A Quick Look At Menstruation

What is menstruation?

Menstruation is the monthly release of blood and tissue from the lining of the uterus.  In response to hormonal changes in a woman’s body, the lining of the uterus (endometrium), sloughs off and passes into the vagina and out of the body. It is also known as a monthly period.

Why does it happen?

Monthly periods begin when a girl reaches puberty and her body begins to produce hormones such as estrogen and progesterone.  Each month the pituitary gland in the female brain produces hormones causing an egg in the ovary to begin developing.  As the egg develops it produces estrogen which causes the lining of the uterus to grow.  About the middle of the monthly cycle, the pituitary secretes another hormone which causes the egg to be released from the ovary and passed into the fallopian tube.  The ovary continues to produce estrogen and another hormone called progesterone which prepares the lining of the uterus to receive and nourish a fertilized egg.  If  the egg is not fertilized by a sperm, the ovary produces less hormone and the lining of the uterus breaks down and menstrual bleeding begins.

What age does menstruation start and when does it stop?

Monthly periods begin when a girl reaches puberty around age 10 to 14.  It can  happen a little earlier or later depending on the individual.  Menstruation stops around age 45 to 55.  This is called the menopause.  The years between the onset of menstruation and its end are the reproductive years of a woman’s life.  These are the years when she is able to get pregnant.

How long does the average person bleed?

Most women bleed from 3 to 7 days.  The first day is usually the heaviest.  Some birth control pills  result in shorter periods.  Young girls who are just starting their periods may have irregular or occasional heavy bleeding.  This is because the release of hormones has not become stable and the ovary is not completely mature. Bleeding for greater than 7 days is unusual and requires  the evaluation of a gynecologist

When during a monthly cycle is a female most likely to get pregnant?

A  woman is most likely to get pregnant if she has sex around the time of ovulation.  This is when the egg is released from the ovary into the fallopian tube.  The time this occurs during the monthly cycle depends on its length.  The average menstrual cycle is 28 days but cycles may range from 22 to 34 days in length.  To determine the length of your cycle you must begin counting days at the start of your period.  Ovulation generally occurs 10 to 15 days after the onset of bleeding but may vary from individual to individual.  Determining the time of ovulation by measuring body temperature, vaginal mucus consistency etc is part of the “rhythm method” of birth control.  This method is especially unsuccessful in teenage girls because they often have irregular cycles.

What is PMS (premenstrual syndrome)?

Premenstrual syndrome or PMS is a very common group of symptoms seen in some women before their periods.  It most commonly begins 3 to 10 days prior to the onset of bleeding and is characterized by moodiness, breast tenderness, bloating etc.  Generally these symptoms are mild and can be tolerated.  Occasional women report very severe emotional changes bordering on psychosis but this is unusual.  Proper diet and exercise will minimize PMS symptoms in many people. PMS is most likely caused by the hormonal changes that occur at the end of the menstrual cycle.

Why do I get cramping during my period?

The body produces a substance called prostaglandin to help initiate menstrual bleeding.  This may also cause spasm and  cramping of the uterus.   Prostaglandin release may also lead to sweating, fatigue and other symptoms.  Aspirin, Motrin, Advil etc are all effective ways to ease these symptoms.

Is it safe to use tampons?

Tampons are generally safe to use so long as they are not left in  too long.  It is usually a good idea to change your tampon at least every 6 to 8 hours.  You should be able to wear one overnight so long as you put a fresh one in before bed and then remove it first thing in the morning.  High absorbency tampons left in the vagina for a long time have been associated with a dangerous illness called toxic shock syndrome.  It is characterized by fever, rash, vomiting, diarrhea and is caused by bacteria.  If you get these symptoms while you are using high absorbency tampons, you should see a doctor immediately.  It may not be toxic shock but it is better to be safe then sorry.

I am a 16 year old girl and I am having trouble inserting tampons.  Why?

Girls frequently have a membrane called the hymen around the vaginal opening.  The size of this membrane varies.  In some girls the hymen may make it very hard to insert a tampon.  It may help to get very slender tampons that are especially made for younger females.

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