Women experience menstruation, or period, which is normal vaginal bleeding that occurs as part of a woman's monthly cycle periods, usually between the ages of adolescence to menopause.

In India, the topic of menstruation or periods is still taboo. However, some schools have started giving a class on menstruation to just girls when they tend to begin menstruating. Instead of providing the proper education, many times, these actions further reinforce the shame surrounding periods. Many people do not properly understand what is menstruation. So, if you haven't had access to suitable sources of information about menstruation, we are here to provide you with it.

A period is just one part of a more complex hormonal, physiological and emotional cycle that revolves around a month or so. Sometimes these changes are noticeable, and other times, they are not. So, let's see the reason behind getting periods and what cycle it is a part of.

The menstruation cycle starts in a section of the brain called the hypothalamus. The hypothalamus produces and releases substances that travel to the pituitary gland and stimulate it. Due to this stimulation, the pituitary releases two hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These, along with estrogen and progesterone, create changes in the ovaries that make an egg mature.

It is important to note that eggs or ovum are not created every month. They are already present in the ovaries, around one or two million since birth; they are just not mature yet. When a person reaches puberty, about three or four thousand eggs are left. These eggs are available for the whole of reproductive life, and around five hundred of these will be released in a lifetime. When most of them are gone, it results in menopause. Menopause begins around the age of 50 years.

For most people, the ovum matures one at a time. When the FSH and LH stimulate an egg to mature, the ovary that holds it ruptures and releases the egg into the fallopian tube. The Fimbriae (tiny finger-like structures that appear to hold the ovary) help pull the egg into the tube. The ovary also produces another hormone, progesterone, during this period. Progesterone prepares the lining of your uterus to nourish and house an egg in case it gets fertilized by sperm. If the egg gets fertilized, even more progesterone is released. If not, then the level of progesterone drops, which is what causes a period.

This whole cycle takes 28 days on average; most menstruate with a cycle of anywhere between 23 to 35 days. The time from when ovulation occurs till you get your periods is about 14 days.

‘Menarche’ is a term for the first period, which usually takes place a couple of weeks after ovulation. The age at which people first start getting their periods varies, but it typically occurs in early puberty. Mostly it is around the age of 12 or 13 years, although others may be a few years younger or older.

 

 

Facts On Periods Based On Common Questions On Menstruation 

Menstruation and Ovulation

It is always beneficial to understand menstruation as every woman has her own unique cycle. A cycle refers to the number of days between the first day of two consecutive menstrual periods. The first day of your period is the first day of your menstruation cycle. The release of an egg (known as ovulation) occurs around 14 days before the beginning of the next menstrual period. Ovulation is the period of maximum fertility. In a standard, 28-day cycle, ovulation would be on Day 14. But, if your cycle is 40 days, you will ovulate roughly 26 days after the first day of your period (because 40-14=26). At ovulation, there are signs such as the onset of a sharp or dull aching in the right or left lower part of your abdomen, which can last between 12-36 hours. This is known as ‘Mittelschmerz’, a term in German meaning “middle- pain”, and occurs when an egg is being released from the ovary.

 

Blood loss during Menstruation

In the absence of fertilization of the egg, shedding of the endometrium (the lining of the uterus) is what causes bleeding. This endometrial lining grows each menstruation cycle to support a potential pregnancy. On average the blood loss is between 40-80 ml per cycle. When bleeding is heavy (menorrhagia) with large clots and carries on for over 7 days, it needs attention to avoid getting anemic.

 

Menstrual Cramps

Pain during menstruation (dysmenorrhea) is normal. However, some women may not experience any pain or discomfort, while some may experience pain which is far worse than usual. A hormone called prostaglandin triggers muscle contractions in the uterus that expels the endometrial lining. These contractions cause pain. However, if the pain is very severe that affects your daily routine, it must be investigated further to rule out certain underlying conditions such as endometriosis or Pelvic Inflammatory Disease. (PID). It is also important to maintain good hygiene during menses, as infections can also cause pain.  

 

Treatment:

Pain management with over-the-counter medications which are a class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs) is helpful. Staying well hydrated, and eating a balanced nutritious diet are important to supplement the management.

 

Home remedies

Hot water bottle/ heating pad, massage of lower back/abdomen relieves some discomfort as does lying with knees bent and practising mild exercises or yoga. Those who in general have kept fit with a healthy lifestyle, balanced diet, exercise, and adding multivitamins and iron capsules when needed, generally tend to handle the pain of menses better.

 

Foods to eat and avoid:       

Eat healthy homemade meals rich in protein and iron. Leafy green vegetables, wholegrains, nuts, eggs, fish, chicken, fruits like banana are excellent sources of much needed nutrition. Stay hydrated. Fatty, fried food, sugar, caffeine, processed and salty or spicy food should be avoided as it may aggravate bloating.

 

Yoga helps:

Maintaining a healthy teen lifestyle can boost overall health, relieve discomfort and relax the body in addition to regulating hormonal cycles when done regularly. It helps blood circulation and releases “feel-good hormones” called endorphins. The following asanas are found to be helpful- Om chanting for relaxation, Dhanurasana, Bhujangasana, Baddha Konasana, Janu Sirasana, Balasana, Setu Bandhasana. Be careful to start Yoga initially with a teacher for maximum benefit and to avoid any injuries.