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What are menstruation and menstrual cycle in girls and how does it work?

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Menstruation is vaginal bleeding that occurs every month. It is a completely natural and normal bodily function that occurs in the female body. Menstruation is basically the discharge of blood through the lining of the uterus (endometrium). And the time during this whole process is the menstrual period. Moreover, it is also called by various names including menstruation, menses, menstrual period, period.

Uterus: The uterus is a pear-shaped organ of the female reproductive system. Which is the progressive female reproductive organ. Which is located in the pelvis between the bladder and the anus.

The blood that comes out of the vagina during menstruation is basically a combination of normal blood and tissue. This fluid flows from the uterus through the cervix and out of the body through the vagina.

pictures : The female reproductive system.
Source: wikimedia through CDC.

Most of the time menstrual bleeding lasts for 3 to 5 days. At this time 15 grams to 70 grams of menstrual blood or period blood may be excreted. The menstrual cycle stops during pregnancy. Menstruation begins during adolescence and stops permanently from the time of menopause.

Menopause: Menopause is when a woman’s ovaries stop producing estrogen and progesterone as they age. This stops her menstrual cycle. And becomes unable to conceive.

What is the Menstrual cycle?

 

The menstrual cycle is a cycle that occurs in the body of adult women, which occurs every month after women have acquired the ability to produce children. Menstruation is a part of the menstrual cycle. It helps the body of girls to be ready for the possibility of pregnancy. Bleeding occurs on the first day of the menstrual cycle. And the day of that bleeding is considered as the day-1 of the menstrual cycle.This cycle lasts an average of 28 days. However, a cycle can be anywhere from 28 days to 35 days. However, although the cycle is 28 days, most of the time menstrual bleeding lasts from 3 to 5 days. This is what we call the normal ‘menstrual period’.

During this cycle, the secretion of various hormones in the body rises and falls.

Hormones: Hormones are fluids secreted from different glands of the body, which are mixed in the blood and regulate various internal activities of the body.

The menstrual cycle is regulated by hormones. Luteinizing hormone and follicle-stimulating hormone produced by the pituitary gland affect ovulation. Both of these hormones affect the production of the sex hormones estrogen and progesterone to stimulate the ovaries. This estrogen and progesterone prepare the uterus and breasts for possible fertilization.

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Ovary: The ovary produces eggs. A reproductive organ. It is a part of the female reproductive system.

Fertilization: Fertilization is a biological process by which the male and female gametes mate to produce a new organism of the same species and form embryos over time.

What happens during the Menstrual cycle?

 

In the first half of the menstrual cycle, the level of estrogen hormone in a woman’s body increases. As a result, the lining of the uterus grows and thickens. Meanwhile, due to the effect of follicle-stimulating secretion from the pituitary, an egg begins to mature in any one of the ovaries. Around 14 days of the menstrual cycle in girls, the ovaries are released from the ovaries under the influence of luteinizing hormone. This is called ovulation.

In the second half of the menstrual cycle, the egg travels from the fallopian tube to the uterus. Meanwhile, the hormone progesterone increases during this time. And the hormone prepares the lining of the uterus for conception.

During this time, if a sperm can come and fertilize the egg, and if that fertilized egg can attach well to the lining of the uterus, then pregnancy is formed. That means the woman was pregnant then. If the egg is not fertilized, it is either dissolved or absorbed by the body. Now if the pregnancy is not formed, the levels of the hormones estrogen and progesterone are reduced and that thick lining of the uterus is eroded during the period.

At this time of the menstrual cycle, the thick lining of the vagina, i.e. the tissue and some blood, is added and exits through the vaginal canal. A woman’s period may not be like this every month, or even with another woman. Bleeding during periods can be mild, moderate, or even heavy. And the duration of menstruation can also be different in different cases. In most cases it takes 3 to 5 days. However, menstruation of 2 to 7 days is also considered normal.

The first few years after the onset of menstruation in an adult girl may be menstrual irregularities. Again it can be irregular even before menopause. In both cases there is a complete digestive tract. In many cases, doctors recommend birth control pills for irregular periods.

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Sanitary pads or tampons are made of cotton or other absorbent material to absorb blood. These sanitary pads are after women insert tampons under their underpants or into the vagina.

Women can have various problems during their period. Such as: severe pain, heavy bleeding, or skipping periods. Below are a few possible reasons.

Amenorrhea:

 

This term is used in two cases.

 

1. Even after the age of 16 years, the period has not started yet.

2. Those who used to have regular periods but suddenly the period has stopped for some time.

Amenorrhea is one of the many factors that can be mentioned – pregnancy, breastfeeding, weight loss caused by serious illness, eating disorders, excessive exercise, or stress. This may involve hormonal problems (pituitary, thyroid, ovarian or adrenal glands) or various reproductive problems.

Dysmenorrhea:

 

It is manifested as ‘severe pain’ during menstruation. The hormone called prostaglandin is responsible for this. Medication can be taken according to the doctor’s advice. Diseases such as uterine fibroids or endometriosis are often responsible.

Abnormal Uterine Bleeding:

 

How can a woman know that her uterine bleeding is abnormal?

Abnormal bleeding is characterized when certain things are noticed. So in this; Noticing heavy bleeding, especially long periods (called menorrhagia, usually 7 days of heavy bleeding, menorrhagia, one in 20 women), resumption of menstruation at short intervals, and intermittent bleeding Etc. are significant.

Menorrhagia and irregular cycles are often caused by hormonal imbalances in early adolescence and near menopause. It is also often called dysfunctional uterine bleeding (DUB). Other causes of abnormal bleeding include uterine fibroids and polyps.

Does a girl get her first period at that age?

 

Early menstruation, that is, the beginning of the menstrual cycle, is also called menarche. A girl can start menstruating at any time between the ages of 8 and 16. Menstruation will not occur until all parts of a girl’s reproductive system have matured and are working together.

How long does a woman’s period last?

 

Women usually continue to have periods until menopause. Menopause usually occurs around the age of 51. This means that she will no longer be able to produce eggs, so she will no longer be able to conceive.

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Like the onset of menstruation, menopause can vary from woman to woman. Some women may experience premature menopause due to surgery or other forms of treatment, or even illness.

When to see a health care provider about periods?

 

You should consult your healthcare provider for the following:

 

If you do not start menstruating by the age of 16. If your period stops abruptly. If you have been bleeding for more days than usual. If you have excessive bleeding. If you suddenly feel sick after using tampons. Bleeding occurs between the two periods (melts more than just a few drops). If you feel severe pain during your period.

How often should pads / tampons be changed?

 

Sanitary napkins (pads) should be changed as needed. Usually before the pad is completely wet in the menstrual flow. Tampons should be changed at least every 4 to 8 hours. Make sure you use a tampon with the absorption capacity needed for your flow.

If you experience any of the following symptoms while using menstruation and tampons, you should contact your healthcare provider immediately.

Today’s discussion i.e. ‘What is menstruation and menstrual cycle in girls and how does it work?’ Ends here. And Female Reproductive Endocrinology can be discussed in detail at an advanced stage later.

References:

 

1. The National Women’s Health Information Center – NWHIC

 

2. Heiman DL. Amenorrhea: Evaluation and Treatment. American Family Physician.

 

3. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea and related disorders. F1000Res. 2017;6:1645.

https://dx.doi.org/10.12688%2Ff1000research.11682.1

4. Adams hillard PJ. Menstruation in adolescents: what’s normal?. Medscape J Med. 2008;10(12):295.

 

5. Whitaker L, Critchley HO. Abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:54-65.

 

https://doi.org/10.1016/j.bpobgyn.2015.11.012

6. Gold EB. The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am. 2011;38(3):425-40.

https://dx.doi.org/10.1016%2Fj.ogc.2011.05.022

 

7. Menstrual hygiene management among Bangladeshi adolescent schoolgirls and risk factors affecting school absence: results from a cross-sectional survey. BMJ Open. 2017; 7(7): e015508

https://dx.doi.org/10.1136%2Fbmjopen-2016-015508

৮. Barbieri RL. The endocrinology of the menstrual cycle. Methods Mol Biol. 2014;1154:145-69.

https://doi.org/10.1007/978-1-4939-0659-8_7

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