During a menstrual period, a woman bleeds from her uterus (womb) via the vagina. This lasts anything from three to seven days. Each period commences approximately every 28 days if the woman does not become pregnant during a given cycle.
Why do women menstruate?
A woman's internal sex organs consist of two ovaries, the Fallopian tubes, the uterus (womb) and the vagina. The ovaries contain the eggs with which the woman is born and, during each period, a single egg will usually ripen and mature due to the action of hormones circulating in the bloodstream.
When the egg is mature it bursts from the ovary and drifts through the Fallopian tube down into the uterus. The lining of the uterus - the endometrium - has been thickened by the action of hormones and made ready to receive the fertilised egg.
After every period, new membranes are formed in the uterus in preparation to receive a fertilized ovum that can develop into a foetus.
If the ovum that’s produced is not fertilized, the uterus will begin bleeding, about two weeks after ovulation.
Menstrual discharge is composed of the endometrium itself, together with a little fresh blood caused by the breaking of very fine blood vessels within the endometrium as it detaches itself from the inside of the uterus.
During the course of your period, your menstruation consists of varying amounts of blood, tissue and fluids from membranes in the uterus. At the beginning of your period, it will contain more blood than at the end. This is why your menstruation will change in colour.
The amount of blood lost due to the normal monthly period is usually less than 80ml.
When does menstruation begin?
These days, girls begin to menstruate when they are about 10 to 14 years-old. The average age is approximately 12. Women will continue to menstruate until the age of 45 to 55, when menopause begins. A woman will have approximately 500 periods in her lifetime.
Ovulation usually takes place roughly 14 days after the first day of the start of a period; however, the exact timing can vary greatly from woman to woman. Some women know when they are ovulating because they can feel a slight pain in their lower abdomen. Other women may bleed slightly in the middle of their cycle. Vaginal discharge also changes at ovulation. It increases in amount and becomes more watery due to hormonal changes. This is one of the ways that women who wish to practice natural family planning using the mucus test can find out whether it is safe to have sex or not.
Women who do not experience such symptoms during ovulation can find out when they are ovulating by taking their temperature. This will rise by 0.5 degrees Celsius when ovulation occurs. To measure temperature effectively, it must be taken at the same time every morning before getting out of bed.
Temperature readings taken from different parts of the body such as the mouth, under the arm, in the ear or in the rectum will all give a slightly different measurement. When checking for temperature, rises can occur for a variety of reasons and, therefore, should not be used as the only method of detecting ovulation.
What influences menstruation?
The menstruation is a complex process involving hormones and the sexual organs. First and foremost, hormones have a major influence on menstruation. If they are not balanced, a woman's cycle will be affected. If a woman's period becomes too irregular, they should see a doctor for advice. Other influences on hormones and menstruation include a woman's weight, stress levels and her general fitness and health.
Weight also influences hormonal balance and menstruation. If a woman is underweight, her hormones will stop working properly and her periods might stop altogether. Stress also affects the hormones. Many women find that if they are worried about something, it can influence menstruation. In some cases, a woman's period might actually stop if she is very worried about whether she is pregnant.
Regular exercise and keeping fit and healthy can help regulate the menstrual cycle.
Symptoms of painful periods
The main symptom of period pain is painful muscle cramps in your lower abdomen . Sometimes the pain comes in intense spasms, while at other times the pain may more constant.
Period pain can sometimes spread to your lower back and your thighs. You may also notice that the pain varies with each period. Some periods may cause you little or no discomfort, while others may be far more painful.
other symptoms
•headaches
•nausea (feeling sick)
•tiredness
•feeling faint
•dizziness
•diarrhoea
Relieve symptoms
There are several things that will help relieve discomfort: while menstruating, refrain from drinking caffeinated drinks such as coffee, tea, cola or cocoa.
avoid stress. Relaxation and massage can work wonders.
exercise and staying fit can help prevent painful periods.
keep your abdomen warm.
finally, use pain-relieving medicines if necessary.
Remember that it is always best to consult your doctor about your specific concerns. Causes painful periods
The pain can be caused by the cervix dilating when the blood and the tissue are passed out of the womb.
the pain can be due to earlier infections or inflammations of the uterus, or benign tumours in the uterus.
in some cases, painful periods are hereditary. If a woman has painful periods, her daughters may later be affected in the same way.
Amenorrhoea
Periods can stop for a number of reasons:
- Pregnancy.
- Premature menopause (this can affect women in their early twenties).
- Weight loss.
- Weight gain.
- Some forms of medication including the contraceptive pill or injections.
- Drug abuse.
- Stress.
- Hormonal imbalances such as an underactive thyroid gland or the overproduction of a hormone called prolactin.
- Polycystic ovaries .
Irregular, infrequent periods (oligomenorrhoea)
This is irregular or infrequent periods. Menstruation can occur anywhere between every six weeks and six months. Many of the causes are the same as those for amenorrhoea.
A common cause is a condition called polycystic ovary syndrome . This is a hormonal disorder that affects the ovaries of up to ten per cent of women . The ovaries have an abnormally large number of follicles - little swellings that develop each month to release an egg.
This condition results in irregular ovulation and thus periods are usually infrequent. The diagnosis of polycystic ovaries is made on the basis of one or more blood tests to measure hormones; a pelvic ultrasound scan of the ovaries is often taken as an additional test.
Treatment is only necessary if there is concern about the irregularity of periods or if a woman is having difficulty becoming pregnant.
The hormonal changes are complex, including high testosterone levels with associated insulin resistance and abnormal lipid levels. Generally the follicles remain immature meaning that eggs are often not released and the woman rarely ovulates and so is less fertile. In addition to irregular periods, women with PCOS may also have excess body hair and be overweight.
