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What is
menstruation? Menstruation (men-STRAY-shuhn) is a woman's monthly bleeding. When
you menstruate, your body
sheds the lining of the uterus (womb). Menstrual blood flows from the
uterus through the small opening in the cervix and passes out of the
body through the vagina. Most menstrual periods last from 3 to 5 days.
What is the menstrual cycle?
When
periods (menstruations) come regularly, this is called the menstrual cycle.
Having regular menstrual cycles is a sign that important parts of your body are
working normally. The menstrual cycle provides important body chemicals, called
hormones, to keep you healthy. It also prepares your body for pregnancy each
month. A cycle is counted from the first day of 1 period to the first day of
the next period. The average menstrual cycle is 28 days long. Cycles can range
anywhere from 21 to 35 days in adults and from 21 to 45 days in young teens. The
rise and fall of levels of hormones during the month control the menstrual
cycle.
What happens during the menstrual cycle?
In the
first half of the cycle, levels
of estrogen (the “female hormone”) start to
rise. Estrogen plays an important role in keeping you healthy, especially by
helping you to build strong bones and to help keep them strong as you get
older. Estrogen also makes the lining of the uterus (womb) grow and thicken.
This lining of the womb is a place that will nourish the embryo if a pregnancy
occurs. At the same time the lining of the womb is growing, an egg, or ovum, in
one of the ovaries starts to mature. At about day 14 of an average 28-day
cycle, the egg leaves the ovary. This is called ovulation.
After the
egg has left the ovary, it travels through the fallopian tube to the
uterus. Hormone levels rise and help prepare the uterine lining for pregnancy.
A woman is most likely to get pregnant during the 3
days before or on the day of ovulation. Keep in mind, women with cycles that
are shorter or longer than average may ovulate before or after day 14.
A woman
becomes pregnant if the egg is fertilized by a man’s sperm cell and attaches to
the uterine wall. If the egg is not fertilized, it will break apart. Then,
hormone levels drop, and the thickened lining of the uterus is shed during the
menstrual period.
What is a typical menstrual period like?
During
your period, you shed the thickened uterine lining and extra blood through the
vagina. Your period may not be the same every month. It may also be different
than other women's periods. Periods can be light, moderate, or heavy in terms
of how much blood comes out of the vagina. This is called menstrual flow. The
length of the period also varies. Most periods last from 3 to 5 days. But,
anywhere from 2 to 7 days is normal.
For the
first few years after menstruation begins, longer cycles are common. A woman's
cycle tends to shorten and become more regular with age. Most of the time,
periods will be in the range of 21 to 35 days apart.
What kinds of problems do women have with their periods?
Women can
have a range of problems with their periods, including pain, heavy bleeding,
and skipped periods.
- Amenorrhea (ay-men-uh-REE-uh) — the
lack of a menstrual period. This term is used to describe the absence of a
period in:
- Young women who haven't started
menstruating by age 15
- Women and girls who haven't had a
period for 90 days, even if they haven't been menstruating for long
Causes can include:
- Pregnancy
- Breastfeeding
- Extreme weight loss
- Eating disorders
- Excessive exercising
- Stress
- Serious medical conditions in
need of treatment
As above, when your menstrual cycles come regularly, this means
that important parts of your body are working normally. In some cases, not
having menstrual periods can mean that your ovaries have stopped producing normal
amounts of estrogen. Missing these hormones can have important effects on your
overall health. Hormonal problems, such as those caused by polycystic
ovary syndrome (PCOS)or serious problems with the reproductive organs, may be involved. It’s
important to talk to a doctor if you have this problem.
- Dysmenorrhea (dis-men-uh-REE-uh) — painful
periods, including severe cramps. Menstrual cramps in teens are caused by
too much of a chemical called prostaglandin (pros-tuh-GLAN-duhn). Most
teens with dysmenorrhea do not have a serious disease, even though the
cramps can be severe. In older women, the pain is sometimes caused by a
disease or condition such as uterine
fibroids or endometriosis.
For some women, using a heating pad or taking a warm bath helps ease their cramps. Some over-the-counter pain medicines can also help with these symptoms. They include: - Ibuprofen (eye-byu-PROH-fuhn)
(for instance, Advil, Motrin, Midol Cramp)
- Ketoprofen (key-toh-PROH-fuhn)
(for instance, Orudis KT)
- Naproxen (nuh-PROK-suhn) (for
instance, Aleve)
If these medicines don’t relieve your pain or the pain interferes
with work or school, you should see a doctor. Treatment depends on what’s
causing the problem and how severe it is.
- Abnormal uterine bleeding — vaginal
bleeding that’s different from normal menstrual periods. It includes:
- Bleeding between periods
- Bleeding after sex
- Spotting anytime in the menstrual
cycle
- Bleeding heavier or for more days
than normal
- Bleeding after menopause
Abnormal bleeding can have many causes. Your doctor may start by
checking for problems that are most common in your age group. Some of them are
not serious and are easy to treat. Others can be more serious. Treatment for
abnormal bleeding depends on the cause.
In both teens and women nearing menopause, hormonal changes can cause long periods along with irregular cycles. Even if the cause is hormonal changes, you may be able to get treatment. You should keep in mind that these changes can occur with other serious health problems, such as uterine fibroids, polyps, or even cancer. See your doctor if you have any abnormal bleeding.
In both teens and women nearing menopause, hormonal changes can cause long periods along with irregular cycles. Even if the cause is hormonal changes, you may be able to get treatment. You should keep in mind that these changes can occur with other serious health problems, such as uterine fibroids, polyps, or even cancer. See your doctor if you have any abnormal bleeding.
When
does a girl usually get her first period?
In the United States, the
average age for a girl to get her first period is 12. This does not mean that
all girls start at the same age. A girl can start her period anytime between
the ages of 8 and 15. Most of the time, the first period starts about 2 years
after breasts first start to develop. If a girl has not had her first period by
age 15, or if it has been more than 2 to 3 years since breast growth started,
she should see a doctor.
How long does a woman have periods?
Women
usually have periods until menopause. Menopause occurs between
the ages of 45 and 55, usually around age 50. Menopause means that a woman is
no longer ovulating (producing eggs) or having periods and can no longer get pregnant.
Like menstruation, menopause can vary from woman to woman and these changes may
occur over several years.
The time
when your body begins its move into menopause is called the menopausal
transition. This can last anywhere from 2 to 8 years. Some women have early
menopause because of surgery or other treatment, illness, or other reasons. If
you don’t have a period for 90 days, you should see your doctor. He or she will
check for pregnancy, early menopause, or other health problems that can cause
periods to stop or become irregular.
When should I see a doctor about my period?
See your
doctor about your period if:
- You have not started menstruating
by the age of 15.
- You have not started menstruating
within 3 years after breast growth began, or if breasts haven't started to
grow by age 13.
- Your period suddenly stops for
more than 90 days.
- Your periods become very irregular
after having had regular, monthly cycles.
- Your period occurs more often than
every 21 days or less often than every 35 days.
- You are bleeding for more than 7
days.
- You are bleeding more heavily than
usual or using more than 1 pad or tampon every 1 to 2 hours.
- You bleed between periods.
- You have severe pain during your
period.
- You suddenly get a fever and feel
sick after using tampons.
How often should I change my pad and/or tampon?
You
should change a pad before it becomes soaked with blood. Each woman decides for
herself what works best. You should change a tampon at least every 4 to 8
hours. Make sure to use the lowest absorbency tampon needed for your flow. For
example, use junior or regular tampons on the lightest day of your period.
Using a super absorbency tampon on your lightest days increases your risk for
toxic shock syndrome (TSS). TSS is a rare but sometimes deadly disease. TSS is
caused by bacteria that can produce toxins. If your body can’t fight the
toxins, your immune (body defense) system reacts and causes the symptoms of TSS
(see below).
Young
women may be more likely to get TSS. Using any kind of tampon puts you at
greater risk for TSS than using pads. The Food and Drug Administration (FDA)
recommends the following tips to help avoid tampon problems:
- Follow package directions for
insertion.
- Choose the lowest absorbency for
your flow.
- Change your tampon at least every
4 to 8 hours.
- Consider switching between pads
and tampons.
- Know the warning signs of TSS (see
below).
- Don't use tampons between periods.
If you
have any of these symptoms of TSS while using tampons, take the tampon out, and
contact your doctor right away:
- Sudden high fever (over 102
degrees)
- Muscle aches
- Diarrhea
- Vomiting
- Dizziness and/or fainting
- Sunburn-like rash
- Sore throat
- Bloodshot eyes