Menstruation - what is it?
One of the most complex processes in the body of a woman, the cyclical changes in the endocrine and reproductive systems. It begins in the cerebral cortex: it includes the work of the hypothalamus, sex hormones and endocrine organs (ovaries, adrenals and thyroid gland) and terminates in the uterus. Menstrual cycle is usually considered the period from the first day of menstruation to the beginning of the next. The cycle duration is 21 -35 days, the discharge lasts from 2 to 7 days (and in the early 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 for this average duration that it is customary to orient in determining ovulation - the period when the egg leaves the ovary and can be fertilized. The biological significance of the cycle is to ensure reproductive efficiency, 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 spotting is the result of the rejection of the "unnecessary" endometrium.
Special situation
It is believed that fitness during menstruation does not pose a health hazard, although active sports activities are best postponed to another day: loads in 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 the sessions, bleeding will be stronger - but you will not lose more blood than usual. The amount of blood that secrete the endometrium (the lining of the uterus) is the same every month, no matter how much you move. In the period of physical activity, palpitation increases, which means blood circulation.
Phases of the menstrual cycle:
1) Follicular: estrogens predominate, the follicle ripens.
2) Ovulatory: the rupture 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.
3) Luteynovaya: fertilization did not occur, the level of hormones falls, the endometrium is rejected, another bleeding begins.
The onset of the first menstruation speaks of sexual development: theoretically this is the beginning of the childbearing period of life. The average age of the onset of menstruation is 11-14 years, it directly depends on the state of health and heredity. The first months can be irregular, but gradually the cycle will be established. The reverse process - the extinction of the reproductive function (menopause) to 52-57 years - will also be gradual.
Violations of the cycle
Disrupt the menstrual cycle can many factors: too much heat or cold, jet lag, malaise or severe stress, abortion - all this affects the work of the ovaries. Intensive exercise and strict diets also affect the menstrual cycle. The percentage of estrogen (a female hormone) in the body is directly related to fat mass. If we burn a lot of calories, getting carried away by sports or food restrictions, the balance can be disturbed - the level of estrogen will decrease, and menstruation becomes irregular (in rare cases, they may stop altogether). Although the duration of each woman's cycle is individual and depends on many factors, deviations from the average rate, especially when combined with a painful period or a pronounced premenstrual syndrome, can talk about various disorders and make it difficult to conceive a child. If the violation is a one-off and in the next cycle did 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 violation of the cycle the gynecologist will offer you ultrasound of the pelvic organs, a study of the hormonal profile (special blood test), a diagnostic examination of the state of the internal standing of the uterus. Visits to a gynecologist should be regular, at least every six months. Abundant menstruation: the discharge does not become less on the 2-3rd day of the cycle, the standard gasket lasts for 2-3 hours. Scarce menstruation: lasts less than 3 days, one gasket lasts for half a day or more. Intermenstrual spotting, especially when combined with painful menstruation, may be one of the symptoms of endometriosis - be sure to discuss this with your doctor. Later (after 13-14 years) the onset of menstruation, most likely, speaks about the increased level of male sex hormones. The cycle in this case is most often irregular, elongated, but with abundant prolonged discharge. A short cycle (less than 21 days) or too frequent (more often than once a month) menstrual bleeding at different intervals may indicate dysfunction of the ovaries, endocrine disorders or diseases of the genitals.
Question of hygiene
In the morning, after sleeping, or after a long stay in the sitting position, the discharge may seem more abundant and thick. This is normal: for several hours you were motionless, and the menstrual blood, including from the cells of the epithelium, endometrial particles and uterine secretions, could not flow freely from the vagina, as a result of which it curled and formed clots. At 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 gives bacteria a great opportunity for reproduction, it is important during the menstruation period to observe hygiene more carefully: tampons and gaskets should be changed every 2 hours even if the discharge is not too high. Aromatized tampons and pads are not the best choice: they can cause irritation. But do not be too zealous, too carefully washing the vagina - it destroys its natural microflora.
Oh, it hurts!
Painful menstruation, or dysmenorrhea, is more common than we would like: more than half of women mark them, and 10% are not so lucky that monthly ones prevent them from leading a normal life within 3-4 days of each cycle. Pain and discomfort during menstruation are caused by prostaglandins - glands of internal secretion, which during this period secrete substances that cause spasms in the areas of the uterus, pelvis, back and bowels by the way, birth pains are similar to repeatedly intensified pain during menstruation. They also exacerbate the sensitivity of nerve endings - so the options for indisposition are so individual: some feel only mild pain or just discomfort, and some are almost unable to get out of bed.
Popular questions about menstruation
Can I have sex at this time?
Yes, but it is better to use a condom - microbes can penetrate into the slightly open yawn of the uterus.
Can I get pregnant during menstruation?
No, you can conceive during ovulation: it will occur before or after menstruation, and the sperm retains its viability for only 36 hours. If the cycle lasts more than 25 days, ovulation may be late, on the 18-20th day of the cycle, but conception in this case will occur before the expected menstruation, in which case it can occur, but will be more scarce.
Can during pregnancy continue monthly?
If a woman is diagnosed with ovarian dysfunction, polycystic ovary syndrome or a bicornic uterus, during pregnancy, there may be regular spotting during the first 12 weeks, on days when menstrual periods should be. If spotting accompanied by pain in the abdomen, you need a doctor's consultation. This can be either a safe sign of the weakness of the walls of the vessels or the introduction of the egg into the uterus, or a symptom of the disorders.
How to deal with PMS?
Reduce the amount of salt consumed - so that the liquid does not stay 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).
What does the irregular cycle say?
About hormonal disorders, decreased ovarian function, stress. Most likely, dysmenorrhea will pass after the first birth: it is believed that only with pregnancy and the birth of a child the body of a woman ripens finally. Sometimes there is secondary dysmenorrhea: in this case, and after the birth, menstrual pain will persist, but they will be caused by disturbances in the body's functioning - this may be a symptom of endometriosis or inflammatory diseases of the pelvic organs. Be sure to consult a gynecologist: he will inspect and appoint additional examinations. To cope with painful sensations will help pain medications (for example, ibuprofen) and, strangely enough, light physical activity, for example walking. The explanation for this is simple: during movements, blood circulation in the pelvic region increases, muscles get more oxygen, and spasms decrease.
Question of contraception
If you take birth control pills that prevent the egg from getting out of the ovary and fertilize, then you have two advantages. First, the risk of pain is much less, secondly, if necessary, you can regulate the duration of your cycle: to speed up or postpone the onset of menstruation (but it is better not to abuse and resort to such methods of adjustment no more than once every six months). When taking monophasic tablets, it is enough to take two packets in a row (then another bleeding will simply be missed) or stop taking them a few days before the package should end and start taking the pill from a new one in a week. If you are taking three-phase pills, in this case, you should consult a gynecologist to choose a circuit for changing the cycle.
Before and after childbirth
The absence of another menstruation (in case the cycle failures are uncharacteristic for you) will become one of the first and most reliable signs of the pregnancy that has come. After the birth of the child, if you do not breast-feed, the menstruation resumes an average of 6-8 weeks. Breastfeeding menstruation may not be quite a long time - there will come a period of so-called lactational amenorrhea. The cycle is renewed individually: this can happen two months after childbirth or a year later, and in some cases it may not be longer. There is an opinion (though not scientifically confirmed) that the resumption of the cycle is associated more with the woman's subconscious than with her physiology: he will recover with more probability if you remember about menstruation that you have not seen for a long time or even just find.
Young mothers
Lactational amenorrhea is better not to be used as a method of contraception, the method is not too 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 complementary foods. 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 after the birth of menstruation: before the menstruation begins, ovulation will already occur, and hence conception is also possible.