Things You Don't Know About Menstruation.



Your menstrual period says a lot about your health. Being aware of the changes and how they happen can help you make choices about your health.

Menstrual cycle is the monthly series of changes in a woman’s body; it is also called menses, emmenia or catamenia. It starts at the age of 12-15 years and isn’t the same for every woman.

The day when bleeding starts is considered as the first day of the menstruation and this may last for 2-7 days. During this period, there is sudden reduction in the release of estrogen and progesterone in the ovary and the decreased level of these two hormones is responsible for menstruation.

Lack of these estrogens and progesterone causes sudden involution of endometrium of the uterus and this leads to reduction in the thickness of endometrium up to 65% of original thickness.

During the next 24 hours, the tortuous blood vessels in the endometrial undergo severe constriction. This vasoconstriction leads to hypoxia which result in necrosis of the endometrium. And due to this necrosis, about 35ml of blood along with 35ml of series fluid is expelled.

The blood clots as soon as it oozes into the uterine cavity and then it stops between 3rd &7th day of menstrual cycle but continues in some exceptional cases which are abnormal. 

PREMENSTRUAL SYNDROME

This is the symptoms that appears before the onset of menstruation, it lasts for about 4-5 days prior to menstruation. The symptoms appear due to the salt and water retention caused by estrogen.

The features of premenstrual syndrome:
1.     Mood swinging
2.     Anxiety
3.     Irritability
4.     Emotional instability
5.     Headache
6.     Depression
7.     Constipation
8.     Abnormal cramping
                                                                                                                                                                                                                                                                                                         
ABNORMAL MENSTRUATION
 
1.     AMENORRHEA:  This is the absence of menstruation during reproductive period of females and it is caused by intensive exercise, extreme weight loss, physical illness and stress. This is not a disease but an abnormalities that has the propensity to cause infertility in women who dare to become pregnant.

Amenorrhea :caused by excessive exercise can be treated by a change of exercise plan, excessive weight loss may require a professional supervised weight gain regime.  but amenorrhea that is inborn or genetic will need a surgical operation.

2    Menorrhagia: Heavy or prolonged menstrual periods, or menorrhagia, are the most common type of abnormal bleeding from the uterus. Periods are considered heavy if there is enough blood to soak a pad or tampon every hour for several consecutive hours.
         Other symptoms of a heavy period can include:

        * Night-time bleeding that requires getting up to change pads or tampons
        *   Passing large blood clot during menstruation
        *  A period that lasts longer than seven days 

         Causes of Menorrhagia

   *  Uterine, ovarian, and cervical cancer; these are rare but possible causes of   heavy  menstrual bleeding
   * Use of blood thinners
   *  An infection of the uterus, fallopian tubes, and other organs of the reproductive system.

    
A normal menstrual cycle is 21–35 days in duration, with bleeding lasting an average of 5 days and total blood flow between 25 and 80 mL. A blood loss of greater than 80 mL or lasting longer than 7 days constitutes menorrhagia.

Usually no causative abnormality can be identified and treatment is directed at the symptom, rather than a specific mechanism. Most common cause include blood disorder or stress-related disorders. A brief overview of causes is given below, followed by a more formal medical list based on the nature of the menstrual cycle experienced.

COMPLICATIONS:
Treatment

Do you know some chai tea can reduce menstrual cramps?

·         Where an underlying cause can be identified, treatment may be directed at this. Clearly heavy periods at menarche and menopause may settle spontaneously (the menarche being the start and menopause being the cessation of periods).

·         The condition is often treated with hormones, particularly as dysfunctional uterine bleeding commonly occurs in the early and late menstrual years when contraception is also sought. Usually, oral combined contraceptive or progesterone only pills may be taken for a few months, but for longer-term treatment the alternatives of injected Depo Provera or the more recent Progesterone releasing IntraUterine system (IUS) may be used.

·         If the degree of bleeding is mild, all that may be sought by the woman is the reassurance that there is no sinister underlying cause. If anemia occurs then iron tablets may be used to help restore normal hemoglobin levels.


·        Anti-inflamatory medication like NSAIDs may also been used. NSAIDs are the first-line medications in ovulatory menorrhagia, resulting in an average reduction of 20-46% in menstrual blood flow.
·          
3.     Polymenorrhea:  Frequent periods or polymenorrhea might be frustrating and cumbersome to handle. However, it is hardly a symptom of a terrible disease as many woman often think it is.

The average length of the cycle is 28 days and this is the length often used in textbooks.  Normal menstrual cycle length can be anyway from 21 to 35 days. If your cycle length is within this range, and that is what you have every month, then that is  what is normal for you. 

  If your cycle is 21 days, then in 365days of the year, you will have about 17 periods (   365/21=17). Similarly, if your cycle is 35 days, you will have  10 periods in a year( 365/35= 10).  We therefore expect that women with normal cycle length between 21 to 35 days should have 10 to 17 periods a year.

Causes of polymenorrhea 

The causes of polumenorrhea overlap with many of the cause of abnormal uterine bleeding or those of irregular periods. Common, simple causes includes stress, excessive exercise, medications. More serious causes include disease of the pelvic organs especially those with hormonal disturbances like polycystic ovarian disease.
TREATMENT: such person involved should see a medical doctor.    
                 
4. Oligomenorrhea: This is a decrease in the frequency of menstruation.   Oligomenorrhea is not considered serious on its own. Menstrual periods can be adjusted with a change in hormonal contraception use or progestin.

    5.     Dysmenorrhea: This is the medical term for the painful cramps that may occur immediately before or during the menstrual period. 
     There are two types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea.

Primary dysmenorrhea: is another name for common menstrual cramps. Cramps usually begin one to two years after a woman starts getting her period. Pain usually is felt in the lower abdomen or back. They can be mild to severe. Common menstrual cramps often start shortly before or at the onset of the period and continue one to three days. They usually become less painful as a woman ages and may stop entirely after the woman has her first baby.

Secondary dysmenorrhea: is pain caused by a disorder in the woman's reproductive organs. These cramps usually begin earlier in the menstrual cycle and last longer than common menstrual cramps.

        What Are the Symptoms of Menstrual Cramps? 

          The symptoms of menstrual cramps include:
         When cramps are severe, symptoms may include:
What Causes Common Menstrual Cramps?

Menstrual cramps are caused by contractions in the uterus, which is a muscle. The uterus, the hollow, pear-shaped organ where a baby grows, contracts throughout a woman's menstrual cycle. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when part of a muscle briefly loses its supply of oxygen.

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