Menstrual cycle

During adolescence the women’s body goes through a number of changes and one of the most important changes is menstrual cycle or periods. This is also known as menstrual bleeding or menstrual period that a woman may have from early teen till menopause or around 50 years of age. Menstrual cycle may be associated with or without pain. Any irregular cycles should be discussed with a doctor.

The menstrual cycle is a series of changes a woman's body goes through to prepare for a pregnancy. Each month, one of the ovaries releases an egg — a process called ovulation. During this period the uterus grows a new lining (endometrium) to get ready for a fertilised egg. When there is no fertilised egg to start a pregnancy, the uterus sheds its lining. This is the monthly menstrual bleeding (also called menstrual period) that women have from their early teen years until menopause, around age 50.

The menstrual cycle is from Day 1 of bleeding to Day 1 of the next time of bleeding. Although the average cycle is 28 days, it is normal to have a cycle that is shorter or longer from 21 to 35 days in adults and from 21 to 45 days in young teens.

Girls usually start having menstrual periods between the ages of 11 and 14.

What happens during the menstrual cycle?

In the first half of the cycle, levels of oestrogen (the “female hormone”) start to rise. Oestrogen plays an important role in keeping you healthy, especially by helping you to build strong bones and to help keep them strong as you get older. Oestrogen also makes the lining of the uterus (womb) grow and thicken. This lining of the womb is a place that will nourish the embryo if a pregnancy occurs. At the same time the lining of the womb is growing, an egg, or ovum, in one of the ovaries starts to mature. At about day 14 of an average 28-day cycle, the egg leaves the ovary. This is called ovulation.

After the egg has left the ovary, it travels through the fallopian tube to the uterus. Progesterone (the hormone made by the ovary) levels rise and help prepare the uterine lining for pregnancy. A woman is most likely to get pregnant during the 3 days before or on the day of ovulation. Keep in mind, women with cycles that are shorter or longer than average may ovulate before or after day 14.

A woman becomes pregnant if the egg is fertilised by a man’s sperm cell and attaches to the uterine wall. If the egg is not fertilised, it will break apart. Then, hormone levels drop, and the thickened lining of the uterus is shed during the menstrual period.

What is Normal menstrual cycle?

The menstrual cycle, which is counted from the first day of one period to the first day of the next, isn't the same for every woman. Menstrual flow might occur every 21 to 35 days and lasts two to seven days. Your menstrual cycle might be regular — about the same length every month — or somewhat irregular, and your period might be light or heavy, painful or pain-free, long or short, and will still be considered normal. Within a broad range, "normal" is what's normal for you.

My period is not stable? What could be causing this?

It is normal to have some variation in your period. Differences of up to 5 days early or late are to be expected, especially for women in their twenties and thirties. If yours occur less than monthly or more frequent than 21 days from the first day of one period to the next, consult with your provider.

It is always wise to follow up with your Health Provider for the best advice.

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What are the causes of Irregular menstrual cycle?

Pregnancy or breastfeeding: A delayed or missed period can be an early sign of pregnancy. Breastfeeding typically delays the return of menstruation after pregnancy.

Eating disorders, extreme weight loss or excessive exercising: Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can disrupt menstruation.

Polycystic ovary syndrome (PCOS): This common hormonal disorder can cause small cysts to develop on the ovaries and irregular periods.

Premature ovarian failure: Premature ovarian failure refers to the loss of normal ovarian function before age 40. Women who have premature ovarian failure — also known as primary ovarian insufficiency — might have irregular or infrequent periods for years.

Pelvic inflammatory disease (PID): This infection of the reproductive organs can cause irregular menstrual bleeding.

Uterine fibroids: Uterine fibroids are noncancerous growths of the uterus. They can cause heavy menstrual periods and bleeding between periods.

Obesity: Being overweight may cause hormonal changes that may change the timing or amount of flow.

Tips to prevent menstrual irregularities:

For some women, use of birth control pills can help regulate menstrual cycles. However, some menstrual irregularities can't be prevented.

Regular pelvic exams can help ensure that problems affecting your reproductive organs are diagnosed as soon as possible.

What can I do to cut down on the mood swings I get when I’m on my period?

Exercise, healthy diet, adequate sleeps are all helpful. If you continue to have concerns, keep a calendar of your symptoms and your periods and consult a doctor.