Normal menstruation period

Menstruation and its Normal Cycle

Menstruation is a monthly hormonal controlled cycle in females from Menarche(Age of starting menses) to Menopause(age of stopping menses). Menstruation has 3 phases which occur every month in normal menstruation cycle:-

1. Menstrual Phase:- First day of menstruation counted from first day of bleeding.Bleeding usually lasts for 4 days ,this is Menstrual Phase of menstruation cycle. In this phase functionalism layer of endometrium (innermost layer of uterus) disintegrate and slough out. Endometrium layer of uterus develops in every cycle and suppose to bear Pregnancy .

2.Follicular(Proliferation) Phase:- This phase start from 5th day and lasts up to 14th day in a typical cycle. In this phase Follicles start to develop in ovary to make an egg. And the same follicles produce Estrogen Hormone. Follicular stimulating hormone(FSH) from Pituitary gland, situated in brain, control this process.

Estrogen hormone stimulate the Innermost layer of Uterus(Endometrium) to develop.Uterus is supposed to bear fetus(Pregnancy) in every cycle.At 14th day estrogen production reached on peak and it triggered the FSH(Follicular stimulating hormone) and LH(Leutinising Hormone) surge. At this peak follicle rupture and release ovum(egg). Later this egg travel to uterus through fallopian tubes.

3.Secretory(Luteal) Phase:- After release of egg,remaining follicle is known as Corpus luteum. Corpus luteum produce Progesterone and less potent estrogen. In this phase uterus's innermost layer(endometrium) more grow to bear pregnancy. This phase remain from 15th to 28th day. And if pregnancy does not occur,then level of progesterone and estrogen falls at end of this phase. Production of Follicular Stimulating Hormone(FSH) and Leutinising Hormone(LH) from pituatry gland of brain also fall. When all hormones fall menstrual phase(Bleeding) start again.

Normal Range Of Menstruation Cycle(Period) may Vary

Normal menstrual cycle --21 to 35 days

Normal Menstruation days-- 2 to 7 days( including 2 heavy days of bleeding)

Average Blood Loss --35 to 150 ML in one menstruation cycle

Abnormal Pattern Of Bleeding

· Menorrhagia - Prolonged (>7 day) or excessive (>80 mL daily) uterine bleeding occurring at regular intervals.

· Metrorrhagia - Uterine bleeding occurring at irregular and more frequent than normal intervals.

· Menometrorrhagia - Prolonged or excessive uterine bleeding occurring at irregular and more frequent than normal intervals.

· Inter menstrual bleeding (spotting) - Uterine bleeding of variable amounts occurring between regular menstrual periods .

· Polymenorrhea - Uterine bleeding occurring at regular intervals of less than 21 days.

· Oligomenorrhea - Uterine bleeding occurring at intervals of 35 days to 6 months.

· Amenorrhea - No uterine bleeding for 6 months or longer.

Causes Of Abnormal Vaginal Bleeding

1. Dysfunctional Uterine Bleeding- it is most common cause.

2. Injury to abdomen.

3. Abortion.

4. Pregnancy- any trauma, Postpartum Hemorrhage.

5. Thyroid problems- Hypothyroidism and Myxedema Coma.

6. Ovarian Cysts.

7. PID- Pelvic Inflammatory Disease.

8. Anemia.

9. Thrombocytopenic Purpura.

Other Diseases which May Cause Vaginal Bleeding

1.Advanced Liver Disease- Cirrhosis.

2.Post coital Bleeding( Bleeding after Sexual Intercourse)

3.Tumor- Leiomyoma,Leukemia,Uterine Cancer,Cervical cancer, Endometrial cancer.

4.Steroids drugs( used in many diseases as- bronchitis,allergic conditions,rheumatoid arthritis,eczema and many other skin diseases.)

5.Inflammatory condition of - cervix, Fallopian tubes.