Period cycle: menstruation in question

Rules or menstruation refer to a natural phenomenon that occurs each month in women between puberty (12 and a half on average in France) and menopause . They are manifested by bleeding from the uterine lining. Their duration can range from 3 to 7 days. The onset of the first menstrual cycle signals that the reproductive system has finished maturing. This implies that the body is able to accommodate a pregnancy.

What are the rules?

Beginning with puberty, the uterus prepares to accommodate a possible pregnancy each month. During this preparation cycle, the endometrium (uterine lining) thickens and fills with blood vessels. If fertilization does not take place, the endometrium evacuates causing vaginal bleeding. This is called menstruation or menstruation. In general, the bleeding lasts from 3 to 8 days.

Outside of pregnancy, this cycle repeats itself every month: this is called the menstrual cycle. According to women, the length of a menstrual cycle (from the first day of menstruation to the first day of the next menstruation) can be from 21 to 35 days.

Where does period blood come from?

Menstrual blood comes from the lining of the uterus (endometrium). To understand this phenomenon, it is necessary to explain the four phases of the menstrual cycle.

• The follicular phase during which the estrogens (hormones produced by the ovaries) secreted in increasing quantities cause the thickening of the uterine lining. During this phase, the ovaries prepare to ovulate. Under the influence of the brain, the pituitary gland secretes follicle-stimulating hormone (FSH) which stimulates the development of several follicles on the ovary. Each of these follicles (from the Latin folliculus: small sac) contains an oocyte. Only one of them matures and releases an oocyte ready to be fertilized in the fallopian tube. As it matures, the follicle produces estrogen, triggering the thickening of the endometrium (inner lining of the uterus). Boosted by high estrogen levels, gonadotropin-liberine (GnRH) comes into play by promoting the secretion of luteinizing hormone (LH).

• The ovulation phase during which the luteinizing hormone (LH) causes the rupture of the follicle ("little sac" located in the ovary containing an oocyte) and releases an oocyte which will migrate into the fallopian tube in the direction of the uterus. Between day 12 and day 14, the mature ovarian follicle releases the egg into one of the fallopian tubes. If sperm are present, fertilization of the egg can take place. After the egg has been expelled, the follicle transforms into the corpus luteum. It is he who secretes progesterone during the second period of the menstrual cycle: the luteal phase.

• The luteal phase (or progestin phase) during which the empty follicle turns into a yellow body and secretes progesterone, stimulating the uterine lining which prepares to receive a fertilized oocyte. If there is fertilization (meeting between the oocyte and a sperm), the oocyte begins its implantation. There is pregnancy. If there is no fertilization, the uterine lining disintegrates and evacuates through the vagina. It is the return of menstruation which inaugurates a new menstrual cycle.

• The menstrual phase marked by bleeding from the disintegration of the endometrium when there is no pregnancy.

How long is a menstrual cycle?

The menstrual cycle starts on the first day of menstruation and ends on the first day of subsequent menstruation. This menstrual cycle lasts an average of 28 days. Each woman being unique, this duration can vary from 21 to 35 days. In the event of a disturbed cycle, do not hesitate to speak to the doctor or the gynecologist.

How to calculate your ovulation day?

Ovulation usually occurs between the 14th and 16th day before the start of the next period. The 6 days before and during ovulation are called the "fertile window" because this is when fertilization can occur. This window can vary from woman to woman depending on the length of her menstrual cycle. For some, the menstrual cycle is 28 days. It is therefore estimated that the day of ovulation is the 14th day after menstruation. For others, this cycle may be shorter or longer. This variation can therefore shift the date of ovulation. For a short cycle of 21 days, we calculate 21-14 = 7 as follows. Clearly, ovulation will occur in all probability on the 7th day after the start of the period. For a 31-day long cycle, the calculation is as follows: 31-14 = 17. Here, ovulation is supposed to occur on the 17th day after the start of the period.

Calculating the date of ovulation in the context of an irregular cycle is almost impossible.

However, there is another solution to spot the big day: stay tuned to your body. Indeed, some signs do not deceive:

• Taut breasts;
• Pain in the ovary which releases the oocyte;
• Increased libido;

To precisely pinpoint the moment of ovulation, you can rely on two methods:

• Observation of cervical mucus;
• The evolution of the basal temperature (lowest temperature that the body displays at rest)

Observation of cervical mucus

The appearance and quantity of mucus secreted by the cervix vary during the menstrual cycle according to this tempo:

• During the follicular phase, you will not see any visible cervical mucus. Between day 10 and day 12, mucus secretion begins. Its appearance is opaque and its consistency sticky;
• At the time of ovulation, that is to say from the 13th day to the 15th day, the cervical mucus is abundant, transparent and stringy (texture close to egg white);
• During the luteal phase, mucus secretion ceases.

The appearance of cervical mucus warns that ovulation is near. For those who plan to get pregnant, this signal gives valuable information about the fertile period. It allows women whose cycles are irregular to better understand their fertility window.

The evolution of the basal temperature

Body temperature changes during the menstrual cycle like this:

• 36.8°C or slightly less during the follicular phase;
• nadir point (lowest temperature of the cycle) at the time of ovulation;
• 37°C or a little more after ovulation and throughout the luteal phase (the secretion of progesterone causing a rise in temperature).

By following your basal temperature daily (in the morning when you wake up), you can draw a curve of your body temperature to the nearest tenth which will allow you to determine your ovulation date.

What symptoms?

Apart from bleeding, menstruation can be accompanied by the following symptoms:

• Sore breasts (imbalance in estrogen);
• Diarrhea, nausea, pain and cramps in the lower abdomen and lower back, (increased prostaglandins causing uterine contractions to evacuate the endometrium and blood);
• Disturbed sleep, mood disorders and migraines (disturbance of neurotransmitters in the brain under the effect of estrogen);
• Acne (excess sebum during the period of ovulation);
• Hot flushes and sweating under the influence of hormones;
• Fatigue (in case of heavy bleeding, the levels of red blood cells and iron in the body drop).

Because each body is unique, it is possible to experience none of these symptoms. In case of excessive pain or discomfort during the menstrual cycle, you should never hesitate to consult a doctor or a gynecologist to discuss these feelings.

How much blood do we lose?

In reality, the volume represented by bleeding during menstruation is not as great as one might imagine. Indeed, blood loss is estimated on average between 5 ml to 25 ml. If your flow is too heavy, refer to the Higham score. This table allows you to calculate it using a table where you will count the number of daily sanitary protections used on the cycle. For each pads and tampons used is awarded a certain number of points. At the end of the rules, the points are added. If the Higham score exceeds 100 points, the bleeding is estimated to be greater than 80 ml. We then speak of menstrual bleeding or bleeding rules that may justify a consultation with the gynecologist.

Irregular or late periods: is it serious?

During the first and subsequent menstrual cycles, it is not uncommon for periods to be irregular. This phenomenon can last two years, the time for the hormonal system to mature.

In the event of absence of menstruation (amenorrhea), the first reflex is to first rule out the possibility of pregnancy. If the absence continues without pregnancy, other avenues can be explored:

• Abnormality of the uterine lining or ovary;
• Polycystic ovary syndrome (PCOS);
• Menopause;
• Incorrectly dosed contraceptive pill;
• Intense sports practice;
• Psychological shock;
• Drug treatments;
• Anorexia.

What are the signs of endometriosis?

Endometriosis is a disease characterized by the presence of endometrium-like tissue (uterine lining) outside the uterine cavity. This condition can colonize the following organs:

• Ovary;
• vagina;
• Bladder;
• Uterosacral ligaments;
• Rectum.

The lesions respond to female hormones as the uterine lining would. They bleed during menstruation and leave scars with each menstrual cycle. Endometriosis affects many women. This condition affects 1 in 10 women of childbearing age.

Symptoms of endometriosis are:

• Recurrent and intense pain in the pelvic region;
• Dysmenorrhea (painful menstruation);
• Dyspareunia (painful intercourse);
• Infertility disorders.

At what age does menopause occur?

When the periods stop definitively, one speaks of menopause. It manifests itself on average between the ages of 45 and 55. This natural phenomenon is explained by an irreversible deficiency of certain hormones (estrogen and progesterone). Menopause marks the end of ovulation. It is preceded by a period of perimenopause ranging from two to four years. This pivotal stage is characterized by:

• Irregular menstruation;
• A menstrual syndrome;
• Hot flashes;
• Night sweats.

Menopause is officially declared after a year without periods. Its symptoms can include:

• Chills, tremors;
• Feelings of intense heat;
• Palpitation;
• Profuse sweating;
• Vaginal dryness;
• Urinary disorders;
• Headache ;
• Fatigue ;
• Sleeping troubles ;
• Mood disorders ;
• Joint pain.

We speak of early menopause when the disappearance of the rules occurs in a woman before the age of 40 years. This primary ovarian insufficiency (PIO) would affect one in a hundred women.

Toxic shock syndrome: what do you need to know?

Toxic Shock Syndrome (TSS) is a serious infection caused by Staphylococcus aureus. This bacterium naturally present in our vaginal flora can cause serious complications when the environment is conducive to its proliferation. This is particularly the case when the blood stagnates in the vagina. Are targeted in particular, the internal hygienic protections such as the tampon or the cup, worn too long. According to doctors, the risk of TSS would be multiplied by two by keeping a tampon or a cup for more than six hours. The risk of TSS would be multiplied by three by keeping a tampon or a cup all night.

The precautions to take to guard against toxic shock syndrome are then simple:

• Change internal protection every 4 hours;
• Do not use internal protection at night.

The best solution is therefore to alternate internal sanitary protection and external sanitary protection such as menstrual panties. Made from OEKO-TEX® STANDARD 100 material (certifying the absence of chemicals harmful to the planet or your health), they are guaranteed leak-proof, moisture-proof and odor-proof. The icing on the cake, they can absorb between 15 and 20 ml of blood, which allows you to live your period in complete freedom and in complete safety.

By Valerie.