Menstruation

Menstruation, also known as a period or monthly, is the regular discharge of blood and mucosal tissue (known as menses) from the inner lining of the uterus through the vagina.

It also channels menstrual flow (menses), which occurs in humans and closely related primates as part of the monthly menstrual cycle.

The first period usually begins between twelve and fifteen years of age, a point in time known as menarche.

Menarche (Greek: μήν mēn "month" + ἀρχή arkhē "beginning") is the first menstrual cycle, or first menstrual bleeding, in female humans.

Menstruation, also known as a period or monthly, is the regular discharge of blood and mucosal tissue (known as menses) from the inner lining of the uterus through the vagina.

It has a basal layer and a functional layer; the functional layer thickens and then is shed during menstruation in humans and some other mammals, including apes, Old World monkeys, some species of bat, and the elephant shrew.

Periods also stop during pregnancy and typically do not resume during the initial months of breastfeeding.

Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP).

These may interfere with normal life, therefore qualifying as premenstrual syndrome, in 20 to 30% of women.

Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period.

Periods also stop during pregnancy and typically do not resume during the initial months of breastfeeding.

Breastfeeding delays the return of menstruation and fertility, a phenomenon known as lactational amenorrhea.

The menstrual cycle occurs due to the rise and fall of hormones.

If pregnancy does not occur, the lining is released in what is known as menstruation.

Common signs and symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes.

Hormonal activity, such as occurs during menstrual cycles and puberty, may contribute to the formation of acne.

The egg is released from an ovary around day fourteen in the cycle; the thickened lining of the uterus provides nutrients to an embryo after implantation.

On average, it occurs during the 20th to the 23rd day after the last menstrual period.

Conditions causing secondary dysmenorrhea include endometriosis, uterine fibroids, and uterine adenomyosis. Although the primary function of the pill is to prevent pregnancy, it may be used to improve some menstrual symptoms and syndromes which affect menstruation, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation) by creating regularity in menstrual cycles and reducing overall menstrual flow.

Nearly half of those affected have chronic pelvic pain, while in 70% pain occurs during menstruation.

Breast swelling and discomfort may be caused by water retention during menstruation.

During a woman's life, her breasts change size, shape, and weight due to hormonal changes during puberty, the menstrual cycle, pregnancy, breastfeeding, and menopause.

Rarely, in individuals who are susceptible, menstruation may be a trigger for menstrual psychosis.

Menstrual psychosis is a term describing psychosis with a brief, sudden onset related to the menstrual cycle, often in the late luteal phase just before menstruation.

Women who had undergone female genital mutilation (particularly type III- infibulation) a practice common in parts of Africa, may experience menstrual problems, such as slow and painful menstruation, that is caused by the near-complete sealing off of the vagina.

In this last procedure, known as infibulation, a small hole is left for the passage of urine and menstrual fluid; the vagina is opened for intercourse and opened further for childbirth.

Oligomenorrhea is infrequent (or, in occasional usage, very light) menstruation.

Menstruation in other animals occur in primates (apes and monkeys).

This breakdown of the endometrium without vaginal discharge is sometimes called covert menstruation.

Dysfunctional uterine bleeding typically occurs in premenopausal women who do not ovulate normally (i.e. are anovulatory).

Amenorrhea (absence of menstruation) occurs in about 20% of women with ovulatory dysfunction.

Menstruation, also known as a period or monthly, is the regular discharge of blood and mucosal tissue (known as menses) from the inner lining of the uterus through the vagina.

In the uterus, the mucous membrane is called the endometrium, and it swells each month and is then eliminated during menstruation.

A sanitary napkin, sanitary towel, sanitary pad, menstrual pad, or pad is an absorbent item worn in the underwear by females who are menstruating, bleeding after giving birth, recovering from gynecologic surgery, experiencing a miscarriage or abortion, or in any other situation where it is necessary to absorb a flow of blood from the vagina.

A tampon is a feminine hygiene product designed to absorb the menstrual flow by insertion into the vagina during menstruation.

In some cases, stronger physical and emotional or psychological sensations may interfere with normal activities, and include menstrual pain (dysmenorrhea), migraine headaches, and depression. Although the primary function of the pill is to prevent pregnancy, it may be used to improve some menstrual symptoms and syndromes which affect menstruation, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation) by creating regularity in menstrual cycles and reducing overall menstrual flow.

Migraines are more likely to occur around menstruation.

As pregnant women may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding.

Menstruation occurs on average 14 days after ovulation, so the likelihood of a false negative is low once a menstrual period is late.

The most common form of hormonal contraception is the combined birth control pill, which contains both estrogen and progestogen. Although the primary function of the pill is to prevent pregnancy, it may be used to improve some menstrual symptoms and syndromes which affect menstruation, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation) by creating regularity in menstrual cycles and reducing overall menstrual flow.

COCPs provide effective contraception from the very first pill if started within five days of the beginning of the menstrual cycle (within five days of the first day of menstruation).

Although the primary function of the pill is to prevent pregnancy, it may be used to improve some menstrual symptoms and syndromes which affect menstruation, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation) by creating regularity in menstrual cycles and reducing overall menstrual flow.

Heavy menstrual bleeding, previously known as menorrhagia, is a menstrual period with excessively heavy flow.

Although the primary function of the pill is to prevent pregnancy, it may be used to improve some menstrual symptoms and syndromes which affect menstruation, such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, amenorrhea, menstrual cramps, menstrual migraines, menorrhagia (excessive menstrual bleeding), menstruation-related or fibroid-related anemia and dysmenorrhea (painful menstruation) by creating regularity in menstrual cycles and reducing overall menstrual flow.

Patients with adenomyosis often present with painful menses (dysmenorrhea), profuse menses (menorrhagia), or both.

Rarely, congenital malformations, intrauterine devices, certain cancers, and pelvic infections cause secondary dysmenorrhea.

As a result, they are used to treat menorrhagia (heavy menses), once pathologic causes of menorrhagia (such as uterine polyps) have been ruled out.