Menstruation — not as black as it’s painted

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Menstruation — not as black as it’s painted

It comes once a month. How many years has it been now…? Every time, a few days before it gets here I feel terrible. I have a headache, my mood changes. The only thing that keeps me going is chocolate and equally sweet idleness under a blanket. Then it finally arrives — just the thought of it makes my stomach turn. And seeing the red sea… Half-jokingly, I’m starting my tale about periods using one of its most common replacements. “This time of the month”, “lady time”. I’m cool about innocent jokes, but period is an extremely significant and natural process. It testifies to our healthy development and functioning of the organism. So it’s worth getting to know “Aunt Flo”. She may not be as infantile and pointlessly cruel as she might have appeared. ;)

Dominika Olchowik

Published: 8.04.20217 minreading time

menstruation what is it illustration

Illustration: Jarek Danilenko

Knock, knock! It’s Your KAYA team here! We feel that you should know that we’re always striving to make our articles inclusive but sometimes science gets in our way. Unfortunately, in order to remain 100% reliable we’re forced to stick to the binary labelling put forward in the research we’re backing our texts with.

What is a menstrual cycle?

The menstrual cycle has one, main goal — to prepare the organism for a possible pregnancy. During the cycle the lining of the uterus thickens. The endometrial lining grows extra layers in order to create a cosy environment in which the fertilised egg could safely grow. If fertilisation doesn’t happen, we get a reboot and the whole process starts anew. The organism pushes to its limits, though not always “like clockwork”. Normal menstrual cycle lasts 28 days; however, it’s more of an agreement rather than a rule. Some sources deem acceptable a range from 21 to 35 days. The length of the menstrual cycle may be influenced by various factors:

  • stress, emotional tension,

  • infection (common colds),

  • intense lifestyle,

  • irregular day rhythm,

  • bad diet,

  • climate change,

  • hormone imbalance.

The real hormone storm which occurs at that point in the organism might significantly impact our mood and even looks. What begins a few days before the actual menstruation? What do we associate with malaise, fatigue, irritation, and particular cravings for sweets? Yeah, I’m talking about the premenstrual syndrome (PMS). It’s most often accompanied by:

  • stomachaches, and sometimes your back may hurt as well — to alleviate the pain you may try relaxing your pelvic floor muscles and yoga might do wonders too!;

  • irritation;

  • increased appetite;

  • the sensation of swelling caused by water retention (a pro-tip — add parsley to your favourite smoothie; in addition, slow your pace, relax a bit more than usual!);

  • headaches, muscle pains, or tender breasts. If they’re unbearable and the home remedies fail, take some painkillers.

The first menstruation (menarche), is the cherry on top of puberty. In young women of our latitude, that is in the northern hemisphere, it usually appears somewhere between the 12th and 13th year of age. I’ve mentioned latitude not without a reason. It has a significant impact on the beginning of your menstrual cycle. The menarche is preceded by a number of changes occurring in the organism of a young woman. Both in appearance (your breasts grow, the hips get wider) and in psyche (during puberty your personality starts to take shape and the awareness of the causal connection begins to bud, etc.). The first menstrual period is thus a turning point of puberty and juvenescence. But in order for it to happen the organism must meet several conditions. One of such is attaining sufficient body mass (BMI). It's the right ratio of weight to height. The menstrual cycle becomes regular during the first five years since the menarche.

Cessation of the menstrual cycle between the age of 45 and 55 is a sign of the onset of menopause. Also called climacterium or more colloquially referred to as the hot flashes, it means that a woman stops producing eggs so pregnancy is no longer an option. Menopause includes symptoms like the aforesaid hot flashes, but also anxiety and depressive states caused by erratic hormone levels, difficulty in falling asleep, or chronic fatigue. You can also read our extensive article about menopause.

How to calculate your menstrual cycle?

Do you want to know how to calculate your fertile window? Well, start the count on the first day of bleeding. The end of the menstrual cycle is the day before the next period. Knowing that, together with the information below, it’ll be easier for you to determine your fertile days. It’s believed that a woman might get pregnant during up to 4-5 days of the menstrual cycle. We’re talking 3 days before ovulation and up to 2 days afterwards. Normally, the egg can survive for about 1 day, but you never know! ;) Sperm shows more resilience and can survive for about 72 hours in the cosy environment of your uterus. Hence, the 3-day period before ovulation. If you want to predict ovulation, you can do a test at home. The luteinizing hormone (LH), produced by the pituitary gland, when detected in urine, signals that the ovaries have started to produce eggs. Remember that the luteinizing hormone is not always present. If your cycle is regular and lasts 28 days, you should start testing your urine around the 11th day (this is when ovulation should normally take place).

BTW: Have you ever wondered why humans menstruate, but some other animal species don't? Read our article about it.

The secrets of the menstrual cycle

“Give her a break, it’s this time of month”, “steer clear of her”, “why are you so miffy, code red down there?” — well, menstruation doesn’t exactly enjoy a high reputation. No wonder — the first thing that comes to mind about periods is bleeding and pain. They can successfully unplug us from daily life.

The menstrual cycle is divided into two main phases. The ovarian cycle phases and the uterine cycle phases. It’s worth knowing what’s happening in all of them to better understand the whole process. This way you can respect your body properly and take good care of it during the whole cycle.

Here are the stages of period:

  • Menstruation. The first day of menstrual bleeding is also the first day of a new menstrual cycle and the beginning of the follicular phase. Estrogen and progesterone levels are low. During menstruation the uterus is cleansed from the layers of endometrium. It sheds the uterine lining. This results in the discharge of menstrual fluid from the birth canal. Blood is only one of the components. The fluid is composed of uterine lining and vaginal epithelium. The length of bleeding depends on numerous factors. The norm for menstrual bleeding is 3 to 7 days. According to research, during menstruation a woman loses 100 ml of the menstrual fluid. This includes 30 to 50 ml of blood. Heavy menstrual bleeding, when women lose more than 150 ml of the menstrual liquid, may be physiologically conditioned or testify to some anomalies of the menstrual cycle.

  • Follicular phase. During the follicular phase ovarian follicles begin to form. Each follicle contains an egg. The FSH (the follicle-stimulating hormone), which is produced in the pituitary gland, is responsible for their development. The follicles themselves start to intensely produce the hormone estrogen. This results in a thickened lining of the endometrium and pumped up blood vessels. The mucus is ample, sticky, runny, and elastic. It's to facilitate the sperm’s journey to the egg. Towards the end of the follicular phase, due to the FSH, a dominant ovarian follicle develops from around 20 follicle “sacs” which were produced during this phase. It's called Graafian follicle.

  • Proliferative phase. This is actually a semi-phase, as it happens during the follicular phase. It occurs somewhere between day 4 and day 14 of the menstrual cycle. The name derives from the proliferation of endometrium. It means that the cells constituting the lining of the uterus simply proliferate. It’s a recurrent process necessary for the appropriate functioning of the reproductive organs. After the bleeding is over, the uterus prepares for a potential pregnancy. 

  • Ovulation. During ovulation, due to the follicle stimulating hormone and the luteinizing hormone (LH), the Graafian follicle ruptures and the egg is released. The egg then travels to the fallopian tube and gets ready for the potential fertilisation. It stays there for about 1 day. Lack of fertilisation results simply in the death of the egg. 

Ovulation begins the second phase of the menstrual cycle and usually happens around the 14th day. The aforesaid factors influencing the length of the cycle may also disrupt this phase. This, in turn, might push the day of ovulation further in time. In some women ovulation is accompanied by spotting (lasting usually up to 2 days), stomachaches (which might stem from fallopian tubes spasms), and increased body temperature.

  • Luteal phase. The luteal phase usually lasts 14 days. During the luteal phase a corpus luteum forms in the ovary. The organism squirrels nutrients and intensely produces the hormone progesterone. It's needed to maintain the thickened lining of the uterus. The luteal phase is one when the changes are most significant. Moments after ovulation, due to the luteinizing hormone (LH) and the follicle stimulating hormone, the remnants of the Graafian follicle transform into the corpus luteum and the lining of the uterus thickens. If fertilisation doesn’t happen and pregnancy does not occur, the levels of estrogen and progesterone drop and the lining breaks down. This results in menstrual bleeding. On the other hand, if a woman gets pregnant, high levels of estrogen prompt the body to start producing human chorionic gonadotropin (hCG), which stimulates the corpus luteum to secrete even more estrogen and progesterone. The mission of corpus luteum is thus extremely important as it sustains the pregnancy in its initial weeks. Corpus luteum keeps producing the hormones until the placenta can carry the torch and do it itself.

Menstruation during pregnancy

As a rule, if you get pregnant your periods stop. However, the presence of blood might not always mean that you’re not pregnant. “Periods” during pregnancy shouldn’t be ignored because they might have some serious fallout. Blood loss during pregnancy might take the form of spotting or long-lasting bleedings. The former might be thick, heavy, and full of blood clots. You might have increased body temperature and nausea. Such symptoms may indicate implantation bleeding. It's caused by the nestling of the embryo in the lining of the uterus. Ectopic pregnancy is yet another possibility. It happens when the egg implants itself in the fallopian tube. Normally, you shouldn’t experience any heavy bleeding during pregnancy. If you are experiencing any health problems, visit your gynaecologist. Just to make sure everything’s alright.

The menstrual cycle: debunking myths

No BS — what’s it with periods?

We know a bit more about the biological processes occurring in a woman’s organism during the menstrual cycle. Despite that, we’re aware that periods often come with tons of doubts, questions, and suppositions. Regrettably, no science-babble can offer a single plausible answer. It’s time to bust some myths and check out some facts about periods.

  • No menstrual period = pregnancy?

Not necessarily! Cessation of the menstrual cycle might have numerous reasons. Stressful job, common cold (general fatigue), and an irregular sleep cycle. These are just some of them. 

  • Hormonal birth control might help to regulate the menstrual cycle?

It’s true. Irregular menstrual cycles are often supervised by gynaecologists. They usually prescribe hormonal medicines. In some women contraceptive pills cause the bleeding to be less heavy. They can also nullify the other ailments of menstruation.

  • Heavy menstrual bleeding might lead to anaemia?

Again — it’s true! If your bleeding is heavier than usual, lasts longer than 7 days, and your skin is paler, drier, and you are more tired and weaker than usual — it might be indicative of anaemia and some serious iron deficiencies.

  • Having sex during menstruation won’t result in pregnancy?

Myth! Indeed, you might get pregnant during menstruation! In some women the menstrual cycle is shorter — it lasts up to 20-22 days. Then ovulation occurs during the last few days of bleeding. The risk increases if menstrual cycles are short but the bleeding itself lasts longer.

  • On the other hand — during menstruation one of the phases might not occur.

True — in some women anovulatory menstrual cycles do happen. The Graafian follicle doesn’t rupture, hence not releasing the egg. Despite that, lack of ovulation does not exclude having regular periods. It becomes noticeable only when a woman tries for a baby. Anovulatory cycles might be indicative of some abnormalities in hormone levels and various sex organs conditions. It’s always advisable to be under constant supervision of a healthcare provider and use pharmacological treatment if necessary.

  • You shouldn't exercise during periods.

That’s obviously false. If you’re not suffering from severe symptoms and pain, there are no contraindications to a light workout and some stretching exercises. Of course, it’s not the best time of month to beat your personal records ;) Moderate exercise might even alleviate the painful uterine cramping and brighten up your mood.

Dysfunctions of the menstrual cycle — when to visit a doctor?

Even in women who enjoy exceptional health the menstrual cycle might become irregular due to various incidental hormonal anomalies and/or excessive stress. It’s advisable then to carefully watch your periods to catch any worrying symptoms and quickly diagnose the pathologies of your menstrual cycle.

It’s worth making an appointment if:

  • bleedings are irregular and don’t occur every month;

  • you’re worried about some unusual ailments accompanying your menstruation. The pain is divided into two groups: primary and secondary pain. The former is connected to hormonal imbalance and pertains to bleedings in the first few years of menstruation. The latter results from specific factors (related to the dysfunction of the reproductive or inflammation);

  • your periods are heavier or more scarce than usual.

All troubling symptoms should be discussed with your doctor. In a woman’s body numerous changes and complicated processes occur during periods. It’s not unusual that some symptoms might be confusing!

Menstruation is cool!

Once more for the back row! The most important things are harmony and insight. We shouldn’t fret about periods! On the other hand, it’s also not right to shove the subject under the bed together with all its “charms”. And don’t even think about belittling its role — instead, learn more about it! So the next time someone asks you: “You’re on your period? You’re so angry!”, just remember this article and pat yourself on the back. Well done! :)

References

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle

https://www.yourperiod.ca/normal-periods/menstrual-cycle-basics/

Author

Dominika Olchowik
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Expert check

lek. Karolina Rasoul-Pelińska
Ginekolog
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Have you heard of premenstrual dysphoric disorder (PMDD)? No, it’s not the same as premenstrual syndrome (PMS). Some say that PMDD is a black sheep in the menstrual family. The bad sister of PMS. We don’t know much about it but those who deal with it have been to hell and back. Others, in turn, try not to demonise PMDD, embracing its presence as being part of them. The part which craves attention uniquely loud and on multiple levels.

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