Menstruation
A period is a monthly release of blood and uterine lining from the vagina, and it’s an important part of the female reproductive system. It’s part of the menstrual cycle, and it’s also called menstruation. Periods typically start about 2 years after the start of puberty, and can be preceded by clear or whitish vaginal discharge about 6 months before it starts. While a typical period lasts about 4-7 days and occurs about monthly, it can take a while for it to become this regular -- but if your period is extremely irregular, heavy, or painful for an extended period of time, it’s a good idea to check with your doctor. Small variations of having your period come a bit earlier or later are normal and they happen due to changing hormone levels -- as we see again, hormones control a lot in the body!
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What is a menstrual cycle?
It is a monthly cycle (usually around 28 days, to be exact) of changing hormones that happens continually after puberty until menopause. There are different stages of the menstrual cycle, but the overall goal is to prepare the female body for pregnancy -- no matter whether the person wants one or not. If pregnancy does not occur, the lining of the uterus sheds during the period and the cycle is ready to start again. This is why missing your period can be an indicator for pregnancy -- if you have been sexually active and your period doesn’t occur, it is possible that an egg in your uterus was fertilized and your body’s preparation for pregnancy is ready to be used rather than discarded through a period! (BUT A MISSED PERIOD DOESN'T ALWAYS MEAN PREGNANCY!) Now, let’s take a closer look at the different stages of the menstrual cycle.
Follicular Phase
First is the follicular phase, of the development of the egg. It starts on the first day of your period, when the hormones FSH and LH are released from the pituitary gland to the ovaries. These hormones stimulate the production of another hormone, estrogen, in the ovaries, and also stimulate the growth of about 15 to 20 eggs in the ovaries. Each of these eggs is in its own “shell,” called a follicle. The rising estrogen levels eventually suppress the production of FSH, which stops any more eggs from starting to develop. As the follicles continue to grow, one follicle in one ovary becomes dominant and suppresses the growth of all the other follicles, which causes them to die. In the end, one follicle remains with one egg that is developing inside, and this follicle also continues to produce estrogen.
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Ovulatory Phase (Ovulation)
Next is the ovulatory phase (also known as ovulation), whose starting time can vary, but typically occurs about 14 days after the first day of the period. The continued amount of estrogen that is being produced by the dominant follicle after the follicular phase triggers an increase in the production of LH. This hormone causes the dominant follicle to release its egg in the ovary. The release of the egg is called ovulation. As ovulation occurs, small projections on the ends of the fallopian tubes called fimbriae catch the egg and sweep it into the fallopian tubes, which lead to the uterus.
Fun fact: 1-5 days before ovulation, there might be a white vaginal discharge -- this cervical mucus is meant to capture and nourish the anticipated sperm cells to help them reach the egg!
Luteal Phase
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Finally, the luteal phase occurs right after the ovulatory phase. The empty follicle that released the egg develops into a structure called corpus luteum, which produces the hormones estrogen and progesterone. The progesterone signals the uterus to start preparing for a fertilized egg to implant. If intercourse has taken place and an egg has become fertilized by a sperm cell (a process called conception), the fertilized egg may travel through the fallopian tubes to the uterus and become implanted -- pregnancy! If the egg does not become fertilized, the egg and the unneeded uterine lining are discarded through the vagina during the menstrual period (which means that the cycle is back to the follicular phase).
How can periods be managed?
The way a female body can prepare for pregnancy every month is amazing! But periods can sometimes be a bit annoying -- cramps can be painful, and it can be inconvenient to worry about blood stains. Not to worry, however, you can do whatever you’d like, even during your period! It’s just a matter of knowing how to deal with them.
Catching Blood Flow Options
Sanitary or menstrual pads are absorbent items that are worn with underwear during your period, after birth, or to catch any bleeding or discharge from the vagina! They catch the blood as it leaves the vagina before it can reach the underwear or your other clothing. Pads should be changed about every 4 hours or as they become saturated in order to prevent odor or bacterial growth.
Pads can be cotton, cloth, or many other varieties, and they also come in many different sizes and shapes. It’s a good idea to experiment and find a type of pad that you like!
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Tampons are similar to pads in that they absorb menstrual blood, but they do so from inside the vaginal canal! Tampons are inserted into the vagina and can be useful because they may be more discreet to wear -- you can even swim with them! Tampons should also be changed about every 4-8 hours, and this can be done by pulling on a string that is left outside the vagina. Be careful -- tampons can leak if they become full, so it may be a good idea to wear a small pantiliner or pad on your underwear just in case!
Another thing to consider when using tampons is the possibility of toxic shock syndrome (TSS), which is a rare but potentially dangerous condition that can be caused by tampon use. Since tampons absorb blood internally, they can also absorb the natural fluid or mucus in the vaginal canal, which can lead to problems. To avoid this, it’s best to use the smallest possible tampon that suits your menstrual cycle, and to change the tampons at appropriate times. If you have any concerns about tampons or TSS, check with your doctor!
Menstrual cups are another option! Unlike pads and tampons, menstrual cups simply catch and store the blood instead of absorbing it, and then you have to dump the blood out before you can use the cup again. Menstrual cups are usually made of a flexible silicone like material, which allows them to be folded and inserted into the vaginal, where they will then unfold and create a vacuum seal that prevents them from falling out! Another thing that sets menstrual cups apart from pads and tampons is that they are reusable (they can last for years!), and you can wear them for up to 12 hours at a time! Then, simply dump out any blood, give them a rinse, and re-insert. It’s important to properly sanitize the cups since they are reusable -- usually boiling the cup before and after each period to sterilize them does the trick. Although the cups may be a bit more expensive than pads or tampons, their reusability and longevity make them more cost effective and eco friendly in the long run.
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Menstrual disks are similar to menstrual cups in that they are inserted into the vagina and catch the blood as it reaches the base of the cervix. It can also be worn for 12 hours, and a benefit to using it is that it may make period cramps less painful, and it is possible to have sex while wearing it. However, unlike a menstrual cup, it is not reusable.
Another option to catch period blood is menstrual underwear -- underwear that has an absorbent “pad” layer built in! These underwear are washable and comfortable, and they can last for years! However, they are more expensive than other options.
Note: Period blood is not “dirty”! In fact, period blood is actually considered quite clean! So, you do not need to try and make your vagina smell good during your period, or try to clean inside -- your body has got it covered!
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Other Aspect of Menstruation
Menstrual cramps: Period cramps are caused by the contractions of the myometrium layer of the uterus, and they can be painful! You may be able to relieve them with medication like ibuprofen or acetaminophen, or by trying a heating pad or some light exercise. It is also important to stay hydrated and well fueled during a period, so eat nutritious food and drink lots of water! If cramps become extreme, talk to your doctor about options like hormonal birth control that may also be able to help, or to check if there may be something else going on.
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Premenstrual syndrome (PMS): Premenstrual syndrome, or PMS, is a common condition that many experience right before or during their period, and it is caused by the hormonal changes of the menstrual cycle. PMS might be something that happens every period, or every once in a while, and it can have a wide range of physical and emotional symptoms. Common symptoms include: craving foods, tender breasts, bloating, fatigue, headache, mood swings, and many more! Managing PMS can look a lot like managing cramps -- you can take medication like ibuprofen or acetaminophen, do yoga or exercise, and keep yourself hydrated and fueled. If you find yourself having these symptoms regularly before every period or the symptoms are interfering with your normal activities, check with your doctor!
Periods are normal & amazing!
Periods are a wonderful way that the female body gets itself ready for the amazing process of childbirth, and they are not gross, weird, or embarrassing! Half of the human population menstruates, and so it’s important to know the details about the menstrual cycle so we can keep each other comfortable with these natural bodily processes. Even non-menstruators should know the basics about periods so they can support and work with menstruators, and this will lead to a society that is more understanding and connected. Periods are not taboo, inappropriate, or something you need to hide...PERIOD!