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What Is Menstruation?
Menstruation, commonly known as a period, refers to the discharge of blood from a female’s uterus through the vagina. The first period, or menarche, is one of the main events of puberty in females.
It is common for girls to be anxious about their first period and for older women to still feel discomfort during menstruation. However, having knowledge about your monthly cycle may help prevent any unnecessary concerns.
Periods happen due to hormonal changes in the body. The hormones estrogen and progesterone, which are released by the ovaries, act as chemical messengers and stimulate the buildup of the uterus lining, also known as the endometrium.
A thick endometrial lining is necessary for the attachment and development of a fertilized egg. If a fertilized egg is not present or not attached, the uterus lining will break down and bleed. Menstruation marks day one of the menstrual cycle.
The hypothalamus and pituitary glands release hormones that stimulate the growth of several ovarian follicles in the ovary. One dominant follicle matures into an egg, and the cycle starts again.
The buildup and breakdown of the endometrium take approximately 1 month. If the hypothalamus and pituitary gland in the brain and the ovary are in perfect harmony, most females will have their periods once a month. (1)
The amount of blood loss during menstruation varies among women. Generally, the duration of the period is between 3 and 5 days.
Some women experience no to minimal distress during their periods. However, in others, the hormonal changes that occur during the whole cycle may cause discomfort or problems.
The most common symptoms of menstruation include abdominal cramps and mood swings, especially before the start of the actual bleeding. Due to unawareness, women may perceive them as abnormalities and get worried about their health.
Therefore, it is vital to know the usual symptoms of menstruation. Understanding these symptoms may also help you in identifying any issue in your cycle and prevent unnecessary stress.
Common Symptoms of Menstruation
Here are the most common symptoms that are perfectly normal during menstruation.
1. Abdominal Cramps
Abdominal cramps during periods are also called as menstrual cramps. They are medically known as dysmenorrhea and are described as cramping, throbbing pain in the lower abdominal region. It may occur along with nausea, headaches, lower back pain, and diarrhea.
Abdominal cramps usually result from an excess of prostaglandins, which are chemicals produced by the uterus that are responsible for its contraction and relaxation. (2)
Typically, the pain starts a couple of days before the period and lasts up to the first 1-2 days of menses. However, in some women, it may last longer.
The following measures may aid relief from abdominal pain:
- Be physically active. Exercise plays a role in the treatment of menstrual pain.
- Apply a warm compress on the painful area to get some relief. Hot water bottles, heating pads, or a hot water bath may be helpful.
- Practice relaxation methods, such as yoga and meditation.
- Over-the-counter ibuprofen (Motrin, Advil) or paracetamol (Tylenol) is usually the first-line pharmacologic treatment.
If these measures don’t work and if the pain is affecting your quality of life, see your gynecologist for further evaluation.
2. Acne and Pimples
Pimples, acne, or zits on your skin are common during menstruation. They are generally caused by hormone fluctuations, including the increase of estrogen and androgens. These hormone changes overstimulate the oil glands in the skin, leading to clogged pores.
Taking good care of your skin helps prevent acne in general. Despite taking such measures, it is common for young women to have a mild to moderate breakout just before menstruation. However, the problem usually subsides once the period is over. (3)
3. Bloated Stomach
Abdominal bloating is a typical manifestation of menstruation. A majority of women experience a bloated stomach before their periods start, continuing for a few days after the onset.
Usually, bloating occurs due to entrapment of air or gas in the gastrointestinal tract. It gives a feeling of fullness similar to after having a hefty meal. The stomach may seem to be tight and bigger, causing pain and discomfort.
Bloating is also part of the battery of symptoms associated with premenstrual syndrome (PMS). It can occur up to 2 weeks before the period and is linked to water retention. Changes in estrogen and progesterone levels make the body retain more water.
Some of the following measures may help with bloating:
- Do some light exercise.
- Follow a low-sodium diet that includes fruits, vegetables, whole grains, and lean protein.
- Avoid refined carbohydrates and sugars.
- Consume more water.
- Drink herbal tea, such as ginger, chamomile, fennel, or green tea.
- Skip caffeine and alcohol.
- Limit processed foods.
- Have multiple light meals throughout the day instead of a couple of heavy meals.
- Take a diuretic after consulting your doctor.
- Talk to your doctor about whether birth control pills may help.
4. Painful Breasts
A majority of women experience pain in their breasts before the onset of menstruation. This pain is due to the hormonal fluctuations associated with the menstrual cycle.
Pain in the breasts usually begins the week before the onset of menses (around ovulation) and dissipates when menstrual bleeding starts. It is frequently bilateral and most severe in the upper outer quadrant of the breasts.
The breast tenderness may also be accompanied by swelling and heaviness.
Although sometimes perceived to be a health concern, painful and tender breasts are quite common during this time.
Around two-thirds of the cases of breast aches in women are that of cyclical breast pain, making menstrual cycle the most common cause of painful breasts.
For women experiencing cyclical breast pain, it is recommended to use a well-fitting brassiere to better support the breast. The use of a support bra with steel underwire tends to reduce the pain in women with pendulous breasts.
The use of sports bras during exercise has been shown to reduce pain related to breast movement.
However, when you are experiencing breast pain, try performing light exercises such as walking or biking, since heavy activities such as running may aggravate the pain.
The role of diet and lifestyle in relieving menstruation-associated breast pain is unclear. However, caffeine abstinence and supplementation with vitamin E and evening primrose oil are worth trying because they are generally harmless and may offer some pain relief. Additionally, these remedies have been supported by a small study. (6)
Following a low-fat diet with a high content of complex-carbohydrates may help manage breast pain; however, this is not backed by sufficient scientific evidence.
5. Blood Clots
Menstruation involves the breakdown of the uterine lining, which is then passed out of the body as period blood.
It is completely normal for menstrual flow to contain small clumps of blood every now and then, which may be bright red, dark red, brown, or even black.
These clots are nothing but tiny chunks of tissue shed from the uterus. They do not indicate a serious problem. If, however, these blood clots become unusually large or start appearing more frequently, a visit to the doctor is recommended to ensure all is well within.
Passing blood clots during menstruation is usually associated with lower abdominal cramps, and gentle heat therapy may help.
Place a warm compress on your lower abdomen, and let it sit for 10-15 minutes. Repeat the application a few times every day for as long as the period lasts.
6. Nausea and Vomiting
Nausea is a common symptom that may or may not result in vomiting. Constantly feeling like you are about to throw up can be extremely discomforting and exhausting. However, it does not pose any serious health risks.
The nausea can set in just before the period or after it starts but usually resolves on its own within the first few days. It can be part of premenstrual syndrome.
It is believed that the nausea during menstruation is caused by the hormonal fluctuations and release of prostaglandins during this time of the month. This discomfort can be addressed by taking birth control pills.
Taking NSAIDs, such as ibuprofen (Motrin, Advil), may also relieve nausea by preventing prostaglandin formation. These medications help with the menstrual cramps, too.
Taking measures to avoid abdominal bloating may also help with the nausea.
7. Loose Bowel Movements
Many women complain of loose bowel movements during menstruation, which are completely normal and do not point toward any kind of digestive dysfunction.
Like most other period problems, loose bowel movements are also consequences of hormonal changes, particularly those relating to progesterone and prostaglandins.
These two compounds are known to regulate the activity of the smooth muscles in your intestines. During periods, these smooth intestinal muscles contract due to the effect of prostaglandins, leading to loose bowel movements.
Loose stools during a period are rarely a cause of concern unless it is accompanied by fever, severe diarrhea with dehydration, or intense gastrointestinal pain.
Certain dietary items can help reduce the severity and frequency of diarrhea, especially probiotics, yogurt, and bananas. It is important to keep your meals light, simple, and not spicy. Avoid refined carbohydrates.
Taking ibuprofen may also help by preventing the formation of prostaglandins.
8. A Rise in Body Temperature
Some women may experience a rise in their temperature during menstruation, which typically subsides within a few days.
This increase in body temperature is on account of hormonal changes, rather than an underlying infection or any health issue, and therefore does not merit any serious concern.
Your hormones go through a lot of fluctuations throughout the menstrual cycle, which can have a bearing on the body’s thermoregulatory function.
The body turns a little warmer than usual after ovulation and continues to remain so until a few days before the next period. But this effect can sometimes become prolonged and spill over into the menstruation phase as well.
Harmless as it may be, running a temperature can be extremely unpleasant and draining. What’s worse is that it is often accompanied by muscle aches and body pain, which can add to the general feeling of uneasiness during menstruation.
If you are experiencing any of these discomforts, try a few cathartic beverages, such as basil or ginger tea, to make yourself feel better. You can also take a sponge bath or a regular bath in lukewarm water to relax your body.
Again, ibuprofen or other NSAIDs can help with these symptoms, too.
Headaches are another common grievance that precedes or accompanies menstruation. Many women with a migraine problem report a worsening of their condition just before or during their periods.
The occurrence of headaches along with menstruation, called menstrual migraines, can be due to the underlying hormonal changes.
The instability in the levels of estrogen and progesterone can adversely affect certain chemicals in the brain, which play a key role in triggering headaches.
You can use topical cold therapy to help ease the pain. Practicing yoga and deep breathing exercises can also help calm your mind and body and reduce the intensity of the headaches.
Ibuprofen can relieve the headaches. Birth control pills can also help in preventing the hormonal fluctuations and thus prevent the headaches.
10. Food Cravings
Not everyone experiences menstruation the same way. For some, it may be entirely painless, whereas others may face excruciating symptoms. The symptoms and degree of discomfort may also vary from person to person. This applies to appetite as well.
Some women don’t feel like eating much while they are menstruating, whereas others experience frequent hunger pangs and strong cravings for specific foods. Such appetite changes are brought on by the physiological and hormonal changes that your body is going through.
A strong urge to eat certain foods is usually the result of fluctuating hormones that make you crave for specific nutrients. So long as you are craving healthy food, it shouldn’t be a problem.
However, a lot of menstruating women find comfort in junk food, which can add to your health woes in numerous ways.
Also, greasy foods are difficult to digest, which can aggravate other menstrual discomforts, such as nausea, abdominal cramps, and diarrhea.
Thus, it is best that you exercise restraint and treat yourself to only an occasional snack rather than make a habit out of it.
Menstruation can really suck the energy out of you, which only adds to its slew of unwelcome symptoms.
Generalized fatigue on its own may not be such a worry. However, when your body is already reeling with pain and mood swings, the loss of energy can make the distress even more pronounced.
Pushing through the pain and tiredness can be difficult. It is best that you heed your body’s message and take things easy until you feel well enough. (4)
12. Mood Swings
Most women go through some degree of physical or emotional distress in the days leading up to their monthly period or once they start menstruating.
This symptom can be part of premenstrual syndrome (PMS) and is often characterized by erratic mood swings, irritability, anxiety/tension, a sad or depressed mood, increased appetite/food cravings, sensitivity to rejection, and diminished interest in activities.
Exercise is known to release feel-good hormones that can help uplift your mood. Restful sleep can also help allay the negative feelings and emotional stress by putting your mind at ease.
However, if you are going through really bad mood swings and depressive symptoms, see your gynecologist for help. These symptoms can be alleviated using antidepressants or sometimes birth control pills.
Some General Queries
How long does a typical period cycle last?
Women may experience variations in their cycle lengths from time to time. However, if your periods occur every 21-35 days, they are considered normal.
There is some cycle variability for the first 5 to 7 years after the start of menses and the last 10 years before the cessation of menses.
In general, the cycle length peaks at approximately age 25 to 30 years and then gradually declines. So, women in their 40s have shorter cycles.
Why should I track my menstrual cycle?
Keeping track of your menstrual cycles is suggested chiefly to determine if they are regular. However, there are additional benefits to this habit, whether your periods are regular or irregular.
If you have regular periods, keeping track will help predict the time of ovulation, when you are most likely to conceive. If you have irregular periods, the data of the irregularity will facilitate your consultation with a medical practitioner.
How much blood does one lose during a period?
Bleeding usually lasts from 2 to 7 days. It is normal to soak 1-7 normal-size tampons or pads during your period (considering that a pad or tampon usually soaks up to 5 ml of blood). Normally, the blood flow is heaviest at the onset of the period. (5)
Periods are a monthly occurrence, and there is no running away from them. Some women are lucky enough to go through this process without any discomfort. But for a lot of others, it is nothing short of a monthly nuisance.
Menstruation can trigger a host of unpleasant symptoms in its wake, which can make even the most mundane tasks seem difficult. The only consolation is that none of these symptoms are likely to cause any real harm.
Every woman is different and has her own experience with menstruation. Hormonal contraceptives and over-the-counter medicines can help significantly with the symptoms if they are distressing. See your gynecologist for an opinion.