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