For all people who menstruate: a teaching guide to menstruation

Menstruation is an extremely important topic in the lives of all people who menstruate, usually from the age of 12. The gynecologists Dr. Caroline Sonego (CRM 35839 – RS) and Dr. Tairine Iwasse (CRM 37267 – BA) clarify the main doubts related to the topic. Understand what menstruation is, how the menstrual cycle works, and more.

What is menstruation?

This is a question that every person who menstruates has asked someone. According to gynecologist Dr. Caroline Sonego, “menstruation is basically a shedding of the endometrium and is part of a woman’s natural reproductive cycle”.

And why does it happen? The specialist explained that, due to the action of the hormones estradiol (proliferative phase) and progesterone (secretory phase), the endometrium (layer that lines the inside of the uterus) becomes thick to receive a possible fertilized egg, preparing for pregnancy. Therefore, usually after a month, if fertilization does not occur, the endometrium sheds, generating bleeding known as menstruation.

the menstrual cycle

To understand the menstrual cycle and its entire functional process, Dr. Sonego explained that, “in general, from the age of 12, menstruation begins to come every month with a duration of about 3 to 8 days”. The first period is also known as menarche. The doctor says that this natural process will happen until menopause (last menstruation), which occurs around the age of 50.

Dr. Caroline also stated that the length of a menstrual cycle is calculated from the first day of menstruation to the day before the next cycle. “A cycle is considered regular when it lasts 21 to 35 days and has three phases: follicular, ovulatory and luteal,” she explained. She understands each phase below, with the help of the doctor:

• Follicular Phase: In this first phase, Dr. Caroline explained that the first day of menstruation marks the beginning of the follicular phase and lasts for about 14 days, varying from woman to woman and cycle to cycle, ending when ovulation occurs.

  According to the gynecologist, “in this phase, the concentration of estrogen and progesterone is low and generates the production of FSH (follicle-stimulating hormone), responsible for stimulating the development of follicles. If there was no pregnancy, the endometrium is expelled and the woman’s body begins again to prepare for a new cycle of production of ovarian follicles – structures in which eggs develop,” she explained.

  And you want to know when eggs finally develop? According to Dr. Caroline, after 7 days, the follicles start to produce estrogen, increasing the production of luteinizing hormone (LH) and thus, the maturation of the egg ends.

• Ovulatory phase: this is, without a doubt, the most important phase of the menstrual cycle according to Dr. Caroline, because “about 12 to 36 hours after the egg matures, it is released and sent to the fallopian tubes. The woman enters the fertile period and the cervical mucus becomes thicker and more elastic, due to the influences of estrogen and LH,” she explained.
• Luteal Phase: Last but not least, this phase usually occurs in the last 12 days of the menstrual cycle. According to the doctor, the dominant ovarian follicle forms the corpus luteum, which increases the concentration of estrogen and progesterone, aiding in the implantation of the embryo. The doctor explained that, “the egg that was sent to the fallopian tubes can be fertilized (starting a pregnancy) or not”.

  Now you must be wondering: what happens when the egg is not fertilized? According to the specialist, the corpus luteum breaks down and, consequently, the levels of estrogen and progesterone decrease again. This causes the endometrium to slough off, causing menstruation.

Very interesting to know what happens to your body during the menstrual cycle, isn’t it? To understand even more about this phenomenon that happens naturally in the lives of people who menstruate, check out the answers to the main questions on the subject.

12 doubts about menstruation

After the first period, some questions begin to arise and these doubts need to be resolved with the help of a gynecologist. Dr. Tairine Iwasse brought answers to 12 questions on the topic, check it out:

Women’s Tips: How many days does a normal period last?

Dr. Tairine Iwasse: normal menstrual flow lasts up to 8 days, with blood loss between 5 and 80 ml. Prolonged irregular menstruation is longer than 8 days and should be studied if usual.

What not to do when you are menstruating?

Take time to change tampon, take time to empty the menstrual collector, perform a vaginal douche (different from the vulva that must be sanitized) and preventive spoon.

What can late period mean?

Delayed menstruation is not always a sign of pregnancy, as other situations such as excessive stress, excessive physical activity, hormonal disorders caused by thyroid problems and PCOS (Polycystic Ovarian Syndrome), premenopausal period and interruption or inappropriate use of contraceptives , can lead to delay in menstruation.

Is it possible to menstruate while pregnant?

No, pregnant women don’t menstruate! What can happen is that during the implantation of the embryo in the endometrium (inner layer of the uterus) called implantation, there is a small bleeding that can last up to 3 days.

Other bleeding situations during pregnancy are: threatened abortion, placenta previa, hydatidiform mole, ectopic pregnancy, placental abruption.

Is it normal for my period to be late?

Yes, after all, the normal menstrual cycle has an average duration of 28 days. However, cycles with an interval between 24-38 days associated with anticipation or delay of 3 days are normal.

Even those who have regular cycles, from time to time may experience some variation. But it should always be thought about the causes of delay such as stress, hormonal disorders, pregnancy, among others.

Can menstruation cause bleeding?

Yes, it is known as Abnormal Uterine Bleeding (AUB) and occurs due to changes in menstruation due to an increase in volume, duration or frequency. Some causes can be: polyp, adenomyosis, fibroids, changes in blood clotting, uterine cancer and polycystic ovary syndrome.

How do you know if it’s the last day of your period?

Normal menstrual flow lasts up to 8 days, each person has an idea of ​​how many days they normally menstruate. At the end of the menstrual cycle, the color of the blood becomes darker, as the quantity and speed of output are lower.

Is it normal to have more than 20 days of menstruation?

No, as normal menstrual flow lasts up to 8 days. If the woman has more prolonged bleeding, she should be investigated for some pathologies such as fibroids, uterine polyps, adenomyosis.

Is there a way to make your period go down?

What exists are treatments, depending on the cause of menstrual delay. For example, in the case of thyroid changes, hormone regulation can regulate cycles. There is no scientific proof that drinking tea for menstruation is really effective.

What shows most results is relaxation, a balanced diet and reducing physical exercises if you perform them in great intensity and excess.

Is there a way to stop menstruation?

There is a range of contraceptives on the market with the function of interrupting menstrual cycles, such as: IUS (intrauterine system – hormonal “IUD”), quarterly injection and continuous use pills.

Now, if the period has already come down, there is no way to make this period stop, just reduce the flow/intensity with the use of some medications such as some anti-inflammatory drugs.

When should I be concerned about menstruation?

Normal menstruation is considered when it lasts up to 8 days, the cycle varies between 24 and 38 days and a flow of up to 80 ml. Any bleeding that does not have these characteristics is considered abnormal.

How long are clots normal?

A light cycle normally does not contain clots. For those who have a moderate-heavy menstrual flow, you may have some clots, especially in the first days/half of your menstrual period.

In all cases, if clots are present, it is normal for it to be smaller than a coin (1in. or 24.5 mm). If your flow is moderate-intense, there’s no reason to panic, especially if it’s always been that way. Just in case, the ideal is to make a gynecological consultation to assess the situation.

Questions clarified? In addition to these, you may have specific issues regarding menstruation and for that, it is very important that you schedule a gynecological appointment to remedy all of them. Here are the main symptoms of menstruation.

What are the symptoms

Yes, menstruation has a list of symptoms that may or may not appear, indicating that the day of bleeding is approaching. Dr. Caroline Sonego has listed each of them. Check out!

• Pain in the legs;
• Abdominal swelling;
• Tiredness;
• Liquid Retention;
• Acne;
• Cramps;
• Headache (headache);
• Sudden change in mood;
• Mastalgia (breast pain).

Have you ever felt any of these symptoms? Some women can feel all of them, while others identify very few. And about menstruation colors, what do you know about them? Check the details in the next topic.

menstruation colors

According to the doctor. Sonego, “during the menstrual period, blood colors may vary”, and the most common tones to observe are bright red, light or dark brown and burgundy. The gynecologist explained that the contact of blood with oxygen can interfere with the color of menstruation, making it darker due to the evaporation of water and, consequently, changing the concentration of pigment. According to the specialist, another factor that alters the tone is the time it takes for the blood to leave the vaginal canal.

The doctor also stated that, “after the end of menstruation, the secretion becomes more yellow or transparent. This is a sign that the endometrium is reorganizing itself.” The doctor also emphasizes the importance of gynecological monitoring and mentions the importance of each woman knowing her menstrual pattern, knowing how to identify when any changes occur and thus seeking help from her gynecologist.

Understanding the natural processes in the body that give rise to menstruation is essential. You begin to realize what is happening to your body, you can more effectively prevent an unwanted pregnancy or prepare for one. In addition, it becomes even easier to identify when something is not going well with your intimate health and go in search of specialized help. Want to know more about menstrual cycle issues? Understand all the details of the fertile period.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.