Menstruation (Period)

Menstruation, commonly known as a period, is a natural and essential biological process experienced by women and girls of reproductive age. It is part of the menstrual cycle, which prepares the body for a possible pregnancy each month. When pregnancy does not occur, the lining of the uterus, called the endometrium, sheds and exits the body through the vagina. This shedding process is what we call menstruation.

The onset of menstruation, known as menarche, usually occurs between the ages of 10 and 15 years, although it can vary depending on genetics, nutrition, and overall health. It continues until menopause, which generally happens between the ages of 45 and 55, marking the natural end of a woman’s reproductive years. On average, periods last for about 3 to 7 days and repeat in a cycle of roughly 28 days, though the length and flow may differ for each individual.

Periods are not just a monthly event but an indicator of reproductive and overall health. Regular menstruation reflects the healthy functioning of hormones and the reproductive system, while irregularities can sometimes point to underlying medical conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal imbalances.

Despite being a natural process, menstruation is often surrounded by myths, taboos, and stigma in many societies, leading to a lack of awareness and discomfort in discussing it openly.

What is Menstruation

Menstruation, often referred to as a period, is a natural biological process in which the body sheds the inner lining of the uterus, known as the endometrium. This process occurs in women and girls of reproductive age, typically starting from puberty and continuing until menopause. Menstruation is an essential part of the menstrual cycle, which prepares the body for pregnancy each month. When pregnancy does not happen, the thickened uterine lining is no longer needed and is released from the body in the form of blood and tissue through the vagina.

The menstrual cycle is usually about 28 days long, though it can vary from 21 to 35 days in different individuals. Menstruation itself generally lasts between 3 to 7 days. The amount of blood loss also differs among women, but on average, the body releases about 30 to 80 milliliters of blood during a period. The flow may start light, become heavier during the middle days, and then gradually decrease before ending.

Menstruation is controlled by a delicate balance of hormones, mainly estrogen and progesterone. These hormones regulate the growth and shedding of the uterine lining. Each month, the body prepares for the possibility of pregnancy by thickening the uterine lining to support a fertilized egg. If fertilization does not occur, hormone levels drop, signaling the body to shed the lining. This shedding is what causes menstrual bleeding.

The first menstrual cycle, called menarche, usually occurs between the ages of 10 and 15 years. The end of menstruation, known as menopause, typically happens between 45 and 55 years of age, when the ovaries stop releasing eggs and hormone production decreases.

The Menstrual Cycle

The cycle is divided into four main phases: the menstrual phase, follicular phase, ovulation, and luteal phase. Each phase plays an important role in the reproductive process.

1. Menstrual Phase (Day 1 to Day 5)
This phase marks the beginning of the cycle. It starts on the first day of bleeding and usually lasts for 3 to 7 days. During this time, the thickened lining of the uterus (endometrium), which was built up in the previous cycle, is shed because pregnancy did not occur. The blood, along with tissue and mucus, exits the body through the vagina. Hormone levels of estrogen and progesterone are at their lowest during this phase, which triggers the shedding process.

2. Follicular Phase (Day 1 to Day 13)
The follicular phase overlaps with the menstrual phase at the beginning and continues after bleeding stops. It is controlled mainly by the follicle-stimulating hormone (FSH), which stimulates the ovaries to produce several small sacs called follicles. Each follicle contains an immature egg. Out of these, usually one follicle becomes dominant and continues to mature. At the same time, estrogen levels gradually rise, which helps the uterine lining grow and thicken again in preparation for a possible pregnancy.

3. Ovulation Phase (Around Day 14 in a 28-day cycle)
Ovulation is the release of a mature egg from the ovary. This occurs when a surge of luteinizing hormone (LH) is triggered by the rising estrogen levels. The mature egg is released into the fallopian tube, where it may meet sperm for fertilization. Ovulation is the most fertile period of the cycle, and it usually happens in the middle of the cycle. Some women may experience mild pain or discomfort, known as “mittelschmerz,” during ovulation.

4. Luteal Phase (Day 15 to Day 28)
After ovulation, the ruptured follicle transforms into a structure called the corpus luteum. This produces progesterone, along with small amounts of estrogen, to support the thickened uterine lining and prepare it for implantation if fertilization occurs. If the egg is not fertilized, the corpus luteum breaks down after about 14 days, leading to a drop in progesterone and estrogen levels. This hormonal decrease signals the body to start menstruation again, beginning a new cycle.

Symptoms During Periods

1. Physical Symptoms
The most common physical symptom during periods is abdominal cramps, medically called dysmenorrhea. These cramps occur because the uterus contracts to push out its lining. The contractions are triggered by hormone-like substances called prostaglandins, which are produced in higher amounts during menstruation. Mild cramps are normal, but very severe pain can be a sign of an underlying condition.

Other physical symptoms include bloating, breast tenderness, lower back pain, fatigue, and headaches. Some women may also experience digestive changes such as diarrhea or constipation, which happen because prostaglandins affect the muscles of the digestive tract as well. Acne breakouts are another frequent symptom, caused by hormonal fluctuations, especially changes in estrogen and progesterone levels.

2. Emotional and Psychological Symptoms
Many women experience emotional changes during their periods. These include mood swings, irritability, anxiety, sadness, or difficulty concentrating. Such symptoms are part of what is commonly called premenstrual syndrome (PMS). While mood changes are often linked to hormonal shifts, they can also be influenced by physical discomfort, stress, or lack of sleep.

Common Menstrual Problems

While menstruation is a natural and healthy process, many women experience difficulties that can interfere with daily life and may sometimes indicate underlying health conditions. These menstrual problems vary in type and severity, and understanding them is important for proper care and timely treatment.

1. Irregular Periods (Oligomenorrhea or Polymenorrhea)
Irregular periods occur when the menstrual cycle does not follow a predictable pattern. For some women, cycles may be shorter than 21 days (polymenorrhea), while for others, they may extend beyond 35 days (oligomenorrhea). Irregularities can be caused by stress, sudden weight changes, poor diet, excessive exercise, hormonal imbalances, or medical conditions like polycystic ovary syndrome (PCOS) and thyroid disorders. Occasional irregularity is common, but persistent irregular cycles may require medical evaluation.

2. Heavy Menstrual Bleeding (Menorrhagia)
Menorrhagia refers to excessively heavy or prolonged menstrual bleeding. Women with this condition may need to change sanitary products very frequently, pass large blood clots, or experience periods lasting more than a week. Heavy bleeding can lead to anemia, fatigue, and weakness due to loss of iron. Causes may include uterine fibroids, hormonal imbalances, certain medications, or bleeding disorders.

3. Painful Periods (Dysmenorrhea)
Dysmenorrhea is the medical term for severe menstrual cramps. While mild discomfort is common during menstruation, intense pain that interferes with normal activities is not typical. Primary dysmenorrhea is caused by the overproduction of prostaglandins, which trigger strong uterine contractions. Secondary dysmenorrhea is linked to medical conditions such as endometriosis, pelvic inflammatory disease, or fibroids. Persistent and severe pain should always be checked by a healthcare professional.

4. Premenstrual Syndrome (PMS)
PMS is a set of physical, emotional, and behavioral symptoms that occur in the days leading up to menstruation. Symptoms may include mood swings, irritability, anxiety, bloating, breast tenderness, headaches, and food cravings. While most women experience mild PMS, some may have severe symptoms that affect daily functioning. In extreme cases, it may develop into premenstrual dysphoric disorder (PMDD), which is a more intense and debilitating form.

5. Absence of Periods (Amenorrhea)
Amenorrhea is the absence of menstruation. It is classified as primary when a girl has not had her first period by the age of 15, and secondary when a woman who previously had regular cycles stops menstruating for three or more months. Common causes include pregnancy, stress, eating disorders, excessive exercise, hormonal problems, or conditions like PCOS. Amenorrhea is not a disease itself but a symptom of an underlying issue that requires medical investigation.

6. Other Related Problems
Some women also face issues like spotting between periods, very short cycles, or very light bleeding (hypomenorrhea). These may be harmless in some cases but can also be linked to hormonal disturbances or gynecological conditions that need attention.

Hygiene and Care During Periods

Maintaining proper hygiene and self-care during menstruation is essential for protecting health, preventing infections, and ensuring comfort. Since menstrual blood is a natural body fluid, it can create a moist environment that encourages bacterial growth if not managed carefully. Good menstrual hygiene practices also help women feel more confident and reduce the physical discomforts associated with periods.

1. Use of Sanitary Products
The most important aspect of menstrual hygiene is the correct use of sanitary products. Women can choose from sanitary pads, tampons, and menstrual cups based on personal comfort and convenience. Sanitary pads are the most widely used and should be changed every 4 to 6 hours to prevent bacterial buildup and odor. Tampons, which are inserted into the vagina, should be replaced every 4 to 8 hours, as leaving them in for too long can increase the risk of toxic shock syndrome (TSS), a rare but serious condition. Menstrual cups, made of medical-grade silicone, can be reused for several years with proper cleaning and are an eco-friendly alternative.

2. Regular Changing and Disposal
Changing pads, tampons, or cups at recommended intervals is crucial to avoid infections such as urinary tract infections (UTIs) or vaginal infections. Used pads and tampons should be wrapped properly and disposed of in closed bins to maintain hygiene and prevent the spread of odor. Flushing these products into toilets can cause blockages and should be avoided. Menstrual cups need to be emptied, rinsed, and sterilized between cycles.

3. Personal Cleanliness
Washing the genital area regularly during periods helps in maintaining freshness and preventing infections. It is advised to use plain water or mild, unscented soap instead of harsh cleansers, as strong chemicals or perfumes can disturb the natural pH balance of the vagina. Frequent washing of the external genital area, especially after changing sanitary products, is recommended, but excessive washing or douching should be avoided because it can irritate the tissues and increase infection risk.

4. Comfortable Clothing
Wearing clean, breathable cotton underwear during menstruation is preferable, as it allows air circulation and reduces moisture buildup. Tight clothing, especially synthetic fabrics, can trap heat and sweat, creating conditions for bacterial growth and discomfort. Choosing loose-fitting clothes during periods often adds to comfort.

5. Diet and Hydration
Proper nutrition and hydration also play a role in menstrual care. Drinking enough water helps reduce bloating, while consuming iron-rich foods like green leafy vegetables, legumes, nuts, and lean meats can replenish iron lost through bleeding. Avoiding excessive caffeine, processed foods, and salty snacks can help reduce cramps, fatigue, and mood swings.

6. Managing Pain and Discomfort
Menstrual cramps and back pain can be relieved by applying a hot water bag to the lower abdomen or back, practicing gentle stretching exercises, and ensuring adequate rest. Over-the-counter pain relievers may be used when necessary but should not replace medical consultation if pain is unusually severe. Light physical activity, yoga, or relaxation techniques can also improve circulation and ease discomfort.

7. Emotional Care
Periods can also affect mood due to hormonal changes. Taking time to rest, practicing relaxation techniques, and ensuring good sleep are vital for emotional well-being. Support from family and open conversations help reduce stress and break social taboos, making it easier for women to take care of themselves without embarrassment.

Menstrual hygiene and care involve proper use of sanitary products, regular cleaning, balanced nutrition, and physical as well as emotional self-care.

Myths and Misconceptions about Menstruation

Menstruation, has long been surrounded by myths, misconceptions, and cultural taboos in many parts of the world. These beliefs arise from a lack of scientific understanding and are passed down through generations. Unfortunately, such misconceptions can lead to shame, restrictions, and even poor health practices among women and girls. Addressing these myths with accurate knowledge is essential for promoting awareness and breaking the stigma.

1. Menstruation as a Sign of Impurity
One of the most widespread myths is that women are “impure” or “unclean” during their periods. This belief often results in restrictions, such as prohibiting women from entering temples, participating in rituals, or even entering kitchens. Scientifically, menstruation is simply the shedding of the uterine lining and has nothing to do with impurity. Labeling it as unclean only deepens stigma and affects women’s dignity.

2. Menstrual Blood is Dirty or Toxic
Another common misconception is that menstrual blood is impure or harmful. In reality, menstrual blood is a mixture of blood, tissue, and mucus that the body naturally sheds when pregnancy does not occur. It is not toxic or waste in the harmful sense. It is just like any other blood that flows from the body, except that it contains uterine tissue.

3. Avoiding Certain Foods During Periods
In many cultures, women are told not to eat foods such as pickles, curd, tamarind, or sour fruits during menstruation. The belief is that these foods will spoil inside the body or worsen cramps. Scientifically, there is no evidence to support such claims. In fact, nutritious foods, including fruits and dairy, provide important vitamins and minerals that help women stay healthy and even reduce discomfort during periods.

4. Menstruation as a Disease
In some communities, menstruation is wrongly thought of as a disease or an illness that needs treatment. This misconception can create fear and embarrassment among young girls when they get their first period. In truth, menstruation is a healthy and normal process that indicates proper functioning of the reproductive system.

5. Talking About Periods is Shameful
Many societies treat menstruation as a secretive or shameful subject, leading to embarrassment and lack of open discussion. This silence prevents girls from learning proper hygiene practices and from seeking medical help when problems arise. Open conversations and education about menstruation are vital for breaking this cycle of shame.

Myths and misconceptions about menstruation have no scientific basis but continue to affect the lives of women and girls. These false beliefs create unnecessary restrictions, increase stigma, and harm both physical and emotional well-being. Replacing myths with accurate knowledge and encouraging open discussion helps society view menstruation as the natural, healthy process it truly is.