One of the most complex processes in a woman’s body is cyclical changes in the endocrine and reproductive systems. It begins in the cerebral cortex: involves the work of the hypothalamus, sex hormones and endocrine organs (ovaries, adrenal glands and thyroid gland) and ends in the uterus.
Menstrual cycle is considered to be the period from the first day of menstruation to the next. The cycle duration is 21–35 days, discharge lasts from 2 to 7 days (and in the first days they are more abundant), the average blood loss is 20–40 ml per day.
In 60% of women, the cycle is 28 days. It is on this average duration that it is customary to navigate when determining ovulation – the period when the egg leaves the ovary and can be fertilized.
The biological value of the cycle is to ensure reproduction, to prepare the body for pregnancy. If conception did not occur in this cycle and the egg cell was not implanted, the functional layer of the uterine mucosa is rejected, and bleeding is the result of rejection of the “unnecessary” endometrium.
Follicular: estrogen dominates, follicle maturation occurs.
Ovulatory: the gap of the mature follicle, the release of the egg, the yellow body begins to produce progesterone (one of the main hormones of pregnancy), the egg is ready for fertilization.
Luteal: fertilization has not occurred, the level of hormones falls, the endometrium is rejected, the next bleeding begins.
The onset of the first menstruation speaks of sexual development: theoretically it is the beginning of the childbearing period of life. The average age of onset of menstruation is 11–14 years, it depends on the state of health and heredity. The first periods may be irregular, but the cycle will gradually settle.
The reverse process – the extinction of the reproductive function (menopause) by the age of 52–57 will also be gradual.
It is believed that fitness during menstruation does not pose a health hazard, although it is better to transfer active sports to another day: exercise during the first days of the cycle can cause weakness, pain in the lower abdomen or in the back, dizziness. In the first days of the cycle it is better to choose relaxing exercises – for example, yoga.
During classes, the bleeding will be stronger – but you will not lose more blood than usual. The amount of blood that the endometrium secretes (the lining of the uterus) is the same every month, no matter how much you move.
During the period of physical activity, the heartbeat increases, and hence the blood circulation.
Many factors can disrupt the menstrual cycle: too much heat or cold, changing time zones, malaise or severe stress, abortion – all of this affects the ovaries. Intensive exercise and strict diets also affect the menstrual cycle.
The percentage of estrogen (female hormone) in the body is directly related to the fat mass. If we burn a lot of calories, carried away by sports or nutritional restrictions, the balance may be disturbed – the level of estrogen will decrease, and menstruation will become irregular (in rare cases it may stop altogether).
Although the cycle time of each woman is individual and depends on many factors, deviations from the average norm, especially in combination with the painfulness of menstruation or pronounced premenstrual syndrome, can speak about various disorders and make it difficult to conceive a child.
If the violation is a one-time and in the next cycle does not happen again – most likely, there is no cause for concern. If the hormonal imbalance persists for several months or repeats periodically, it is better to consult a doctor.
In all cases of a cycle violation, the gynecologist will offer you a pelvic ultrasound, a hormonal profile (special blood test), a diagnostic study of the state of the inner layer of the uterus. Visits to the gynecologist should be regular, at least every six months.
Abundant menstruation: discharge does not become less on the 2−3rd day of the cycle, the standard gasket lasts for 2−3 hours.
Poor menstruation: lasts less than 3 days, one strip lasts half a day or more.
Intermenstrual spotting, especially in combination with painful menstruation, can be one of the symptoms of endometriosis – be sure to discuss this issue with your doctor.
Later (after 13–14 years), the onset of menstruation most likely indicates an increased level of male sex hormones. The cycle in this case is most often irregular, elongated, but with abundant long-term secretions.
A short cycle (less than 21 days) or too frequent (more often than once a month) menstrual bleeding at different times may indicate ovarian dysfunction, endocrine disorders, or diseases of the genital organs.
In order for menstruation to occur, a harmonious work of hormones will be needed: follicle-stimulating (FSH), luteinizing (LH), prolactin, adrenocorticotropic (ACTH), somatotropic (STH) and thyrotropic (TSH).
After the baby is born, the menstrual cycle may change, especially if it was short or long: most likely, it will become average in duration,
25–26 days. The good news: the pain can disappear or become much weaker!
Only 20 years ago, doctors were unanimously against bathing, sex and sports during menstruation, and also advised to avoid hot showers and physical exertion.
In the morning, after sleeping, or after being in a sitting position for a long time, the discharge may seem more abundant and thick. This is normal: you were immobile for several hours and menstrual blood, including epithelial cells, endometrial particles and uterine secretions, could not flow freely from the vagina, resulting in coagulation and clots.
Your choice – pads, tampons or special flexible silicone cups – menstrual caps, which are inserted into the vagina and collect blood. Since a warm and humid environment provides bacteria with great opportunities for reproduction, it is important to follow the rules of hygiene more carefully during menstruation: tampons and pads should be changed every 2 hours even with not too significant secretions. Flavored tampons and pads are not the best choice: they can cause irritation.
But it is not necessary and too zealous, too carefully washing the vagina – it destroys its natural microflora.
Painful menstruation, or dysmenorrhea, is more common than we would like: more than half of women notice them, and 10% are not so lucky that menstruations prevent them from leading a normal life for 3–4 days of each cycle. Pain and discomfort during menstruation are caused by prostaglandins – endocrine glands, which during this period secrete substances that cause spasms in the uterus, pelvis, back and intestines (by the way, labor pains are similar to repeatedly increased pain during menstruation).
They also exacerbate the sensitivity of nerve endings – therefore the ailments are so individual: some feel only mild pain or just discomfort, and some are almost unable to get out of bed.
Most likely, dysmenorrhea will pass after the first birth: it is believed that only with pregnancy and childbirth the woman’s body finally ripens.
Occasionally, secondary dysmenorrhea is also encountered: in this case, even after childbirth, menstrual pains persist, but the cause will be disturbances in the functioning of the body — this may be a symptom of endometriosis or inflammatory diseases of the pelvic organs. Be sure to consult a gynecologist: he will conduct an examination and prescribe additional examinations.
Painkillers (for example, ibuprofen) and, oddly enough, light physical activity, such as walking, will help to cope with painful sensations. The explanation for this is simple: during movements, blood circulation in the pelvic area increases, muscles get more oxygen, and spasms decrease.
Lactational amenorrhea is best not to use as a method of contraception: this method is not very reliable. For successful protection from pregnancy, breastfeeding should be regular, on demand, without long (more than two hours) breaks, including night, without the use of bottles, pacifiers and supplements. The age of the baby should not exceed 6 months.
However, you can find out that you are pregnant, and not waiting for the first menstruation after childbirth: before the menstrual period begins, ovulation already occurs – which means that conception is quite possible.
If you take birth control pills that prevent the egg from leaving the ovary and fertilizing it, then you have two advantages. Firstly, the risk of pain is much less, secondly, if necessary, you can adjust the duration of your cycle yourself: speed up or postpone the onset of menstruation (but it is better not to abuse and resort to such adjustment methods no more than once every six months).
When taking monophasic pills, it is enough to take two packs in a row (then the next bleeding will simply be missed) or stop taking them a few days before the package should end, and start taking pills from a new one a week later.
If you are taking a three-phase pill, in this case, you should consult with the gynecologist to select a cycle change scheme.
The absence of regular menstruation (in case the cycle fails for you is not typical) will be one of the first and most reliable signs of the onset of pregnancy.
After giving birth, if you are not breastfeeding, menstruation will resume on average 6–8 weeks. When breastfeeding menstruation may not be quite a long time – there will come a period of so-called lactational amenorrhea. The cycle resumes individually: it may happen two months after giving birth or in a year, and in some cases it may not be longer.
There is an opinion (though not confirmed scientifically) that the resumption of the cycle is associated more with the woman’s subconscious than with her physiology: it is more likely to recover if you think of menstruation that are not there for a long time, or even you will find packaging in the cabinet tampons
1) Is it possible to have sex at this time?
Yes, but it is better to use a condom – microbes can penetrate into the open mouth of the uterus.
2) Can I get pregnant during menstruation?
No, you can get pregnant during ovulation: it will occur before or after menstruation, and the sperm cell only lasts for 36 hours. If the cycle lasts more than 25 days, ovulation may be late, on the 18–20th day of the cycle, but conception will then occur before the expected menstruation, in which case it may occur, but will be more scarce.
3) Can menstruation continue during pregnancy?
If a woman is diagnosed with ovarian dysfunction, polycystic ovary syndrome, or a two-horned uterus, during pregnancy there may be regular spotting during the first 12 weeks, on those days when there should be menstruation. If the bleeding is accompanied by abdominal pain, you should consult a doctor.
This can be a safe sign of weakness of the vascular walls or the introduction of an egg into the uterus, as well as a symptom of disturbances.
4) How to cope with PMS?
Reduce the amount of salt consumed – so that the liquid does not linger in the body. Avoid chocolate, but choose foods rich in potassium and zinc (bananas, dried apricots, grain bread, pumpkin seeds) and vitamin E (nuts, salmon, yolk).
5) What does the irregular cycle mean?
About hormonal disorders, reduced ovarian function, stress.