Women Guide

Definition of Menstruation**
Menstruation refers to the vaginal bleeding that occurs approximately once a month, constituting a normal aspect of the menstrual cycle. This phenomenon is commonly referred to as having a period.

Typically, menstrual cycles occur at intervals ranging from 21 to 35 days, although this duration may vary from one cycle to another. The length of the menstrual cycle can be determined by counting the number of days from the first day of one period to the first day of the subsequent period.

The menstrual cycle prepares the body for potential pregnancy and is regulated by hormones produced by the brain and ovaries.

Phases of the Menstrual Cycle
During each menstrual cycle, an egg matures within one of the ovaries. Upon maturation, the egg is released from the ovary, a process known as ovulation. At this juncture, the egg may be fertilized by sperm, leading to the possibility of pregnancy. Concurrently, the lining of the uterus thickens in preparation for potential implantation.

In the absence of pregnancy, the uterine lining is shed, resulting in menstrual bleeding, and the cycle recommences.

Expectations During Menstruation
Menstruation varies among individuals. Most females experience bleeding for a duration of 3 to 7 days. The flow may range from light to heavy, with blood color varying from bright red to dark brown. Typically, the flow begins more heavily and gradually diminishes. It is not uncommon to observe small clots during this time.

Some individuals may experience menstrual discomfort, characterized by cramps or aches in the lower abdomen or back.

Additional symptoms that may accompany menstruation include:

• Abdominal bloating or weight gain
• Constipation or diarrhea
• Headaches
• Breast tenderness and swelling
• Acne
• Fatigue
• Mood fluctuations and irritability

Onset of Menstruation
Females typically experience their first menstrual period during puberty, with the average age being 12 or 13 years; however, it may commence as early as 9 or as late as 16 years.

Potential Menstrual Issues
Menstrual-related issues may include:

• Heavy bleeding, which can lead to low iron levels
• Severe menstrual pain (dysmenorrhea), potentially linked to conditions such as endometriosis
• Unpredictable or irregular menstrual cycles
• Absence of menstruation (amenorrhea)
• Intermenstrual bleeding
• Premenstrual syndrome (PMS), also referred to as premenstrual tension (PMT)

Cessation of Menstruation
Menstruation temporarily ceases during pregnancy and may also stop during breastfeeding. Some individuals may experience a temporary cessation of periods due to fluctuations in body weight, stress, travel, excessive physical activity, or hormonal imbalances.

Certain medications, such as contraceptives, may also halt menstruation, which can be beneficial for individuals experiencing heavy or painful periods. It is important to note that after discontinuing hormonal contraceptives, it may take some time for menstrual cycles to resume.

Menstruation permanently ceases upon reaching menopause, which typically occurs around the age of 51 in Australia.

Menstrual Products
Various products are available to manage menstrual bleeding, and the choice of product is a personal decision.

• Sanitary Pads: These are affixed to underwear to absorb menstrual blood and should be changed approximately every 4 hours or when saturated.
• Tampons: These are inserted into the vagina to absorb blood and should be changed every 3 to 4 hours or when full. It is crucial not to leave a tampon in for more than 8 hours to avoid the risk of toxic shock syndrome; therefore, it is advisable to refrain from using tampons overnight. Proper hand hygiene is essential before inserting or removing a tampon.
• Menstrual Cups: These are inserted into the vagina to collect blood and should be emptied when full. Adhering to product instructions is vital to prevent toxic shock syndrome.
• Period Underwear: This type of underwear contains an absorbent layer and can be used independently or in conjunction with other sanitary products.

When utilizing tampons or disposable pads, it is important to wrap them securely and dispose of them in the trash, as flushing them down the toilet can cause plumbing issues. Reusable pads should be rinsed and laundered, while menstrual cups and period underwear can be cleaned and reused. Maintaining proper hand hygiene before changing sanitary products is essential.

It is advisable to keep a “period kit” in your handbag or school bag to prepare for unexpected menstruation. This kit may include pain relief medication, sanitary products, and a spare pair of underwear.

Self-Care During Menstruation
Individuals should be able to engage in their regular activities during menstruation. Swimming is permissible with the use of tampons, menstrual cups, or certain types of period underwear. If engaging in sexual activity, it is important to remove the tampon beforehand.

Some individuals may feel the need to rest during their period. For those experiencing pain, the application of a hot water bottle or the use of pain-relieving medications may provide relief.

When to Consult a Healthcare Professional
It is imperative to seek medical attention promptly if experiencing any bleeding post-menopause. Additionally, individuals aged 16 or older who have not yet begun menstruating should consult a healthcare provider.

Consult a healthcare professional if:

• Menstrual flow becomes heavier
• Menstrual duration exceeds 8 days
• Menstrual cycles occur less than 3 weeks apart or more than 2 months apart
• There are changes in the pattern of menstrual cycles
• Menstruation has ceased for more than 6 months without explanation
• There is intermenstrual bleeding or bleeding post-coitus
• Severe menstrual pain interferes with daily activities

Individuals may also wish to discuss any menstrual-related concerns that impact their overall well-being or quality of life with their healthcare provider.

Resources and Support
For further information regarding the menstrual cycle, please visit the Jean Hailes for Women’s Health website. Should you have any concerns regarding your menstrual health, consider consulting your healthcare provider or local sexual health clinic, or seek information from the sexual health website pertinent to your state or territory.

To locate healthcare services, the Service Finder can assist in identifying doctors, pharmacies, hospitals, and other health services. For immediate inquiries, you may contact healthdirect at 1800 022 222 to speak with a nurse for additional information and guidance.

References

• Jean Hailes (About the menstrual cycle)
• Royal Women’s Hospital Victoria (About periods)
• Sexual Health Victoria (The menstrual cycle)
• Shine SA (The menstrual cycle)
• Australian Family Physician (Dysfunctional uterine bleeding)
• Jean Hailes for Women’s Health (Is your period regular?)
• Jean Hailes (What is menopause?)
• Sexual Health Victoria (Menstrual conditions)
• Queensland Government (Late period)
• The Royal Women’s Hospital (Problem periods)
• Family Planning Australia (Menstrual cycle)
• Family Planning Australia (Period problems)
• Family Planning Australia (Premenstrual syndrome)