Menstrual cycle (Menstruation): Normal or Abnormal?
Last updated on July 28th, 2018 at 05:21 am
The normal menstrual cycle is the cyclical shredding of the endometrium, while menstruation is the vagina cyclical bleeding experienced by women monthly as a result of the shredding of the endometrium. The endometrium is the inner lining of the uterus or womb. There in between 2 menstruation is the the menstrual cycle
In normal women the menstrual cycle is important to prepare the womb for union of the sperm and egg, implantation and nurturing the embryo. The first time a woman experiences her period is menarche while the time it stops in a women is menopause.
At menarche, the menstrual cycle may not be regular. However, as the woman gets older she will begin to have a regular menstrual cycle. The menstrual cycle lasts for about 2 to 7 days and occurs every 21 to 35 days. Women who experience more than normal bleeding is menorrhagia. However, some women do not experience bleeding at all. This is amenorrhea.
Some factors that can cause irregular menstrual cycle are emotional anxiety from academic or pregnancy fears, changes in climate and chronic diseases in women.
During your menstruation, it is estimated that the amount of blood loss is less than 80mls. Presence of blood clots more than a day and prolonged menstruation more that 7 days is suggestive of heavy menstrual bleeding. The amount of sanitary pad change in a day is often used by your doctor to estimate the amount of blood loss
What causes menstruation in a woman?
The cause of menstruation is sill not understood but the following play a role on menstruation
- Decreased estrogen
- Decreased progesterone
- Endometrial toxins
- Hypothalamus
- Pituitary gland
- Luteinizing hormone (LH)
- Follicle stimulating hormone (FSH)
- Prostaglandins
- Gonadotropin releasing hormone (GnRH)
The hypothalamus produces GnRH hormone which stimulates the pituitary gland to produce LH and FSH. The FSH and LH hormone will then stimulate the ovaries to produce estrogen or progesterone. However, the level of estrogen and progesterone a control over the amount of FSH and LH that is produced by the pituitary.
What is menstrual cycle?
Prior to your period, you will experience some Premenstrual symptoms (PMS). These symptoms are headache, depression, abdominal bloating, abdominal cramps in women. The first day of your menstruation is the first day of your menstrual cycle. You will begin to shred the inner lining of the uterus.
At this point, the level of estrogen is low. This will stimulate the the pituitary gland to produce FSH and small amounts of LH. This FSH will stimulate the growth of the ovarian follicles. As the follicles grows they produce estrogen .
Within the follicles there are 2 types of cells. The theca and granulosa cells. Both cells are vital in the production of estrogen under hormonal influence of LH and FSH. The LH acts on the theca cells to produce androgens from cholesterol while the granulosa cells converts androgen to estrogen. Therefore, both LH and FSH are vital for adequate level of estrogen in an normal menstrual cycle.
The estrogen levels will continue to rise to a level when it will inhibit the production of FSH (negative feedback). This process will result in reduction of FSH production with resultant selection of one fast growing follicle. This is the dominant follicle. The other follicles regress and gets smaller. This happens on the 6th day of your menstrual cycle.
The cells of the theca internal continue to produce estrogen. This is important for building up the shred lining of your womb in response of ovulation that will soon occur. The rising estrogen will become rapid at about 36 to 48 hours before ovulation. This rapid increase will stimulate the pituitary to cause a surge in LH production and small FSH production. This is the LH surge.
Why is the LH surge important?
Ovulation occur 12 to 24 hours after the LH surge. This is important in women who are planning to get pregnant. The ovulation kit women use is based on this principle. It detects the LH surge and tells the most fertile period in a woman.
Also, the LH with prostaglandins are important for ovulation. Through prostaglandins inflammatory like response there is expulsion of the egg due to smooth muscle contraction.
What happen next?
The ruptured follicle gets filed with blood and the theca and granulosa cells gets replaced with lipid filled cells called corpus luteum. The corpus luteum produces predominantly progesterone and small estrogen.
Therefore, before ovulation there is estrogen dominance while after ovulation there is progesterone dominance. Both hormones are important for preparing the endometrium for implantation.
If there is union of the sperm and egg, HCH level is raised and the corpus luteum will maintain pregnancy through production of its hormones.
If the perm does not fertilize the ovum then there the corpus luteum will breakdown. Production of progesterone and estrogen is therefore reduced.
This reduction of these hormones will lead to breakdown and shredding of the endometrium. This will start another menstruation and menstrual cycle.
When is my ovulation period?
The lifespan of the sperm is about 5 days. However, the ovum lifespan of the egg is estimated to be 12 to 24 hours. In a woman with a 28 day cycle her ovulation period is on day 14 of the cycle. However, menstrual cycle is not regular for many women. And sometimes if regular, The menstrual cycle is either more or less than 28 days
Your first day of your last period (LMP) is used to calculate your ovulation period. On day 11 to day 21 of of your cycle, most women will ovulate. To get pregnant, it is important to have regular sex at this period.
This complete guide to ovulation will help you
Ovulation Cycle, Test, Signs And Symptoms
The ovulation calculator can also be used to determine your fertile periods.
When is my menstrual cycle normal?
It is important for every woman to understand their menstrual cycle. These are features of a normal cycle.
- The duration of your period is between 2 to 7 days
- The frequency of period is about 21 to 35 days
- The bleeding in not in blood clots. This is because menstrual discharge contains many different cells. Blood cells, macrophages, endothelial cells, vaginal epithelial cell and large amount of fibrinolysin. This fibrinolysin is important because it breaks down blood clots. It is therefore abnormal for blood clots to be present in your period for more than a day.
- The pain felt is not more than 48 hours after onset of your period and your normal activities are not affected
- There are no severe change in your mood and behavior.
When is my menstrual cycle abnormal?
- When your period lasts for less than 2 days
- Presence of large amounts of blood clots
- When your period flow more than 7 days
- Change in your mood that affects your activity.
- Presence of swelling in your abdomen (Fibroids) that can cause prolonged menstrual flow
If you experience any of this during your menstruation then inform your doctor.
What are the causes of abnormal menstruation?
- Fibroids
- Endometriosis
- Adenomyosis
- Endometrial polyps
- Infection
- Polycystic ovaries (PCOS)
Now its your turn. Let us know if you experience a normal menstrual cycle or not. Share your experience below.