Menstruation

What is Menstruation?

Menstruation is the cyclic occurrence of uterine bleeding that occurs near the end of puberty in girls. Typically, first periods occur around age 12 or 13. However, some girls begin having periods as young as 8 or 9 years old, while others may be as old as 15 or 16. If menarche does not occur by the time a girl reaches the age of 16, she should see her doctor for evaluation. Menstruation usually begins about 2 1/2 years after girls begin developing breasts, and growing pubic and underarm hair.

Once menstruation begins, it continues until menopause occurs around the age of 50 when monthly menstrual cycles end. Surgical menopause occurs following removal of the ovaries during hysterectomy. Menstruation also temporarily stops during pregnancy. Hormonal contraceptives also stop normal menstruation and can safely be used to stop periods indefinitely or until pregnancy is desired. If menstruation fails to occur for any other reason, amenorrhea occurs. Amenorrhea is a menstrual cycle disorder.

For the most part, the menstrual cycle occurs predictably and without problems. However, when things don’t go right -– when you experience heavy or excessive bleeding, when your period doesn’t occur when expected, when you have physical or emotional symptoms during the weeks before you menstruation, or when you experience painful periods or other symptoms –- you may have a menstrual cycle disorder. 

Abnormal uterine bleeding is a common menstrual cycle disorder that includes several types of abnormal bleeding, including amenorrhea. Other menstrual cycle disorders include dysmenorrhea, premenstrual syndrome or PMS, premenstrual dysphoric disorder or PMDD, and uterine fibroid tumors. Other factors that may affect normal menstruation include stress, illness, exercise, diet and nutrition, and work, family, and relationship issues.

What Causes the Menstrual Cycle and Menstruation? 

Your endocrine system produces hormones that work together with your reproductive organs to cause the menstrual cycle and menstruation when conception does not occur. The glands of the endocrine system produce hormones that regulate various bodily functions such as blood sugar levels, metabolism, and reproduction. The menstrual cycle occurs in distinct phases during which hormones cause the changes that prepare the uterus to sustain a pregnancy, and to cause menstruation when pregnancy does not occur.

How Often Does Normal Menstruation Occur?

The average menstrual cycle is 28 days and women menstruate, on average, about five to seven days during each cycle. The first day, or Day 1, of the menstrual cycle is the first day any bleeding occurs, even if it’s just spotting. It’s a good idea to use a calendar to keep track of your menstrual cycle. Tracking your periods and any symptoms that occur during the menstrual cycle can help your physician diagnose any problems that may occur. 

How Much Blood Loss is Normal during Menstruation?  

You might be surprised to learn that, while it might often seem like much more, the total amount of blood lost during menstruation is only a few tablespoons. You may be experiencing excessive bleeding if you have to change pads or tampons every hour or so for several hours in a row. Contact your health-care provider if you experience excessive bleeding during your period. 

What to Tell Your Doctor about Your Period?

When your first period occurs, make sure to inform your doctor. From that point on throughout your reproductive years, your doctor appointments should include notation of the first day of your last period. Having a menstrual cycle calendar helps you to remember this information when asked. Other things you should tell your doctor about your period include:

• Having irregular, excessive, or other types abnormal bleeding
• Experiencing severe cramps during menstruation that is not relieved by OTC pain-killers, or experiencing pelvic pain that is unrelated to menstruation
• Not having periods
• Having menstrual cycles that are less than 21 days, or more than 35 days apart
• Anything about your period, or menstrual cycle, that seems abnormal for you

 

Tip: Girls often have irregular periods during the first few years after menstruation begins. It’s completely normal to have irregular periods while your body adjusts to all the physical and emotional changes that occur during adolescence.