What is periods? Each month one of your ovaries releases an ovum. At the same time, your uterus prepares for this ovum to be fertilized and the start of the pregnancy: its endometrium thickens, and the cells of the follicle that released the ovum to the fallopian tubes are developing into a temporary endocrine gland – the corpus luteum. Under the influence of progesterone, the endometrium – the mucosa of the uterus – prepares for a possible pregnancy and implantation of a fertilized ovum. If fertilization does not occur, in a few days the gland begins to shrink in size, regenerates into scar tissue and produces less and less progesterone, and your body rejects the mucosa of the uterus through the vagina. This is your period, which takes place every 28 days on average.
Normal periods (normal menstruation) differs from woman to woman. However, tracking your cycle and its changes is important for timely prevention of problems. In this article we tell you what to pay attention to. Take the following menstrual factors as a guide but remember: the only normality is what is normal for you (and the gynecologist you trust). After all, you know what periods you usually have, so pay attention to the changes and discomfort.
Normal periods duration
The menstrual cycle begins on the first day of the last menstruation and ends on the first day of the next. Although the average cycle length is 28 days, anywhere from 21 to 45 days is considered normal.
24 days difference – can you imagine? And all this is the norm.
The length of the cycle is also affected by age – in the first years after the beginning of menstruation or the years before menopause, the menstrual cycle is different. In addition, taking birth control pills or an intrauterine device also affects. The duration of menstruation itself also depends on the above aspects, but any duration from 2 days to a week is the norm.
One of the most common reproductive health problems faced by women is heavy menstruation. Approximately 35% of women face it at some point in their lives.
Normally, a woman loses the equivalent of two to three tablespoons of blood every month. Menstruation is considered heavy if you lose five or more spoons.
You can understand this by the number of tampons or pads you use. If you have to change sanitary products every hour for several hours, this is a sign of heavy menstruation.
Such bleeding can have various causes, including:
- Kidney or liver disease;
- Pelvic inflammatory diseases;
- Violation of blood coagulation;
- Problems with the thyroid gland;
- Changing of oral contraceptives;
- Ectopic pregnancy or miscarriage;
- Certain medicines (including blood thinners or steroids);
- Uterine polyps or fibroids (benign tumors inside the uterus);
- Endometriosis – abnormal growth of the mucous membrane of the uterus;
- Certain IUDs (hormonal intrauterine device) – if your IUD does not contain hormones, it can make your period heavier
- Hormonal disorders – it may cause the formation of an overly dense mucosa of the uterus, which should come out during periods
- Certain types of cancer, including cancer of the ovaries, cervix, or uterus itself, can cause excessive bleeding that looks like a heavy period.
Heavy menstruation, during which you change hygiene products every hour for at least 12 hours, or periods that last more than a week, is called menorrhagia. This condition occurs infrequently, but it significantly reduces the quality of life, because it is mostly accompanied by convulsions. In addition, such blood loss can lead to anemia, fatigue, shortness of breath, weakness and dizziness.
However, even heavy periods can cause the symptoms listed above, just of a lower intensity. In particular, heavy blood loss during menstruation is considered one of the main causes of iron deficiency (anemia).
What can be done
Of course, the best thing you can do is to see your gynecologist. First, the specialist will exclude diseases that can cause heavy periods. Further, in particular, he may recommend oral contraceptives, which will help regulate your menstrual cycle and reduce blood loss. Another solution is a hormone-releasing IUD. It also could be drugs that help stop bleeding by increasing blood clotting. Remember, all these medicines must be prescribed by a doctor!
If the bleeding continues, your gynecologist may recommend an ultrasound or other test to determine the source of the problem.
No woman would call “these days” the most comfortable days of the month, and slight discomfort in the first days of menstruation, such as a pulling back pain or heaviness, is the norm.
However, there are also situations when the pain is so strong that it becomes difficult to live a normal life. Sometimes a woman cannot even get out of bed and is forced to take days off.
This condition is called dysmenorrhea, and it can also be accompanied by nausea, or even vomiting, as well as diarrhea.
The cause of dysmenorrhea can be the already mentioned endometriosis and benign formations in the female reproductive organs, like polyps, fibroids, as well as polycystic ovaries.
Recent studies show that the sensations during menstruation are also hormonal in nature. According to data from the Department of Obstetrics and Gynecology at the University of Chicago Pritzker School of Medicine, low serum oxytocin concentrations are associated with painful menstruation.
Therefore, treatment of these conditions will help. It is also possible to take non-steroidal anti-inflammatory drugs, but only after prescription by your gynecologist!
Do not hesitate and eliminate any discomfort.
Irregular menstruation or its complete absence
There are only two periods in a woman’s life when irregular menstruation or its temporary cessation is the norm. This is the time of the onset of menstruation (the age of menarche) and perimenopause – when the body prepares for menopause. If menstruation stops during reproductive age, this is always a reason to consult a gynecologist.
The causes of amenorrhea (absence of menstruation) are diverse and not always related to diseases.
According to the American College of Obstetricians and Gynecologists` Committee on Adolescent Health Care, adults and adolescents with eating disorders may experience gynecologic problems or symptoms that include irregular periods, amenorrhea, pelvic pain, atrophic vaginitis, and breast atrophy.
Also, according to the American College of Sports Medicine, amenorrhea is common among female athletes. And especially those who do sports where a thin body is considered favorable for physical performance, for example, aesthetic sports and endurance sports. At the same time, moderate physical activity is not only useful, but also not contraindicated during periods.
And do not forget about the main reason for the cessation of menstruation in the reproductive age: pregnancy! Even if you are confident in your contraception, none of them gives a 100% guarantee. Have the test.
Other possible reasons for delayed menstruation:
- Uterine disease
- Ovarian failure (loss of normal ovarian function before age 40)
- A disorder of the hypothalamus (the area of the brain that helps regulate reproductive hormones)
- Polycystic ovary syndrome and other hormonal imbalances
- Disorders of the thyroid gland or pituitary gland
- Oral contraceptives (although birth control pills usually only make periods easier, not stop them completely)
Unusual secretions during and between periods
The release of individual blood clots is normal – the epithelium of the uterus goes out, it is precisely its particles that you observe on your pad or tampon.
Immediately, the main thing: if you observe bleeding during the cycle, consult a gynecologist, because this is not the norm. Mostly, it is not something terrible and serious, but it can indicate an ectopic pregnancy or a miscarriage, so it should be ruled out immediately. Also, certain conditions listed above can cause these symptoms, and although this is not an emergency, it should be evaluated and treated.
The same, if you have recently experienced an abortion or miscarriage, and the discharge of blood (black, brown) lumps or pink clots does not stop after two weeks, this is a reason to consult a doctor.
In other cases, lumps during menstruation should worry you if they are accompanied by the symptoms we mentioned above: heavy periods, severe pain, irregularity and unusual length of periods. Also, if the clots are really big – more than four inches, if you have a fever and feel worse – see a doctor as soon as possible.
Yes, not all periods are the same. Usually, a violation of the menstrual cycle or the course of menstruation does not indicate something serious. But do not delay in contacting a doctor if:
- You are in a lot of pain
- Pregnancy is suspected
- Your period lasts more than seven days
- Menstruation is more abundant than usual
- Menstruation suddenly stops for more than 90 days (and pregnancy is excluded)
- A pad or tampon should be changed every hour
Remember: your health is in your hands. Be attentive to your body and its calls – and periods are one of the best markers of your health – so a little attention and timely response will save you from most of the possible troubles.
And the best contribution to your health is awareness of the amazing processes that take place in your body. Our courses are dedicated to this: A girl becomes a woman, All about you. What it’s like to be a Woman, All about you 35+.
I’m eager to file all of these courses in English, just send me a request to firstname.lastname@example.org
You can always choose your doctor at the Lior Medical Center.
Issued by Dr. Silina School of Women’s Health, journalist Maria Zavialova
All materials published on the website “Dr. Silina School of Women’s Health” were reviewed by a gynecologist-endocrinologist, the founder of the educational project, candidate of medical sciences, Natalya Silina.