Menstrual period

Synonyms

Menstruation (lat: mensis - the month, stratus- scattered), bleeding, menstruation, menstrual bleeding, menstrual flow, cycle, days, period, menorrhea
English: menstruation, menstrual period

definition

Menstruation is the term used to describe the female menstruation that begins every 28 days and lasts for around 4 days. In addition to blood, mainly mucous membrane is expelled. The average amount of blood is only 65 ml.

The female cycle

In order to understand how the menstrual period develops, it helps to understand the female cycle:

With the onset of puberty, and with it sexual maturity, the female hormonal balance begins to change. Be in the brain Hormones releasedthat in the ovary (Ovary) stimulate eggs already laid in embryonic age. An egg, called a follicle together with its envelope, matures into what is known as the dominant (leading) follicle. The coating of the egg itself now produces a female sex hormone (estrogen), which builds up the lining of the uterus and so on a pregnancy should prepare. This section of the female cycle is known as Follicular phase (5th to 13th day of the cycle).

In addition, the hormone estrogen stimulates another hormone in the brain ovulation (ovulation) (14th day of the cycle).

Learn more about the topic Cycle calendar at our partner.

The egg is now released from its cover and takes its way to the uterus via the fallopian tubes. The so-called corpus luteum is created from the covering that remains in the ovary. This produces the luteal hormone progesterone, also called pregnancy-maintaining hormone, because it prevents the rejection of the uterine lining and thus the menstrual period. One speaks here of the corpus luteum phase (15th to 28th day of the cycle).

However, if the egg does not meet any sperm on its way and thus a pregnancy does not occur, the corpus luteum degenerates into the so-called corpus albicans. This no longer produces hormones, so that hormone withdrawal bleeding occurs, the menstrual period (1st to 4th day of the cycle).

This entire cycle lasts 25 to 31 days. By definition, the cycle begins on the 1st day of the menstrual period, which is followed by the follicular phase after approx. 4 days. The duration of this phase varies greatly from woman to woman, which explains the time differences in the cycle length. The subsequent ovulation occurs relatively regularly 14 days before the start of the next cycle. This constancy is caused by the last luteal phase between ovulation and your period, which is always 14 days.

With regard to the hormonal balance, estrogen dominates towards the end of the first half of the cycle (in the days before ovulation) and progesterone dominates the entire second half of the cycle (luteal phase). These hormone fluctuations can cause cycle-dependent complaints (see below).

The first menstrual period is called menarche. After menopause (menopause) the bleeding stops.

You might also be interested in: Ovulation bleeding

Duration of the menstrual period

The length of a woman's cycle can vary greatly from woman to woman. With some women it only lasts 23 days, with others even 35 days. In 5% of women, the normal cycle is even longer. The average, normal control cycle is with 28 days however, deviations from this duration are no exception and generally do not cause concern.

The first day of the cycle begins with the onset of the menstrual period. This, too, can last for very different times depending on the woman. Usually it lasts between three and seven days. The woman usually loses between 30 and 60 milliliters of blood. However, some women have very long and heavy bleeding (Menorrhagia), which in some cases even lead to such pronounced blood losses that the health of women is impaired. In extreme cases it can Iron deficiency and Anemia come. In this case, medical therapy is indicated.

In most cases, the symptoms can be treated successfully with hormone preparations. The bleeding that occurs when taking hormone supplements while they are not taking them is also called Withdrawal bleeding because it does not correspond to the actual menstrual period. It is simply a reaction of the body to the falling hormone levels. For many women, taking the pill brings relief because the bleeding is less severe and in many cases does not last as long. The pain symptoms often improve during the bleeding, with which many women had problems beforehand.

Shortening the bleeding time

The menstrual period is not the same for every woman, so the duration of the bleeding can be very variable. Some women complain of very heavy and long bleeding, while other women show very short courses. The Duration is very strong depending on the hormone levels of the woman and is therefore indirectly influenced by all factors that have an influence on the hormone level.

Many women find a shorter menstrual period more comfortable and therefore want to shorten their menstrual period. Especially women with a very long and heavy menstrual period feel restricted by this. Generally can regular exercise and a healthy lifestyle help with that Stabilize period duration.

Ultimately, help with very severe complaints hormonal contraceptiveslike the “pill”, which often successfully shortens and stabilizes bleeding. Before taking a hormonal contraceptive, an interview with an experienced gynecologist is necessary. After taking the medical history and an examination, the doctor can determine the cause of the long menstrual period, because hormonal contraceptives are not suitable for every cause.

Hygiene products

First and foremost are hygiene Tie, also called templates, and Tampons to disposal. The selection of the right articles should be based on the personal bleeding intensity, constitution and preference.
While sanitary towels are simply stuck into the panty, tampons must be inserted vaginally. A so-called withdrawal thread helps to remove the tampon again. You shouldn't feel a properly seated tampon. A tampon change should be changed when the tampon yields when pulling on the retrieval thread, but no later than after eight hours.

Postponing the menstrual period

It often happens that a rainy period does not fit into the individual schedule. There are a few ways to postpone the rule:

Women who take a single-phase preparation (all tablets are the same color) can simply continue their pill after the usual 21 days without a break. The rule can be postponed for up to 3 weeks, after which the bleeding usually starts. Instead of taking the second pack completely, the break can only be postponed by as many days as the rule is to be postponed.

It is also possible to bring the bleeding forward: To do this, you should stop taking the pill up to 5 days earlier than usual. However, as usual, the subsequent break should not exceed 7 days. If the pill intake is shortened by more than 5 days, the next intake does not have to be started after a 7-day break, but rather on the first day of the period. Otherwise, safe contraception is no longer guaranteed.

Women who take a multiphase preparation (tablets have different colors) should proceed differently:
The last color of the first pack should be followed by the same color as the second pack. So e.g. First the intake of the red tablets from the 1st pack, followed by the red tablets from the 2nd pack, then the yellow tablets from the 1st pack followed by the yellow tablets from the 2nd pack and so on. Again, the period can be postponed by up to 3 weeks.

Although you can postpone your menstrual period with the help of these hormonal preparations, everyone should be aware that they massively interfere with the hormonal balance of the female body. Therefore one should refrain from using this method in multiple ways.

Read more about this:

• Postpone your period without a pill

Prevention of the menstrual period

If the menstrual period has already started, it cannot be stopped. However, there are ways to prevent the onset of your menstrual period. It is also possible to permanently stop the menstrual period so that it no longer occurs in the future.

Birth control pills

With the Birth control pills it is possible to postpone or suppress the monthly menstrual period, as mentioned above. The pill is usually taken for 21 days, after which it is paused for seven days. The normal female cycle is simulated while taking pills. During the seven hormone-free days, a withdrawal bleeding sets in, which does not correspond to normal menstruation, but only comes about due to the sudden hormone deficiency. The bleeding will stop again at the latest when the next tablet blister opens after the one-week break.

In principle, it is possible to continue taking the pill without a break. Since the body receives hormones continuously in this case, the typical withdrawal bleeding does not occur. In some women, however, there may be light spotting in the meantime as the body has to get used to the continuous doses of hormones. Otherwise there will be no menstrual period. If there is a desire to take the pill without a break, this should first be discussed with the gynecologist in order to clarify the individual risks of this therapy.

Learn more about: pill

Endometrial ablation

The so-called Endometrial ablation is used to treat irregular or heavy menstrual bleeding if it cannot be treated with hormones. The lining of the uterus is removed down to the muscles so that it can no longer build up during the cycle. The intervention can be carried out using various methods, for example one Laser or microwave ablation, be performed.

Subsequently, the menstrual period is either greatly weakened or it no longer occurs (around 40% of patients). Accordingly, this leads to a infertilityso that the procedure can only be performed on women who do not want to have children. A malignant disease of the uterus must also be ruled out in advance. Endometrial ablation is not a suitable method of contraception, as the mucous membrane can never be 100% removed. If a permanent and complete freedom from bleeding is desired, it is advisable to remove the entire uterus (hysterectomy).

No menstrual period

Menstrual Period During Puberty

If the menstrual period does not stop there can be a number of reasons. Especially at the beginning of the menstrual period puberty the cycle can still be very irregular, so that the menstrual period does not start at regular intervals. This is not a cause for concern, as the body first has to learn to regulate the hormonal balance. Over time, your menstrual period will become more regular.

pregnancy

Menstruation no longer occurs during pregnancy. The fertilized egg embeds itself in the uterus and develops into an embryo. Part of the placenta that supplies the growing child forms beta-hCG, a hormone that is essential for maintaining the pregnancy, in the early stages of pregnancy. It stimulates the ovaries to produce progesterone, another hormone that subsequently suppresses ovulation. The menstrual period is accordingly prevented, as this would otherwise result in the rejection of the fertilized egg cell with the uterine lining. However, so-called pseudo-menstrual bleeding can occur, especially at the beginning of pregnancy. These continue to follow the rhythm of the normal control cycle, but are usually weaker than usual. This means that pregnancy may not be recognized until late.

After the pregnancy has ended, it can take some time for the body to resume its normal control cycle. The hormonal balance must first normalize. The menstrual period then recurs regularly.

However, some women occasionally have bleeding during pregnancy. Immediately at the beginning of pregnancy, the implantation of the fertilized egg in the uterus can lead to light bleeding, the so-called implantation bleeding. It lasts for about one to two days and poses no danger. Even in later stages, certain processes in the child's development can trigger light bleeding. Usually these are harmless, but should be clarified gynecologically. Since the cervix is ​​very sensitive, it can bleed easily at the beginning of the pregnancy.

Other causes of bleeding during pregnancy can also include infections in the genital area and minor injuries from sexual intercourse.If the bleeding is heavy and accompanied by symptoms such as malaise, abdominal cramps and pain, a doctor should definitely be consulted. These signs could indicate an impending miscarriage, ectopic pregnancy, or damage to the child or placenta.

Read more on the topic: Signs of pregnancy

Stress and underweight

Also psychological factors play an important role in the regular onset of the monthly menstrual period. At stress, Illness, lack of sleep and psychological problems, fears and worries, the menstrual period can be postponed for a few days or even stop altogether.

Another important factor is Underweight. In severely underweight women, the menstrual period may stop. The body then uses its remaining energy reserves for vital functions.

Hormonal contraceptives

Women who hormonal contraceptives may have an irregular cycle at the beginning. When taking the hormone preparations, the onset of bleeding does not correspond to the normal menstrual period. Nevertheless, it worries many women when this so-called withdrawal bleeding does not start. After a few months of taking the pill, the cycle should be regular. If the preparation is taken without interruption, there will also be no bleeding. After stopping the pill, it may take some time for the normal cycle to level off again. Absent or irregular bleeding is initially not a cause for concern, but occurs relatively frequently.

Menopause

With the onset of Menopause the woman loses her fertility. Accordingly, the menstrual period stops at some point. This is often first announced by cycle irregularities, until the body has finally adjusted its hormone balance to the new situation. The woman then no longer gets her menstrual period because she no longer ovulates each month.

Missing menstrual period due to illness

Ultimately, a missed menstrual period can also affect one Disruption of the hormonal balance are based. If there are regulatory disorders in the hormone control loops that are responsible for ovulation, the menstrual period may fail to occur. If the bleeding does not occur for a long time for no apparent reason, a doctor should be consulted. Also a disease of the ovaries, for example one Ovarian cyst or a malignant disease of the ovaries (Ovarian cancer) can result in the absence of a menstrual period. A gynecological clarification of cycle irregularities is therefore always advisable.

Menstrual disorders

Impairments to the female cycle can have numerous causes, which should always be clarified. Otherwise there is a risk of complications like infertility or the overlook of serious underlying diseases - quite apart from the great suffering many women suffer.

Bleeding disorders

Abnormally changed here both Bleeding duration, Bleeding intensity as well as Time of bleeding be. A weakening in all three criteria as well as intermenstrual bleeding are most likely to indicate a hormonal disorder. Depending on the indication, hormone therapy is used for almost all bleeding disorders (e.g. the pill) effectively used. Bleeding that occurs again after the menopause is particularly dangerous. You can identify a malicious process (Uterine cancer) Clues.

• abnormal bleeding time = longer than 6 or shorter than 3 days

• abnormal bleeding intensity = more than 5 pads or tampons per day or only Spotting (normal are up to 200 ml)

• abnormal timing of bleeding = Heavy bleeding outside of your period or after menopause. Spotting around your period, before ovulation, or mid-cycle. Failure to have your first menstrual period up to the age of 15. The causes are genetic defects, malformations, hermaphroditism, competitive sports and nutritional and eating disorders (anorexia, Obesity, bulimia)

• Bleeding without ovulation = in spite of the lack of ovulation (conspicuous due to lack of pregnancy or hormone tests by the doctor), menstrual bleeding occurs.

• abnormal frequency of bleeding = (1) Renewed menstruation after less than 25 days (counted from the 1st day of the last menstruation). The cause here is usually a shortening of the first half of the cycle (follicular phase). (2) Renewed menstruation after more than 31 days (counted from the first day of the last menstruation). The cause here is usually inadequate follicle maturation, which is usually longer than 6 months. The causes here are hormonal disorders due to malfunction of the ovaries or higher-level brain centers, psychological stress (see also mental disorder), Competitive sports or problems of the genital organs.

Menstrual cramps

In addition to the menstrual cramps listed here, you will find detailed information on our website: Menstrual irregularities

Premenstrual syndrome

This refers to a complex of symptoms that occur in the second half of the cycle, i.e. in the 2 weeks before the period. One of the causes is a hormone imbalance, which can lead to the following symptoms:

• Headache up to migraine attacks (Please refer: Migraine), mental instability (depression, sluggishness, nervousness, irascibility)
• Chest pain and water retention
• blemished skin to acne
• Indigestion (constipation, gas, bloating)
• Dizziness, hot flashes, and sweats
• Abdominal and back pain

Hormone preparations in the form of the “pill” and dehydrating agents are used therapeutically.

Among other things, nausea can also occur as part of the premenstrual syndrome. Read more about this under: Premenstrual Syndrome and Nausea

Dysmenorrhea

This means the onset of severe pain shortly before your period and on the first two days. The symptoms are particularly evident in the form of Abdominal cramps, dizziness and nausea. Malformations of the genital organs as well as hormonal and psychological factors are possible causes. Diseases of the genital organs such as inflammation, fibroids or endometriosis can also cause severe symptoms.

Painkillers, anticonvulsant medication or hormone treatment (for example in the form of the pill) can be considered therapeutically.

Personal measures such as using a hot water bottle or doing certain exercises can also help.

Color of the menstrual period

The menstrual period can be very individual and is therefore not the same for every woman. The hormone levels of women, which can be influenced by factors such as diet, physical exertion, stress, competitive sports and medication that are taken, have an influence on their course. The color of the menstrual period can also vary for various reasons. The color of the menstrual period can also allow conclusions to be drawn about the underlying cause, such as bleeding myomas.

Usually the color of the menstrual period is a medium shade of red. However, this can vary within the menstrual period and does not always have to be exactly the same shade of color.
A rather dark red color is also possible and can indicate a high level of estrogen. Most of the time, the bleeding is rather thick. The high level of estrogen ensures that the lining of the uterus grows. If this is then rejected during menstruation, it causes dark, heavy bleeding.
Another reason for such a dark menstrual period can be bleeding fibroids, which are very common in young women.

Lighter bleeding can be seen, for example, in competitive athletes who tend to have lower estrogen levels. Even in times of hunger or in patients with anorexia or severely underweight, the menstrual period tends to be very light, pale in color, such as light pink or very light red. A light brown to dark brown color is also quite normal.

Many women notice a more brown color, especially at the end of their period. Since towards the end of the menstrual period hardly any uterine lining is shed and often only clotted blood is shed, the color appears more brown to dark brown. Spotting and intermenstrual bleeding are often dark brown, but strictly speaking, these are not part of the menstrual period.

Read more on the topic: The first visit to the gynecologist