for ovulation
|Rise in the secretion of hormone estrogen causes the lining of the uterus to thicken as it prepares to support a fertilized egg.
Typically, by Day 7, changes in hormone levels also cause fluid-filled pockets called follicles to grow and mature. These follicles contain the egg.
|Between Day 7 and 14||Follicle matures||One follicle continues to grow and attain maturity.
The Uterine lining continues to thicken and becomes rich in nutrients and blood. It is now ready for implantation of a fertilized egg.
|Around day 14||Ovulation||The egg is released from a follicle on the ovary (called ovulation). Ovulation can occur somewhere between 10 and 21 days after the first day of a woman’s cycle. During this time, the levels of luteinizing hormone (LH) in the urine increases and a woman’s body temperature usually rises.
Women may experience pain on one side of their pelvic area called “Mittelschmerz” or “middle pain,” since it occurs in the middle of the cycle.
The egg moves down the fallopian tube towards the uterus over the next few days. In case a sperm meets with the egg here, the egg is fertilized and will continue its journey down the fallopian tube and attach itself to uterine lining. (called implantation)
|Day 25||If the egg remains unfertilized, the levels of hormone start to dip, signaling the lining of the uterus, called the endometrium, to be shed during menstruation. This breakdown causes the bleeding of the menstrual cycle.|
Menstrual Cycle: What’s normal and What’s not?
The menstrual cycle isn’t alike for all women. Your cycle might be regular or slightly irregular, long or short, painful or pain-free, and the period flow might be light, moderate or heavy, and still be considered normal.
Since there is no set definition of what constitutes a “normal” menstrual cycle, tracking your cycle can help you understand what’s normal for you. Start by keeping a record of your menstrual cycle on a calendar (or an App) for several months to know the regularities or abnormalities of your periods. Keeping a record of the following can help you in picking out the oddities in your cycle:
- Begin Date: First day of your cycle
- End Date: Length of your cycle to identify whether it was longer or shorter than usual
- Flow: Record the heaviness of your flow- lighter or heavier than usual, passage of blood clots, etc.
- Abnormal Bleeding: Bleeding between periods
- Symptoms: such as Pain, bloating, mood swings, and whether it was more than usual
- Note Any Other Changes: Start of new regime, medication, environmental changes, etc.
The most common menstrual irregularities include:
- Amenorrhea or absence of periods: When a woman doesn’t get her first period by age 15, or when the period stops for at least 90 days and she isn’t pregnant.
- Oligomenorrhea and Polymenorrhea: Periods that occur more than 35 days apart and those occurring less than 21 days apart.
- Menorrhagia: Heavy bleeding.
- Prolonged menstrual bleeding: Bleeding exceeding 8 days in duration on a regular basis.
- Dysmenorrhea: Painful periods with severe menstrual cramps.
- Intermenstrual bleeding: Bleeding or spotting between periods.
What are the Causes of Menstrual Irregularities?
Irregularities can be due to a number of reasons including:
- Pregnancy or breastfeeding:A missed period can be an early sign of pregnancy. Breastfeeding can also delay the return of normal menstruation.
- Eating disorders, extreme weight loss or excessive exercising can disturb menstruation.
- Stress interferes with the normal hormonal secretion and can, therefore, cause a missed or late menstrual period.
- Polycystic Ovary Syndrome (PCOS):Women with this disorder may have irregular periods as well as enlarged ovaries.
- Uterine fibroids: These noncancerous growths of the uterus can cause heavy, prolonged or painful periods.
- Premature ovarian failure: Loss of normal ovarian function before age 40 also called primary ovarian insufficiency might lead to irregular periods.
- Pelvic inflammatory disease (PID): An infection of the reproductive organs, PID can cause menstrual irregularities.
- Others: Serious medical conditions, Bleeding disorders, thyroid dysfunction, Hormonal birth control (birth control pills, injections, or IUDs), Medications, can cause irregular or abnormal periods.
While some menstrual irregularities can’t be prevented, others can be regulated by the use of over the counter medicines or treatment of any underlying problems.
Irregular/Abnormal Periods: When should you see your Doctor?
While some irregularities are considered normal, it is important to see a doctor if any of the following occurs:
- Periods haven’t started by the age of 15.
- Menstruation didn’t start within 3 years of breast development, or if breasts haven’t started to grow by age 13.
- Periods suddenly stop for more than 90 days — and you’re not pregnant
- Periods become erratic after having been regular
- Bleeding lasts for more than seven days
- Bleeding is heavier than usual or soak through more than one pad or tampon every hour or two.
- Periods are less than 21 days or more than 35 days apart
- Bleeding between periods
- Severe pain during your period
- Bleeding or spotting after sex
- Bleeding after menopause
Regular menstrual cycles are an indication that important parts of your body are working normally. While menstrual cycle irregularities aren’t usually serious, sometimes they can indicate underlying health problems. It is thus important to track your cycle and visit a doctor for any striking changes.