1. What is Menstruation? Menstruation (or period) is a natural phenomenon where a woman’s uterus experiences cyclic bleeding due to the influence of hormones. It is a normal part of a woman’s reproductive system.

At birth, females already have millions of immature eggs in their ovaries. During puberty, under the influence of hormones, several eggs begin to grow each month. Typically, only one egg fully matures and is released from the ovary, which is called ovulation, preparing for potential fertilization.

Meanwhile, the uterine lining thickens to prepare for a possible pregnancy. If the egg is not fertilized, the thickened tissue is shed through the vagina, resulting in menstrual blood. After this, the next menstrual cycle begins.

2. When Does Menstruation Begin and End? Generally, girls experience their first menstruation around the age of 11-12. Women typically experience menopause between the ages of 45-55, marking the end of menstruation and the cessation of the ability to conceive.

3. Do Women Have Menstruation Every Month? No, the menstrual cycle varies from person to person and can change due to different factors affecting one’s health.

A typical menstrual cycle lasts anywhere from 21 to 35 days, starting from the first day of menstruation to the first day of the next period.

For example:

• Last period: October 1
• This period: October 29
• Menstrual cycle: 28 days

Young girls experiencing their first periods and women approaching menopause are more likely to have irregular cycles.

Several factors can disrupt hormonal balance and lead to irregular periods:

• Overweight or underweight
• Eating disorders (e.g., anorexia)
• Intense physical activity
• Stress
• Certain medications (e.g., hormonal contraceptive injections)
• Substance abuse
• Breastfeeding
• Chronic diseases or endocrine disorders (e.g., polycystic ovary syndrome, thyroid issues)
• Changes in ovarian function

If vaginal bleeding occurs between two menstrual cycles, it could be linked to endometrial disorders, polyps, infections of the vagina/cervix, or even cervical cancer. These situations may be confused with irregular periods.

For sexually active women, it’s important to note that if a period is missed after the expected cycle, pregnancy may be the cause. It's best to consult with a healthcare provider promptly.

4. Am I Experiencing Heavy Menstrual Bleeding? Heavy menstrual bleeding refers to excessive menstrual blood flow or a prolonged period.

Signs of heavy menstrual bleeding may include:

• Periods lasting more than 7 days (most women’s periods last 2 to 7 days)
• Needing extra-absorbent pads, requiring a change every 1-2 hours
• Passage of large blood clots
• Sudden, heavy blood flow that soaks through underwear or clothing
• Waking up frequently at night to change sanitary products
• Staining sheets even while using pads or tampons
• Menstrual flow interfering with work, home life, or social activities
• Feeling dizzy, short of breath, or fatigued during or after the period

5. What is Menstrual Pain (Dysmenorrhea)? Menstrual pain refers to mild to severe discomfort in the lower abdomen before or during menstruation.

Pain is most intense when menstrual flow is heavy and may also be accompanied by gastrointestinal discomfort, such as vomiting or diarrhea.

Menstrual pain can be divided into two categories:

• Primary dysmenorrhea: Commonly occurs in young women, typically easing with age or after childbirth.
• Secondary dysmenorrhea: Caused by underlying medical conditions, such as endometriosis, pelvic infections, or intrauterine device (IUD) use.

Secondary dysmenorrhea symptoms may last 1 to 3 days and often include abnormal vaginal discharge or fever. The pain might not just occur during menstruation but could also happen after sex.

For many women, heat pads or common painkillers can alleviate menstrual pain. Women who maintain regular physical activity tend to experience less menstrual pain, but if over-the-counter pain medications aren’t effective, it might indicate a need for further gynecological treatment.

If you have any of the following symptoms, it's advisable to consult a healthcare provider:

• No menstruation by age 16
• Sudden irregularities in your menstrual cycle
• Vaginal bleeding between periods
• Post-intercourse bleeding
• Vaginal bleeding one year after menopause
• Menstrual pain after the age of 40
• Menstrual cycles shorter than 21 days
• Heavy periods (as referenced in question 4)
• Severe menstrual or abdominal pain
• Menopause before age 45