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All you should know about menstruation, ovulation and menopause



THE menstrual cycle is the natural changes in the uterus and ovary as an essential part of making sexual reproduction possible.  It is the essential part of production of eggs and for the preparation of the uterus for pregnancy.

The cycle occurs only in fossil female humans and other female primates. In humans, the length of a menstrual cycle varies greatly among women on an average of 28 days.  Each cycle can be divided into three phases based on events in the ovary or in the uterus.  In the menstrual cycle, changes occur in the female reproductive system as well as in other bodily systems, which can lead to breast tenderness or mood changes.  A woman’s first menstruation is termed Menarche and occurs typically around 12 and 13 years.  The end of a woman’s reproductive phase is called the Menopause and this commonly occurs between the ages of 45 and 55.

The length of a woman’s menstrual cycle typically varies with some shorter and some longer.  A woman who experiences variations of  less than eight days between her longest cycles and shortest cycles is considered to have regular menstrual cycles.  It is unusual for a woman to experience cycle length variations of less than four days.


Menstruation, which is also called menstrual bleeding, menses, catamenia or period is the first phase of the uterine cycle.  The flow of menses normally serves as a sign that a woman has not become pregnant.

A regular menstruation that lasts for a few days is usually between three and five days but anywhere from two to seven days is also considered normal.  The average blood loss during menstruation is 35 milliliters with 10-80ml considered normal.


The average menstrual cycle lasts 28 days.  The variability of menstrual cycle length is highest for women under 25 and is lowest, that is, most regular for ages 35 to 39.  Subsequently, the variability increases slightly for women aged 40 to 44.  Usually, length variation between eight and 20 days in a woman is considered as moderately irregular menstrual cycles.

Variation of 21 days or more is considered very irregular.


The phases of the menstrual cycle correlate with women’s moods.  In some cases, hormones released during the menstrual cycle can cause behavioural changes in females.  The menstrual cycle phase and ovarian hormones may contribute to increase empathy in women.  In a study, when completing empathy exercises, women in the follicular stage of their menstrual cycle performed better than women in their mid luteal phase of their cycle.


Menstruation is a monthly occurrence for women in which the body sheds the lining of the uterus also known as the womb which is then passed through a small opening in the cervix and out through the vaginal canal.

Some pain, cramps and discomfort during menstrual periods are normal.  However, excessive pain causes you to regularly miss work or school.  The medical term for painful menstruation is dysmenorrhea.

Primary dysmenorrhea occurs in women who experience pain just before and during menstruation but are otherwise healthy.  Women who have had normal periods that later become painful may have secondary dysmennorrhea.  This condition is usually accompanied by a problem affecting the uterus or other pelvic organs.


There may not be an identifiable cause of your painful menstrual periods.  Certain women are at a higher risk for having painful menstrual periods.  They are:

(1)   Under 20

(2)           Family history of painful periods

(3)           Smoking

(4)           Heavy bleeding of periods

(5)           Irregular periods

(6)           Never had a baby

(7)           Early puberty (before 11).

However, hormone-like substances called prostaglandins trigger muscle contractions to help your uterus expel its lining each month.  These contradictions can cause pain while women with higher levels of prostaglandins may experience more severe menstrual cramps and pains. In some cases, such as with secondary dysmenorrheal, painful menstrual periods can be the result of an underlying medical condition such as:

(1)   Premenstrual syndrome

(2)           Endometriosis (a painful medical condition in which cells from the lining of the uterus grow in other parts of the body).

(3)           Fibroids in the uterus (noncancerous tumors).

(4)           Pelvic inflammatory disease, an infection of the uterus fallopian tubes, or ovaries often caused by sexually transmitted infections.

(5)           Sexually transmitted infections (STIs).

(6)           Stress and anxiety.

Home care for menstrual pains:

(1)    Apply a heating pad to your lower belly area.

(2)           Drink warm beverages.

(3)           Eat light but frequent meals.

(4)           Keep your legs raised while lying down, or lie on your side with your knees bent.

(5)           Take warm showers or baths.

(6)           Walk or exercise regularly.

(7)           Follow a diet rich in complex carbohydrates such as whole grains, fruits, vegetables, low salt, sugar, alcohol and caffeine.


Ovulation is when a mature egg is released from the ovary, pushed down the fallopian tube and is available to be fertilized.  Every month, an egg will mature within one of your ovaries.  As it reaches maturity, the egg is released by the ovary where it enters the fallopian tube to make its way towards awaiting a sperm.

Here, the lining of the uterus has thickened to prepare for the fertilized egg.  If no conception occurs during this period, the uterine lining as well as blood will be shed which leads to menstruation.


A woman’s monthly cycle is measured from the first day of her menstrual period until the first day of her next period. On average, a woman’s cycle normally is between 28 and 32 days, but some women may have much shorter or much longer cycles.

Ovulation can be calculated by starting with the first day of the last menstrual period or by calculating 12-16 days from the next expected period.  Most women ovulate anywhere between Day 11 to Day 21 of their cycle.  This is what many refer to as the Fertile Time of a woman’s cycle, because sexual intercourse during this time increases the chance of pregnancy.  Ovulation can occur at various times during a cycle and may occur on a different day each month.


Menopause is a stage in life when a woman stops having her monthly period.  It is a normal part of aging and marks the end of a woman’s reproductive years.  This typically occurs in a woman’s late 40s to early 50s.  However, women who have their ovaries surgically removed undergo sudden menopause.

At this stage, the ovaries have stopped releasing eggs and producing most of their estrogen.  Menopause is diagnosed when a woman has gone without a period for 12 consecutive months.


Perimenopause can begin 8 to 10 years before menopause, when the ovaries gradually produce less estrogen.  It usually starts in a woman’s 40s but can start in the 30s as well.  However, in the last one to two years of Perimenopause the drop in estrogen accelerates and at this stage, many women can experience menopause symptoms.  Women are still having menstrual cycles during this time and can also get pregnant.


These are years after menopause.  During this stage, menopausal symptoms such as hot flashes can ease for most women but as a result of a lower level of estrogen, post menopausal women are at increased risk for a number of health conditions such as osteoporosis and heart disease.


Here are some of the symptoms to make you know if you are transiting into menopausal stage:

(1)   Night sweats or cold flashes.

(2)           Vaginal dryness

(3)           Urinary urgency

(4)           Insomnia

(5)           Emotional changes

(6)           Dry skin, eyes or mouth.

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