What is menstruation?
Menstruation is the monthly process of shedding built up uterine lining. The average age at which a woman stops menstruating is 50 years old.
The menstrual cycle is a series of hormone-regulated changes that a woman's body goes through to get it ready for a possible pregnancy. It occurs in monthly cycles between puberty and menopause, except during pregnancy. The first occurrence of menstruation is called menarche. A woman usually starts menstruating or attains menarche between the age of 10 and 16 years old. Menopause marks the end of the menstrual cycle. It's diagnosed when the menstrual period has not occurred in 12 months.
Women usually stop menstruating or attain menopause in their 40 or 50s, the average age being 50 years old. Sometimes, menopause may occur earlier due to a medical condition, medication, drug treatment or surgery such as the removal of the ovaries. Menarche and menopause are natural biological processes. After a woman attains menopause, her menstrual cycle ends, and she would no longer be able to get pregnant. If bleeding occurs after 12 months of not having periods, it is called postmenopausal bleeding. This requires medical attention.
What is a menstrual cycle?
During each menstrual cycle, an egg develops and is released from one of the ovaries (ovulation). At the same time, the lining of the uterus becomes thicker due to hormonal changes. If pregnancy does not occur, the thickened lining (endometrium) of the uterus sheds through the vagina accompanied by bleeding. Bleeding usually lasts for three to eight days and this is known as menstruation or a period. A menstrual cycle usually lasts between 24 and 38 days but is typically 28 days long.
Hormones regulating the menstrual cycle
The menstrual cycle is regulated by a complex group of hormones produced by the pituitary gland and hypothalamus along with the ovaries. Luteinizing hormone and follicle-stimulating hormone produced by the pituitary gland promote ovulation and stimulate the ovaries to produce estrogen and progesterone.
Phases of the menstrual cycle
There are four phases of the menstrual cycle
- Menstruation: The period of shedding of the uterine lining accompanied by bleeding is called menstruation. Estrogen and progesterone levels are low.
- The follicular phase: This is the time between the first day of the period and ovulation. The estrogen level increases as an egg prepares to be released and the uterine lining builds up.
- Ovulation (day 14): During this time, an egg is released rom the ovary mid-cycle.
- The luteal phase: This is the time between ovulation and the start of menstruation. The body prepares for a possible pregnancy. The progesterone level peaks and then drops if pregnancy does not occur.
Causes for irregularities in the menstrual cycle
- Pregnancy (missed period)
- Eating disorders such as anorexia nervosa
- Extreme weight loss
- Excessive exercising and physical activity
- Polycystic ovary syndrome
- Premature ovarian failure
- Pelvic inflammatory disease
- Uterine fibroids
What is menopause?
Menopause is considered to have occurred when a woman has not had a menstrual period for 12 consecutive months. This occurs because the ovaries no longer make estrogen and progesterone. Women typically experience menopause in their 40s and 50s. After a woman attains menopause, her menstrual cycle ends and ovulation stops and she would no longer be able to get pregnant. The period before menopause is called perimenopause. During this time, estrogen and progesterone levels fluctuate, and numerous symptoms may be experienced.
Premature menopause is when a woman stops menstruating between the age of 30 and 40 years old.
Symptoms of perimenopause
Perimenopause symptoms occur for four years on an average before menopause. These include
- Irregular, lighter or heavier periods
- Hot flashes
- Night sweats
- Aches and pains
- Weight gain and slowed metabolism
- Changes in skin texture
- Thinning hair
- Loss of breast fullness
- Bladder control problems
- Vaginal dryness
- Change in sexual desire
- Lower fertility
- Sleeping difficulty
- Anxiety, depression and mood swings
- Memory loss
There are several treatment options available to treat menopause symptoms. This includes hormonal therapy, non-hormonal medications and lifestyle modifications. Women may consult a doctor to seek treatment for their menopausal symptoms.
Lifestyle changes to manage menopausal symptoms
Lifestyle changes that can be made to manage menopause symptoms include
- Regular exercise
- Healthy diet
- Quitting smoking
- Limiting alcohol intake
- Seeking counseling
- Good sleeping habits
- Doing Kegel exercises to strengthen the pelvic floor
- Joining a fitness club, volunteering or taking up a new hobby
- Keeping an active sex life
- Over-the-counter gels and other products for vaginal dryness
Postmenopausal health risks
After menopause, the risk of following health issues increases
- Breast cancer (some types of breast cancer are more likely to develop)
- Cardiovascular disease
- Uterine polyps
If bleeding occurs after 12 months of not having periods, it is called postmenopausal bleeding. This requires medical attention because it could be due to benign or malignant tumors.