Menstruation

Menstruation is a natural process in women when a woman’s body initiates the process of monthly bleeding. Also called menses, menstrual period, or period; menstruation may be referred to as the symbolic and diagnostic attainment of puberty. The menstrual blood which flows out of a women’s body through the vagina via the small opening in the cervix is partly blood and partly tissue from the inside of the uterus. A normal menstrual period last from three to five days. Menstruation as a part of the menstrual cycle is the first step in preparing a woman’s body for pregnancy.

On reaching menstruation cycle a woman’s body becomes mature and capable of bearing a child. Although the average menstrual cycle is of 28 days, a cycle can range anywhere from 23 days to 35 days. At about day 14 of a typical 28-day cycle, in response to a surge of luteinizing hormone, the egg is discharged from the ovary. This process is called ovulation. Menstruation occurs if on the onset of ovulation and the egg isn't fertilized thereby disregarding the extra uterine lining. In such cases, falling hormones make the uterine lining break down into the mixture of blood and tissue shed through the vagina during a menstrual period.

The menstrual cycle occurs due to the rise and fall in the levels hormones during a month. Estrogen and progesterone are two of the important female hormones released by the ovaries while other hormones involved in the menstrual cycle include follicle-stimulating hormone (FSH) and luteinizing hormone (LH), made by the pituitary gland.

Menstrual Cycle
The lining of the uterus responds to hormones made in the ovary. The pituitary gland at the base of the brain secretes a hormone called follicle stimulating hormone which forces the egg follicles in the ovary to make estrogen. Estrogen causes the endometrium to thicken.  When ovulation occurs, a second hormone is secreted by the ovary. This causes the lining of the uterus to become spongy. When the progesterone and estrogen levels fall, the endometrium sheds in a menstrual period.

Ovulation
If ovulation does not occur, the ovary will continue making estrogen, causing the endometrium to keep thickening.  This often leads to a late menstrual period followed by irregular bleeding and spotting.   This can also result in endometrial polyps, or in extreme long-standing cases, cancer of the lining of the uterus.  Any stress, such as traveling or a new job can interfere with ovulation.   Fortunately this will usually be temporary, and rarely requires treatment. Longstanding lack of ovulation is treated with progesterone on a regular basis, which causes the endometrium to shed regularly.  It is usually possible to induce ovulation, but this is reserved for women attempting to become pregnant.

Abnormal Uterine Bleeding
Generally, woman stop having the periods if she is pregnant, but bleeding during pregnancy is not uncommon.  If the pregnancy is abnormal, such as a tubal pregnancy or impending miscarriage, the bleeding may be interpreted as being from a menstrual period rather than a complication of pregnancy.  Because pregnancy is such a common cause of abnormal bleeding, a pregnancy test should be among the first tests in anyone who is sexually active; even if she is "sure" she couldn't be pregnant! Thyroid disorders can cause heavy bleeding, as can disorders in which the blood does not clot normally.  A physician can test for these problems if they are suspected of contributing to the abnormal bleeding.

Precautions during Menstrual Cycle
Sanitary napkins should be changed as often as necessary, before the pad is soaked with menstrual flow. Each woman should decide for herself what is comfortable. Tampons should be changed every four hours. Make sure that you use the lowest absorbency of tampon available. For example, do not use super absorbency on the lightest day of your period. Your period should not affect your daily activities. You can continue to exercise, swim, bike ride, and have fun. Some girls and women even find that exercising while they are having their menstrual period reduces or prevents stomach cramps and discomfort.

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