Menstruation

Menstruation refers to the detachment of the endometrium or uterine lining taking place regularly in certain female mammals of reproductive age. Bleeding form the uterus through the vagina, or overt menstruation, is observed mostly in humans and some chimpanzees. Regular menstruation that lasts for 3 to 5 days (although 2 to 8 days is deemed normal) is termed eumenorrhea. Blood loss averages 35 ml, with 10 to 80 ml being considered normal. Dysmenorrhea is the occurrence of uterine cramps due to the uterine muscle contractions as it discharges endometrial blood from the body. An enzyme known as plasmin contributes to keep blood from clotting.

Menstruation however is only a part of the menstruation cycle. The menstruation cycle is essential for reproduction and is divide in three stages, follicular, ovulation and luteal. The follicular stage is that in which a hormone causes the uterus lining to grow. At the same time a few ovarian follicles are stimulated and compete with each other for dominance. The one that continues to grow will eventually become the ovum. During ovulation, this ovum breaks off and is released into the fallopian tube where it can be fertilized. The last stage, or luteal phase, starts with the formation of the corpus luteum and ends with pregnancy or luteolysis. In other words, if the woman has intercourse within some 5 days before ovulation or 1 to 2 days after, she has a high probability of becoming pregnant, unless a contraceptive method is used, or abstinence is exercised during the period, in which case the ovum will dissolve.

The menstruation cycle can present different abnormalities, including the dysmenorrhea mentioned above, ovulation disorders (anovulation), cycle length disorders (amenorrhea, menometrorrhagia, irregular menstruation, oligomenorrhea), flow disorders (hypomenorrhea, menorrhagia). In anovulation  the ovaries are not able to release an ovum, in other words, ovulation does not happen. Amenorrhea is the lack of menstruation. In menometrorrhagia there is prolonged uterine bleeding takes place irregularly and more often than normal. Metrorrhagia is bleeding that occurs in between expected menstrual periods. Oligomenorrhea is rare or light bleeding. Hypomenorrhea is an abnormally light blood flow, and menorrhagia is the opposite, an unnaturally heavy and extended menstrual period.

Another closely related phenomenon is premenstrual syndrome, or PMS. The main PMS symptoms include irritability, tension and dysphoria (the opposite of euphoria). Other emotional, non-specific symptoms are stress, anxiety, insomnia, headache, fatigue, mood swings, increased emotional sensitivity and libido changes. However, more than 200 symptoms have reported to Clitoris.com. Physical symptoms associated with menstruation (bloating, cramps, constipation, breast tenderness or swelling, acne, muscle or joint pain) without emotional are considered PMS. Risk factors of PMS include caffeine intake, stress, aging, depression, and dietary factors. Some of the treatments that are recommended to relieve symptoms of PMS are supportive therapy (evaluation, reassurance, counseling), calcium supplements, vitamin E, vitamin B6, magnesium, tryptophan, selective serotonin reuptake inhibitors, hormonal contraception, progesteron, gonadotropin-releasing hormone agonists, diuretics, non-steroidal anti-inflammatory drugs, clonidine, and St. John’s wort.

A less common occurrence is that of menstrual psychosis, which features characteristics such as abrupt onset after a period of normality, brief duration and full recovery, psychotic traits (confusion, mutism, stupor, delusions, hallucinations and manic syndrome) and a monthly periodicity.

This natural process has given way to a slew of menstrual products that women use to absorb their periods. These include sanitary napkins that are fastened in the underwear with wings or adhesive, tampons (rayon or cotton disposable cylinders inserted into the vagina), padettes, disposable menstrual cups. Furthermore, there are similar reusable items such as cloth pads, menstrual cups, sea sponges, padded panties and towels, and other female sanitary and hygiene products.

Much like the life that it makes possible, menstruation has a beginning and an end. The very first menstrual bleeding in a female human being is called menarche, and is considered from a medical and social point of view as the main event of puberty. Menarche may be experienced at different ages, and is influenced by biologic, genetic and environmental factors. The age has decreased in the last Century with the average being 11,75 years. On the other hand, postmenopause signals the end of menstruation, and is applied when a woman who still has a uterus and is not pregnant or lactating hasn’t had a period in at least 12 months.