1ST CITY CLINICAL HOSPITAL

Author: obstetrician-gynecologist (head) of the highest qualification category of the gynecological department No. 2 of the healthcare institution "1st City Clinical Hospital", Salamakha A.V.

Menstruation is a vaginal discharge in women of reproductive age, regularly repeated outside of pregnancy. Its composition is rejected thickened endometrium (inner lining of the uterus) and blood. During the life of each modern woman there are about 400 menstruations.

The nature of menstrual flow (volume, regularity) is influenced by many factors. Monitor all changes to exclude reproductive disorders and, if there are any deviations, consult a doctor.

The onset of menstruation is a very important and very emotional moment in a girl's life. The onset of menstruation serves as a signal that the girl's body is beginning to prepare for the possibility of becoming a mother. Menstruation usually begins between the ages of 10 and 15. The first menstruation is called menarche.

During the first menstruation, the discharge is usually light and dark in color. Then it becomes more abundant and brighter in color. Sometimes small blood clots appear in the discharge, which is absolutely normal.

The age of menarche is an important indicator when assessing the risks of various diseases. Be sure to record this information (remember it or write it down in your phone/notepad), as you will need it when visiting an obstetrician-gynecologist, regardless of the reason for visiting him.

Sometimes there may be slight deviations in the age of menarche from the generally accepted norms. Ask your female relatives when their periods began. It is possible that the earlier or later appearance of secondary sexual characteristics and menstruation is a family trait.

If a girl under 8 years of age starts menstruating, or if a 15-year-old girl does not have her period, this is a reason to see a doctor to rule out sexual development disorders.

Menstruation is the cyclical shedding of the uterine lining. Some people may think that menstruation marks the end of their cycle. In reality, menstruation marks the first day of a new cycle.

For your convenience, use special mobile applications in which you can enter data about the onset of menstruation, or record this information in a calendar.

Modern calendar apps allow you to mark the beginning and end of your period, automatically calculate the expected date of your next cyclical bleeding, and also record any symptoms that bother you, which you should tell your doctor about at your appointment.

Some tests (for example, determination of sex hormone concentrations) and diagnostic examinations (ultrasound of the pelvic organs) must be performed at a certain time of the menstrual cycle (this is reported by the doctor when prescribing them). If the examination timeframes are not met, the results obtained will be incorrectly interpreted.

81% of women have painful periods, and the pain can have varying degrees of severity. During menstruation, the uterine walls contract. They are periodically occurring spasms and can cause moderate discomfort and minor pain. Menstrual blood is dark in color, has a specific odor, and usually does not clot. The amount of discharge and the severity of discomfort can vary, but if you notice significant changes or previously uncharacteristic symptoms, it is advisable to tell your doctor about them.

In case of severe discomfort during menstruation, a single dose of antispasmodics and painkillers is acceptable. However, you should not abuse them, as these medications can provoke exacerbations of gastrointestinal diseases and other complications.

In case of severe pain during menstruation (when even pills do not help), be sure to consult a gynecologist!

Irritability, anxiety, depressive symptoms before menstruation occur in about 60% of women. For 3-8% of women, PMS is a real disease that greatly affects the quality of life. PMS can and should be treated. Consult a doctor to select the treatment that is right for you.

To reduce the severity of premenstrual symptoms and discomfort during menstruation, try to limit the consumption of excessively salty and spicy foods, simple carbohydrates, drink enough water, do moderate-intensity physical exercise and get enough sleep.

Normally, the duration of menstruation (bloody discharge itself) is on average 3–8 days.

The normal length of the entire menstrual cycle—from the first day of one period to the first day of the next—is between 24 and 38 days.

The menstrual cycle should be approximately the same length (there is an equal amount of time between periods).

For teenagers in the first two years of menstruation, when the cycle is not yet established, and for women in perimenopause, an irregular cycle is normal, as is for a woman after pregnancy, especially if she is breastfeeding. If your period always comes a little differently (for example, sometimes after 28, sometimes after 31 days) - this may be a normal variant.

Irregularity of the menstrual cycle is not a diagnosis, but a symptom. It may indicate gynecological diseases and requires examination to clarify the cause of the fluctuations. If menstruation occurs more often than 24 days or less often than 38 days for several cycles in a row, consult a doctor.

The reasons for delayed menstruation are quite extensive. They are not always associated with diseases. In particular, this may be due to:

• Stress
• Physical exercise
• Weight gain/loss
• Change of climate, time zone

However, only a doctor can determine the true cause of the delay. If, after excluding pregnancy (for example, using pharmacy tests), menstruation does not occur, consult an obstetrician-gynecologist.

On average, a woman loses about 40 ml of menstrual fluid during one menstruation, normally - from 40-80 ml. If your menstruation is very heavy, be sure to tell your obstetrician-gynecologist about it.

The reproductive period is followed by the menopausal transition stage, followed by menopause and postmenopause.

The menopausal transition is characterized by variability in the menstrual cycle. It ends with menopause, the last menstruation.

Menopause occurs on average at age 51, but some women experience the first changes around age 45. Menstruation may gradually become lighter, the cycle may shorten to 19-21 days or lengthen to 35-40 days.

Menopause is considered timely at 46–54 years of age. If menstruation has stopped before this period, a more in-depth examination is necessary to exclude diseases and their risks in the future, as well as to determine indications for special therapy. In case of later menopause, it is also necessary to consult an obstetrician-gynecologist, first clarifying the family history - this may be a family trait.