Menstruation is the process of bleeding from the vagina that occurs due to the natural monthly cycle of a woman's body. This cycle is the process of the female reproductive organs to prepare for pregnancy. This preparation is characterized by thickening of the uterine wall (endometrium) which contains blood vessels. If pregnancy does not occur, the endometrium will slough off and come out with blood through the vagina.
This cycle lasts about 4 weeks, starting from the first day of menstruation, until the first day of the next menstruation arrives. The menstrual cycle in a woman is regulated by various hormones, both those produced by the reproductive organs and other glands. Some of the hormones involved are GnRH (gonadotropin relasing hormone), FSH (folicle sstimulating hormone), LH (luteinizing hormone), estrogen and progesterone.
Based on changes in uterine conditions and hormone concentrations, the menstrual cycle is divided into several phases, namely:
- Menstrual phase. Menstrual phase is the first phase in the menstrual cycle. This phase is characterized by the sloughing of the uterine wall which contains blood vessels and mucus. Menstrual phase occurs when the egg is not fertilized so pregnancy does not occur. This condition causes the uterine wall which had thickened in the previous phases to prepare for pregnancy, is no longer needed by the body.
- follicular phase. This phase occurs when the hypothalamus gland in the brain secretes GnRH to stimulate the pituitary or pituitary gland to secrete FSH. FSH will stimulate the ovaries or ovaries to form follicles containing immature eggs. The follicle will continue to grow for about 16 days along with the development of the egg. Follicles that are undergoing maturation will release the hormone estrogen which begins to stimulate the thickening of the uterine wall.
- Ovulation phase. Ovulation phase occurs when the ovary releases a mature egg into the fallopian tube. The egg will come out of the ovary when the LH level in the body reaches its peak. The egg that comes out of the ovary will travel to the uterus to be ready to be fertilized by sperm. If not fertilized, the egg will fuse 24 hours after ovulation. In women who have a menstrual cycle of 28 days, ovulation generally occurs on day 14. At this time, the vagina will secrete cervical mucus.
- luteal phase. This phase occurs when the follicle that has released a mature egg turns into a tissue called the corpus luteum. The corpus luteum will secrete the hormones estrogen and progesterone to keep the uterine wall or uterus thick, so that the uterus remains ready to accommodate an egg if it is fertilized. If pregnancy occurs, the woman's body will secrete the hormone HCG.Human Chorionic Gonadotropin) to keep the corpus luteum in the ovary so that the uterine wall does not shed. However, if pregnancy does not occur, the corpus luteum will decay so that the levels of the hormones estrogen and progesterone in the blood will also decrease. Decreased levels of the hormones estrogen and progesterone will cause the uterine wall to slough off and menstruation occurs. The luteal phase generally lasts about 11-17 days with an average length of 14 days.
Menstruation normally occurs about 3-7 days in most women. However, not all women experience the same cycle, even among women of similar age. Menstrual cycles can sometimes come sooner or later, with differences ranging from 21 to 35 days.
Age of First Menstruation
The first menstrual cycle occurs in teenage girls when they enter puberty, usually starting at the age of 12 years or about 2-3 years after breasts begin to grow. The age of the first menstruation experienced by a child also generally occurs at the same age as their mother or older sister.
The first period can come sooner or later. Some have experienced it since around the age of 8 years, and some have just experienced it over the age of 12 years. However, most teenage girls have experienced menstruation regularly at the age of 16 to 18 years. Menstruation will continue until menopause arrives. Menopause can occur in women aged 40 years to mid-50 years.
Symptom-Symptoms on Cycle Menstruation
syndrome premenstrual (PMS)
In the menstrual cycle, changes in hormone levels in a woman's body will occur. Changes in the amount of hormones can affect physical and emotional, which can appear a few days before menstruation. This symptom is called premenstrual syndrome or premenstrual syndrome (PMS).
A number of physical and emotional changes that usually appear before menstruation are:
- Tired
- Headache
- Bloated
- Breasts become sensitive
- Weight gain
- Pain in muscles and joints
- Diarrhea or constipation
- Acne appears.
- Vaginal discharge or vaginal discharge is normal before menstruation.
Meanwhile, emotional changes that can occur when women experience PMS are:
- grumpy
- Unstable mood
- Difficult to concentrate
- Easy cry
- Hard to sleep
- Changes in appetite
- Excessive anxiety
- Decreased self-confidence
- Decreased sex drive.
In some women, PMS symptoms can seriously interfere with daily activities, forcing women with severe PMS to rest. However, regardless of how severe PMS symptoms are, they will subside after about 4 days.
Menstruation
During menstruation, women will experience vaginal bleeding for 2 days to a week, with an average blood volume of about 30-70 milliliters. But there are some women who bleed more so that menstrual blood clots. The highest volume of bleeding during menstruation occurs on the first and second day.
During menstruation, abdominal pain or cramps may also occur. If you experience stomach pain or cramping that interferes with your daily activities, the following ways can be useful to reduce it:
- Warm the stomach, for example with a warm compress
- Light exercise, such as walking or cycling
- Massaging the lower abdomen
- Taking painkillers, such as paracetamol
- Quit smoking
- Practice relaxation techniques, such as yoga and meditation
- Avoid drinks containing caffeine and alcohol.
Abnormalities in the Menstrual Cycle
The duration and volume of bleeding in the menstrual cycle experienced by each woman is different. Every woman is encouraged to pay attention to or record her menstrual cycle so that she can immediately notice if certain irregularities appear. An unusual menstrual cycle or excessive blood volume can sometimes signal a health problem.
Symptoms of menstrual cycle abnormalities are different for each disorder. But in general, the symptoms that need to be considered as a sign of menstrual cycle abnormalities are:
- Occurs more than 7 days
- Experiencing heavy bleeding that causes the need to change pads or tampons every 1-2 hours
- Menstruation occurs more frequently within 21 days
- The occurrence of menstruation less than it should be within 45 days
- Experiencing heavy bleeding followed by the appearance of bruising or bleeding. This should be of particular concern in women who have a family history of bleeding disorders.
Menstrual abnormalities in women at the early age of menstruation can be observed from signs such as:
- Menstruation has not occurred within 3 years after breast development
- Menstruation has not occurred at the age of 15 years
- Menstruation has not occurred at the age of 14 years followed by signs of hirsutism.
Problems in menstruation that commonly occur are divided into four categories, namely:
Menorrhagia
Menorrhagia is excessive blood volume during menstruation. Some of the symptoms in this condition are:
- The volume of blood is too much so you have to change pads every hour and this lasts for several hours
- Have to use two pads to contain the bleeding
- Have to get up to change sanitary napkins while sleeping
- Have symptoms of anemia, such as weakness or shortness of breath
- Menstrual duration that lasts more than 7 days or long menstruation
- Passing large blood clots for more than a day
- Forced to limit the routine because the volume of blood lost is excessive during menstruation.
This disorder can be caused by various things, ranging from hormonal imbalances to fibroids that grow in the uterus. Therefore, you should consult a doctor if you experience excessive bleeding so that it can be treated carefully.
Metrorrhagia
Metrorrhagia is bleeding from the vagina that occurs between two menstrual periods. The causes of metrorrhagia are quite diverse, can be caused by hormonal imbalances, infections, fibroids, to cancer. If metrorrhagia appears, it is recommended to consult a doctor for an examination so that the cause can be treated. Treatment of metrorrhagia depends on the cause of the occurrence of metrorrhagia.
Oligomenorrhea
Menstruation usually comes every 21 to 35 days. However, there are also women who experience irregular menstruation, that is, when menstruation comes after 90 days. This condition is referred to as oligomenorrhea.
There are several causes, such as the use of contraception, drugs to delay menstruation, strenuous exercise, eating disorders, as well as diabetes and thyroid disease, so the treatment is different.
Amenorrhea
Amenorrhea is a medical term in which menstruation stops completely. This condition can occur naturally or caused by disease and the consumption of certain drugs.
A number of natural factors can cause this problem, including:
- Pregnancy
- Breast-feed
- Menopause.
Diseases that attack the ovaries (ovaries), such as: polycystic ovarian syndrome (PCOS), scars on the uterine wall, abnormal vaginal shape, reproductive organs that are not fully developed, thyroid hormone disorders, and the presence of tumors in the pituitary gland or pituitary in the brain can also cause amenorrhea.
Consumption of drugs and birth control pills, stress, excessive exercise, and being underweight can also cause amenorrheaea. If the cause is resolved, menstruation will return to normal.
Dysmenorrhea
Dysmenorrhea or menstrual pain is a common thing that has been felt by every woman. Dysmenorrhea which usually occurs before and during menstruation is generally in the form of pain or cramping in the lower abdomen that continues, and sometimes spreads to the lower back and thighs. The pain can also be accompanied by headaches, nausea, and diarrhea.
Painkillers can be used to treat dysmenorrhea. But call your doctor if you experience menstrual pain that is unbearable or gets worse to make sure that this condition is not caused by a certain disease, especially if you are over the age of 25.