Menstrual Awareness

Menstrual awareness focuses not only on understanding the menstrual cycle but also provides knowledge about menstrual hygiene, debunking social and cultural myths, raising awareness about signs of menstrual abnormalities, and their management. Menstruation is a natural process experienced by females of reproductive age, but this topic of periods has been surrounded with mysteries, myths, and misconceptions leading to a lack of understanding and awareness.

Menstrual awareness gives females the capacity to accept and comprehend the biological cycles of their bodies. This article aims to address frequently asked questions (FAQs) related to the menstrual cycle, menstrual hygiene, menstrual products, menstrual disorders, and their management.

Normal menstruation

What is menstruation and why does it occur?

Menstruation is a natural process that occurs in females of reproductive age every month, from puberty until menopause. It involves the shedding of the uterine lining. During the menstrual cycle, an egg is produced and released into the uterine tube for possible fertilization. At the same time, the uterine lining is thickened and prepared for implantation in the case of a possible pregnancy. When fertilization does not occur, the uterine lining sloughs off as menstrual bleeding.

The main purpose of menstruation is to prepare the body for a possible pregnancy.

At what age does menstruation start?

The onset of menstruation, known as menarche, occurs at puberty. Puberty is a transition from childhood to adolescence and is accompanied by biological and physical changes, including the beginning of the menstrual cycle. The first periods normally occur between the ages of 9 and 16, but the average age of menarche is 12 years.

The onset of menstruation varies among girls and is affected by genetic factors, nutrition, overall health, and environmental conditions.

What is the length of the normal menstrual cycle?

The average length of the menstrual cycle is 28 days, however, a length between 21 to 35 days is considered normal. The length of a menstrual cycle can vary among females. Some have short while others have long cycles. The length of the cycle is counted from the first day of the menstrual period to the first day of the next menstrual period.

How long does a normal period last?

The menstrual period can last anywhere between 2 to 7 days. However, the average length of a menstrual period is 3 to 5 days. The duration of periods differs from female to female. Some have periods for only 3 days, while others experience bleeding that lasts for a week.

What are the common symptoms of periods?

During menstrual periods, females experience a wide range of physical and emotional symptoms. These symptoms include:

  • Abdominal cramps and discomfort
  • Fatigue
  • Headache
  • Nausea and vomiting
  • Backache
  • Tender breasts
  • Mood swings
  • Anxiety
  • Acne
  • Bloating.

How much menstrual bleeding is considered normal?

The normal amount of blood lost during the period is between 30 to 50 milliliters or 2 to 3 tablespoons. This amount of bleeding is considered normal. The passing of blood clots and the appearance of symptoms associated with anemia, such as fatigue and weakness, should be observed as they are linked with abnormally heavy bleeding.

What are the different phases of the menstrual cycle?

The menstrual cycle consists of 4 phases:

  • The follicular phase occurs when hormones from the brain act upon the ovaries, helping to mature a follicle into an egg. At the same time, the uterus is being prepared for the implantation of the upcoming embryo.
  • Ovulation is defined as the release of an egg from the ovary into the uterine tube.
  • During the luteal phase, the follicle from which the egg is released converts into a hormone-releasing structure called the corpus luteum. Further thickening of the uterus occurs.
  • Menstruation occurs if fertilization does not happen; the corpus luteum degenerates and the uterine lining starts to slough off as menstrual bleeding.

What is menopause and how does it affect menstruation?

Menopause is a natural biological process. It is the permanent stoppage of menstrual cycles and the end of fertility. It occurs between the age range of 45 and 55 years. It happens when the ovaries no longer release eggs, so there is a complete cessation of periods. Symptoms include:

  • Irregular periods
  • Hot flashes and night sweats
  • Sleep disturbances
  • Mood changes
  • Dry skin, dry eyes, or dry mouth
  • Changes in sexual desire
  • Hair thinning or loss
  • Vaginal dryness.

How can I track my menstrual cycle?

  • Tracking with Menstrual Portal: The period tracker at Menstrual Portal predicts precise ovulation, fertile window, and period dates. It is very helpful if you’re attempting to conceive, schedule your activities around your cycle, or just want to understand your body better.
  • Period tracking applications: There are various menstrual cycle tracking applications available for smartphones, such as Clue, Flo, and Period Tracker.
  • Menstrual cycle tracking devices: Some wearable devices and smartwatches come with built-in menstrual cycle tracking features.
  • Calendar method: Use a calendar to mark the first day of your period every month. Count the number of days between the beginning of one cycle and the beginning of the next to determine your cycle’s length.

Menstrual disorders

What are the risk factors for developing menstrual abnormalities?

Various risk factors contribute to the development of menstrual abnormalities. They include:

  • Obesity
  • Genetic factors
  • Hormonal imbalance
  • Stress
  • Underlying diseases
  • Pelvic infections
  • Medications and contraceptives.

What is premenstrual Syndrome?

Premenstrual syndrome is a collection of physical and emotional symptoms that occur one or two weeks before periods. It includes:

  • Bloating
  • Breast tenderness
  • Headache and body pains
  • Fatigue
  • Mood swings
  • Irritability and anxiety
  • Food cravings.

All of these symptoms are due to hormonal fluctuations.

What is endometriosis?

Endometriosis is a condition in which tissue similar to the uterine endometrium (the inner lining of the uterus) grows outside the uterus, in the ovaries, fallopian tubes, or other pelvic organs. As the normal uterine endometrial lining sloughs off, the abnormally grown endometrial tissue also responds to hormones, causing its shedding. But, it has no way to exit, leading to further problems such as:

  • Prolonged bleeding
  • Heavy periods
  • Period pain
  • Pelvic pain.

What is polycystic ovary syndrome (PCOS) and how can it disrupt the menstrual cycle?

PCOS is a hormonal disorder in which there is the formation of multiple small cysts in the ovaries. It is characterized by the production of excess androgens (male hormones), menstrual irregularities, hirsutism, acne, and difficulty in losing weight. It affects the menstrual cycle in several ways. The production of excess androgens inhibits the production and development of follicles resulting in failure of ovulation and the formation of small cysts in ovaries. It causes skipped periods, anovulation, dysmenorrhoea, and other menstrual irregularities.

What are the symptoms and effects of menorrhagia (heavy menstrual bleeding)?

Menorrhagia is excessive and prolonged bleeding during periods. The symptoms of menorrhagia include:

  • Bleeding more heavily than normal
  • Periods that extend beyond a week
  • Fatigue and weakness
  • Abdominal cramps.

The effects of menorrhagia on the body are excessive loss of blood causing iron deficiency anemia, fatigue, stress, and emotional impact.

What is amenorrhea and what is the cause of it?

Amenorrhea is the absence of menstrual periods in women of reproductive age.

  • Primary amenorrhea is when periods do not start even after the age of 16. It can be due to genetic causes, chromosomal abnormalities, or hormonal issues.
  • Secondary amenorrhea is the absence of periods for three consecutive months or more. It can be due to pregnancy, PCOS, uterine fibroids, adenomyosis, hormonal imbalance, and other structural abnormalities.

What is dysmenorrhea and how it can be managed?

Dysmenorrhea refers to the pain and discomfort experienced during periods. It typically occurs 1-2 days before or during the first days of periods. Pain is felt in the lower abdomen, back, and thighs. Primary dysmenorrhea is without any pelvic disease, while secondary dysmenorrhea is due to the presence of an identifiable disease.

Pain in dysmenorrhea can be alleviated by NSAIDs (ibuprofen), painkillers (acetaminophen), heat therapy, exercise, and herbal therapies.

Does the color of menstrual blood indicate a health problem?

The normal color of menstrual blood is bright red. This color can also indicate uterine fibroids and adenomyosis. The dark red or brown color appears towards the end of a period due to blood that took time to leave the uterus, and this is also normal. Greyish or orange-colored blood can indicate bacterial vaginosis. Black-colored blood is sometimes normal, while at other times, it can be a sign of an infection.

Can menstrual diseases affect fertility?

It depends on the condition and its severity. Not all menstrual abnormalities directly cause infertility; they do so by causing complications that interfere with conception. Some diseases that contribute to infertility are:

  • Polycystic ovary syndrome
  • Pelvic inflammatory disease
  • Endometriosis
  • Uterine fibroids.

These conditions do not cause infertility in all cases, there are chances that females can get pregnant even with these conditions.

What are the side effects of oral contraceptives?

They are generally considered safe, however, the use of oral contraceptives is linked with some side effects. It includes

  • Nausea
  • Headache
  • Mood swings
  • Irregular periods
  • Weight changes
  • Very rarely blood clotting disorders.

Menstrual hygiene and related issues

What is the importance of maintaining menstrual hygiene?

Menstrual hygiene refers to maintaining cleanliness during periods. It’s important to maintain good menstrual hygiene to prevent the risk of infections and reproductive health complications. It also increases confidence and promotes well-being.

How can I maintain good hygiene during periods?

Maintaining good menstrual hygiene is important for the overall health of females. Here are some tips you can follow for hygiene during periods:

  • Choose the right menstrual product
  • Change menstrual products regularly
  • Properly dispose of the used menstrual products
  • Wash your hands thoroughly before and after changing the menstrual products
  • Wash your genital areas
  • Stay hydrated
  • Avoid using scented products
  • Take regular baths.

What are the risks associated with poor menstrual hygiene?

Poor menstrual hygiene causes various infections and diseases. It increases the risk of

  • Urinary tract infections 
  • Reproductive tract infections 
  • Bacterial vaginosis 
  • Pelvic Inflammatory Disease 
  • Vaginal irritation 
  • Toxic shock syndrome
  • Candidiasis.

What is toxic shock syndrome (TSS) and how is it related to menstrual hygiene?

Toxic shock syndrome is a rare but life-threatening condition caused by bacteria. When high-absorbency tampons are left in the vagina for more than eight hours, it allows bacteria to grow and multiply. The bacteria release toxins that affect various organs. Symptoms include:

How can I safely dispose of menstrual products?

Menstrual products can properly be disposed of by wrapping used menstrual products in plastic or disposable bags and throwing them in dustbins. Don’t flush the menstrual products ever.

Can poor menstrual hygiene cause urinary tract infections?

Any unhygienic measure that causes bacterial growth will cause bacteria to go up to the urinary tract and start producing infection there. Prolonged infection of the urinary tract can also reach the kidneys and start damaging them. Maintaining proper hygiene is extremely important to prevent the risks of a UTI. Symptoms of UTI include:

  • Burning micturition (A burning sensation while urinating)
  • Bloody, or strange urine smell
  • Feeling tiredness
  • Pain in your back or lower abdomen
  • Fever or chills
  • Pelvic pain.

Can poor menstrual hygiene affect fertility?

Poor menstrual hygiene alone does not directly affect fertility. However, certain menstrual hygiene practices, if linked with any underlying medical condition, can indirectly affect fertility. Untreated or recurrent infections resulting from poor menstrual hygiene, such as pelvic inflammatory disease (PID), can lead to inflammation and scarring in the reproductive organs. These complications can interfere with normal reproductive function and increase the risk of infertility.

Evaluate your Menstruation Hygiene

Picture showing different menstruation products

Are females during menstruation considered impure?

In some cultures, females are considered impure when they are on periods. But this is an absolutely illogical and incorrect belief. There is no basis on which a female can be considered impure while on their period.

Is it unhealthy to exercise or swim during periods?

No, it is completely safe to engage in any physical activity or exercise during periods. In fact, it is beneficial for promoting good health and relieving cramps associated with periods. Exercise increases dopamine levels, enhancing mood, and alleviating anxiety.

Swimming is also safe, just ensure that you use proper menstrual products (such as tampons are best for swimming).

Can the menstrual cycle reveal information about women’s health and fertility?

A menstrual cycle can provide some information regarding women’s health and fertility, but it is not a definitive indicator. A regular menstrual cycle indicates hormonal balance and proper ovulation, both are essential for fertility. On the other hand, irregular cycles are manifestations of hormonal imbalance and other reproductive system complications.

Painful menstruation sometimes reveals other medical conditions. For example, painful periods can be due to uterine fibroids or endometriosis that affect fertility.

Does severe pain during menstruation signify a serious health problem?

Pain during periods can be a symptom of normal menstruation. However, it is a cause for concern if there is severe pain that doesn’t get relieved by painkillers and is associated with unusual symptoms such as heavy bleeding. These signs indicate that there might be some underlying medical condition causing the intense pain.

Do menstrual cycles sync among females who live together?

The idea that menstrual cycles among females who live together synchronize over time was published in a study in 1971. However, subsequent scientific research has generally not supported this theory. Most of the comprehensive studies and reviews conducted since then suggest that any synchronization of menstrual cycles among women living together is likely due to chance or shared environmental factors rather than any biological syncing mechanism.

Menstruation products and related setbacks

What are the different types of menstrual products available?

Different types of menstrual products available include:

  • Pads
  • Tampons
  • Menstrual cups
  • Period panties
  • Cloth pads
  • Menstrual sponges.

How to choose between pads, tampons, and menstrual cups?

It all depends upon personal choices. You can choose between them while considering your flow rate, comfort, and availability. Pads provide longer periods of absorbance. Tampons are great if you are uncomfortable with wearing underwear. Menstrual cups are cost-effective in the long run. Ultimately, the choice is yours.

Are there any health risks associated with using tampons?

There are no particular health risks associated with using tampons. Make sure to take hygienic measures and change tampons regularly every 6 to 8 hours. Don’t leave tampons in for more than 8 hours, it can increase the risk of toxic shock syndrome.

How to use a menstrual cup properly?

Menstrual cups can be used properly by following these instructions.

  • Wash hands before and after using the menstrual cup
  • Fold the cup
  • Insert the cup at a slight angle
  • Ensure the proper placement of the cup
  • Change the cup after 12 hours
  • Empty and wash the cup.

What are the environmental impacts of different menstrual products?

  • Disposable pads and tampons are made of plastic, cotton, or other synthetic materials. Their single-use and disposal increase waste accumulation. Also, the bags needed for their disposal contribute to waste.
  • Menstrual cups are reusable, decreasing the need for multiple products and reducing waste. They can easily be washed and reused. However, the manufacturing process and potential disposal of menstrual cups can still have some environmental impact.
  • Cloth pads can be washed and reused. However, they require water, energy, and detergent.

How to choose the right size of menstrual cup and tampon?

  • Choosing the right size of a menstrual cup depends on flow rate as various cups are available with different capacities. Also, age-related factors and cervical height can be considered when choosing a menstrual cup.
  • Tampons also come in different absorbencies. Some are highly absorbent while others are low. Tampons are also available in different sizes depending on body size and comfort.

What are reusable menstrual products and what are their benefits?

Alternatives to pads and tampons, various reusable menstrual products are available. They can be washed and reused, reducing the need for single-use products. They include menstrual cups, cloth pads, and period underwear. They are environmentally friendly and cost-effective.

Periods management and lifestyle changes

How to manage irregular periods?

The management of irregular periods includes:

  • Adopting a healthy lifestyle with a proper diet, exercise, and good sleep
  • Hormonal contraceptives
  • Medicines such as analgesics, antibiotics, and GnRH agonists
  • Surgery options such as endometrial ablation, myomectomy, and hysterectomy.

Irregular periods are a cause for concern when you have a cycle shorter than 21 days or longer than 35 days, heavy bleeding, and severe cramps.

How to treat severe menstrual cramps?

Some effective medical treatments for severe menstrual cramps include:

  • Nonsteroidal anti-inflammatory drugs (ibuprofen)
  • Analgesics (acetaminophen)
  • Prostaglandins inhibitors
  • GnRH agonists
  • Hormonal contraceptives
  • Intrauterine devices.

Transcutaneous electrical nerve stimulation, as well as vitamin B1, B3, and magnesium supplements can also be used.

Is hormonal therapy beneficial to manage irregular periods?

The root cause of irregular periods is hormonal imbalance. Hormonal therapy, like progestin-only or progestin and estrogen combined pills, rings, and patches helps to treat symptoms of irregular periods.

What over-the-counter medications are available for managing menstruation symptoms?

Over-the-counter medications are available for managing menstrual symptoms such as:

  • Nonsteroidal anti-inflammatory drugs (ibuprofen)
  • Analgesics (acetaminophen)
  • Vitamin supplements.

What is the role of exercise and yoga in managing menstruation discomfort?

Exercise and yoga help to promote overall health and well-being. They also decrease discomfort and pain associated with periods. Exercise increases blood flow and enhances dopamine levels. Yoga reduces stress and improves flexibility. There are many yoga poses that are beneficial for periods.

How effective is heat therapy for relieving menstrual pain?

Heat therapy is really effective for menstrual cramps. Pain is caused due to the constriction of blood vessels, blocking blood flow to the uterus. Heat therapy allows heat to cause vasodilation and improve blood flow toward the uterus, decreasing pain.

Can aromatherapy or essential oils be used to manage symptoms of menstrual diseases?

Aromatherapy is the use of plant extracts in the form of essential oils for physical and mental well-being. Aromatherapy helps with menstrual mood swings, stress, and discomfort due to its soothing and calming properties. However, there is limited scientific research on this and that is also of low quality.

Mental health and social impact

How does menstruation affect mental health?

Menstruation involves changing hormonal levels. These hormonal changes also affect females emotionally and mentally. Irritability, mood swings, anxiety, and depression are linked with the menstrual cycle. Changing patterns of the menstrual cycle sync with emotional and mental states.

How can schools and workplaces be made more period-friendly?

Making an environment that prioritizes the comfort and well-being of females who menstruate can help make schools and workplaces more period-friendly. Some of the suggestions are:

  • Making menstrual products accessible
  • Providing disposal options
  • Promoting education and awareness
  • Establishing menstrual hygiene facilities.

What is period poverty?

The lack of access to sanitary products, education on menstrual hygiene, toilets, handwashing facilities, or waste disposal is referred to as period poverty. It is a global issue that primarily affects women and it has serious social, economic, and health consequences. To address period poverty, affordable menstrual products should be made available, proper hygienic steps should be implemented and awareness should be promoted.

How to support a woman suffering from menstrual pain or discomfort?

Show empathy and understanding towards a woman experiencing menstrual pain. Provide her with space to express feelings and concerns. Bring her OTC painkillers and hot water bottles. Provide her with full emotional support and also respect her privacy.

Last medically reviewed on July 30, 2023.