Menstruation 101

Menstruation, also called a “period,” refers to the regular monthly shedding of the uterine lining (endometrium) when pregnancy does not occur. It is part of the menstrual cycle, a sequence of hormonal and physiological changes that prepare the body for potential conception.

A typical menstrual cycle lasts about 21 to 35 days, with menstruation (bleeding) lasting 3 to 7 days on average. The cycle can be divided into key phases:

1. Menstrual Phase (Days 1–5): This is when bleeding occurs as the uterine lining sheds. Symptoms may include cramps, fatigue, or mood changes.
   

2. Follicular Phase (Days 1–13): Overlaps with menstruation initially. The hormone FSH stimulates the ovaries to produce follicles, one of which matures into an egg. Estrogen levels rise, thickening the uterine lining.
   

3. Ovulation (Day 14 in a 28-day cycle): Triggered by a surge in luteinizing hormone (LH), the mature egg is released. This is the most fertile window.
   

4. Luteal Phase (Days 15–28): Progesterone prepares the uterus for a possible pregnancy. If conception does not occur, hormone levels drop, leading to menstruation.

NB: The days for each phase of the cycle may vary depending on the cycle length. The above is for women with 28-day cycles.

Understanding these basics helps women recognize what is normal and identify when something may be wrong. Unfortunately, many women do not receive adequate education on these processes, leaving them vulnerable to confusion and fear when abnormalities occur.

What Women Should Know About Menstrual Abnormalities

Not every menstrual cycle follows the textbook pattern. Menstrual abnormalities are common and can indicate underlying health concerns. Some of the most important ones include:

1. Amenorrhea: Absence of menstruation. It may be primary (no periods by age 15) or secondary (menstruation stops for three months or more after previously being regular). Causes include hormonal imbalances, excessive exercise, stress, polycystic ovary syndrome (PCOS), thyroid disorders, or pregnancy.
   

2. Oligomenorrhea: Infrequent periods occurring more than 35 days apart. Often linked to PCOS, hormonal disorders, or excessive weight changes.
   

3. Menorrhagia: Abnormally heavy or prolonged bleeding. Women may need to change pads or tampons very frequently, or experience anemia due to blood loss. Causes range from uterine fibroids and endometriosis to bleeding disorders.
   

4. Dysmenorrhea: Painful periods that interfere with daily activities. While mild cramps are common, severe pain may indicate conditions like endometriosis or adenomyosis.
   

5. Polymenorrhea: Menstrual cycles shorter than 21 days. This may signal hormonal issues, infection, or structural abnormalities in the reproductive system.
   

6. Irregular cycles: Fluctuations in cycle length are common during adolescence and perimenopause, but persistent irregularity may suggest PCOS, thyroid problems, or other endocrine disorders.

Recognizing these menstrual abnormalities is critical. Many women dismiss irregularities as “normal” or suffer silently, but early recognition and medical consultation can improve quality of life and prevent complications.

Menstrual Hygiene: Why It Matters

Menstrual hygiene is more than just cleanliness; it is an essential aspect of overall health and dignity. Poor practices can lead to infections, discomfort, and even reproductive health complications. Unfortunately, menstrual hygiene remains a challenge in many communities due to stigma, lack of education, and limited access to affordable products.

Best practices for menstrual hygiene include:

1. Regularly changing sanitary products (pads, tampons, menstrual cups) every 4–6 hours to prevent infections and odor.
   

2. Using clean, safe products. Avoid using makeshift materials such as cloths that are not properly sanitized.
   

3. Maintaining proper genital hygiene by washing with clean water and mild soap. Harsh chemicals or scented products should be avoided.
   

4. Disposing products safely, ensuring they do not contaminate the environment.
   

5. Educating girls and women early about safe practices and normalizing discussions around menstruation.

Good menstrual hygiene improves confidence, reduces absenteeism from school and work, and enhances reproductive health outcomes.

The Importance of Cycle Tracking

Cycle tracking is one of the most powerful yet underutilized tools for women’s health. By documenting the start and end of each period, along with symptoms such as pain, mood changes, or irregularities, women can:

• Identify menstrual abnormalities early.
  

• Recognize ovulation patterns for family planning (whether to achieve or avoid pregnancy).
  

• Anticipate premenstrual symptoms, allowing for better preparation.
  

• Monitor long-term health, as menstrual irregularities may reflect underlying systemic conditions like diabetes, thyroid disease, or PCOS.

Modern tools such as menstrual apps and symptom trackers make this process easier, but even a simple journal can be effective. Many women who adopt tracking report better self-awareness and improved communication with healthcare providers.

Breaking the Silence Around Menstruation

Cultural and societal stigma has forced many women into silence about their menstrual challenges. In some communities, menstruation is seen as unclean or shameful, leading to embarrassment, poor education, and inadequate care. To change this, it is essential to foster open conversations, provide accurate education, and encourage women to seek help without fear.

Healthcare providers, educators, parents, and policymakers all have a role to play in normalizing discussions about menstruation and promoting menstrual health as a public health priority.

Silence, stigma, and misinformation have held women back for too long. Now is the time to replace secrecy with knowledge, shame with empowerment, and neglect with proactive care.