The Reality, Nature, and Necessity of Menstruation
Globally, almost every young woman experiences menstrual bleeding each month, with only a few exceptions.
The Nature of Menstruation
Menstrual blood discharges from the uterus during menstruation. This blood originates
from the ovaries, where an egg is released and moves into or prepares to move
into the uterus. This process causes changes in the uterus, including increased
blood circulation, which initiates a cleaning process that expels blood, water,
and tissue fragments.
During menstruation, the muscular activity of the uterus, particularly its muscles, leads to inflammation and stimulation. This activity causes blood to flow, which then mixes with the waste materials inside the uterus and begins to be expelled from the body.
Why Menstrual Blood Occurs
In ancient times, it was believed that the moon and stars influenced women's monthly cycles. Some scholars thought that because of a supposed dominance of coldness in a woman's body, not all bodily waste was fully expelled, leading to its accumulation and subsequent monthly expulsion in the form of menstruation. However, it is now understood that menstrual blood signifies a girl’s transition to maturity.
A question often arises: since the ovaries and uterus are present from birth, why doesn't menstrual blood occur from the start of life? The answer lies in the fact that certain parts of our body only begin functioning as we reach puberty, although they continue to develop during childhood. For example, in young girls, the ovaries start producing eggs and a special fluid known as female semen, while the uterus expels menstrual blood each month. Similarly, a woman’s breasts begin producing milk before childbirth, ensuring adequate nutrition for the newborn.
Conversely, in young men, the testes begin producing semen, which is stored in the seminal vesicles, where it ferments and produces sperm. This semen is then discharged through the penis during arousal. If semen is discharged during sleep, it is known as a wet dream (nocturnal emission), and if discharged during intercourse, it is called ejaculation.
In both men and women, these processes start when their sexual organs are fully developed. Before maturity, these organs are not fully developed and thus do not function. Once they achieve full development, not only do menstruation or nocturnal emissions occur, but individuals also gain the ability to reproduce, ensuring the survival and flourishing of their species.
Important Objections to Menstrual Blood
Some researchers argue that the blood discharged during menstruation is not real blood. They claim that pure blood coagulates immediately after it leaves the arteries and veins, whereas menstrual blood does not coagulate.
Reason for Menstrual Blood Not Clotting
Research shows that menstrual blood initially forms clots as it is discharged from the capillaries when the uterine lining is shed. If the uterus is examined a couple of hours after menstruation begins, numerous clots of coagulated blood can be seen. These clots are dissolved by an enzyme called thrombolysin, which is secreted by the glands of the uterus, transforming them into a fluid state.
This discharged blood lacks fibrin and fibrinogen, which are essential for forming fibrous clots. Additionally, menstrual fluid contains about 33% moisture and high levels of calcium, as well as sufficient amounts of iodine components and lactic acid, which prevent the blood from clotting. Initially, the components of the mucous membrane are abundant and diminish towards the end of the menstrual period. If a woman's menstrual blood appears as clots, it is considered a pathological condition.
The Theory of Simple Organopathy and the Reality of Menstruation
The previous explanation clarifies the reality of menstruation and the reasons why menstrual blood does not clot. It indicates that menstrual blood is real blood, as evidenced by the presence of coagulated blood clots in the uterus a few hours after menstruation begins. However, it also states that if a woman's menstrual blood appears in the form of clots, it is a pathological condition. This seems contradictory.
To clarify, menstrual discharge is not pure blood but rather a mixture of waste products from the uterus and ovaries, expelled in a dark reddish color, which does not coagulate like pure blood.
When menstruation flows freely for six consecutive days, the woman is considered fortunate, indicating good health and a high likelihood of fertility. Conversely, if pure blood is discharged even in small quantities, it clots, which may indicate weaker health and reduced fertility. This is similar to how the expulsion of bodily waste keeps the body light, active, and healthy.
The human body expels waste products through various natural pathways such as the ears, mouth, anus, urethra, uterus, or skin. These substances are termed waste because they are unnecessary for the body. Therefore, the substance discharged during menstruation cannot be considered pure blood, as pure blood is essential for the body, while menstrual discharge is regarded as impure waste. This is why intercourse is often discouraged during menstruation. Additionally, most of the substance expelled from the uterus originates from the muscles, giving it a reddish color, which is why it is called menstrual blood.
Duration of Menstruation
In healthy women, the menstrual cycle typically occurs every 28 days each month. However, variations exist, with some women experiencing their cycle every 24 days, while others may have it every 32 days. As long as this pattern remains consistent and regular for an individual, it is not usually considered a medical issue.
Conversely, irregularities in the cycle, such as significant fluctuations in cycle length or skipped periods, may indicate underlying medical conditions that warrant further evaluation and treatment. Therefore, regular monitoring and understanding of one's menstrual cycle are essential for overall health and well-being.
Duration of Menstrual Flow
Typically, healthy women experience menstrual flow for 4 to 6 days each month, and this continues until they reach the age of 45 to 50. During this reproductive phase, they have the potential to conceive children.
After menstrual blood ceases, signaling the end of the reproductive period, women enter a stage known as menopause. During menopause, hormonal changes lead to the cessation of menstruation and a decrease in fertility. This transition usually occurs around the age of 45 to 50, although it can vary for each individual.
Changes in the Uterus During Menstruation
Before menstruation begins, there is an increase in blood flow to the muscles of the uterus, accompanied by swelling of the uterine glands. This leads to a nearly doubled size of the uterine mucosa.
During menstruation, this mucosal layer undergoes a process of shedding and thinning out as it dies. The dead parts of the mucosa, along with the enlarged glandular components, are expelled, constituting the menstrual discharge.
As the thick material is gradually expelled over 4 to 5 days, a minor secretion occurs, reducing blood flow to the uterus. This secretion helps to clean and refresh the uterine mucosa.
During pregnancy, menstruation ceases. However, some women may experience discomfort in their stomach, heart, and brain. This discomfort can manifest as a lack of appetite and frequent indigestion. In some cases, pregnant women may experience vomiting after eating, leading to distress.
Also read: A Woman's Wellness: Strategies for Relieving Genital Itching and Burning
Onset of Menstruation
In India and Pakistan, the average age at which young girls begin menstruating is typically between 14 and 16 years old. However, several factors can influence this timing, including climate, diet, family environment, modern lifestyle, and the degree of interaction between boys and girls, especially in co-educational settings. Interestingly, urban girls often experience menstruation at an earlier age compared to their rural counterparts.
In Bangladesh, where the climate may contribute to earlier physical maturation, menstruation often commences as early as 9 years of age. Conversely, in colder regions such as those in Europe, the onset of menstruation may be delayed, sometimes not occurring until the age of 20.
These variations highlight the complex interplay of biological, environmental, and cultural factors in determining the onset of menstruation in different regions and populations.
Physical Changes Due to Menstruation
When young girls start menstruating, several significant physical changes often occur. For instance, their sexual organs undergo contraction and expansion, similar to the changes observed in boys' genital organs. Just as the penis enlarges with arousal and returns to its original state afterward, girls' sexual organs experience similar changes during sexual excitement.
Additionally, one of the most notable and visible signs is the development of the breasts, causing the chest to fill out. Moreover, there is an increase in the growth of hair in the pubic area and around the vagina, indicating that the girl has reached maturity and is now capable of bearing children.
These physical changes signify the transition from childhood to adulthood and are part of the natural process of sexual development in girls.
Amount and Characteristics of Menstrual Blood
Typically, a healthy young woman discharges approximately 2 to 4 ounces of menstrual blood during her menstrual period. Initially, the blood may appear dark red, transitioning to a deeper red in the middle of the period, and then lightening in color towards the end.
The flow of menstrual blood often follows a pattern, with lighter flow on the first day, followed by heavier flow on the second and third days. Subsequently, the flow diminishes, and menstruation typically ceases after 4 or 5 days.
These variations in color and flow are considered normal and are part of the natural menstrual cycle experienced by women.
Precautions During Menstruation
When a girl or woman begins menstruating, it is advisable to avoid exposure to cold, including cold drinks, and to bathe with lukewarm water instead. Sudden exposure to cold may lead to the abrupt cessation of menstruation, accompanied by severe pain in the uterus.
Furthermore, it's important to recognize that the substance discharged during menstruation primarily consists of muscle and glandular secretions, often containing abundant acidic materials. Due to this composition, menstrual discharge may harbor various germs. Therefore, maintaining proper hygiene, such as using clean menstrual products and practicing good genital hygiene, is essential during menstruation to minimize the risk of infection.
Irregularities in Menstruation
As previously discussed, menstruation comprises a combination of waste products from the uterus and ovaries. Irregularities in menstruation, such as scanty flow, painful discharge, or complete cessation, are common occurrences. However, these irregularities can cause significant discomfort and may impact a woman's ability to conceive.
Addressing menstrual irregularities early is crucial to ensure a woman's overall well-being and her ability to achieve her life goals, including starting a family. Seeking medical advice and appropriate treatment for menstrual irregularities can help alleviate symptoms and ensure a fulfilling life.
Scanty or Light Menstrual Flow
For some women, menstruation manifests as very light periods without any accompanying pain. However, others may experience scanty menstruation coupled with intense pain, particularly at the beginning of their cycle. In such cases, the menstrual blood may emerge in drops rather than a steady flow.
These variations in menstrual flow and associated symptoms are common and can be influenced by factors such as hormonal fluctuations, lifestyle, and underlying health conditions. If the symptoms are severe or significantly impact daily life, seeking medical advice is advisable to identify any potential underlying issues and explore appropriate treatment options.
Diagnostic Misunderstandings
Many women perceive their menstrual flow as insufficient and believe that a heavier flow would alleviate their discomfort. However, healthcare providers sometimes misinterpret this perception and prescribe foods and medications to increase menstrual flow without addressing the underlying issue. This approach can potentially exacerbate the problem rather than resolving it.
Instead of solely focusing on increasing menstrual flow, it's crucial for healthcare providers to thoroughly evaluate the individual's symptoms and identify the root cause of any menstrual irregularities or discomfort. This may involve investigating hormonal imbalances, underlying health conditions, or lifestyle factors contributing to the perceived insufficiency of menstrual flow.
By adopting a comprehensive approach to diagnosis and treatment, healthcare providers can better address the individual needs of women experiencing menstrual irregularities and ensure that interventions are tailored to effectively alleviate symptoms and promote overall well-being.
Two Main Causes of Scanty Menstrual Flow
1. Excessive Fluids and Intense Nervous Stimulation:
Scanty menstrual flow, often painless and barely noticeable, can result from an abundance of bodily fluids and intense nervous stimulation. In such cases, the surplus bodily fluids dilute the blood, leading to reduced menstrual flow. This dilution may soothe the uterine muscles, preventing the typical discharge of uterine waste. Furthermore, heightened nervous stimulation can trigger the onset of menstruation by stimulating the body and uterine muscles.
2. Excess Bile and Heat, and Inflammation of Uterine Glands and Mucosa:
Scanty menstrual flow accompanied by severe pain may be attributed to an excess of bile and heat in the blood, leading to the dissolution of muscle tissue. This dissolution process can result in scanty menstruation. In such cases, medications aimed at reducing inflammation of the uterine glands and mucosa are often prescribed. With proper treatment, normal menstruation typically resumes within two to three months.
By understanding these underlying causes, healthcare providers can develop targeted treatment plans to address the specific factors contributing to scanty menstrual flow and associated symptoms.
Excessive Menstrual Flow
Just as insufficient menstrual flow can be concerning, excessive menstrual flow can also significantly distress and weaken a woman, potentially leading to serious consequences.
Difference Between Excessive and Normal Menstrual Flow
As previously discussed, normal menstruation involves the expulsion of waste from the uterus and ovaries, which ultimately energizes and prepares a woman for potential childbearing.
In contrast, excessive menstrual flow can result from inflammation in the uterine muscles, leading to the rupture of arteries and subsequent hemorrhage. Initially, uterine waste is expelled along with the blood. However, as the hemorrhage persists, pure blood may begin to flow out. When the individual stands up, the discharge of large blood clots often occurs, causing distress, weakness, dizziness, and even fainting. If the hemorrhage is not promptly controlled, it can ultimately result in fatal consequences.
Understanding the difference between normal and excessive menstrual flow is crucial for identifying and addressing potential health concerns in women experiencing abnormal menstrual bleeding. Early intervention and appropriate medical management are essential for ensuring the well-being and safety of individuals experiencing excessive menstrual flow.
