Menstruation , also known as period or monthly , is the regular removal of blood and mucosal tissue (known as menstruation) from the inner lining of the uterus through the vagina. The first period usually begins between twelve and fifteen years, a time point known as menarche. However, periods can sometimes begin as young as eight years and are still considered normal. The average age of the first period is generally later in the developing world, and previously in the developed world. The typical length of time between the first day of one period and the first day is 21 to 45 days in young women, and 21 to 31 days in adults (28 days on average). Bleeding usually lasts about 2 to 7 days. Menstruation ceases after menopause, which usually occurs between 45 and 55 years. The period also stops during pregnancy and usually does not continue during the early months of breastfeeding.
Up to 80% of women report having some symptoms before menstruation. Common signs and symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood swings. This can interfere with normal life, thus qualifying as premenstrual syndrome, in 20 to 30% of women. In 3 to 8%, the symptoms are severe.
The lack of a period, known as amenorrhea, is when the period does not occur at age 15 or has not occurred in 90 days. Other problems with the menstrual cycle include painful periods and abnormal bleeding such as bleeding between periods or severe bleeding. Menstruation in other animals occurs in primates, such as apes and monkeys, as well as bats and shrew rats.
The menstrual cycle occurs due to the rise and fall of hormones. This cycle results in the thickening of the lining of the uterus, and the growth of the egg, (which is necessary for pregnancy). Eggs are released from the ovaries around the fourteenth day of the cycle; the thickened uterine lining provides nutrients to the embryo after implantation. If the pregnancy does not occur, the layer is released on what is known as menstruation.
Video Menstruation
Onset and frequency
The first menstrual period occurs after the onset of pubertal growth, and is called menarche. The average age of menarche is 12 to 15. However, it may start as early as eight. The average age of the first period is generally later in the developing world, and previously in the developed world. The average age of menarche has changed little in the United States since the 1950s.
Menstruation is the most visible phase of the menstrual cycle and its beginning is used as a marker between cycles. The first day of menstrual bleeding is the date used for the last menstrual period (LMP). The typical length of time between the first day of one period and the first day is 21 to 45 days in young women, and 21 to 31 days in adults (28 days on average).
Perimenopause is when fertility in women decreases, and menstruation occurs less regularly in the years leading up to the end of the menstrual period, when a woman stops her full menstrual period and is no longer fertile. The medical definition of menopause is one year without period and usually occurs between 45 and 55 in Western countries.
During pregnancy and for some time after delivery, there is no menstruation; this condition is known as amenorrhoea. If menstruation has not returned, fertility is low during breastfeeding. The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this can be done deliberately as birth control.
Maps Menstruation
Health effects
In most women, various physical changes are caused by fluctuations in hormone levels during the menstrual cycle. This includes uterine muscle contractions (menstrual cramps) that may precede or accompany menstruation. Some may see water retention, changes in sex drive, fatigue, breast tenderness, or nausea. Breast swelling and discomfort may be caused by water retention during menstruation. Usually, such sensations are mild, and some women see very little physical changes associated with menstruation. A healthy diet, reducing the consumption of salt, caffeine and alcohol, and regular exercise may be effective for women in controlling some symptoms. Severe symptoms that interfere with daily activities and functions can be diagnosed as premenstrual dysphoric disorder. Symptoms before menstruation are known as premenstrual molimina.
Cramp
Many women experience painful cramps, also known as dysmenorrhea, during menstruation. Pain is caused by ischemia and muscle contraction. The spiral artery in the secretory endometrium narrows, resulting in ischemia in the secretory endometrium. This allows the uterine lining to peel. The myometrium contracts spasmodically to induce menstrual fluid through the cervix and out of the vagina. Contractions are mediated by the release of prostaglandins.
The painful menstrual cramps resulting from excessive release of prostaglandins are referred to as primary dysmenorrhea. Primary dysmenorrhea usually begins in one or two years of menarche, usually with the onset of the ovulatory cycle. Treatments that target the pain mechanism include non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives. NSAIDs inhibit prostaglandin production. With long-term treatment, hormonal birth control reduces the amount of fluid/uterine tissue removed from the uterus. Thus resulting in shorter menstruation and less pain. These drugs are usually more effective than treatments that do not target the source of the pain (eg acetaminophen). Risk factors for primary dysmenorrhea include: early age at menarche, long or heavy menstrual period, smoking, and family history of dysmenorrhea. Regular physical activity can limit the severity of uterine cramps.
For many women, primary dysmenorrhea gradually subsides at the end of the second generation. Pregnancy has also been shown to reduce the severity of dysmenorrhea, when menstruation is continued. However, dysmenorrhea may progress to menopause. 5-15% of women with symptoms of dysmenorrhea experience severe enough to interfere with daily activities.
Secondary dysmenorrhea is a diagnosis given when menstrual pain is the secondary cause of other disorders. The conditions that cause secondary dysmenorrhea include endometriosis, uterine fibroids, and uterine adenomyosis. Rarely, congenital malformations, intrauterine devices, certain cancers, and pelvic infections cause secondary dysmenorrhea. Symptoms include pain that spreads to the hips, lower back and thighs, nausea, and frequent diarrhea or constipation. If pain occurs between menstrual periods, lasts longer than the first few days of the period, or is inadequately exempted by the use of non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, women should be evaluated for secondary dysmenorrhea.
When severe pelvic pain and bleeding occur suddenly or worsen during the cycle, the woman or girl should be evaluated for ectopic pregnancy and spontaneous abortion. This evaluation begins with a pregnancy test and should be done as soon as the unusual pain starts, because ectopic pregnancy can be life-threatening.
In some cases, strong physical and emotional or psychological sensations can interfere with normal activities, and include menstrual pain (dysmenorrhea), migraine headaches, and depression. Dysmenorrhea, or severe uterine pain, is very common for young women (one study found that 67.2% of girls aged 13-19 years had it).
Drugs in the non-steroidal anti-inflammatory class (NSAIDs) are commonly used to relieve menstrual cramps. Some herbs are also claimed to help.
Mood and behavior
Some women experience emotional disturbances starting one or two weeks before their period, and stop shortly after the period begins. Symptoms may include mental tension, irritability, mood swings, and a crying spell. Problems with concentration and memory may occur. There may also be depression or anxiety.
It is part of premenstrual syndrome (PMS) and is thought to occur in 20 to 30% of women. In 3 to 8% it is severe.
More severe symptoms of anxiety or depression may be signs of premenstrual dysphoric disorder (PMDD). Rarely, in susceptible individuals, menstruation can be a trigger for menstrual psychosis.
Extreme psychological stress can also cause menstruation to stop.
Bleeding
The average volume of menstrual fluid during the monthly menstrual period is 35 milliliters (2.4 tablespoons of menstrual fluid) with 10-80 milliliters (1-6 tablespoons of menstrual fluid) which is considered typical. Menstrual fluid is the correct name for the flow, although many people prefer to call it menstrual blood. Menstrual fluid contains some blood, as well as cervical mucus, vaginal fluid, and endometrial tissue. Menstrual fluid is reddish brown, a color slightly darker than venous blood.
About half of menstrual fluids are blood. This blood contains sodium, calcium, phosphate, iron, and chloride, to what extent depends on women. As well as blood, the fluid consists of cervical mucus, vaginal fluid, and endometrial tissue. The vaginal fluid in menstruation mainly contributes to water, general electrolytes, organ parts, and at least 14 proteins, including glycoproteins.
Many adult women see blood clots during menstruation. It appears as a blood clot that may look like a tissue. If there is a question (for example, is there a miscarriage?), The examination under a microscope can confirm whether it is the endometrial tissue or pregnancy tissue (conception product) that is shed. Occasionally, menstrual blobs or endometrial tissue removed incorrectly are thought to indicate fetal miscarriage in the early period. An enzyme called plasmin - which is contained in the endometrium - tends to inhibit blood from clotting.
The amount of iron lost in menstrual fluids is relatively small for most women. In one study, premenopausal women who exhibited iron deficiency symptoms were given endoscopy. 86% of them actually have gastrointestinal disease and are at risk of being misdiagnosed just because they are menstruating. Severe menstrual bleeding, occurring every month, can cause anemia.
Menstrual disorders
There are various differences in how women experience menstruation. There are several ways that one's menstrual cycle can be different from the norm, wherever it should be discussed with the doctor to identify the underlying cause:
There is a movement among gynecologists to discard the above-mentioned terms, which, although widely used, have no precise definition. Many now contend to describe menstruation in simple terms, including:
- Cycle regularity (irregular, regular, or non-existent)
- The frequency of menstruation (often, normal, or rare)
- The duration of menstrual flow (prolonged, normal, or short)
- Menstrual flow volume (heavy, normal, or bright)
Dysfunctional uterine bleeding is a bleeding disorder caused by hormones. Dysfunctional uterine bleeding usually occurs in women who do not ovulate normally (ie, anovulation). All of these bleeding disorders require medical attention; they may show hormonal imbalances, uterine fibroids, or other problems. Because pregnant women may experience bleeding, a pregnancy test is part of the evaluation of abnormal bleeding.
Women who have experienced female genital mutilation (especially type III-infibulation) practices that are common in some parts of Africa, may experience menstrual problems, such as slow and painful menstruation, caused by an almost complete blockage of the vagina.
Premature or delayed menarche should be investigated if menarche begins before 9 years, if menarche has not started at age 15, if there is no breast development at 13 years of age, or if there is no period 3 years after the onset of breast development.
Ovulation Suppression
Birth control
Since the late 1960s, many women have chosen to control the frequency of menstruation with the hormonal contraceptive pill. They are most often combined hormone pills containing estrogen and taken in a 28-day cycle, 21 hormone pills with either a 7 day break from a pill, or 7 placebo pills during a woman's menstruation. Hormonal birth control acts by using low-dose hormones to prevent ovulation, and thus prevent pregnancy in sexually active women. But by using placebo pills for a range of 7 days during the month, regular bleeding periods are still experienced.
Injections such as depo-provera became available in the 1960s. Implants of progestogens such as Norplant in the 1980s and extended cycles combined oral contraceptive pills in the early 2000s.
Using synthetic hormones, it is possible for a woman to completely eliminate the menstrual period. When using progestogen implants, menstruation can be reduced to 3 or 4 menstrual periods per year. By taking the only progestogen-only contraceptive pill (sometimes called a 'mini pill') continuously without a 7-day span using placebo pills, the menstrual period did not occur. Some women do this only for comfort in the short term, while others prefer to eliminate time altogether if possible.
Some women use hormonal contraception in this way to remove their menstruation for months or years at a time, a practice called menstrual suppression. When the first birth control pill is being developed, researchers realize they can use contraception for menstrual periods spaces of up to 90 days apart, but they settle on a 28-day cycle that will mimic the natural menstrual cycle and produce a monthly period. The purpose behind this decision is the hope of its discoverer, John Rock, to win the approval of his invention of the Roman Catholic Church. The effort failed, but the 28-day cycle remained the standard when the pill was available to the public. There is a debate among medical researchers about the potential long-term impact of these practices on women's health. Some researchers point to the fact that historically, women have much fewer menstrual periods during their lifetime, the result of shorter life expectancy, and longer time spent on pregnancy or lactation, which reduces the number of periods experienced by women. These researchers believe that the higher number of menstrual periods by women in modern society may have a negative impact on their health. On the other hand, some researchers believe there is a greater potential for the negative impact of exposing women who may not necessarily be the usual low-dose synthetic hormones during their reproductive years.
Breastfeeding
Breastfeeding causes negative feedback to occur in the pulse of gonadotropin-releasing (GnRH) hormonal secretion and luteinizing hormone (LH). Depending on the strength of negative feedback, breastfeeding women may experience a complete emphasis on follicular development, follicular development but no ovulation, or a normal menstrual cycle can be continued. The suppression of ovulation is more likely when breastfeeding is more common. Production of prolactin in response to breastfeeding is important to maintain lactational amenorrhea. On average, women who breast-feed fully who their babies suck often experience a return of menstruation at fourteen and half months postpartum. There are various responses among women who are breastfeeding individually, however, with some having menstrual returns at two months and others remaining amenorrhea up to 42 months postpartum.
Menstrual Management
Menstruation is managed by menstruating women to avoid clothing damage or in accordance with the norms of public life. Menstrual management practices range from menstrual medical suppression, through wearing special clothing or other items, washing or avoiding laundry, disposal and laundry of stained materials, for menstrual separation to certain places or activities.
Menstrual products (also called "feminine health products") are made to absorb or capture menstrual blood. A number of different products are available - some can be discarded, some can be reused. Where women can afford it, the items used to absorb or catch menstruation are usually commercially produced products.
There are disposable products:
- sanitary napkins (also called bandages or pads) - Square pieces worn on underwear to absorb menstrual flow, often with a glue pad to hold the pads in place. Disposable pads may contain wood pulp or gel products, usually with a plastic coating and bleached.
- Tampons - Disposable tubes of a rayon/cotton mixture or cotton fur, usually bleached, are inserted into the vagina to absorb menstrual flow.
- Disposable menstrual cups made of soft plastic - A powerful and flexible cup-shaped tool used inside the vagina to collect menstrual flow.
Reusable products include:
- Menstrual cups - A hard and flexible bell tool used inside the vagina to collect menstrual flow. Menstrual cups are usually made of silicone and can last 5 years or longer.
- Reusable cloth cushions - cotton pads (often organic), terrycloth, or flannel, and can be processed (from materials or reused old clothes and towels) or stored alone.
- Overgrow pants or proof-of-length clothing - Reusable cloth clothing (usually cotton) with an extra absorbent layer sewn to absorb the flow. Some also use patented leak-proof technology, such as the THINX brand.
- Sea sponge - Natural sponge, worn internally like a tampon to absorb menstrual flow.
- Blankets, towels - (also known as a picture) - a large piece of reusable clothing, most commonly used at night, placed between the legs to absorb menstrual flow.
In developing countries, many poor women can not afford commercial feminine hygiene products. Instead, they use materials found in the environment or other improvised materials. The absorption materials that can be used by women who can not afford anything include: sand, ash, small holes in the earth, fabrics, whole leaves, leaf fiber (such as water hyacinth, banana, papyrus, cotton fiber), paper (toilet paper, back paper, pulped and dried paper), for example goat skin pelt animals, double layers of underwear, skirts or saris.
Society and culture
Tradition and taboo
Many religions have traditions related to menstruation, for example:
- Islam prohibits sexual intercourse with women during menstruation in chapter 2 of the Quran. Women are freed from Salah (prayer). They are also forbidden fasting and fasting obligatory Ramadan should be done during other days. During mens pilgrimage is allowed; however, encircling the Kaaba is forbidden and must be done at other times.
- The Law of Niddah in Judaism can forbid certain actions during menstruation (such as sexual intercourse in some Judaism movements) or rituals performed at the end of each menstrual period (such as
). Some traditional societies seize women in residence called "menstrual cottages" provided for exclusive purposes. - In Hinduism, it is also crimped to go to the temple and do pooja (ie, pray) or do
pooja at religious events if someone is menstruating. The Metaphormic Theory, as proposed by the cultural theorist Judy Grahn and others, places menstruation as the central organizing idea in the creation of culture and the formation of early human rituals.
- Although most Christian denominations do not follow a specific or prescribed ritual for menstruation, Western civilization, which has been predominantly Christian, has a history of menstrual taboos, with menstruating women believed to be dangerous.
Anthropologists, Keys and Nguyen (2010), have noted that heavy medicines from the stage of reproductive life of women in the West, imitating the power structures considered, in other cultural practices, serve as a form of "social control". The medalization of women's life stages, such as birth and menstruation, has revived a feminist perspective exploring the social implications of biomedical practice. "[C] ultural reproductive analysis... attempts to show how women... show resistance and create the dominant alternative meaning of body and reproduction to those who are dominant among the medical profession."
In some parts of South Asia, women are isolated during menstruation. In 2005, in Nepal, the Supreme Court abolished the practice of chhaupadi, keeping women in the cow shed during menstruation.
Sexual activity
Sexual intercourse during menstruation does not cause damage in itself, but a woman's body is more vulnerable during this time. The vaginal pH is higher and thus less acidic than normal, the cervix is ​​lower in position, the cervical opening is wider, and the uterine endometrium layer is absent, allowing the organisms direct access to the bloodstream through multiple blood vessels that fertilize the uterus. All of these conditions increase the likelihood of infection during menstruation.
Education
Menstruation education is often taught in combination with sex education in the US, although one study showed that women would prefer their mothers to be the main source of information about menstruation and puberty. A study in Nigeria showed the following details in menstrual education: "56% parents, 53% friends, 46% books, 44% teachers, 45% internet, and 54" had the greatest influence on menstrual education. Information about menstruation is often shared among friends and peers, who can promote a more positive view of puberty.
The quality of menstrual education in a community determines the accuracy of the community's understanding of the process. This is partly due to the separation of male and female counterparts during the education session. Failure to teach an accurate understanding of menstruation to students of all sexes has social implications for gender relations and the body's objectification of women. Discomfort arises when students do not have access to the same information, reinforcing the belief "that menstruation is dirty and must be hidden". Girls are encouraged to hide the fact that they may be menstruating to be considered desirable. Sexual harassment and teasing about menstruation leads to anxious daughters as they have to struggle to ensure that they do not give signs of menstruation.
An effective educational program is essential to provide children and adolescents with clear and accurate information about menstruation. Some education and sexual health experts have learned the key features needed for such programs. Some experts argue that schools are the right place for menstrual education to occur because they are the institutions that young people attend consistently. Schools are meant to broaden students' knowledge and thus serve as the appropriate site for delivering menstrual education.
Other experts argue that programs led by colleagues or third-party agencies are more effective than those taught in the school classroom. This may be due to the use of small group interactions, the ability of these programs to target specific populations, or the likelihood that many youth choose to participate voluntarily in these programs, rather than being mandated to attend school programs.
Evolution
All female placental mammals have a layer of uterus that accumulates when the animal is fertile, but is dismantled when the animal is infertile. Most female mammals have an estrus cycle, but only primates (including humans), some species of bats, and elephant mice have menstrual cycles. (The killer whale, Orcinus orca , is one of several species undergoing menopause.) Some anthropologists question the energy cost of rebuilding the endometrium every fertility cycle. However, anthropologist Beverly Strassmann has proposed that energy savings because it does not have to continuously maintain the lining of the uterus more than offset the energy costs of having to rebuild the layers in the next fertility cycle, even in species like humans. in which many layers are lost due to bleeding (menstruation is obvious) rather than reabsorbed (menstruated veiled).
Many have questioned the apparent evolution of menstruation in humans and related species, speculating on what advantages might be for blood loss associated with endometrial discharge, rather than absorbing it, as most mammals do. Humans, in fact, absorb about two thirds of the endometrium every cycle. Strassmann asserted that blatant menstruation occurs not because it is beneficial in itself. Conversely, fetal development of this species requires more advanced endometrium, which is too thick to be fully absorbed. Strassman correlates species that have real menstruation for those who have a large uterus relative to the size of an adult female body.
Beginning in 1971, several studies have shown that the menstrual cycle of cohabiting women becomes synchronized. Some anthropologists hypothesized that in hunter-gatherer societies men would go on a hunting trip while females from that tribe were menstruating, speculating that females would not be so readily acceptable during menstruation. However, there is currently a significant disagreement, whether there is synchronization of menstruation.
See also
- Menstrual cycle
- Menstrual Hygiene Day
References
Further reading
-
Howie, Gillian; Shail, Andrew (2005). Menstruation: Cultural History . Palgrave Macmillan. ISBNÃ, 1-4039-3935-7 . Retrieved November 9 2013 . - Knight, Chris (1995). Blood Relation: Menstruation and Cultural Origin . New Haven and London: Yale University. ISBNÃ, 0-300-04911-0 . Retrieved November 9 2013 .
External links
- Museum of Menstruation
Source of the article : Wikipedia
0 Comments