What is Menstruation?

Menstruation, also referred to as menses, menstrual period, menstrual cycle, or period involves the monthly shedding of the uterine lining. During menstruation, menstrual blood, which is a combination of blood and tissue from the inner lining of the uterus, is discharged from the uterus, passes through the cervix, and exits the body through the vagina.

The pituitary gland, located in the brain, and the ovaries, which are part of the reproductive system, play crucial roles in producing and releasing specific hormones at different stages of the menstrual cycle.

These hormones stimulate the thickening of the uterine lining, preparing it for the potential implantation of a fertilised egg in the event of pregnancy. Additionally, the hormones trigger the release of an egg from the ovaries, known as ovulation. The released egg then travels down the fallopian tubes, awaiting fertilisation by sperm. If fertilisation does not occur, the uterine lining breaks down and sheds, resulting in menstruation or the menstrual period.

What is the typical age for the onset of menstruation?

The average age at which a young woman experiences her first menstrual period is around 12 years old. This usually occurs about 2 to 3 years after the onset of breast development and shortly after the appearance of pubic and underarm hair. It's important to note that factors such as stress, intense physical activity, and diet can influence the timing of a girl's first period.

If a young woman has not started menstruating by the age of 15 or has not yet begun developing breast buds, pubic hair, or underarm hair by the age of 13, it is recommended to consult with her healthcare provider.

What is the duration of a menstrual cycle?

The average length of a menstrual cycle for menstruating women is 28 days. It begins on the first day of the last period and concludes on the first day of the subsequent menstrual period. However, it's important to note that the duration of women's cycles can vary, especially during the first year or two after a young woman experiences her first period. During this time, cycles can be as short as 21 days or as long as 45 days. It's worth mentioning that if a woman's cycle falls outside of this range, it may be necessary to seek medical attention.

Phases of menstrual cycle

The menstrual cycle consists of four primary phases.

1. Menstruation

Menstruation, often referred to as a period, involves the shedding of the uterine lining, which then flows out of the vagina. During this phase, blood, mucus, and cells from the uterus lining are discharged. The average duration of a period ranges from three to seven days.

To manage menstrual flow, various options are available, such as sanitary pads, tampons, period underwear, or menstrual cups. 

2. The follicular phase

This phase marks the beginning of the menstrual cycle, commencing on the first day of menstruation and spanning approximately 13 to 14 days until ovulation occurs. In this phase, the pituitary gland in the brain secretes a hormone that stimulates the development of follicles on the surface of one of the ovaries. Typically, only one follicle will fully mature and release an egg, which usually transpires around day 10 of the cycle. Additionally, during the follicular phase, the lining of the uterus thickens in anticipation of a potential pregnancy.

3. Ovulation 

Ovulation is the process in which a fully developed egg is discharged from an ovary and travels through a fallopian tube toward the uterus. Typically occurring once per month, approximately two weeks before the subsequent menstrual period, ovulation spans a duration of 16 to 32 hours.

Conception is feasible during the five days preceding ovulation and on the day of ovulation itself, but the highest likelihood exists during the three days preceding and encompassing ovulation. 

4. Luteal phase

This phase follows ovulation, during which cells in the ovary known as the corpus luteum release progesterone and a small amount of oestrogen. This hormonal activity prompts the lining of the uterus to thicken in readiness for a potential pregnancy.

If a fertilised egg successfully implants in the uterine lining, the corpus luteum persists in producing progesterone, thereby sustaining the thickened uterus lining.

However, if pregnancy does not transpire, the corpus luteum eventually deteriorates, leading to a decline in progesterone levels. Consequently, the uterine lining sheds, initiating the start of a new menstrual period.

How does menstruation change over time?

Menstruation undergoes changes throughout a person's life, from their teenage years to their 40s or 50s. When you first start menstruating, it is common to experience longer cycles or a heavier flow. As you enter your 20s, your menstrual cycles tend to become more consistent and predictable. However, as your body undergoes the transition towards menopause, your periods will once again change and become more irregular.

Conclusion:

Your menstrual cycle is an important indicator of your reproductive health and provides valuable information to your healthcare provider. Typically, a normal menstrual cycle spans from 21 to 35 days in length. When you get your period, you can generally expect to experience bleeding for a duration of three to seven days. If you have any inquiries or concerns regarding your menstrual cycle, it is advisable to reach out to your healthcare provider. It's worth noting that irregularities in your cycle could indicate the presence of a health condition that may require treatment.