The menstrual cycle is the monthly changes in a woman’s body that prepare her body for possible conception and subsequent gestation. Many women mistakenly believe that the discharge is the end of the cycle, although in reality it is its initial period. Blood, along with particles of exfoliating endometrium, is released from the uterine cavity, and the body begins to prepare for the maturation of a new egg. The ratio of sex hormones changes, certain changes in well-being are formed — malaise, swelling, discomfort in the chest. Doctors say that a healthy woman should not have pain during menstruation, her appearance is a sign of problems with the reproductive sphere.

First menstruation: when the discharge appears

First menstruation: when the discharge appears

The growing up of a girl and her puberty are inextricably linked with the formation of the menstrual cycle. Due to successive changes in the body, an increase in the concentration of sex hormones, secondary sexual characteristics are formed, breasts grow, hair on the legs appears, and then the first menstrual flow. Depending on the region of residence, hereditary characteristics and health status, menstruation can occur in the period from 11-12 to 14-15 years. At first, the discharge will be irregular, differing in duration and abundance, which is associated with the formation of the menstrual function. In about a year or a little more, the menstrual cycle acquires stability, cyclicity, forming the individual duration and volume of discharge. The reproductive period ends at about 50-55 years, again with individual fluctuations. Gradually, the discharge becomes irregular and stops, after which the woman is no longer capable of childbearing.

Individual characteristics, deviations from the norms in the release of blood

On average, blood is secreted for 4-5 days, in the first couple of days the volume of secretions is maximum, then decreasing to weak spotting. The duration of the menstrual cycle can vary from 28 to 33 days, depending on the characteristics, hormonal status and ovarian activity. According to doctors, the acceptable extreme options for the cycle may be to reduce it to 21-24 days or lengthen it to 40-42 days. But in these cases, it is important to exclude all possible pathologies, hormonal imbalances. Blood can be released from three to seven days, again taking into account the exclusion of all possible painful causes of such deviations.

It is important to pay attention to delays in menstruation lasting more than one cycle, as well as the complete cessation of menstrual flow if pregnancy is excluded. No less alarming is the situation when blood appears at a time when it is still early before menstrual bleeding (intermenstrual discharge). This is an occasion for an unscheduled visit to the doctor.

How hormones regulate the cycle

Menstrual functions in a woman’s body are regulated by sex hormones — progesterone and estrogens. In each phase of the cycle, their concentrations have certain fluctuation boundaries, which allows certain processes to form in the ovaries and uterus. The level of hormones is subject to external influences and changes under the influence of certain metabolic processes, therefore, even in a completely healthy woman, menstruation may not be the same day, but with slight deviations for a couple of days. In addition, individual reactions of the body to changes in the concentration of hormones are possible in the form of malaise, discomfort in the chest and genital area. Hormones are affected by overwork and stress, climate change, nutrition and the amount of physical activity, so there may be certain variations in the duration and volume of discharge even with full reproductive health. But in general, the general patterns of the menstrual cycle should not change, sharp deviations from the norm, long delays, pain, malaise, an increase or a sharp decrease in the volume of secretions are cause for concern and consultation with a gynecologist.

Is pain, nausea, malaise acceptable?

Is pain, nausea, malaise acceptable?

Often a woman anticipates in advance, according to her feelings and changes in her body, the imminent onset of menstruation. Perhaps malaise, mood changes, irritability. This condition is called PMS (or premenstrual syndrome). It is not expressed in everyone, it is an individual feature of the body and a reaction to changes in hormone concentrations. But there should be no acute pain in the groin or abdomen, a pronounced malaise, menstruation is a physiological state, it should not disturb the usual life. Possible variations in the course of PMS are weight fluctuations, swelling, and breast engorgement. If there is pain, nausea, fever — these may be signs of inflammation, hormonal failure, cystic formations, endometriosis. This is a reason to see a doctor. On the first day of discharge, there may be a feeling of tension in the groin, an ache in the lower back, a slight dull pain due to the tone of the walls of the uterus, which does not disturb the usual life.

Where is the bleeding at the beginning of the menstrual cycle?

The menstrual cycle, as we said earlier, begins with bleeding. This is a detachment of the inner wall of the uterus, which has lost its functionality due to a missed conception. The cells become obsolete, begin to exfoliate and expose the vessels under them, bleeding is formed, with which the endometrial cells are also separated. On average, in one menstrual cycle, blood loss is from 50 to 100 ml, and such a lost volume of blood is not dangerous for the body. Recovery occurs quickly due to the regenerative abilities of the bone marrow and the synthesis of new blood cells. The discharge is usually copious for the first two or three days, then becoming scanty. Long and heavy discharge can be dangerous, and this is a reason to visit a doctor. Loss of increased blood volume during menstruation can cause anemia or latent iron deficiency, which adversely affects health. The doctor will find out in detail the causes of such deviations and then prescribe corrective therapy and anti-anemic treatment.

Obstetrics / Ed. Savelieva G.M. 2000

Endocrinology / Ed. Dedova I.I., Melnichenko G.A. 2013