Menstruation

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  What Is Menstruation?

  Menstruation is what most people call having your period. During menstruation, the lining of the uterus flows out through your vagina. Menstruation usually happens each month, and lasts from 3 to 7 days.

  Your First Period Most young women have their first menstruation when they're between 9 and 16 years old. If you're a teen, there is a lot of useful information about having your period in Info for Teens. If you don't get your period by the time you are 16, you may want to talk to your health care provider.

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  What Is the Menstrual Cycle?

  The menstrual cycle is the time from the first day of one period to the first day of the next. A normal menstrual cycle can be as short as 21 days or longer than 35 days. For most women, the menstrual cycle lasts 25-30 days. But it's not unusual for the number of days in each cycle to vary from month to month.

  Menstrual flow usually lasts 3 to 7 days, but it may be slightly shorter or longer. Once your period ends, hormones cause some of the eggs in your ovaries to start to ripen or mature. The hormones also cause the lining of the uterus to thicken.

  About half way through your menstrual cycle, one mature egg leaves the ovary. This is called ovulation. Most women do not feel it when they ovulate. But some women feel pain in the lower abdomen around the time they ovulate. Some women have light spotting of blood for a day or two after ovulation.

  After leaving the ovary, the egg then travels through a fallopian tube toward your uterus. As the egg travels through the fallopian tube, a spongy, soft lining continues to build up in the uterus. The lining is where a fertilized egg may attach for pregnancy to begin. If pregnancy does not happen, the lining breaks down and the blood and tissue flow from your uterus through your cervix and out of your body. This is your period. During an average period, you will lose 4 teaspoons of menstrual fluid.

  Pregnancy and the Menstrual Cycle Pregnancy is most likely to happen from unprotected vaginal intercourse during the six days before ovulation. It is also possible, but not as likely, on the day after ovulation. To avoid pregnancy, some women use fertility-awareness based methods to predict when they will ovulate. They abstain from vaginal intercourse or use condoms or another kind of birth control during this time in their menstrual cycle.

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  Should I Use Pads, Tampons, or Menstrual Cups?

  

  The choice is yours. Women can use sanitary pads, tampons, or menstrual cups to absorb their menstrual flow. Many women use different ones at different times during menstruation. There are a wide variety of pads and tampons. Some are for lighter flows. Some are for heavier flows. Some are made of cotton or ogranic cotton. Some are made of rayon or a blend of cotton and rayon. The best way to choose what is best for you is to try different products or ask a friend or family member what works best for her.

  Most pads stay in place by sticking inside the underwear. You should change the pad every few hours, or when it is soaked with fluid. You may want to use a thicker pad at night when you sleep.

  Tampons and menstrual cups fit inside the vagina. They are held in place by the walls of the vagina. Putting a tampon or menstrual cup in your vagina shouldn't be painful. But it may take some practice. Many tampons come with applicators that are inserted into the vagina to help put the tampon in the right place. Menstrual cups and certain types of tampons are inserted with the fingers.

  Tampons have a string that hangs out of the vagina. Pulling the string gently removes the tampon. Some menstrual cups have a "stem" that can be pulled for removal. Others are removed by hooking a finger around the rim. Some cups are emptied, washed, and used again. Other cups are thrown away. You should empty or change your cup a few times a day.

  It's important to change your tampon every 3 to 4 hours. It's safest to use the least absorbent tampon you need. If a tampon is left in place for a long time it can cause a rare illness called toxic shock syndrome. If you vomit and develop a high fever, diarrhea, muscle aches, sore throat, dizziness, faintness or weakness, and a sunburn-type rash while using a tampon, take it out and see your health care provider immediately.

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  Why Do I Have Cramps During Menstruation?

  During menstruation your uterus contracts — cramps up — to help the lining separate and leave the body. Most women have menstrual cramps at some point during their lives. Menstrual cramps can be dull or throbbing pains in your lower abdomen.

  Some women have cramps right before they have their periods. The medical name for painful menstruation is dysmenorrhea. The good news is that for many women, cramps become milder as they get older.

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  What Can I Do to Relieve Menstrual Cramps?

  Women can try a variety of ways to relieve cramps during menstruation. You can

  • exercise
  • have an orgasm
  • rest
  • soak in a hot bath
  • take an over-the-counter pain reliever
  • use a heating pad

  Sometimes cramps during menstruation are bad enough that they make it difficult to do everyday things. Very rarely, cramps during menstruation may be a sign of another problem.

  Severe cramps may be a sign of

  • Pelvic inflammatory disease — an infection of a woman's reproductive organs that is usually caused by an untreated sexually transmitted infection
  • Endometriosis — a condition in which the tissue that forms the lining of the uterus begins to grows outside of the uterus, around other organs
  • Fibroids — non-cancerous tumors that grow inside or around the uterus

  If you have severe pain during menstruation, see your health care provider to get help managing your pain and to find out whether you have a more serious condition.

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  What Is Premenstrual Syndrome (PMS)?

  Premenstrual syndrome (PMS) refers to the physical and/or emotional changes you may feel in the week or two before menstruation begins. Most women have had at least one of the following PMS symptoms:

  • acne
  • bloating
  • breast tenderness
  • crying
  • depression
  • feeling tired
  • food cravings
  • headaches
  • joint or muscle pain
  • mood swings
  • trouble falling asleep
  • upset stomach, constipation, or diarrhea

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  What Can I Do to Relieve PMS?

  There are different ways to relieve PMS symptoms. Many of the things that help with cramps can also help with PMS.

  Many women find that over-the-counter pain relievers like aspirin, ibuprofen (like Advil), or naproxen (like Aleve) help with headaches, backaches, breast tenderness, and cramps.

  Birth Control and PMS You may have heard that the birth control pill, patch, and ring can help with painful menstruation and PMS. This is true for many women. If you suffer from PMS or other period-related symptoms, talk to your health care provider about whether birth control may help you.

  Severe PMS Premenstrual dysphoric disorder (PMDD) is a very severe form of PMS. The symptoms of PMDD are more severe than PMS symptoms. Some common PMDD symptoms include craving foods or binge eating crying for no reason feeling angry for no reason feeling out of control feeling really sad or even suicidal feeling very tense having no interest in your usual activities panic attacks trouble thinking or paying attention trouble sleeping If you have any of these symptoms in the week or two before your period, talk with your health care provider about ways to manage or treat your symptoms.

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  What If I Miss a Period or My Menstrual Cycle Is Irregular?

  When a woman misses a period, or if her period is late, the most common concern is pregnancy. It is often the first sign of pregnancy. Taking a pregnancy test is the only way to know for sure if you are pregnant.

  However, many women may have irregular periods at some time — or throughout their lives. An irregular period is one that is out of the ordinary for you. You might miss a period or your period may come earlier or later than usual. It may be much heavier or lighter than usual.

  There are many reasons your menstrual cycle may change, including

  • birth control — especially IUDs and hormonal birth control such as the pill, patch, ring, or shot
  • hormonal imbalance
  • illness
  • medication
  • menopause
  • over exercising
  • poor nutrition
  • stress
  • sudden weight gain or loss
  • travel

  If you think you may be pregnant or are worried about changes in your menstrual cycle, talk with your health care provider.

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  When Should I See a Health Care Provider About My Menstrual Cycle?

  Many women are not sure if their menstrual cycle is normal. Be sure to talk to your health care provider if

  • you bleed much longer than usual
  • you bleed more heavily than usual
  • you do not start menstruating by the time you are 16 years old
  • you have severe pain before or during menstruation
  • you have unusual bleeding between periods
  • you suddenly feel sick or get a fever when using tampons
  • you use more than one pad or tampon every two hours
  • your periods or PMS keeps you from doing what you usually do
  • your periods stop or suddenly become irregular

  Staff at your local Planned Parenthood health center or another health care provider can talk with you about any concerns you may have about menstruation.