All you should know about menstrual cycle

Menstrual cycle is defined as a series of events that prepares a woman’s body for pregnancy. Menstruation is a monthly bleeding or periodical flow of blood from the uterus through the cervix and out through the vagina. It occurs during the menstrual cycle. Menstruation occurs during the years between puberty and menopause and it is the normal part of a woman’s life. Menstruation plays an important role in the renewal of uterine lining and to prepare a woman for pregnancy.

Phases of Menstrual cycle

The duration of the menstrual cycle is categorized into four phases:

  • Menstrual phase - This phase is five days, that is the first day of menstruation till the last day of menstruation. In this phase, the uterus sheds the inner lining of the soft tissue and causes blood loss. Most often, it is accompanied by cramps and abdominal pain.
  • Follicular phase - This phase is of 13 days and it also begins from the first day of menstruation but it ends on the 13th day of the menstrual cycle. During this phase, the pituitary gland secretes hormones that stimulate the egg cells and the egg takes 13 days to reach maturity. Now the follicles of these eggs secrete a hormone that stimulates the uterus and leads to the development of the lining of a blood vessel and soft tissue.
  • Ovulation phase - This phase is the 14th day of menstrual cycle and on this day of the cycle, the pituitary gland secretes hormones which causes the ovary to release the mature egg.
  • Luteal phase - This phase begins on the 15th day of the cycle and ends on the last day of the menstrual cycle. During this phase, the egg that was released in the ovulation phase stays in the fallopian tube for 24 hours and if a sperm cell does not impregnate the egg cell within that time, the egg cell disintegrates.

The problems with menstruation can range from no problem to severe problem and it varies from one woman to another. There are multiple numbers of menstrual problems and some of the common problems are as follows:

1. Dysmenorrhea

Dysmenorrhea is a medical term which is used to describe painful menstruation. It is one of the most common complaints made by girls to gynecologists. Research has stated that dysmenorrhoea affects the quality of life and reduces the productivity of women. Most often, pain occurs in the lower abdomen but it can occur in other parts like lower back and thighs as well. Dysmenorrhea can be categorized into two - primary and secondary. 

  • Primary dysmenorrhea - This type of pain occurs due to menstruation and it is caused by the contraction of the uterus. It is not considered to be life threatening but it significantly affects daily life.
  • Secondary dysmenorrhea - This type of pain is menstrual related but it is accompanied by other medical related conditions. It can be a serious condition as it is associated with other medical conditions.

2. Menorrhagia

Menorrhagia is a medical term which is used to describe heavy menstrual bleeding. This problem affects many people of reproductive age. Menorrhagia is characterized by an excessive menstrual blood loss which has a significant impact on women as it interferes with the woman's physical, emotional, social and material quality of life. Sometimes, it is accompanied by other symptoms such as cramps and pain. Sometimes, the pattern of bleeding indicates some underlying condition that causes menorrhagia. For example, Intracyclical heavy bleeding can occur due to endometrial polyps. Menorrhagia is often accompanied by dysmenorrhea.

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3. Amenorrhea

Amenorrhea is a medical term which indicates the absence of menstruation. Amenorrhea is basically of two types:

  • Primary amenorrhea - This type of amenorrhea occurs when a girl does not begin to menstruate by the age of 16 or the girls who do not show the signs of sexual development (breast development and pubic hair) by age 13.
  • Secondary amenorrhea - This type of amenorrhea occurs when a girl has had experienced normal menstruation but has not stopped menstruating for at least three months.

4. Oligomenorrhea

Oligomenorrhea is a medical term which is used to define infrequent or light menstruation. It is a condition which occurs when a woman experience irregular and infrequent menstruation, greater than 35 days apart. Oligomenorrhea can be an important symptom manifesting in several medical conditions. It can result from diseases like prolactinomas, thyrotoxicosis, hormonal changes in perimenopause, Prader–Willi syndrome, and Graves disease.

5. Premenstrual syndrome

Premenstrual syndrome is characterized by physical, emotional, and behavioral symptoms that occur during the last week of the luteal phase (a week before menstruation) in most cycles. Usually, the symptoms that occur in this type of menstrual disorders are resolved within four days after the beginning of the bleeding. Although the symptoms of this disorder can occur at any time, most often it occurs in women between the ages of late 20’s and early 40’s.

Some common causes of painful menstrual cramps

  • Hormonal imbalance
  • Pelvic inflammatory disease
  • Uterine fibroid