All About Menstruation (Period): Normal Menstruation Cycle, Painful and Absence

Neha Mittal   by Neha Mittal, MS, Biotechnology    Last updated on May 17, 2018,

what is menstruation

 

What is menstruation? Why do periods occur?

Menstruation is defined as a vaginal bleeding which occurs every month in females. It is a part of a woman’s regular monthly cycle. Menstruation is also known as period.

It usually begins between the age of 11 and 14, which is termed as menarche and ends nearly at the age to 51, which is known as menopause. Menstruation occurs every month for a duration of 6 days in which continuous blood flows from the vagina. Besides bleeding, a woman experiences cramps and pain in abdomen, lower back and legs, mood swings, etc.

During period, the menstrual blood leaves a woman’s body through vagina. Along with the blood, the inner lining of the uterus is also shed away. In the later days of the period, the inner lining of the uterus regrows and starts preparing the uterus for pregnancy.

The normal length of time between two menstrual cycles is 21 to 45 days in young women, and 21 to 31 days in adults. Menstruation stops during pregnancy and usually resume after the initial months of breastfeeding.

What is menstrual cycle (menstrual cycle)? What is the normal menstrual flow?

Menstrual cycle is referred to the monthly occurrence of menstrual bleeding. If the bleeding occurs regularly without any delay or other complication, then it can be inferred that the woman’s fertility organs are working properly.

Any change in the monthly cycle can be a sign of some complication. Therefore, it is always advisable to consult a doctor in case any irregularity is observed.

Menstrual cycle prepares a woman’s body for pregnancy every month. It also provides certain chemicals, known as hormones, to keep her healthy. A normal menstrual cycle is 28 days long. It usually starts from the first day of period and goes up to the first day of next period.

The menstrual cycle involves functioning of many hormones and their interactions. The major set of hormones involved in a woman’s monthly cycle is as follows:

  • Oestrogen or estrogen and Progesterone (secreted by ovaries)
  • Luteinising hormone and Follicle stimulating hormone (secreted by pituitary glands)
  • Hormones secreted by hypothalamus

Proper interaction between these hormones results in a proper regulation of the cycle.

What are the different phases of menstrual cycle? What happens to you when you get your period?

During a menstrual cycle, the inner lining of uterus continuously sheds and then regrows. This process occurs from the day 1 of the cycle to the day 1 of the next cycle. During the progression of a menstrual cycle, a series of hormonal interactions occur which are very important for maintaining a regularity in periods.

The menstrual cycle is divided into three major phases namely:

  • the menstrual phase (lasts for about 1- 5 days),
  • the proliferative phase (lasts for about 6-14 days), and
  • the secretory phase (lasts for 15-28 days).

A woman has two ovaries which also follows a proper cycle for releasing egg. This cycle is known as ovarian cycle. In this cycle, a woman’s ovaries prepare the egg and release it during ovulation phase. This process is further classified into two phases known as the follicular phase (lasts for the 1 to 14 days) and the luteal phase (lasts for 15 to 28 days). During these phases, various hormones are released which differ in their level of secretion.

The three phases of menstrual cycle are as follows:

Menstrual Phase

Menstrual phase lasts for about 3 to 5 days. On the day 1 of the phase, a woman’s menstrual bleeding starts in which her uterus starts shedding its thickened inner lining, known as endometrium along with blood through the vagina.

This is the phase in which a woman experiences pain and cramps in her abdomen, lower back, legs and other parts of her body. This pain can range from mild to severe depending upon the woman’s monthly cycle. Around 100 to 150 ml of blood is released out from the body but it can also vary from one woman to another.

Proliferative phase or Follicular phase

On the last day of menstrual bleeding or period, a woman’s body starts preparing for ovulation. A hormone, called follicle-stimulating hormone (FSH) is secreted from pituitary glands. This hormone helps in stimulating the ovaries to produce a mature egg. One mature egg is normally produced in one menstrual cycle.

During the maturing process of egg, a hormone, called estrogen is released from the ovaries which help in nourishing the inner lining of the uterus. Estrogen thickens the inner lining of the uterus wall with proper blood supply and nutrients so that it can provide a proper support in case pregnancy occurs.

This phase also experiences ovulation in which the mature egg is released into the fallopian tube and moves toward the uterus. Another hormone known as progesterone is also released by the ovaries which also help in keeping the inner lining of the uterus intact. Here, the egg can survive for 12 to 22 hours. It can occur anytime from 7th day to 22nd day of the cycle.

Secretary phase

This is the end phase of one menstrual cycle. If occurs only when the egg is not fertilized with the sperm. This phase lasts for 14 to 15 days in which the level of hormones such as estrogen, progesterone, luteinizing hormone, and follicle stimulating hormone in the uterus decreases. This results in reducing the supply of blood and nutrients to the endometrium (inner lining of the uterus). Due to this, the blood vessels present in the inner lining of uterus shrinks and the cells start to die and shed. This results in the menstrual bleeding. From here a new menstrual cycle starts.

What is premenstrual syndrome or PMS?

Premenstrual syndrome is normally referred to as PMS. PMS is a set of symptoms which are experienced by a woman at the time of her period.

During the periods, the body experiences a sudden rise and fall in the levels of hormones. These changes or fluctuations result in certain changes in the body that affect the mood.

Progesterone hormone plays a major role in the progression of PMS. As the level of progesterone increases during periods, a woman experiences an increase in her stress level. This stress leads to major mood swings.

What is the first sign of your period? How do you know if your period is coming?

Some common signs of PMS experienced by a woman are:

  • Pain and cramps in various parts of the body
  • Tiredness
  • Anxiety
  • Headaches
  • Fever
  • Pimples
  • Mood swings
  • Irritability
  • Bloated stomach
  • Tender or sore breasts

As the menstrual cycle progresses and the level of hormones decreases, the above PMS symptoms improve. Usually, these signs are very prominent in the initial 3 days of the cycle but decreases with the progression of time.

What are the complications due to improper menstruation?

There are many complications which can occur in a woman having periods. Some of the major complications are as follows:

Amenorrhea

Amenorrhea is a condition in which a woman experiences the lack of monthly periods or absence of periods in young girls who haven’t started her monthly cycle by the age of 15 or woman who haven’t had her period for approximately 90 days.

Missing periods can be due to many reasons such as:

  • Pregnancy
  • Breastfeeding
  • Major weight loss
  • Eating disorder
  • Stress
  • Medical condition which may need urgent treatment

Apart from pregnancy or breastfeeding, missing periods can be a sign of some problem in the reproductive part of the body. It might be an indication that the ovaries are not able to produce estrogen properly. In such cases, it becomes important to consult a doctor.

Dysmenorrhea

Dysmenorrhea is a condition of painful periods in which a woman experiences severe cramps. Menstrual cramps in young teens occur due to the presence of too much of a chemical called prostaglandin.

Although many young girls with dysmenorrheal do not experience serious disease, but the cramps can be severe. In older women, the severe pain is caused due to a disease like uterine fibroids or endometriosis.

Abnormal uterine bleeding

Abnormal uterine bleeding is also known as vaginal bleeding and is very different from vaginal bleeding. It involves:

  • Bleeding between periods
  • Spotting anytime in the menstrual cycle
  • Bleeding after sex
  • Bleeding after menopause
  • Heavy bleeding more than normal days

Abnormal bleeding in woman can occur due to any reason. It is very important for a woman to consult a doctor to know the actual reason.

How to manage premenstrual syndrome or PMS?

Since, menstrual cycle is an every month phenomenon, its proper management is necessary. There are various methods which can be utilized to control premenstrual syndrome. Some of them are:

Medications for menstrual cramps

In some cases, the cramps or the pain can be severe and it is not possible to handle them naturally. In such cases, various pain medications are prescribed by a doctor. Some of the medicines are as follows:

  • Ibuprofen like advil, motrin, etc
  • Ketoprofen like orudis KT
  • Naproxen like Aleve.

Use of disposable products

Various disposable products are available in the market which can be used to properly handle menstrual bleeding. For example:

Sanitary napkins

Sanitary napkins are the rectangular pieces of absorbing material with an adhesive back for holding the napkin in the place. It is generally made up of wood pulp or a gel product and used for absorbing blood. These napkins should be changed approximately after 6 hours in order to prevent any infection.

Tampons

Tampons are disposable cylinders which are normally made up of rayon or cotton blends. It is inserted into the vagina to absorb menstrual flow.

Disposable menstrual Cups

Menstrual cups are small cups shaped devices, made up of soft, flexible plastic material. It is inserted in the vagina to collect and hold the menstrual flow.

Resuable products

There are some reusable products which are also used to manage the menstrual flow. For example:

Menstrual cup

Menstrual cup is a bell shaped device which is made up of silicone. It is used to hold menstrual flow.

Sea sponges

Sea sponges are the naturally occurring sponges, which are worn in the vagina like a tampon to absorb the menstrual bleeding.

Exercise

Regular exercise is a gateway to a good health. At least 15 minutes of exercise everyday is always recommended. Exercise helps in relieving stress, stretching muscles and feeling fresh. It also helps in relieving pain.

Proper sleep

It is very important to get a sleep of 7 hours to relax the muscles and regain energy for next day work.

Healthy diet

It is important for a woman on period to have a proper healthy diet. Food items containing too much of sugar, salt, and caffeine should be avoided. During these days, intake of fruits and vegetables should be increased as it provides proper vitamins and minerals to the body.