Menstruation

 

MENSTRUATION:

• The menstrual cycle is a natural process in a woman’s body that happens every month.
•  Throughout the menstrual cycle, the uterus lining thickens in preparation for a potential pregnancy. If pregnancy doesn’t occur, estrogen and progesterone levels drop, signaling the start of menstruation.
• Menstrual cycle is counted from the first day of your period until the first day of your next period. Hormone levels (estrogen and progesterone) fluctuate during this cycle and can cause menstrual symptoms.
• Menstruation is when a woman has her monthly bleeding, commonly known as her “period.” During menstruation, the body sheds the lining of the uterus (womb). The blood and tissue flow out of the uterus through the cervix and exit the body via the vagina.
• Regular periods during the years from puberty to menopause indicate normal functioning.
• Irregular, heavy, or painful periods are not normal and may need attention.
• Some women experience premenstrual syndrome (PMS) symptoms. If you have period-related issues, consider talking to your doctor or nurse for advice.
• Some women have such regular periods that they can predict the exact day and time their periods will start. Others can predict it within a few days.

HOW DOES MY MENSTRUAL CYCLE CHANGE OVER AGE?

• Younger Years (Teens):
• Periods are often heavier during your teenage years.
• As you move into your 20s and 30s, they usually become lighter. This is normal.
• After Your First Period:
• For a few years after, longer cycles (more than 38 days) are common.
• Most girls develop regular cycles within three years of their 1^st periods.
• If longer or irregular cycles persist beyond that, consult your doctor rule out health issues like polycystic ovary syndrome (PCOS).
• 20s and 30s:
• During this time, your cycles are usually regular and can last anywhere from 24 to 38 days.
• 40s and 50s (Transition to Menopause):
• Your cycles might become irregular.
• Menstrual periods may stop for a month or a few months and then start again.
• They could be shorter, longer, lighter, or heavier than usual.

Remember to talk to your doctor or nurse if you have cycles longer than 38 days, shorter than 24 days, or if you’re concerned about your menstrual cycle

TRACKING OF MENSTRUAL CYCLE IS IMPORTANT!

·         Regular Periods:

o   If your periods are regular, tracking them helps you:

o   Know when you ovulate (release an egg).

o   Understand when you’re most likely to get pregnant.

o   Predict when your next period will start.

·         Irregular Periods:

o   If your periods aren’t regular, tracking them helps you:

o   Share any problems with your doctor or nurse.

·         Period Pain or Bleeding:

o   Tracking symptoms like pain or heavy bleeding helps you and your healthcare provider find effective treatments.

o   Severe pain or bleeding that disrupts your daily activities isn’t normal and should be addressed.

 

·         How to track Menstrual Cycle?

o   You can keep track of your menstrual cycle by marking the day you start your period on a calendar.

o   You can also download apps (few are free) on your mobile to track your periods. Some include features to track your PMS symptoms, energy and activity levels, and more.

WHEN DOES A GIRL USUALLY GET HER FIRST PERIOD (MENARCHE)?

·         Average Age for First Period:

o   In the United States, the average age for first period is around 12.6 years old.

o   The average age for menarche in India is around 12 to 13 years

o   However, not all girls start at the same age.

·         When It Can Happen:

o   Girls can begin their periods anytime between 8 and 15 years old.

o   Typically, the first period occurs about two years after breast development starts and pubic hair begins to grow.

·         Predicting Menstruation:

o   The age at which a girl’s mother started her period can give a clue about when the girl might start hers.

·         When to consult a doctor:

o   A girl should consult her doctor if:

§  She starts her period before age 8.

§  She hasn’t had her first period by age 15.

§  She hasn’t had her first period within three years of breast growth.

HOW LONG WOMEN MENSTRUATE?

·         On average, women experience menstruation for about 40 years of their lives.

o   Most women have regular periods until perimenopause, which is the transition to menopause. This phase may last a few years.

o   During perimenopause, your period may not come regularly.

·         Menopause:

o   Menopause occurs when you haven’t had a period for 12 consecutive months.

o   For most women, menopause typically happens between the ages of 45 and 55.

o   The average age of menopause in the United States is 52.

·         Other Factors:

o   Periods also stop during pregnancy and exclusive breastfeeding.

o   When to Seek Help:

o   If you go without a period for 90 days (three months) and you’re not pregnant or breastfeeding, it’s essential to talk to your doctor or nurse.

o   Check for pregnancy or underlying health issues if experiencing irregular periods.

WHAT IS A NORMAL AMOUNT OF BLEEDING DURING MENSTRUATION?

·         Average Bleeding:

o   On average, a woman loses around 30 to 40 milliliters of blood during her normal period.

o   However, what’s normal can vary from person to person. Some may have lighter or heavier periods.

·         Variability:

o   The flow may also change from month to month.

o   What’s normal for you might not be the same for someone else.

o   Changes Over Time:

§  As you get older, your periods may change.

§  Some women experience heavy bleeding during perimenopause, which is the transition to menopause.

·         Symptoms of heavy menstrual bleeding include:

o   Bleeding through one or more pads or tampons every one to two hours.

o   Passing blood clots larger than the size of quarters.

o   Bleeding that often lasts longer than eight days.

Average Bleeding:

HOW OFTEN ONE CHANGES SANITARY UTILITIES:

·         Pads:

o   Most women change their pads every few hours.

o   Follow the instructions on the packaging for specific guidance.

·         Tampons:

o   A tampon should not be worn for more than 8 hours due to the risk of toxic shock syndrome (TSS).

o   Change tampons regularly, especially on heavier flow days.

·         Menstrual Cups and Sponges:

o   These may only need to be rinsed once or twice a day.

o   Again, follow the manufacturer’s instructions.

·         Period Panties:

o   Period panties (underwear with washable menstrual pads sewn in) can usually last about a day, depending on the style and your flow.

Remember to choose a product size and absorbency appropriate for your menstrual bleeding. The amount of blood can vary during your period, so some women use different products on different days.

WHAT IS TOXIC SHOCK SYNDROME (TSS)?

Toxic Shock Syndrome (TSS) is a rare but potentially deadly condition caused by bacterial toxins. In 1980, 63 women died from TSS linked to a specific brand of super absorbent tampons, which were subsequently removed from the market.

·         Current Risks:

o   Using highly absorbent tampons or not changing them every 4-8 hours.

o   Menstrual cups, cervical caps, sponges, or diaphragms left in place too long (over 24 hours).

o   Remove sponges within 30 hours and cervical caps within 48 hours.

·         Stay safe by following these guidelines!

·         If you have any symptoms of TSS, take out the tampon, menstrual cup, sponge, or diaphragm, and go to the hospital right away.

o   Sudden high fever

o   Muscle aches

o   Vomiting

o   Nausea

o   Diarrhea

o   Rash

o   Kidney or other organ failure

COMMON MENSTRUAL PROBLEMS:

Amenorrhea: Absence of menstruation.

·         This is when you have no periods. It is normal and expected during pregnancy and breast-feeding. It can also be caused by serious illness, weight loss, extreme stress, excessive exercise, anorexia, and problems with the pituitary, thyroid, ovaries, or other glands.

·         If your periods don’t start by age 16, or if previously regular periods stop for 2 months or more, you should see your healthcare provider.

Dysmenorrhea: Severe menstrual pain.

Dysmenorrhea refers to intense menstrual cramps that can interfere with daily activities. It can be classified into two types:

·         Primary Dysmenorrhea: Common menstrual cramps that are not linked to any other medical condition. They usually start 1-2 days before menstruation and last for 2-4 days.

·         Secondary Dysmenorrhea: Pain caused by a reproductive system disorder, such as endometriosis or fibroids. This type of pain often begins earlier in the menstrual cycle and lasts longer than primary dysmenorrhea.

Menorrhagia: Heavy or prolonged menstrual bleeding.

Heavy or prolonged menstrual bleeding, also known as menorrhagia, can significantly impact daily life. Common causes include:

·         Hormonal Imbalances: Disruptions in hormone levels can lead to excessive bleeding.

·         Uterine Fibroids or Polyps: Non-cancerous growths in the uterus.

·         Bleeding Disorders: Conditions that affect blood clotting.

·         Endometrial Hyperplasia: Thickening of the uterine lining.

·         Infections: Infections in the reproductive organs.

·         Medications: Certain drugs, like anticoagulants, can cause heavy bleeding.

·         Cancer: Rarely, cancers of the uterus or cervix

Oligomenorrhea: Infrequent menstrual periods.

Oligomenorrhea refers to menstrual cycles that are infrequent, typically occurring more than 35 days apart. Common causes include:

·         Hormonal Imbalances: Issues with thyroid or pituitary glands.

·         Polycystic Ovary Syndrome (PCOS): A condition causing irregular periods.

·         Stress: High levels of stress can disrupt menstrual cycles.

·         Weight Changes: Significant weight loss or gain can affect menstruation.

·         Excessive Exercise: Intense physical activity can lead to infrequent periods.

Bleeding Between Periods:

Bleeding between periods, also known as intermenstrual bleeding, can be caused by various factors:

·         Hormonal Imbalances: Fluctuations in hormones can lead to unexpected bleeding.

·         Uterine Fibroids or Polyps: Non-cancerous growths in the uterus can cause bleeding.

·         Infections: Infections of the reproductive organs can result in bleeding.

·         Medications: Certain medications, like birth control pills, can cause spotting.

·         Pregnancy Complications: Issues like ectopic pregnancy or miscarriage can lead to bleeding.

·         Cancer: In rare cases, bleeding can be a sign of cancer in the reproductive organs

Polymenorrhea: Frequent menstrual periods.

            Polymenorrhea refers to menstrual cycles that occur more frequently than normal, typically less than 21 days apart. Common causes include:

·         Hormonal Imbalances: Issues with estrogen and progesterone levels.

·         Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual frequency.

·         Polycystic Ovary Syndrome (PCOS): A condition that can cause irregular and frequent periods.

·         Stress: High stress levels can disrupt the menstrual cycle.

·         Infections: Infections of the reproductive organs can lead to frequent bleeding.

Premenstrual Syndrome (PMS):

PMS refers to a group of symptoms that occur in the days leading up to menstruation. Common symptoms include:

·         Mood Swings: Irritability, anxiety, or depression.

·         Physical Discomfort: Bloating, breast tenderness, and headaches.

·         Fatigue: Feeling unusually tired or low on energy.

·         Changes in Appetite: Cravings or changes in eating habits.

·         Sleep Disturbances: Trouble sleeping or changes in sleep patterns.

OTHER HEALTH PROBLEMS RELATED TO MENSTRUAL CYCLE?

The changing hormone levels throughout the menstrual cycle can also affect other health problems:

o   Depression and Anxiety Disorders: These conditions often overlap with premenstrual syndrome (PMS).

o   Symptoms of depression and anxiety can resemble those of PMS and may worsen before or during your period.

o   Asthma: Your asthma symptoms may be worse during specific parts of your menstrual cycle.

o   Irritable Bowel Syndrome (IBS):

§  IBS causes cramping, bloating, and gas.

§  Symptoms of IBS may intensify right before your period.

o   Bladder Pain Syndrome: Women with bladder pain syndrome are more likely to experience painful cramps during PMS.

Menstruation, whether welcome or inconvenient, is a natural part of women’s lives. Menstrual cycles differ from woman to woman and can change at various stages of life. If you have concerns about your cycle’s regularity, it’s best to consult your healthcare provider. Remember that individual experiences can vary, and it’s essential to pay attention to your body and seek medical advice if you have concerns.