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UNDERSTANDING THE PROCESS OF MENSTRUATION


What is Menstruation ?
Also commonly known as the menstrual period or monthly 'period', it is a normal biological and physiological function of the female body. In essence, it is the discharge of blood and tissue from the vagina at monthly intervals. Typically the cycle lasts 28 days, but cycles varying from 24 days to 35 days are not uncommon. In the first year or so the cycles can be quite irregular. There can be no fixed pattern to it and a few months may pass between the first few periods. But there is no need for alarm. This is a common occurrence.

When does it start?
The beginning of menstruation, known as menarche may occur sometime between the ages of 10 years - 16 years. Just as no two individuals are alike, neither are the menstrual patterns of any two girls. Each body is different with different patterns and rhythm, so some may start as early as 9 years while others as late as 16 years. Menarche is a major milestone in a young girl's life, indicating the onset of the reproductive cycle in females. However, while a girl can technically bear children after achieving menarche, for all practical purposes she is underdeveloped and immature for the role of motherhood both, physically as well as psychologically. The menstrual cycle continues uninterruptedly month after month, except during pregnancies or for specific health reasons, until menopause. Menopause occurs when a woman is in her 40s to 50s and it is when the monthly cycles cease to occur.

What really happens?

While a lot of changes are happening at menarche in your daughter, a number of internal changes also occur. Her reproductive system has been developing in the lower abdomen and it is not something your daughter is aware of. A pear shaped organ called the uterus also known as the womb. It has a cavity where the babies grow before they are born.

The uterus is connected on either side by the fallopian tubes to two small glands called the ovaries, which has two functions :
* To produce the female hormone oestrogen.
* To produce the female egg cells, called Ova.

In the fallopian tube the female egg cell and male egg cell unite to form the embryo, which then travels through the fallopian tubes to the uterus, to get its nourishment.

Understanding the process of Menstruation
A small gland located in the base of the brain, called the pituitary gland, which causes a play of various hormones triggering menstruation. The pituitary gland produces chemicals that act like messengers, travelling in the blood to the ovaries. Inside the body, the reproductive system begins to function. During each monthly cycle, one of the ovaries releases an egg cell. It enters the nearby fallopian tube and travels towards the uterus. Meanwhile the hormone
oestrogen has been busy preparing the uterus to receive the embryo, by developing a thick lining of blood and nutrient filled tissue called the endometrium, which provides the embryo with immediate nutrition required for its survival and growth. However, if the egg cell is not fertilized and the embryo is not formed then the lining of the uterus is not needed to develop, so the lining of the uterus will disintegrate causing bleeding and this sheds from the uterus through the vagina and out of the vaginal opening as menstrual blood. This is called Menstruation. The time between the beginning and end of the menstrual flow is called as the menstrual period. The length of each menstrual period varies from person to person, as does the amount of menstrual flow. Usually a period lasts from three to five days, though variations from two to eight days are also common.

Each time a girl gets her period, a new cycle begins. The cycle usually lasts about 28 days, but the length of the cycle may also vary. Each girl's menstrual cycle can be different, with cycles as short as 24 days to as long as 35 days. This cycle repeats month after month. Generally a woman keeps to her individual established pattern, although stress, illness or strenuous exercises may alter her personal cycle.

How to calculate the Monthly Menstrual Cycle?
Mark with an 'X' or a red dot, the first day of the current menstrual cycle.

*
The next month, circle the first day of the new period.
*
Count the days between the first day of the last period and the first day of the next one. The number of days between the two dates will be the menstrual cycle duration. If the number is 28 days, the next period will probably follow after 28 days - so if the first day of the last cycle was 5th of April, the next period can start on 2nd or 3rd of May.


Irregularities that can occur during Menstruation
As mentioned earlier, the menstrual cycle will typically be between 28 to 30 days. In the first year or two following menarche, your daughter may have her period at irregular intervals, but that's nothing to worry about as it usually settles down. She however may need frequent assurance, since young girls are often concerned about having irregular cycles. They need to understand that the body needs time to develop a regular pattern. A change in environment or routine or any emotional stress or illness may upset the cycle, causing the period to begin later or earlier than expected. Apprehension about a forthcoming exam, excitement about a family wedding, a crash diet all these situations can disturb an established pattern. However, if the periods continue to be irregular even otherwise, you should consult a gynaecologist. Some conditions like those described below, may indicate that a problem with menstruation exists and should be referred to gynaecologists.

* Menstruation has not begun by age 17 - Primary Amenorrhea
* Menstruation has occurred and stopped briefly like in pregnancy or in
some illnesses or conditions of stress - Secondary Amenorrhea
* Abnormal heavy flow - Menorrhagia
* Scanty flow - Oligomenorrhea
* Consistently irregular menstrual periods - Metroragia
* Painful menstruation - Dysmenorrhea