Women experience a monthly bleeding cycle in which the lining of the uterus is shed and released through the vagina. This is referred to as menstruation or a period.
Most often, the first menstrual period is experienced by young girls ranging in age from 8 to 15 and may begin as irregular cycles of bleeding. The average age for onset of menstruation in the United States is 12.
The menstrual cycle is controlled by the body’s hormones. Each hormone has a vital role in menstruation and a specific job.
Additionally, progesterone is responsible for the thickening of cervical mucus and increasing temperature. Both estrogen and progesterone cause breast swelling and tenderness. If no pregnancy has occurred, these hormones decrease and menstrual bleeding occurs.
For most women, their period will recur every 28 days. However, cycles of 21 to 35 days are also normal in adult women. Teenagers can experience more irregular cycles that range from 21-45 days.
Periods typically last from 3-7 days and vary in the amount of blood loss. They also range in severity from mild, moderate, and heavy in quantity.
Some women may have medical conditions that have a negative impact on their menstrual cycle. These conditions include polycystic ovarian disease, uterine fibroids, and endometriosis.
Not every woman will experience the same premenstrual symptoms. Common symptoms include:
Some women report feeling the symptoms of premenstrual syndrome, also referred to as PMS. This very common condition can include symptoms such as:
These symptoms can vary in intensity. Other symptoms may include joint or muscle pain, headaches, fluid retention, constipation, and diarrhea.
PMS may be caused by certain conditions such as changes in hormone or serotonin levels.
Some women experience a severe form of PMS known as premenstrual dysphoric disorder or PMDD. PMDD can lead to the following symptoms:
People should speak with their doctor for evaluation and treatment if they feel they may be experiencing PMDD. Depression may be an underlying cause of PMDD.
At times, some women may experience problems with their menstrual cycle. Commonly experienced problems include:
Some women may confuse the symptoms of menstruation with early pregnancy symptoms, as they can be similar. These include a missed period, breast tenderness or swelling, nausea, a more frequent need to urinate, and tiredness.
In early pregnancy, some women will also experience what is referred to as implantation bleeding, caused by the embryo attaching to the uterine wall. Menstrual bleeding can be expected around 10 to 14 days after conception.
If bleeding occurs 6-12 days after ovulation, implantation bleeding may be the cause. It can be described as light, brown spotting compared with the bright red flow of a menstrual period. In most cases, implantation bleeding is brief and requires no treatment.
If someone thinks they may be pregnant despite a negative pregnancy test, they should speak to a healthcare provider for evaluation. They may benefit from a blood test to evaluate for pregnancy.
It is important for you to speak with our office if you are concerned about any symptoms. Some indications for speaking with a doctor include:
Symptoms of toxic shock include:
Toxic shock is a medical emergency and requires medical attention immediately.
Premenstrual symptoms affect women differently. Treatment of these symptoms will depend on their severity. The Mayo Clinic recommend regular exercise, reducing stress, and diet modifications.
Diet changes include:
Additionally, the application of warm compresses in the lower belly may provide relief of cramps. Other menstrual symptoms, such as those in PMS, may be treated with a variety of medications such as:
Our office will provide instructions on medication use.
Alternative therapies that may offer some relief include treatment with acupuncture and the use of certain supplements. Supplements include calcium, magnesium, vitamin E, gingko, ginger, chasteberry, evening primrose oil, and St. John’s wort.
It is important to note that there may be interactions with certain supplements and other medications. St. John’s wort will reduce the efficacy of oral contraceptives when taken alongside them. It is vital that people speak with their healthcare provider before starting any herbal or supplement courses.
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