Posts filed under ‘Menstruation’

The Menstrual Cycle

Why do women menstruate?

Menstruation is a very complicated process involving many different hormones, the woman’s sex organs and the brain.

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.

If the egg is fertilized and the woman becomes pregnant, it will fasten itself onto the endometrium. If the egg is not fertilized, however, resultant hormonal changes cause the endometrium to slip away and menstruation begins.

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.

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.

Can you feel ovulation?

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 (NFP) 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. For this reason, it is important to choose one location and stick to it. 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?

As described above, menstruation is a very complex process involving many different hormones, the sexual organs and the nervous system.

First and foremost, hormones influence menstruation. If they are not in balance, the cycle will similarly be affected. If a woman’s periods are very irregular, she can ask her doctor to measure the hormones in her blood to find out if her hormones are out of balance. This will give a rough indication as to whether there is a serious hormonal problem. However, since what is ‘normal’ varies greatly with regard to women’s hormones, blood tests are not a particularly good measure of what can be considered much more subtle imbalances in a woman’s cycle.

Weight also influences hormonal balance and menstruation. If a woman is underweight, her hormones will stop working properly and her periods might stop altogether. Recent research has also shown that obesity can throw hormones out of balance and make it harder for women to conceive. 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. On the other hand, exercising too much and overstressing the body can have a negative effect on the hormones to the extent that menstruation may cease.

What are the symptoms of painful periods?

The degree of discomfort experienced during menstruation varies from woman to woman. Some are never bothered by their periods, while others can be badly affected by unpleasant symptoms. These may include:

  • pains in the abdomen
  • pain in the vagina
  • feeling nauseous and generally unwell
  • diarrhoea
  • sweating
  • fatigue.

What can women do to relieve their 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.

What causes painful periods?

There is no single proven theory, but there are several possible reasons:

contractions of the uterus similar to those felt in childbirth due to the hormone prostaglandin.

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.

Why do some women’s periods stop altogether (amenorrhoea)?

Periods can stop for a number of reasons. The most common are:

  • 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.
  • a condition called polycystic ovaries (see below) is a very common cause of irregular or absent periods.

The treatment suggested will depend upon the diagnosis. If you are uncertain as to why your periods have stopped, seek advice from your doctor. Investigation usually involves a blood test to measure the levels of various hormones in your body.

Irregular, infrequent periods (oligomenorrhoea)

Periods are often light or infrequent both when a young woman starts having periods, and also when a woman is nearing menopause. This is normal because they are not producing an egg every month.

Many women experience one or two irregular periods every six months. This is not usually caused by any serious condition; however, many women do seek an explanation and reassurance from their GP or gynaecologist.

The most common cause of infrequent periods is a condition called polycystic ovaries. This is a common condition affecting as many as 10 per cent of women, in which a large number of very small (less than 1cm) cysts on the ovaries appear in association with a hormone imbalance.

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.

Visit Menstrual Cycle for more information.

July 22, 2011 at 4:18 pm Leave a comment


Menstruation is also called menstrual bleeding, menses, catamenia or a period. The flow of menses normally serves as a sign that a woman has not become pregnant. (However, this cannot be taken as certainty, as a number of factors can cause bleeding during pregnancy; some factors are specific to early pregnancy, and some can cause heavy flow.)


Eumenorrhea denotes normal, regular menstruation that lasts for a few days (usually 3 to 5 days, but anywhere from 2 to 7 days is considered normal). The average blood loss during menstruation is 35 milliliters with 10–80 ml considered normal. (Because of this blood loss, women are more susceptible to iron deficiency than men are.)[14] An enzyme called plasmin inhibits clotting in the menstrual fluid.


Painful cramping in the abdomen, back, or upper thighs is common during the first few days of menstruation (most women experience some pain during menstruation). Severe uterine pain during menstruation is known as dysmenorrhea, and it is most common among adolescents and younger women (affecting about 67.2% of adolescent females). When menstruation begins, symptoms of premenstrual syndrome (PMS) such as breast tenderness and irritability generally decrease.  Many sanitary products are marketed to women for use during their menstruation.

July 22, 2011 at 4:10 pm Leave a comment

Menstrual Cycle

The menstrual cycle is the scientific term for the physiological changes that can occur in fertile female humans and apes. Overt menstruation (where there is blood flow from the uterus through the vagina) occurs in humans and some animals such as chimpanzees. Females of other species of placental mammal undergo estrous cycles, in which the endometrium is completely reabsorbed by the animal (covert menstruation) at the end of its reproductive cycle. This article focuses on the human menstrual cycle.

The menstrual cycle, under the control of the endocrine system, is necessary for reproduction. It is commonly divided into three phases: the follicular phase, ovulation, and the luteal phase; although some sources use a different set of phases: menstruation, proliferative phase, and secretory phase. Menstrual cycles are counted from the first day of menstrual bleeding. Hormonal contraception interferes with the normal hormonal changes with the aim of preventing reproduction.

Stimulated by gradually increasing amounts of estrogen in the follicular phase, discharges of blood (menses) slow then stop, and the lining of the uterus thickens. Follicles in the ovary begin developing under the influence of a complex interplay of hormones, and after several days one or occasionally two become dominant (non-dominant follicles atrophy and die). Approximately mid-cycle, 24–36 hours after the Luteinizing Hormone (LH) surges, the dominant follicle releases an ovum, or egg in an event called ovulation. After ovulation, the egg only lives for 24 hours or less without fertilization while the remains of the dominant follicle in the ovary become a corpus luteum; this body has a primary function of producing large amounts of progesterone. Under the influence of progesterone, the endometrium (uterine lining) changes to prepare for potential implantation of an embryo to establish a pregnancy. If implantation does not occur within approximately two weeks, the corpus luteum will involute, causing sharp drops in levels of both progesterone and estrogen. These hormone drops cause the uterus to shed its lining and egg in a process termed menstruation.

In the menstrual cycle, changes occur in the female reproductive system as well as other systems (which lead to breast tenderness or mood changes, for example). A woman’s first menstruation is termed menarche, and occurs typically around age 12. The end of a woman’s reproductive phase is called the menopause, which commonly occurs somewhere between the ages of 45 and 55.


Source: Menstrual Cycle


July 22, 2011 at 4:06 pm Leave a comment

Abnormal Menstruation

I. The Absence of Menstruation (Medical term: Amenorrhoea)

We will use the term “amenorrhoea” on the rest of this page when referring to the absence of a menstrual period. There are to subgroups, primary and secondary amenorrhoea. The two most common causes of amenorrhoea, pregnancy and menopause, will be discussed elsewhere.

Secondary amenorrhoea is usually define as the absence of a cycle for more than 90 days in a previously normal individual. ( Three missed cycles). If periods are absent for more than three months it should always be investigated

Primary amenorrhoea occurs when menstruation is still absent at a age when a girl should be menstruating. The onset of the first menstruation varies in different populations but should be present in most populations at the age of sixteen. If a young girl’s peers are all menstruating and she is not , she should be examined.

The conditions that cause primary amenorrhoea will be discussed later.

    The following organs are involved in the occurrence of a normal menstrual cycle

  1. The endometrium.
  2. The ovaries
  3. The pituitary gland
  4. The hypothalamus (special area of the brain)

1. The Endometrium
The endometrium is usually either thick (stimulated by estrogen) or thin (estrogen stimulation absent). Also see “The Female Reproductive Organs” and “Normal Menstruation“.

2. The Ovaries

Menstruation depends on the secretion of hormones by the ovaries. In the absence of menstruation there is usually anovulation (the ovary is not releasing any egg cells). Also see “The Normal Ovary”.

    There are a few possibilities

  1. The follicles do not develop and no estrogen are produced. In this case the endometrium will be thin.
  2. The follicles might developed but they do not rupture. Estrogen is produced but it is not opposed by progesterone and the endometrium becomes thick. In the latter case there is usually one or many estrogen producing follicles present.

Sonar examinations might show the presence of follicles and blood tests will determine the estrogen levels in the blood. Refer to this page and this one for more information.

3. The Pituitary Gland

The pituitary gland secrete many hormones that control the function of our bodies. Three of these hormones are important as far as menstrual function is concerned. They are FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone) and Prolactin. It is possible to determine the levels of these hormones via a blood test. Also see “The Pituitary and Menstrual Cycle”.

If the FSH and LH levels are high and the estrogen levels low, than the problem is usually in the ovary. The ovary is not responding to FSH and LH and the FSH and LH levels keep on increasing trying to get the ovaries to respond.

If the FSH is normal but the estrogen and LH are high , polycystic ovarian disease must be excluded. (See polycystic ovaries .

If the FSH , LH and Estrogen are all low , a problem in the pituitary or in the hypothalamus must be excluded.

A high prolactin level should also be investigated further.

The information obtained from blood tests combined with the microscopic diagnosis of the endometrium will give the medical practitioner a clear indication about the cause of the amenorrhoea.

Treatment will depend on the desirability of pregnancy. It a pregnancy is required ovulation induction treatment will be given else hormonal treatment will be given to normalize the cycle. It is very important in cases with a thick endometrium that the cycle should be normalized to prevent endometrial cancer later in life. ( please remember if your endometrium is thick , you do not have cancer, but it can develop into cancer over a period of years (more than ten years) if it is not treated.).

Highly effected medicines are now available to treat high prolactin levels. In many instances these drugs are able to shrink tumors (growths) of the pituitary gland. It is also important to remember that it is only a minority of persons with high prolactin levels that will develop pituitary tumors.

II. Heavy Menstruation(Medical term: Menorrhagia)

There are three kinds of heavy menstruation. The volume of the bleeding is increase, the duration of the bleeding is increased or both the volume and duration are increased.

The causes of heavy menstruations are:

  1. Hormonal
  2. Abnormalities in the genital tract
  3. Other hormonal problems (eg. diseases of the thyroid gland)
  4. General diseases.

III. Acyclic Bleeding. (Medical term Metorrhagia)

This is bleeding that occurs at any time and the duration of the bleeding is unpredictable. Sometimes it lasts for weeks and than on other occasions only for a few days. without a cyclic pattern.

Source:  Abnormal Menstruation

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August 7, 2009 at 5:48 pm


Menstruation Cycle

Menstruation Cycle

Menstruation is the cyclic occurrence of uterine bleeding that occurs near the end of puberty in girls. Typically, first periods occur around age 12 or 13. However, some girls begin having periods as young as 8 or 9 years old, while others may be as old as 15 or 16. If menarche does not occur by the time a girl reaches the age of 16, she should see her doctor for evaluation. Menstruation usually begins about 2 1/2 years after girls begin developing breasts, and growing pubic and underarm hair.

Once menstruation begins, it continues until menopause occurs around the age of 50 when monthly menstrual cycles end. Surgical menopause occurs following removal of the ovaries during hysterectomy. Menstruation also temporarily stops during pregnancy. Hormonal contraceptives also stop normal menstruation and can safely be used to stop periods indefinitely or until pregnancy is desired. If menstruation fails to occur for any other reason, amenorrhea occurs. Amenorrhea is a menstrual cycle disorder.

For the most part, the menstrual cycles occurs predictably and without problems. However, when things don’t go as expect -– when you experience heavy or excessive bleeding, when your period doesn’t occur when expected, when you have physical or emotional symptoms during the weeks before you menstruation, or when you experience painful periods or other symptoms –- you may have a menstrual cycle disorder.

Abnormal uterine bleeding is a common menstrual cycle disorder that includes several types of abnormal bleeding patterns, including amenorrhea. Other menstrual cycle disorders include dysmenorrhea, premenstrual syndrome or PMS, premenstrual dysphoric disorder or PMDD, and uterine fibroid tumors. Other factors that may affect normal menstruation include stress, illness, exercise, diet and nutrition, and work, family, and relationship issues.

June 30, 2009 at 5:43 pm


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