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Menstruation is the shedding of the uterine lining (endometrium). It occurs on a regular basis in reproductive-age females of certain mammal species. Overt menstruation (where there is bleeding from the uterus through the vagina) is found primarily in humans and close evolutionary relatives such as chimpanzees.[1] The females of other placental mammal species have estrous cycles, in which the endometrium is reabsorbed by the animal (covert menstruation) at the end of its reproductive cycle. Many zoologists regard this as different from a "true" menstrual cycle.

Contents

Overview

Eumenorrhea denotes normal, regular menstruation that lasts for a few days (usually 3 to 5 days, but anywhere from 2 to 7 days is considered normal).[2] The average blood loss during menstruation is 35 millilitres with 10-80 mL considered normal;[3] many women also notice shedding of the endometrium lining that appears as tissue mixed with the blood. (Sometimes this is erroneously thought to indicate an early-term miscarriage of an embryo.) An enzyme called plasmin — contained in the endometrium — tends to inhibit the blood from clotting. Because of this blood loss, premenopausal women have higher dietary requirements for iron to prevent iron deficiency. Many women experience uterine cramps, also referred to as dysmenorrhea, during this time, caused largely by the contractions of the uterine muscle as it expels the endometrial blood from the woman's body. A vast industry has grown to provide drugs to aid in these cramps, as well as sanitary products to help manage menses.

As part of the menstrual cycle

Menstruation is the most visible phase of the menstrual cycle. Menstrual cycles are counted from the first day of menstrual bleeding, because the onset of menstruation corresponds closely with the hormonal cycle.

During pregnancy and for some time after childbirth, menstruation is normally suspended; this state is known as amenorrhoea, i.e. absence of the menstrual cycle. If menstruation has not resumed, fertility is low during lactation. The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this may be done intentionally as birth control (lactational amenorrhea method).

Evolution

All female placental mammals have a uterine lining that builds up when the animal is fertile, but is dismantled (menstruated) when the animal is infertile. Some anthropologists have questioned the energy cost of rebuilding the endometrium every fertility cycle. However, anthropologist Beverly Strassmann has proposed that the energy savings of not having to continuously maintain the uterine lining more than offsets energy cost of having to rebuild the lining in the next fertility cycle, even in species such as humans where much of the lining is lost through bleeding (overt menstruation) rather than reabsorbed (covert menstruation).[1][4] However, even in humans, much of it is re-absorbed.

Many have questioned the evolution of overt menstruation in humans and related species, speculating on what advantage there could be to losing blood associated with dismantling the endometrium rather than absorbing it, as most mammals do.

Beginning in 1971, some research suggested that menstrual cycles of co-habiting human females became synchronized. A few anthropologists hypothesized that in hunter-gatherer societies, males would go on hunting journeys whilst the females of the tribe were menstruating, speculating that the females would not have been as receptive to sexual relations while menstruating.[5][6] However, there is currently significant dispute as to whether menstrual synchrony exists.[7]

Humans do, in fact, reabsorb about two-thirds of the endometrium each cycle. Strassmann asserts that overt menstruation occurs not because it is beneficial in itself. Rather, the fetal development of these species requires a more developed endometrium, one which is too thick to completely reabsorb. Strassman correlates species that have overt menstruation to those that have a large uterus relative to the adult female body size.[1]

Culture and menstruation

Common usage refers to menstruation and menses as a period, a contraction of "menstrual period". A woman might say that her "period is late," or simply "I'm late," when an expected menstrual period has not started. Delay or cessation of menstruation is commonly expected to be the first indication to a woman that she may be pregnant. However, this cannot be taken as certainty. Irregular cycles are common in the first few years of menstruation. Regularity of the menstrual cycle may be also be affected by physical or emotional stress. Moreover, continued menstruation in early pregnancy is not uncommon.[8]

Many religions have menstruation-related traditions. These may be bans on certain actions during menstruation (such as intercourse in orthodox Judaism, Hinduism and Islam), or rituals to be performed at the end of each menses (such as the mikvah in Judaism and the ghusl in Islam). Some traditional societies sequester females in residences, "menstrual huts", that are reserved for that exclusive purpose until the end of their menstrual period.

Since the late 1960s, some women have chosen to control the frequency of menstruation with long-acting hormonal birth control. This allows women to plan months in advance when she will menstruate as combined hormone pills are taken in 28 day cycles, 21 hormonal pills with either a 7 day break from pills, or 7 placebo pills during which the woman menstruates. Injections such as depo-provera became available in the 1960s, progestogen implants such as Norplant in the 1980s and extended cycle combined oral contraceptive pills in the early 2000s.

Characteristics

Physical experience

In many women, various intense sensations brought about by the involved hormones and by cramping of the uterus can precede or accompany menstruation. Stronger sensations may include significant menstrual pain (dysmenorrhea), abdominal pain, migraine headaches, depression, emotional sensitivity, feeling bloated, changes in sex drive and nausea. Breast swelling and discomfort caused by premenstrual water retention or hormone fluctuation is very common. Binge eating occurs in a large minority of menstruating women.[9] This may be due to fluctuation in beta-endorphin levels. More severe symptoms may be classified as premenstrual dysphoric disorder (PMDD). The sensations experienced vary from woman to woman and from cycle to cycle.

Emotional reactions

Women may experience emotional disturbances associated with menstruation. These range from the irritability popularly associated with premenstrual syndrome (PMS), to tiredness, or "weepiness" (i.e. tears of emotional closeness). A similar range of emotional effects and mood swings is associated with pregnancy.[10] Rarely, in individuals susceptible to psychotic episodes, menstruation may be a trigger (menstrual psychosis).

Flow

The normal menstrual flow follows a "crescendo-decrescendo" pattern; that is, it starts at a moderate level, increases somewhat, and then slowly tapers. Sudden heavy flows or amounts in excess of 80 mL (hypermenorrhea or menorrhagia) may stem from hormonal disturbance, uterine abnormalities, including uterine leiomyoma or cancer, and other causes. Doctors call the opposite phenomenon, of bleeding very little, hypomenorrhea.

Duration

The typical woman bleeds for two to seven days at the beginning of each menstrual cycle.[2][11] Prolonged bleeding (metrorrhagia, also meno-metrorrhagia) no longer shows a clear interval pattern. Dysfunctional uterine bleeding is hormonally caused bleeding abnormalities. Dysfunctional uterine bleeding typically occurs in premenopausal women who do not ovulate normally (i.e. are anovulatory). All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems. As pregnant patients may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding.

Menstrual products

Most women use something to absorb or catch their menses. There are a number of different methods available.

Disposable items:

  • Sanitary napkins (Sanitary towels) or pads — Somewhat rectangular pieces of material worn in the underwear to absorb menstrual flow, often with "wings," pieces that fold around the undergarment and/or an adhesive backing to hold the pad in place. Disposable pads may contain wood pulp or gel products, usually with a plastic lining and bleached. Some sanitary napkins, particularly older styles, are held in place by a belt-like apparatus, instead of adhesive or wings.
  • Tampons — Disposable cylinders of treated rayon/cotton blends or all-cotton fleece, usually bleached, that are inserted into the vagina to absorb menstrual flow.
  • Padettes — Disposable wads of treated rayon/cotton blend fleece that are placed within the inner labia to absorb menstrual flow.
  • Disposable menstrual cups — A firm, flexible cup-shaped device worn inside the vagina to catch menstrual flow. Disposable cups are made of soft plastic.

Reusable items:

  • Reusable cloth pads are made of cotton (often organic), terrycloth, or flannel, and may be handsewn (from material or reused old clothes and towels) or storebought.
  • Menstrual cups — A firm, flexible bell-shaped device worn inside the vagina to catch menstrual flow. Reusable versions include rubber or silicone cups.
  • Sea sponges — Natural sponges, worn internally like a tampon to absorb menstrual flow.
  • Padded panties — Reusable cloth (usually cotton) underwear with extra absorbent layers sewn in to absorb flow.
  • Blanket, towel — (also known as a draw sheet) — large reusable piece of cloth, most often used at night, placed between legs to absorb menstrual flow.

In addition to products to contain the menstrual flow, pharmaceutical companies likewise provide products — commonly non-steroidal anti-inflammatory drugs (NSAIDs) — to relieve menstrual cramps. Some herbs, such as dong quai, raspberry leaf and crampbark, are also claimed to relieve menstrual pain;[12] however there is no documented scientific evidence to prove this.

Further reading

Footnotes

  1. ^ a b c Strassmann BI (1996). "The evolution of endometrial cycles and menstruation". Q Rev Biol 71 (2): 181–220. doi:10.1086/419369. PMID 8693059.  
  2. ^ a b The National Women's Health Information Center (April 2007). "What is a typical menstrual period like?". U.S. Department of Health and Human Services. http://www.4woman.gov/faq/menstru.htm#4. Retrieved 2005-06-11.  
  3. ^ David L Healy (2004-11-24). "Menorrhagia Heavy Periods - Current Issues". Monash University. http://www.med.monash.edu.au/ob-gyn/research/menorr.html.  
  4. ^ Kathleen O'Grady (2000). Is Menstruation Obsolete?. The Canadian Women's Health Network. http://www.cwhn.ca/resources/menstruation/obsolete.html. Retrieved 2007-01-21.  
  5. ^ Desmond Morris (1997). The Human Sexes. Cambridge University Press.  
  6. ^ Chris Knight (1991). Blood relations: menstruation and the origins of culture. New Haven, Conn: Yale University Press. ISBN 0-300-06308-3.  
  7. ^ Adams, Cecil (2002-12-20). "Does menstrual synchrony really exist?". The Straight Dope. The Chicago Reader. http://www.straightdope.com/columns/021220.html. Retrieved 2007-01-10.  
  8. ^ Menstrual Period, Late or Missed http://www.med.umich.edu/1libr/pa/pa_menstrua_hhg.htm
  9. ^ Price WA, Giannini AJ (November 1983). "Binge eating during menstruation". J Clin Psychiatry 44 (11): 431. PMID 6580290.  
  10. ^ Giannini AJ, Price WA, Loiselle RH (June 1984). "beta-Endorphin withdrawal: a possible cause of premenstrual tension syndrome". Int J Psychophysiol 1 (4): 341–3. PMID 6094401.  
  11. ^ John M Goldenring (2007-02-01). "All About Menstruation". WebMD. http://www.webmd.com/a-to-z-guides/all-about-menstruation. Retrieved 2008-10-05.  
  12. ^ "Herbs For Premenstrual Syndrome". HerbalRemedies.com. 2004. http://www.herbalremediesinfo.com/premenstrualsyndrome.html. Retrieved 2006-08-08.  


Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

See also menstruation

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Menstruation

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Noun

Menstruation f. (genitive Menstruation, plural Menstruationen)

  1. menstruation

Synonyms


Simple English

Menstruation or menses is when a girl has blood come out of her vagina for 2-7 days every month. A slang word for menses is a period or "dot".

Contents

Cycle

Stages

Leaking

Before women begin their menses, there is cloudy white liquid-like fluid that comes out of the vaginal wall and eventually leaks on to their underwear. A girl begins this cycle about a year before the actually menstruating happens. When the liquid turns a deep brownish colour, the leaking starts to become often. After the leaking stops, which is within a year of it first happening then she begins to menstruate for 3-5 days. Once the experience becomes normal and adjusts to the body function, then she will leak about 2-7 days.

Menstruation

Most women menstruate for 3-5 days every month. However, anywhere from 2-7 days is normal. The amount of blood lost is normally about 50ml. Women usually use a pad or a tampon to keep the blood from staining their undergarments.

Menopause

Menopause is menstruation pausing at the age of around 45-70. Symptoms include irritability, heat, vaginal burning and/or discomfort, vaginal dryness. A slang word for it is called "the change". Most women must take a few months to adjust to the dryness. After they stop their period they can no longer produce babies.

Physical appearance

The fluid that comes out looks like blood, but it is more than just blood. It also has endometrial tissue. This is the tissue that lines the inside of the uterus (womb).

Menses happens in the first days of the menstrual cycle. This is the changes that happen in a woman's body every month. These changes are started by changes in hormone levels in the blood. These changes also cause a woman to ovulate and make an ovum (also called "egg"). Menstruation usually starts around the age of 11, even as early as 9 years old, and ends when the woman is too old to have children. However, some women can still have children from the age of 50-70.

Effect

Some women have pain in the low part of the abdomen when they menstruate, known as cramps. The hormones that are produced before and during a period can also make a woman feel moody, or just strange. This is called premenstrual syndrome or PMS. A women can feel bloated or swollen and have long cramps. Hormones can rage and cause an aggressive sex drive. Women can throw temper tantrums and can even feel suicidal or depressed.

Materials

Most women use something to absorb or catch their menses. There are a number of different methods available. The most common used way to absorb the menses is using sanitary napkins, tampons and padded underwear. Some women use sea sponges, towels and other reusable absorbing items.

In addition to products to contain the menstrual flow, pharmaceutical companies likewise provide products — commonly non-steroidal anti-inflammatory drugs (NSAIDs) — to relieve menstrual cramps. Some herbs, such as dong quai, raspberry leaf and crampbark, are also claimed to relieve menstrual pain, however there is no documented scientific evidence.









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