What is the menstrual cycle?
The menstrual cycle is an increase and decrease of a series of hormones along with a 28-30 (average) day cycle that allows the body to prepare for pregnancy each month.
The menstrual cycle can be divided into two phases, the luteal phase and the follicular phase. The follicular phase of the menstrual cycle occurs before ovulation when the egg is still being matured in the ovaries. Hormone levels tell the ovaries to release the egg that travels along the fallopian tube and then waits to be fertilized by the sperm.
If the egg is fertilized, it moves into the uterus and attaches itself to the lining that is full of nutrients for the future embryo. If it's not fertilized - the luteal phase of the menstrual cycle starts. The body sheds the uterine lining since it’s no longer needed, showing externally as your period. Once the lining is shed, the follicular phase begins and the whole cycle starts over again.
What is menstruation?
Your first menstruation signifies that your body has produced its first egg. After that, once a month, your body releases a newly matured egg from the ovaries, a process called ovulation, and waits for it to be fertilized. If fertilization doesn’t happen, you menstruate producing menstruation discharge. It is a mixture of blood and uterine lining, which is shed by the uterus. If the egg is fertilized, then you have no menstruation, meaning you’re pregnant .
What is normal menstruation?
Normal menstruation is more of a spectrum that one set thing. It usually lasts somewhere between 3-7 days, with a blood loss of around 4 tablespoons of blood in total. However, there is nothing set in stone, some people have lighter periods than others, and it can even vary from cycle to cycle. Young girls tend to have lighter, irregular periods becoming heavier and more regular over time.
When does a girl usually get her first period?
Unfortunately, it’s not an easy thing to predict. What is true is that menstruation begins during puberty, which starts around the ages of 12-14 for most girls, but some will get it earlier or later. There is no real way to know when a girl will get her first period.
Common menstruation problems
During menstruation, there is a cocktail of hormones that can cause you to suffer from a few issues. The most common menstruation problems are:
- PMS: also known as premenstrual syndrome, it can give you headaches, mood swings, cramps, acne or general discomfort.
- Cramps: menstrual cramps are usually a throbbing pain in your lower abdomen and/or lower back and can range from mild to debilitating. These cramps are caused by the contractions of your uterus, a muscle, against the blood vessels around it. They can get better with age and after giving birth.
- Bloating: the hormonal imbalance that happens around your period can cause you to bloat, but will subside once your period is over.
- Acne: it is a normal part of adolescence and happens to both men and women. There is such a thing as hormonal acne that tends to affect women more than men. While hormonal acne during puberty occurs on the T-zone (forehead, chin and nose), adults find hormonal acne on the lower part of their face. This condition is not severe and usually subsides once your period is over. However, if this is something that worries you, speak to your doctor to find a treatment that works for you.
- Delayed menstruation: this is very common, especially for adolescent girls and women entering menopause. Hormones are not acting quite normal in both these situations, in one, they are just starting to be produced and have to stabilize. For women entering menopause, the hormones aren’t working like they used to and are being produced in less quantity.
Amenorrhea is the lack of menstruation for three cycles or more, or when a young woman doesn’t get her first period before turning 15 years old. Amenorrhea can be caused by natural moments in a woman’s life, like pregnancy, breastfeeding or menopause. However, if you are none of those things and haven’t had your period for three consecutive cycles, we recommend you see a doctor for further evaluation.
A lack of menstruation can suggest a hormonal imbalance of some sort that is preventing the cycle to occur in its normal rhythm.
Dysmenorrhea symptoms can be caused by the pressure of the uterine muscle contracting on nearby blood vessels. This pain can vary from light to severe and usually lasts 24-72 hours. However, it is not normal to suffer from debilitating menstrual cramps that stop you from living a normal life. Extreme menstrual cramps can sometimes be a sign of underlying issues, such as endometriosis or pelvic inflammatory disease and should be taken care by a physician.
Prolonged menstruation: is it normal?
Menorrhagia is the medical term for a prolonged (more than 7 days) or heavy menstruation. A lot of women have heavy flows or long periods that are considered completely normal, but if you are having to restrict your normal daily activities because of your heavy flow - consider speaking to a doctor.
If you have menorrhagia, there are enough treatments that your doctor might recommend based on your clinical history and test results. These range from oral contraceptives to surgical procedures. It will depend on the underlying cause of the menorrhagia, that’s why it’s so important to visit your doctor.
Abnormal uterine bleeding
Abnormal uterine bleeding (AUB) affects up to 25% of women, and its main characteristic is bleeding outside of the regular menstrual cycle. It usually happens due to a hormonal imbalance, which makes it more common among young girls and women entering menopause.
While AUB can be caused by a hormonal imbalance that may dissolve on its own, if you experience fainting, dizziness, low blood pressure, pale skin, pain, weakness or soak a pad every hour, you should consider seeing a doctor to find the underlying cause.
When should I see a doctor about my period?
When it comes to your period, you have to consider what is normal for you. What happens when you get your period is unique to you, each person is different and goes through menstruation in their own way. So, keep track of how you feel on your period, how your flow looks like and take notice if you feel very different on one cycle compared to your norm.
If you are bleeding through more than one pad or tampon per hour, for several consecutive hours, that could be a sign of menorrhagia, very heavy bleeding. Menorrhagia can be a symptom of a number of conditions that should be checked out by your doctor.
Another symptom that can be a cause for concern and should be seen by a doctor is extreme PMS or severe period pain. If you are debilitated by cramps, it could be a sign that you are suffering from any of these conditions:
- Endometriosis: a condition in which there is uterine tissue outside of the uterus. Common symptoms are heavy bleeding and severe period pain.
- Uterine fibroids: These are small growths that occur in the uterus, uterine lining and muscle that seem to be influenced by the hormone estrogen.
- Pelvic inflammatory disease: An infection caused by an STD.
- Cervical stenosis: An anatomical condition in which the cervix is too narrow, impeding menstrual flow and causing pain.
What type of period protection is right for me?
Being on your period means that you need to take care of the bleeding that occurs consequently. There are many methods out there to deal with this depending on your lifestyle and personal preference.
- Pads are the classical period product and maybe the most straightforward. It goes on your underwear, so you don’t have put anything inside your body. This product is perfect for young girls that are just starting out, because it’s easy to put on, or for anyone who has a problem with inserting products into their vagina.
- A tampon is another disposable period product, like a pad, but this one goes inside your vagina. It’s sort of like a sponge, though it’s usually made out of cotton, that absorbs the blood and stops it from leaving your body.
- Menstrual cups are a reusable period product made out of silicone. This product is very similar to a tampon, in the fact that it goes in your vagina, but it doesn’t absorb the blood, it collects it. It’s a “cup” that sits in your vagina, creating a vacuum to stop the blood from going through and collects it.
- Leak-proof underwear is a recent technology that allows you to bleed straight into your underwear without leaking onto your clothes. It’s a great first-period product for young girls as it can be used alone or as a back up to prevent blood stains on clothes or bed sheets.
Frequently asked questions (FAQ) about periods
Are periods lasting more than 7 days normal?
In teenagers, periods can last from 2 to 7 days. This variation is associated with fluctuations in hormonal levels as the cycle is being established.
The duration of menstruation at this stage may vary from month to month: it can be quite short one month and very long the next.
Are irregular periods in puberty a cause for concern?
A teenager’s menstrual cycle is established within the first 2 years and may remain irregular during this time.
It is important that periods shouldn't be more frequent than once every 21 days, and they shouldn’t happen less often than once every 45 days.
Otherwise, you should consult a doctor.
Are abdominal pain, chest swelling, or mood swings before a period a sign of a disease?
85% of women experience at least one of these conditions during their lifetimes.
These are not the signs of a disease, but usually indicate the start of menstruation.
Gynecologists list about 150 symptoms that may appear shortly before a period, including back pain, acne, and increased appetite.
What helps relieve unpleasant symptoms before menstruation?
Regular short-term aerobic exercise such as 30 minutes of fast walking, running, or riding a bicycle can alleviate unpleasant symptoms.
For this reason, it is also recommended to get enough sleep, avoid caffeine and fatty foods, and cut down on salt and sugar.
Is it necessary to track the cycle length?
One of the main indicators of a woman's health is the cycle length, which is not to be confused with the duration of menstruation.
A new cycle begins on the first day of the period and lasts until the first day of the next period.
If the cycle gets longer or shorter, it may indicate various diseases.
Are blood clots and brownish discharge during menstruation normal?
The color of menstrual blood can range from pink to bright red or dark brown throughout the period.
Most women may also have small blood clots, especially on the days of the most profuse bleeding. This is absolutely normal.
Can the duration of menstruation be reduced or increased?
The duration of menstruation depends on many factors.
However, hormones play a key role.
They determine the beginning, the duration, and the flow of menstruation.
If the menstrual flow is light, can you wear one pad or tampon the whole day?
Even if your menstrual flow is very light, you should change hygiene products every 4–8 hours.
Otherwise, it will result in skin irritation and unpleasant odor.
Does the smell of menstrual blood signal health problems?
Menstrual blood in healthy women has a slight smell, which usually doesn't cause discomfort.
However, this can change due to poor hygiene. The main reason for an unpleasant smell is the growth of both beneficial and pathogenic bacteria.
If you use a tampon instead of a pad, can your menstrual flow become heavier?
Menstruation flow doesn't depend on the hygiene product you use. It is regulated exclusively by hormones.
Should menstruation come before the age of 16?
Every girl develops differently, but the beginning of menstruation usually occurs between the ages of 10–16.
If this doesn't happen, it is sensible to consult a doctor. In 97.5% of girls in the U.S., the first period comes before they are 16 years old.