Menstruation
Menstruation refers to the periodic vaginal discharge of blood and bodily cells that are shed from the lining of a woman's uterus. Menstruation begins at puberty and marks the onset of a woman's capacity to bear children, although other health factors may limit this capacity.
Menstruation usually begins between 10 and 16 years of age, depending on a variety of factors, including the young woman's general health, nutritional status, and body weight relative to height.
Menstruation continues approximately once a month until a woman is about 45 to 50 years of age, again depending on health and other influences. The end of a woman's ability to menstruate is called menopause and it marks the completion of a woman's childbearing years.
Length of the Menstrual Cycle
The average length of the menstrual cycle is 28 days, but ranges from 21 to 40 days. The length of the cycle may also vary for a woman during different phases of life, and even from one month to the next depending on a variety of factors, including the woman's physical, emotional, and nutritional health.
Menstruation is part of the regular process that prepares a woman's body each month for pregnancy. This cycle involves several phases that are controlled by the interactions of hormones secreted by the hypothalamus, anterior pituitary gland, and ovaries.
At the beginning of the cycle, the cell lining of the uterus begins to develop and thicken. This lining will serve as the anchor for the developing fetus if the woman is impregnated. Hormones signal an ovum or egg in the ovary to begin developing. Soon, an ovum is released from the woman's ovary and begins to move through the Fallopian tube toward the uterus.
If the ovum is not fertilized by a sperm during the course of vaginal intercourse (or through artificial insemination), however, the lining of the uterus separates from the uterine wall and begins to decompose. The blood system washes the lining away and it and the blood are discharged through the woman's vagina.
The period of discharge or bleeding, known as the menstrual period (or just "period"), lasts from three to seven days. If a woman becomes pregnant, her monthly menstruation ceases for the duration of the pregnancy. Consequently, missing a menstrual period is a likely although not a definitive sign that a woman is pregnant. Pregnancy can be confirmed with a simple blood test.
First Menstruation — A Potentially Upsetting Time for Girls
Unless a girl has been prepared for the onset of menstruation, this can be an upsetting time. Girls who are ignorant of their body and normal reproductive processes may assume that menstruation is evidence of a disease or even a punishment for misbehavior. Girls who are not taught to think of menstruation as a normal body function may experience considerable shame and a feeling of being unclean during their first menstruation. Even when menstruation is finally recognized as a normal process, feelings of uncleanliness may linger well into adulthood.
In recent years, however, better education about anatomy and physiology has led to acceptance of menstruation. In fact, many women have come to view menstruation with pride as a distinctly female process. Some families even have a private celebration to honor the maturation of the young woman.
Symptoms of Menstruation Discomfort
Nonetheless, many women experience physical discomfort several days before their menstrual period. About half of all women suffer from dysmenorrhea, which is a painful menstruation. This is especially common during the early adult years. Symptoms of menstrual discomfort may include tenderness of the breasts, sore nipples, retaining fluid (bloating), and irritability.
Some women experience quite intense discomfort, including cramps caused by contractions of the smooth muscles of the uterus, headaches, Mittelschmertz or pain in the midsection, nervousness, fatigue, stuffy nose, and crying spells.
Premenstrual Syndrome
In its most severe form, often involving depression and anger, this condition is known as premenstrual syndrome or PMS, and may require medical attention.
In several court cases in Great Britain and France, attorneys have used the occurrence of PMS to successfully argue for diminished capacity during the commission of violent crimes. While in the past, PMS was dismissed as a psychosomatic condition, and continues to be the subject of derisive humor, today it is recognized as having organic causes. Several medications have been developed to treat the symptoms of PMS.
Menstruation Failure — Amenorrhea
Some women experience a condition known as amenorrhea, or failure to menstruate over a protracted period of time. This condition can be caused by various factors including stress, rapid weight loss, regular strenuous exercise, or illness. Conversely, some women experience excessive menstrual flow, a condition known as menorrhagia. Not only may the flow of blood be particularly heavy, but it may extend for a longer than normal period.
Attitudes toward menstruation vary widely from society to society and even within a particular society. Many societies view women as contaminated or polluted during menstruation and seclude them from the community based on the fear that everything they touch will be polluted. In such settings, there may be diverse derogatory euphemisms to refer to menstruation.
In U.S. society, examples of the latter include "the curse" and being "on the rag." Menstruation is one of the justifications that has been offered for denying women access to clerical roles in some religions. Cleansing rituals at the end of menstruation are prescribed in a number of societies. However, other societies treat menstruation as a natural or normal bodily function and do not punish or restrict women during their menstrual period.
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