Why do we need periods?

Menstrual irregularities

- a reason to seek advice from a gynecologist. Critical days are the calling card of a woman’s body condition. Any cycle failure is a signal calling you to pay attention to your health. This may be a delay in menstruation in the absence of pregnancy, scanty menstruation or, conversely, too heavy menstruation. If there are such violations of the monthly cycle, it is imperative to be examined, determine their cause and begin treatment. We must always remember that dangerous diseases can be hidden behind menstrual irregularities.

Menstrual irregularities. First about the norm

The reproductive period in a woman's life is accompanied by menstruation

– periodic bleeding from the genital tract. This is a natural process by which the body restores its readiness for pregnancy. It is cyclical; The duration of the cycle and its regularity are a mirror of a woman’s intimate health. Menstrual irregularities are an alarm signal and should never be ignored.

Menstruation usually begins at the age of 12-14 years. During the year after the first menstruation, there is no clear periodicity; the cycle is just being established.

The menstrual cycle is counted from the first day of one menstruation to the first day of the next. On average it is 28 days, but there may be individual deviations. The normal duration is from 21 to 35 days. The duration of the discharge itself is usually 3-5 days. Menstruation is often preceded by the so-called premenstrual syndrome - a period of poor health. You may feel pain in the lower abdomen, swell your breasts, increase swelling, and have a headache.

No menstruation during pregnancy. After childbirth, the menstrual cycle is restored. The earliest this can happen is 6 weeks after birth. When breastfeeding, menstruation returns much later; how much later depends on the individual characteristics of the female body.

On the eve of menopause, the menstrual cycle may become unstable, and the intervals between menstruation may increase. Such disorders at the age of 45-55 are not a pathology.

What should you be concerned about during menstruation?

Doctors recommend paying attention to the following nuances:

• in the absence of natural menstrual flow for more than one month and a negative pregnancy test, the problem may be associated with hormonal imbalance;
• severe pain during the cycle may appear due to endometriosis or other pathologies, which requires consultation with a gynecologist;
• a visit to the doctor is necessary if bloody discharge occurs that is not associated with ovulation or menstruation, which lasts more than 72 hours;
• fibroids or hormonal imbalance is manifested by long-term (more than 8 days) or short-term (less than 3 days) discharge, the condition requires ultrasound diagnostics;
• acute pain during sexual intercourse can be a herald of rupture of an ovarian cyst or follicle; the anomaly is accompanied by heavy bleeding and requires urgent surgical intervention.

Parents should worry if a teenager develops mammary glands, but menstruation does not come. A consultation with a gynecologist is also necessary for adolescents over 15 years of age who have not entered the puberty phase.

Types of menstrual irregularities:

• absence of menstruation for six months or more (amenorrhea). This condition is normal during pregnancy, breastfeeding, during menopause and in girls who have not yet reached puberty. In all other cases, this is a pathology;
• infrequent menstruation (menstrual cycle more than 35 days);
• frequent menstruation (menstrual cycle less than 21 days);
• violation of the duration of menstruation (too short - less than 2 days; too long - more than 7 days);
• too scanty menstruation (blood loss less than 20 ml.) or heavy (more than 150 ml.);
• menstruation outside the cycle.

Scanty menstruation

Insufficient development of the uterine mucosa is the main cause of scanty menstruation. However, hypomenstrual syndrome can also be a genetic feature of women. A change in menstruation towards reduction is considered normal if:

• The girl’s cycle has not yet fully established itself (puberty).
• In a woman aged 45 years or older, scanty menstruation indicates the approach of menopause.

It should be remembered that taking birth control pills significantly reduces the amount of menstruation.

The list of possible reasons is not exhaustive. In order to establish the cause, a medical examination is required, and in some cases, a comprehensive examination.

Causes of menstrual irregularities

The cause of a disruption in the menstrual cycle may be mental trauma or emotional shock. It can also be caused by severe physical pain, overheating or hypothermia, or climate change when moving. If this is the case, then there should not be a repeat violation of the cycle unless the cause that caused it does not recur.

A number of gynecological diseases lead to cycle disruption:

• pelvic inflammatory diseases;
• sexually transmitted diseases;
• endometriosis;
• uterine fibroids;
• polyps.

Violation of the cycle may be a consequence of a surgical intervention, such as an abortion.

The menstrual cycle can also be disrupted as a result of a non-gynecological infectious disease. It can be affected by exhaustion of the body, vitamin deficiency, and lack of nutrition. Ill-conceived diets often lead to cycle disruption.

Among the causes, hormonal disorders occupy an important place. In this case, disruption of the menstrual cycle may be accompanied by an increase in body weight, the appearance of hair in atypical places, the appearance of acne, and increased oily skin.

This list of possible reasons does not end there. In order to establish the cause, a medical examination is required, and in some cases, a comprehensive examination.

Lecture “How to avoid becoming a victim of a gynecologist”

Introduction

It just so happens that the reproductive function is activated in the girl’s body at the moment when she does not care about this function at all.
Having just put the dolls aside, the girl is faced with a whole series of little-understood processes occurring in her body, which immediately begin to be heatedly discussed among her peers, with consultations from those who are older. And mothers in this situation do not always rise to the occasion, since they themselves are poorly versed in this topic. So, let’s figure out once and for all what happens to you every month, dear women, what is considered normal, what should alert you.

Most women, when asked about the duration of their menstrual cycle, answer with a similar phrase “about once a month, a couple of days earlier than in the previous month”

- this intricate phrase denotes the duration of the cycle of 28 days. This cycle length occurs in most healthy women, but does this mean that a shorter or longer cycle is a manifestation of pathology? No!

It is recognized that a normal menstrual cycle can last from 21 to 35 days

, that is, plus or minus a week from the average of 28 days. The duration of menstruation itself can normally range from 2 to 6 days, and the volume of blood lost should be no more than 80 ml. A longer cycle occurs among residents of the northern regions, a shorter cycle among those living in the southern regions, but this is not an absolute pattern.

Regularity is important in the menstrual cycle.

That is, if a woman’s cycle is always 35-36 days, then this can be absolutely normal for her, but if it is either 26, then 35, then 21, this is not the norm.
Thus, a pathology can be considered irregularity
(when menstruation comes at an unequal period of time),
a long cycle
(more than 36 days) or
a short cycle
(less than 21 days). In general, the menstrual cycle can vary greatly depending on the condition of the woman and the situation in which she finds herself.

However, the lability of the menstrual cycle varies among different women depending on external and internal factors. For some, a little stress can already lead to a delay in menstruation, while for others, severe depression is not a reason for menstrual irregularities. The menstrual cycle of one woman can adapt to the menstrual cycle of another if they live together for a long time. This is often seen on women's sports teams or when living together in a dorm. It is not entirely clear what explains this fact. All we can say is that the menstrual cycle

Although it is a clear mechanism,
it can change significantly in a normal healthy woman
, and these changes are a reflection of the body’s reaction to external and internal factors.

The menstrual cycle is not always stable

The most irregular period is the first two years after the start of menstruation and three years before its end (menopause). Violations during these periods are due to completely physiological reasons, which we will discuss below.

Where do these numbers come from and why might they change?

The menstrual cycle is divided into three phases:

menstruation, the first phase (follicular) and the second phase (luteal). Menstruation lasts on average 4 days. During this phase, the lining of the uterus (endometrium) is shed due to failure to become pregnant.

First phase

lasts from the end of menstruation until ovulation, that is, on average until the 14th day of the cycle with a 28-day cycle (the days of the cycle are counted from the moment the menstruation begins).

This phase is characterized by the following events:

several follicles begin to grow in the ovaries (from birth, the ovaries contain a lot of small vesicles (follicles) containing eggs). During their growth, these follicles secrete estrogens (female sexual hormones) into the blood, under the influence of which the mucous membrane (endometrium) grows in the uterus.

Shortly before the 14th day of the cycle, all follicles except one stop growing and regress, and one grows to an average of 20 mm and bursts under the influence of special stimuli. This process is called ovulation. An egg emerges from the ruptured follicle and enters the fallopian tube, where it awaits the sperm. The edges of the ruptured follicle gather (like a flower closing for the night) and this formation is now called the “corpus luteum.”

Immediately after ovulation, the second phase of the cycle begins.

It lasts from the moment of ovulation until the start of menstruation, that is, about 12-14 days. During this phase, the woman's body waits for the pregnancy to begin. In the ovary, the “corpus luteum” begins to flourish - the corpus luteum formed from the burst follicle sprouts vessels and begins to secrete another female sexual hormone (progesterone) into the blood, which prepares the uterine mucosa for the attachment of a fertilized egg and the beginning of pregnancy. If pregnancy does not occur, then a signal is sent to the corpus luteum and it curtails its work.

When the corpus luteum stops secreting progesterone, a signal is sent to the uterus, and it begins to reject the no longer needed endometrium. Menstruation begins.

With different cycle lengths, the duration of the phases is reduced - this means that one woman needs 10 days for the follicle to mature, while another needs 15-16.

Having understood what the menstrual cycle consists of, it is easy to understand what determines its duration normally and in the presence of pathology.

Why is everything often unstable at the very beginning and then, after childbirth, it gets better?

A woman's reproductive system matures gradually and, being a complex mechanism, requires a period of adjustment.

The fact that a girl has her first menstruation
does not mean that her system is mature and ready to work fully
(although for some, the menstrual cycle begins to work correctly from the very beginning).

The functioning of the female reproductive system can best be compared to an orchestra, the coordinated play of all the instruments of which creates the unique sound of a piece of music - in our case, the regular menstrual cycle.

Just as instruments in an orchestra require a period of tuning, all components of the reproductive system need to agree with each other to understand and work together harmoniously. Such a rehearsal usually takes about 6 months - for some it is longer, for others it is shorter, and for others it may take longer.

Why do there be delays or do my periods start earlier?

Everything is very simple - if during the first phase of the cycle it is not possible to grow a full-fledged follicle, which could burst in the middle of the cycle (ovulation), then the second phase of the cycle, accordingly, does not begin (no ovulation - there is nothing to form the corpus luteum from). The first phase lasts a long time, until the uterine mucosa (endometrium), which has grown under the influence of estrogen, begins to be rejected on its own (like a pyramid of cubes collapses when it is stood too high). The cycle in this situation can last up to several months.

In this case, in the next cycle, ovulation may occur and the cycle will have a normal length. When such alternation occurs, they speak of an irregular menstrual cycle.

Another reason for delayed menstruation may be the existence of the corpus luteum for too long.

As I noted above, it lives for about 10 days and then begins to curtail its work, since pregnancy has not occurred. But sometimes it happens that despite the fact that pregnancy has not occurred, the corpus luteum continues its work and menstruation does not occur, and occurs only when the corpus luteum finally decides to leave.

Earlier onset of menstruation

This is usually due to the fact that the notorious corpus luteum, on the contrary, stops its work too early. This leads to an earlier onset of menstruation.

Remember how the orchestra sounds when it tunes its instruments - the same cacophony from the menstrual cycle is often observed at the beginning. The components of the reproductive system negotiate so that they can grow a follicle in 14 days, start the ovulation process, and maintain the corpus luteum for at least 10 days. At the beginning, she does not succeed in all stages of this work and this is manifested by an irregular menstrual cycle.

But this adjustment can be seriously interfered with by the person himself. Nothing has such a negative effect on the development of the reproductive system as stress.

(intense study, exams, unhappy love),
intense sports training, extreme weight loss, frequent illnesses, smoking, alcohol and drugs.
Against the backdrop of all of the above, quite often
menstruation disappears
and then you have to wait a long time for them. And the reason is very simple, I would say there is simple biological expediency in this - in extreme living conditions and when, for health reasons, a woman cannot bear healthy offspring - the reproductive function is switched off until better times. It’s not for nothing that during the war, most women stopped menstruating; this phenomenon was even given a special term “wartime amenorrhea.”

What to do about it?

Let me make a reservation right away that I am not taking into account various diseases, I am talking about some common problems with adjusting the menstrual cycle. Such cycle disorders are solved by taking hormonal contraception. Here we need to return again to the comparison with the orchestra. If the orchestra starts to go out of tune, you must stop playing completely, give the musicians a rest and start again. Hormonal contraception does just that. She turns off the reproductive system and “rests” the entire time she takes contraception. Then, after its cancellation, the system begins to work again and, as a rule, the cycle failures disappear.

Why does the cycle quite often become stable after childbirth, and sexuality flourishes?

The orchestra can rehearse as much as it wants, but it is finally played only when it performs its first concert from beginning to end. Pregnancy is the only purpose for which the reproductive system is designed in the body.

Only after the first full pregnancy, which ends in childbirth and the period of breastfeeding, the reproductive system matures completely, since during this period all the functions provided by nature are realized. After pregnancy, a woman finally matures and all the not fully “unpacked” properties of the body finally begin to work in full force.

The reproductive system must be used for its intended purpose - this is important; menstruation is not a function of the reproductive system, but a monthly reminder that it exists at all and is still working.

Let's step beyond 30...

Time passes, the reproductive system, which on average is allotted to exist in working order for 38 years (from 13 to 51), instead of performing its function is limited only to regular menstruation.

For reference:

on average, a woman experiences about 400 menstruation during her life (with 2 births) and loses about 32 liters of blood, while during reproductive behavior (pregnancy, childbirth, 3 years of breastfeeding, and only then 1-2 menstruation and pregnancy again ) there are about 40 menstruation periods.

In addition, as a woman ages, her history of various gynecological and general diseases

, and all this begins to affect the state of the reproductive system and, therefore, is reflected in menstrual irregularities.
Inflammation, abortion, gynecological operations, overweight or underweight, and common chronic diseases can cause problems.
Menstrual irregularities in the form of delays or earlier onset of menstruation a couple of times a year can occur even in the absence of any pathology.

As a rule, this is due to climate change or other stresses on the body (illness, hard work, personal problems, etc.). All nervous professions can lead to either delays in menstruation, their earlier onset or complete cessation.

Every woman is different, so everyone's cycle will change differently depending on the type of stress response and the phase of the cycle in which it occurs. For the majority of women, nerve work does not affect their menstrual cycle at all. Cycle disorders

, especially if it was stable before, often make a woman think that something is wrong with her.
Not in all cases you need to panic.
If you can clearly remember any negative events in the recent past that greatly shocked you, then most likely this is a one-time cycle disruption and there is nothing wrong with it. If there is no menstruation for a very long time (and the pregnancy test is negative), then you need to consult a doctor. If menstruation came earlier and does not end, this is also a reason to rush to see a gynecologist.

Sometimes cycle disorders can manifest as very frequent menstruation

(several times a month).
And there is no need to delay it - see a doctor immediately. But if the regularity of the cycle disappears completely
, this is also a reason to consult a doctor.

Regularity

– the main indicator of the normal functioning of the reproductive system. Sometimes it happens that a cycle had one duration and suddenly becomes shorter while maintaining its regularity. As a rule, this is due to the fact that the second phase of the cycle becomes shorter, as the corpus luteum begins to work less. Such changes are more often observed closer to 40 years. This is not a reason to panic, but simply a reflection that your reproductive system will change as you age, just like you.

Early menopause

This is one of the very common fears of women. In fact, this fear is exaggerated, since early menopause is quite rare

. It is mainly caused by rare congenital diseases, rare systemic diseases, consequences of treatment (chemotherapy, radiation therapy for cancer) and other rare conditions. There are situations when, as a result of surgery, a woman’s ovary or part of it is removed. Then menopause may occur earlier due to the fact that there is little tissue left in the ovaries that could support the normal functioning of the reproductive system.

Early menopause

As a rule, it is manifested by the cessation of menstruation and the appearance of symptoms of insufficiency of female sex hormones (hot flashes, irritability, tearfulness, insomnia, etc.). There is no prevention of this disease.

Painful periods and PMS

For some reason, it is generally accepted that feeling unwell during menstruation is normal.

The presence of pain, nausea, and migraines during menstruation
is not normal.
This condition of painful menstruation is called
dysmenorrhea
and requires treatment. Even if these phenomena are expressed insignificantly, they can and should be corrected.

Dysmenorrhea

It can be either
primary
(most often at a young age), when it is most likely due to simply the immaturity of the reproductive system, and
secondary
– when it is a reflection of a number of serious
gynecological diseases
.

The same applies to premenstrual syndrome. In general, the widespread popularization of this syndrome allows women to attribute their sometimes not entirely adequate actions and behavior to manifestations of this syndrome. However, PMS is not a woman’s personality trait.

, which everyone has to put up with.
PMS is a disease
that has incompletely understood causes, a whole list of symptoms and specific treatment measures. Manifestations of PMS can and should be corrected. It is wrong to take monthly illness for granted in modern conditions. If you have such problems, consult a doctor.

How it all ends

Decline of the reproductive system

usually occurs in the same way as its formation. Menstruation becomes irregular and there is a tendency to be delayed. This is due to the same reasons as in the beginning.

The ovaries respond less well to stimuli from the brain. It is not possible to grow follicles that could reach ovulation - accordingly, the cycle is delayed. If ovulation occurs periodically, the resulting corpus luteum does not work well. Because of this, periods either start earlier or, on the contrary, are delayed for a long time. Eventually your periods will stop, and if you haven't had them for more than 6 months, you should see a doctor. Based on hormonal tests and ultrasound, the onset of menopause can be assumed.

Sometimes there are cases when menstruation stops for a long period of time

, and according to tests and ultrasound, the onset of menopause is expected. This can be especially frightening for young women. However, this may only be a temporary period, and menstruation may resume on its own, for example after proper rest.

Thus, the myth that 28 days is the norm and everything that differs from this figure is pathology has been debunked. The main thing in the menstrual cycle is its regularity, and the duration of the cycle can fluctuate over a wide range.

And yet, there is a simple rule: if you regularly undergo preventive examinations with a gynecologist (at least once a year), if any violations appear, do not put off an “unpleasant” trip to the gynecologist - then you will almost never have serious gynecological problems.

Video version:

For what menstrual cycle disorders should you consult a doctor?

Any irregularity in the menstrual cycle is a good reason to contact a gynecologist. The absence of a clearly defined cycle means a violation of reproductive function, which can affect the ability to become pregnant and bear a child. And most importantly, this is a possible sign of a serious illness.

You should definitely visit a doctor if:

• a girl did not start menstruating at the age of 15;
• discharge is observed during pregnancy;
• menstruation is extremely painful, accompanied by pain in the lower abdomen (this may be a sign of an ectopic pregnancy);
• heavy bleeding is observed (this can occur with an ectopic pregnancy, spontaneous abortion, or a malignant tumor of the uterus).

Features of physiology

Teenagers wonder what menstruation is and why the process occurs regularly. To understand, you need to know the basics of the structure of the uterus. The organ consists of three layers: the membrane, the muscular layer and the inner layer (endometrium). After conception, on the seventh day, the embryo begins to move into the uterine cavity through the fallopian tube. There it clings to the wall and the implantation process begins, followed by development over 9 months.

Integration takes place on the endometrium and does not affect the muscle layers (if there is no pathology). The mucous membrane is important for the normal development of the fertilized egg, so it must be ready to receive the embryo. Regular renewal of the endometrium occurs through monthly rejection with the formation of a new layer (preparation for future pregnancy).

Before menstruation, the volume of this cover is equal to one centimeter, and in the first days after its completion - no more than 3 mm. During the cycle, clots of rejected tissue come out along with the blood. If the particles are too large and there is heavy bleeding, there is a possibility of spontaneous abortion, so non-standard manifestations are another reason to contact a gynecologist.