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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