Understanding of Normal and Abnormal Menstruation

Understanding Menstruation

Menstruation is the discharge of blood from the vagina as a monthly cycle experienced by women. This cycle occurs naturally and is part of the process of the female reproductive organs to prepare for pregnancy. Every month, the female reproductive organs prepare for pregnancy. This preparation is characterized by thickening of the uterine wall (endometrium) which contains blood vessels. If pregnancy does not occur, the endometrium will shed and come out with blood through the vagina. Menstruation can also be called menstruation or menstruation. The duration of the menstrual cycle occurs on average every 28 days and is around 4 to 7 days long. The amount of blood lost during menstruation reaches 20-60 milliliters. The first menstruation can come sooner or later. However, on average the first menstrual cycle starts at the age of 12 years, or 2-3 years after breast growth. The menstrual cycle will continue until menopause.

Menstrual Phase

The menstrual cycle is a term used to describe the sequence of events during which a woman’s body indicates that she is ready to experience pregnancy each month. The count of the menstrual cycle is considered to start on the first day of blood coming out through the vagina (menstruation). Even though it happens regularly, many women don’t know the menstrual phase.

The following is the menstrual process which is divided into 4 phases, namely:

1. Menstrual phase.
   The menstrual phase is marked by the shedding of the uterine wall which contains blood vessels and mucous fluid. This process starts on the first day of menstruation and lasts for 4-7 days. When this happens, women will experience pain in the stomach and back caused by contractions in the uterus when the endometrium sheds.
2. Follicular phase.
   In the follicular phase, the ovaries will form follicles containing immature egg cells. These follicles and egg cells will grow and stimulate thickening of the uterine wall. The follicular phase generally lasts 11–27 days, depending on each woman’s cycle.
3. Ovulation phase.
   The ovulation phase occurs when the ovaries release mature eggs. This egg is ready to be fertilized by sperm in the fallopian tubes. However, if it is not fertilized by sperm, the egg will fuse within 24 hours after the ovulation phase occurs. The ovulation phase generally occurs on day 14 of the menstrual cycle.
4. Luteal phase.
   The luteal phase is marked by the transformation of the egg cell into the corpus luteum. This tissue will release hormones that thicken the uterine wall. However, if it is not fertilized by sperm, the corpus luteum will shrink and be reabsorbed. Eventually the uterine lining will shed during menstruation. The luteal phase lasts 11–17 days.

Causes of Abnormal Menstruation

Normally, the menstrual cycle comes every 21-35 days with a menstrual period of 3-7 days. During the menstrual phase, women bleed with an average volume of less than 80 milliliters. The time span of each woman’s menstrual cycle can be different, but there are some women who experience menstrual cycle abnormalities. Some abnormalities that are often found are irregular menstrual schedules, as well as excessive blood volume.

There are several factors that can cause a woman’s menstrual cycle to be abnormal, namely:

1. Using an IUD form of contraception.
2. Taking certain medications, such as birth control pills or antidepressants.
3. Exercising too hard.
4. Suffering from certain diseases, such as hyperthyroidism, hypothyroidism, or polycystic ovarian syndrome (PCOS).
5. Are pregnant or breastfeeding.
6. Suffering from stress.
7. Suffering from uterine disorders such as myoma.
8. Smoke.

Menstrual Symptoms

During the menstrual cycle, women can feel certain symptoms in two phases, namely before menstruation and during menstruation. Here is the explanation:

• Premenstrual symptoms (PMS).
  During the menstrual cycle, hormone levels in a woman’s body will change. Changes in the amount of these hormones can affect your physical and emotional state several days before menstruation. These symptoms are called premenstrual syndrome or premenstrual syndrome (PMS). Some symptoms that appear during premenstruation include:
  1. Headache
  2. Pain in the breast
  3. Pimples appear on the skin
  4. Bloated
  5. Mood swings
  6. Changes in sex drive

The symptoms above can last for 6-7 days, namely 4 days before menstruation and 2-3 days after menstruation.

• Symptoms during menstruation
  During menstruation, the uterine muscle experiences stronger contractions to shed its lining. Hormonal changes during the menstrual phase will also cause menstrual symptoms, which generally last for 1-3 days. Symptoms felt during menstruation include:
• 1. Pain in the stomach
  2. Feeling like pressure in the stomach
  3. Pain in the hips, lower back and inner thighs
  4. Headache
  5. Dizzy
  6. Nauseous
  7. Diarrhea

These menstrual symptoms will decrease with age or even disappear when the woman gives birth.

Recognizing Abnormal Menstrual Cycles

The duration and volume of bleeding due to the menstrual cycle can vary for each woman. Therefore, every woman is advised to record her menstrual cycle. The aim is that if any irregularities arise they can be immediately noticed. Changes in the menstrual cycle can indicate a health problem. Therefore, immediately see a doctor if you experience signs of menstrual abnormalities, such as:

1. Irregular menstrual schedule, such as not menstruating for more than 3 months or earlier than 21 days.
2. There is a lot of blood that comes out during menstruation.
3. Bleeding lasts more than 7 days.
4. Bleeding occurs outside the menstrual cycle.
5. Menstrual symptoms are heavier than usual.

Treatment of Menstrual Disorders

To confirm menstrual disorders, the doctor will ask about the patient’s menstrual cycle and history of illnesses. The doctor will also carry out a number of examinations to confirm menstrual disorders, namely by:

1. Blood tests, to detect anemia and other diseases
2. Pap smear, to diagnose cervical cancer
3. Examination of vaginal fluids, to detect possible sexually transmitted infections
4. Ultrasound of the uterus, to check for possible myomas or ovarian cysts
5. Biopsy or taking tissue from the uterine wall, to diagnose hormonal imbalances, endometriosis, or cancer cells

Medical treatment to treat menstrual disorders depends on the symptoms experienced. The following is the explanation:

1. Painful. To relieve pain before or during menstruation, you can take over-the-counter pain relievers, such as paracetamol or ibuprofen.
2. Irregular menstrual schedule. To treat menstrual cycle disorders, the doctor will prescribe drugs that contain the hormones estrogen and progesterone, such as birth control pills. Doctors can also carry out other medical procedures, according to the results of the diagnosis.
3. Excessive menstrual bleeding. To prevent anemia due to excessive bleeding during menstruation, you can buy blood-boosting supplements that are sold freely at pharmacies. Apart from that, your doctor may also advise you to undergo progestin injections. In some cases, doctors will perform surgery to treat menstrual abnormalities due to certain diseases, such as endometriosis and myoma.

Complications of Menstrual Disorders

Menstrual disorders that are not treated immediately risk causing complications, such as:

1. Anemia.
   Excessive and long-lasting menstrual bleeding can cause blood deficiency (anemia) and iron. This condition can also be followed by symptoms, such as lethargy and getting tired easily.
2. Risk of fertility disorders.
   Irregular menstrual schedules, excessive bleeding, or not menstruating for a long time can interfere with the ovulation process. If the ovulation process is disrupted, sufferers can experience fertility problems.

Prevention of Menstrual Disorders

Symptoms that appear during the menstrual cycle are difficult to avoid. However, there are several ways you can do to relieve pain during the menstrual cycle, namely:

1. Replace carbohydrate intake with complex carbohydrates, such as whole wheat, brown rice, or cereal.
2. Increase your consumption of foods and drinks high in calcium, such as yoghurt and green vegetables.
3. Reduce consumption of sugar, salt and fatty foods.
4. Avoid drinks that contain caffeine and alcohol.
5. Do not smoke.
6. Manage stress well.
7. Get enough rest.
8. Exercise regularly with light or moderate intensity.