Menstrual health encompasses the experience of having a period, including the ability to participate in work and social activities, the age at which a person starts or ceases menstruation, symptoms associated with menstruation that require medical intervention (such as heavy bleeding or pain) and the emotional or mental health challenges that may accompany menstruation; as well as access to information and education, menstrual products, sanitation, and competent and empathetic care.
Menstruation begins in girls as early as age 8 or as late as 16 years old, and continues through menopause, the time when a woman hasn’t had a period for one year. The menstrual cycle is the time from the first day of your period until the first day of your next period. While each woman’s cycle is slightly different, the process is the same.
Menstrual Health with Advantia Health
Once your period is well established, small changes in the timing or flow of your period generally aren’t anything of concern. There are a few universal signs and symptoms that could mean that something is wrong.
- No period for 90 days (if you know that you aren’t pregnant)
- Sudden irregularity if your period has always been normal
- If you’re bleeding for longer than 7 days
- If you soak through a pad or tampon in less than 2 hours
- You notice quarter sized blood clots when you use the toilet
- If your periods are fewer than 21 days apart or more than 35 days apart
- Bleeding or heavy spotting between periods or after intercourse
- Severe and debilitating pain during your period or the days leading up to it
- If you get a fever or feel seriously ill after using a tampon (this may be a sign of toxic shock syndrome (TSS))
If you experience the symptoms above, you should make an appointment with a healthcare provider. Or, if you have other questions or concerns about your menstrual cycle, Advantia Health providers are available to help you build knowledge and improve outcomes.
During a visit about your menstrual health, Advantia Health providers will likely discuss your past medical history and that of your family, and the history of your period. Your provider may recommend additional tests or other options based on your symptoms.
Four Phases of the Menstrual Cycle
Your menstrual cycle is the hormonal process that prepares your body for pregnancy each month and serves as an important indicator of reproductive health. On average, the length of the menstrual cycle is 28 days. Cycles ranging from 21 to 35 days are also considered normal. It consists of the following phases.
Some types of birth control, pregnancy or breast-feeding, extreme weight loss or exercising, polycystic ovary syndrome (PCOS), uterine fibroids and pelvic inflammatory disease can cause irregularities in the menstrual cycle.
Menstruation
The menstrual phase (typically days 1-14) marks the beginning of your menstrual cycle—it starts on the first day of your period.
When an egg from the previous cycle isn’t fertilized, and pregnancy hasn’t occurred, your levels of the hormones estrogen and progesterone decrease.
As a result, the thickened lining of the uterus, which would have supported a pregnancy, is no longer needed and is shed through the vagina. This shedding consists of a mix of blood, mucus, and tissue. Periods typically last from three to five days, but periods that are somewhat shorter or longer are not a cause for concern.
During their periods, women lose between 20 to 90ml (or between 1 to 5 tablespoons of blood. There are a number of products available for use specifically during your period to absorb this blood, including tampons, menstrual cups, sanitary pads and period underwear. These hygiene products should be changed regularly, and disposed of or washed in accordance with their specific instructions
Follicular Phase
Because this phase starts on the first day of your period and continues until ovulation, there is some overlap with the menstrual phase.
During this time, estrogen levels begin to rise, which stimulates the thickening of the uterine lining (the endometrium). At the same time, follicle-stimulating hormone (FSH) encourages the growth of follicles in your ovaries. Between days 10 and 14 of your cycle, on average, one of these follicles will mature into a fully developed egg (ovum).
Ovulation
A sharp rise in luteinizing hormone (LH) triggers your ovary to release an egg, marking the process of ovulation. This phase typically occurs halfway through the menstrual cycle, or around day 14 of a 28-day cycle. The time around ovulation is when you are most fertile.
Luteal Phase
This phase spans from about day 15 to day 28 of your cycle. After the egg is released from your ovary, it travels through the fallopian tubes toward your uterus. During this time, progesterone levels rise to prepare the uterine lining for a potential pregnancy. If the egg is fertilized by sperm and successfully implants in the uterine wall, pregnancy occurs. If fertilization doesn’t happen, levels of estrogen and progesterone drop, and the uterine lining is shed during your period.
Management Strategies for Your Pain
Common symptoms you might experience before and during your period include:
- Bloating
- Cramps
- Tender breasts
- Mood swings and irritability
- Headaches
- Difficulty sleeping
- Fatigue
- Lower back pain
- Acne
Lifestyle changes can help relieve some symptoms associated with pre-menstrual syndrome (PMS). For example, eating smaller meals, limiting salt intake and eating healthy foods can reduce bloating. Regular exercise can help alleviate fatigue and a depressed mood. Getting plenty of sleep, massage and low-impact exercise like yoga can also help reduce stress and improve mood.
For menstrual cramps and back pain, over-the-counter pain relievers such as ibuprofen and naproxen sodium can help you manage the pain associated with your period. Taking these medicines as directed at the start of your period or when you first feel symptoms for two to three days can reduce or eliminate symptoms temporarily.
Hormonal birth control that prevent ovulation can reduce the severity of menstrual cramps and other discomfort related to your birthday. For cramps caused by fibroids or endometriosis, surgery to correct those disorders can help alleviate period pain. If you are experiencing severe PMS or menstrual symptoms, consult your healthcare provider.
Why Is It Important to Understand Menstrual Health?
A woman’s menstrual cycle can change dramatically throughout the course of their life, and no two women are the same. What is completely normal for one may be a warning sign for another. It is important to understand and know your body so you can notice when it is trying to tell you that something is wrong.
Additionally, when non-menstruating individuals and healthcare providers understand menstrual health, they can be better prepared to support people who menstruate, and better able to determine individual health and well-being and that of a population. A greater societal understanding of menstrual health helps reduce stigma, reduce discrimination and increase access to resources to support menstrual health and hygiene, including menstrual products and clean water.
Our Expert Guidance Ensures Comprehensive Support
With specialized training and experience in women’s health, Advantia Health providers can help support your menstrual health with education, diagnosis of conditions that affect menstrual health, counsel on various treatment options, and offer personalized treatment plans as appropriate to help manage symptoms.
