What is Menstruation? Why?How?What?When? All FAQs

A complete question and answer ppt on Menstruation and related queries, questions. Find information about Period pain, excess bleeding,PCOD/PCOS, menopause and much more...

1. Menstruation

2. Menstruation/ Menses/ periods is- A natural process NOTHING TO BE ASHAMED OF A protective mechanism in human body- to avoid unwanted pregnancies to plan a healthy pregnancy

3. Natural process to help women bear children when desired

4. Lifespan of a woman is divided into three phases „ FIRST Phase -birth to puberty. During this period, reproduction related organs are inactive. SECOND Phase -onset of puberty (9-16 years) to the onset of menopause (45-50 years). First menstrual cycle is known as menarche . Permanent stoppage of the menstrual cycle in old age is called menopause During this 35 years of reproductive age, women can menstruate and reproduce. „ THIRD Phase- after menopause to the rest of the life

5. Menstruation marks the beginning of puberty in girl children Puberty= when a young girl slowly starts becoming a woman Several changes take place in the body beginning at puberty Puberty can be attained any time in between 9 to 16 years

6. Changes at puberty Breast development Hip size enlargement Hair growth at Underarms Genitals Acne occur on skin

7. Menarche= the first menstruation Menopause= end of menstruation Normally, menarche occurs after 2 years of beginning of breast growth Menarche age can depend upon mothers age at menarche too It also depends on physical development of a girl

8. The science behind menstruation

9. After ovulation, if pregnancy does not occur, the thickened endometrium is shed. This is expelled out through vagina along with blood and tissue fluid. The process of shedding and exit of uterine lining along with blood and fluid is called menstruation or menstrual bleeding. It lasts for about 3 to 7 days. This period is called menstrual period or menses. The day when bleeding starts is considered as the first day of the menstrual cycle

10. Life of egg after ovulation= 1-2 days Life of sperm in female genital tract= around 4 days Maximum chances of pregnancy/fertilisation= during the 3 days before or on the day of ovulation No day of menstrual cycle is 100% safe from pregnancy Always use contraceptives- video available in hindi /English on JIL doc Chances of pregnancy

11. Why is it a cycle? Why does it repeat ? When periods (menstruations) come regularly, this is called the menstrual cycle. Having regular menstrual cycles is a sign that important parts of your body are working normally. The menstrual cycle provides important body chemicals, called hormones, to keep you healthy. It also prepares your body for pregnancy each month.

12. How much blood is lost per cycle? 2-4 tablespoons of blood is lost in menstruation = 30-60ml per cycle

13. How long is a normal menstrual cycle? A cycle is counted from the first day of 1 period to the first day of the next period. The average menstrual cycle is 28 days long. Cycles can range anywhere from 21 to 35 days in adults and from 21 to 45 days in young teens. A variation of 3-5 days between cycles is normal.

14. Why is my period delayed? In the first 2-3 years after attaining menarche- irregular periods are common .. Later it becomes regular with age If it exceeds >3 months between two periods= should consult doctor At any age.. For delayed periods ----always rule out pregnancy first Other common causes of delayed periods= Any recent health problem, sudden weight loss, stress, too much exercise.

15. Problems related to menstruation

16. AMENORRHEA -lack of a menstrual period Young women who haven't started menstruating by age 16 Women and girls who haven't had a period for 90 days, even if they haven't been menstruating for long Causes can include: • Pregnancy • Breastfeeding • Extreme weight loss • Eating disorders • Excessive exercising • Stress • Serious medical conditions in need of treatment In some cases, not having menstrual periods can mean that your ovaries have stopped producing normal amounts of estrogen which can affect your overall health. Hormonal problems, such as those caused by polycystic ovarian syndrome (PCOS) or serious problems with the reproductive organs, may be involved. It’s important to talk to a doctor if you have this problem.

17. Premenstrual syndrome (PMS) is the symptom of stress that appears before the onset of menstruation. It is also called premenstrual stress syndrome, premenstrual stress or premenstrual tension. It lasts for about 4 to 5 days prior to menstruation. Symptoms appear due to salt and water retention caused by estrogen . Common Features 1. Mood swings 2. Anxiety 3. Irritability 4. Emotional instability 5. Headache 6. Depression 7. Constipation 8. Abdominal cramping 9. Bloating (abdominal swelling).

18. Reason for body pains during periods? Excess production of some chemical hormones (prostaglandins) in body

19. Before some days of periods/ during periods

20. Also mood and behavior changes These are normal

21. Menstrual symptoms are the unpleasant symptoms with discomfort, which appear in many women during menstruation. These symptoms are due to hormonal withdrawal, leading to cramps in uterine muscle before or during menstruation. Common Menstrual Symptoms 1. Abdominal pain 2. Dysmenorrhea (menstrual pain) 3. Headache 4. Occasional nausea and vomiting 5. Irritability 6. Depression 7. Migraine (neurological disorder, characterized by intense headache causing disability).

22. Remedies- Hot fomentation at site of pain with hot cloth or bottle in cloth or taking bath with warm water

23. 2. by gently massaging area of pain 3. by herbal drink made with ginger/ cumin 4. consuming food rich in iron 5. drink more water- avoid coffee/tea 6. decrease salt and sugar 7. light exercise activity/ walking 8. yoga to relieve pain

24. Eat well, be active

25. Dysmenorrhea- painful periods, including severe cramps Most teens with dysmenorrhea do not have a serious disease, even though the cramps can be severe. In older women, the pain is sometimes caused by a disease or condition such as uterine fibroids or endometriosis . Some over-the-counter pain medicines like Ibuprofen can also help. If these methods don’t relieve your pain or the pain interferes with work or school, you should see a doctor.

26. Abnormal uterine bleeding — vaginal bleeding that’s different from normal menstrual periods It includes: • Bleeding between periods • Bleeding after sex • Spotting anytime in the menstrual cycle • Bleeding heavier or for more days than normal • Bleeding after menopause Treatment for abnormal bleeding depends on the cause. In both teens and women nearing menopause, hormonal changes can cause long periods along with irregular cycles. Even if the cause is hormonal changes, you may be able to get treatment. You should keep in mind that these changes can occur with other serious health problems , such as uterine fibroids, polyps, or even cancer. See your doctor if you have any abnormal bleeding.

27. When should I see a doctor about my period? • You have not started menstruating by the age of 16. • You have not started menstruating within 3 years after breast growth began, or if breasts haven't started to grow by age 13. • Your period suddenly stops for more than 90 days. • Your periods become very irregular after having had regular, monthly cycles. • Your period occurs more often than every 21 days or less often than every 35 days. • You are bleeding for more than 7 days. • You are bleeding more heavily than usual or using > 1 pad or tampon every 1 to 2 hours. • You bleed between periods. • You have severe pain during your period You suddenly get a fever and feel sick after using tampons. (Toxic Shock Syndrome)

28. How often should I change my pad or tampon? You should change a pad before it becomes soaked with blood. Each menstruator decides for themself what works best. You should change a pad/tampon at least every 6 to 8 hours even if its not full.

29. TSS with tampons If you have any of these symptoms of TSS while using tampons, take the tampon out, and contact your doctor right away: • Sudden high fever (over 102 degrees) • Muscle aches • Diarrhea • Vomiting • Dizziness and/or fainting • Sunburn-like rash • Sore throat • Bloodshot eyes

30. Why does menstrual blood smell bad? Menstrual blood doesn’t have any bad smell.. It’s the same as the blood inside our body After coming in contact with pad/air and Chemical reactions take place due to which a smell may be there

31. Smell can be prevented by changing pad on time

32. Blood discharged during menstruation is impure or dirty? No because Menstruation blood doesn’t release toxins or impurity from the body.. This blood is the inner lining of uterus shed every cycle when pregnancy doesn’t happen in the cycle This blood is fresh and is the same as the blood inside the body

33. White discharge? Some white discharge is normal It happens in everyone Discharge amount and form varies throughout the cycle Go to doctor if- Smells bad Excess discharge Other color discharge

34. General hygiene tips? Daily bathing and washing genitals is necessary during periods too Always cleaning genitals from front to back , to avoid infection To use Washed and Dry undergarments and clean – dry menstrual absorbents only to avoid infections

35. Should we use vaginal wash? Only when prescribed by doctor No chemical product should be used inside vagina as it can cause harm To clean external genitalia skin- normal bathing soap is enough Vagina has self cleansing mechanism Good bacteria in vagina maintain a pH of 4.5 with lactic acid Hence bad bacteria cant grow in vagina No chemical product should be used inside vagina as it can cause harm To clean external genitalia skin- normal bathing soap is enough Only when infections happen this balance is unsettled and need external intervention Before puberty, after delivery, in infections and in menopause the pH is high and infections can happen

36. When to consult with your gynecologist

37. Normal vaginal secretion The vaginal secretion is small in amount in healthy women and consists of white coagulated material. n Normal vaginal secretion is small in amount and varies with the phase of the menstrual cycle. Döderlein’s bacilli predominate. They are Gram-positive and grow anaerobically in an acid medium of 4.5 pH. Low acidity does not allow other organisms to grow and cause vaginitis. The vaginal secretion is acidic due to the presence of lactic acid, and this acidity inhibits the growth of pathogenic organisms. The pH of the vagina averages about 4.5 during reproductive life. The acidity, which is undoubtedly oestrogen dependent, falls after menopause to neutral or even alkaline. Before puberty, the pH is about 7. This high pH before puberty and after menopause explains the tendency for the development of mixed organism infections in these age groups During the puerperium and also in cases of leucorrhoea, the acidity of the vagina is reduced and pathogenic organisms are then able to survive.

38. Anovulatory cycle is the menstrual cycle in which ovulation does not occur. The menstrual bleeding occurs but the release of ovum does not occur. It is common during puberty and few years before menopause. When it occurs before menopause, it is called perimenopause. If it occurs very often during childbearing years, it leads to infertility. Common Causes 1. Hormonal imbalance 2. Prolonged strenuous exercise program 3. Eating disorders 4. Hypothalamic dysfunctions 5. Tumors in pituitary gland, ovary or adrenal gland 6. Long-term use of drugs like steroidal oral contraceptives

39. Menstruation and Anemia You can have anemia if you often feel- tired, weak, giddy, look pale, don’t feel energetic Get your hemoglobin level checked; Normal Hb= > 12 g/dl Healthy diet and active lifestyle is needed Diet rich in iron= Rajma- chhole - spinach-groundnuts Eat local and seasonal fruits-vegetables Take iron supplements as advised on blood check up results Future consequences of anemia = complications in pregnancy and labour and even malnourished baby

40. PCOD = polycystic ovarian disease Due to hormone imbalance Irregular periods Excess body hair Weight gain Infertility To prevent it- Healthy lifestyle Diet and exercise

41. Perimenopause (between 45- 55 years)

42. A word on menopause- a life with low estrogen Transition period- Osteoporosis   - low bone density and bone fragility Heart Disease Sexual Dysfunction- vaginal dryness, irritation, painful sex Incontinence- increased urge to urinate, painful urination, or accidental leakages, postmenopausal women may have more  frequent urinary tract infections Depression

43. Family support Eat healthy Stay active Have hobbies Yoga/meditation *calcium supplement * Soyabean in diet

44. More questions?? Please post them in comment section.