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What are menstrual cycles?
The menstrual cycle is the hormonal process a female’s body goes through monthly to prepare for a possible pregnancy. During this process, a woman's uterus grows and sheds a lining called the endometrium which may support the development of a fertilized egg. Consistent menstrual cycles in the years between puberty and menopause are generally a sign that your body is working well and is healthy. Puberty, menstruation and menopause are normal and nothing to be ashamed about. They are natural and happen to every woman and some trans/non-binary people.
The day 28 May is observed as ‘World Menstrual Hygiene Day in an attempt to break the silence and spark awareness around menstruation as well as to highlight the importance of good menstrual hygiene.
The menstruation process is a sequence of biological fluctuations in hormonal balance and the architecture of the women's reproductive system's uterus and ovaries that allow for childbirth. The ovarian cycle regulates egg production and secretion, as well as estrogen and progesterone release.
What is Menstrual health?
Whenever we think of the menstrual cycle, we automatically think of periods, a monthly reminder that we aren’t pregnant. Even though this is undoubtedly true and a relief to many, the whole cycle lasts for around 28 days. This time frame varies for different people and everyone reacts differently to this natural process. There are four phases of the menstrual cycle. The first phase is the period/ menstruation, then the follicular phase, ovulation, and luteal phase.
The menstruation phase is when a thick lining around the uterus is released through the vagina. Many people think that during menstruation, the menstrual fluid is only blood but it primarily consists of mucus, endometrial cells and blood. During this phase, there are different ways to handle your cycles such as pads, tampons, menstrual cups, etc.
The follicular phase is a longer phase that goes on from the start of the menstrual cycle to ovulation. This phase is when a hormone called follicle-stimulating hormone helps the ovary produce 5-20 follicles that contain immature eggs. Only one follicle normally matures into an egg and the rest line the uterus to prepare for the pregnancy.
Ovulation is the phase right after menstruation when a mature egg is released from the ovary. The egg is triggered into the uterus because of the high levels of luteinizing hormones. The eggs normally live for around 24 hours unless they meet a sperm before that period.
The Luteal phase is when the egg bursts the follicle and the follicle releases hormones that maintain the thickened lining of the uterus. If pregnancy doesn’t occur by the 22nd to 28th day, the lining eventually dies. There is also something called the luteal phase defect which is associated with this phase.
Common medical conditions associated with periods
KINDLY NOTE: DON NOT SELF DIAGNOSE BASED ON THE INFORMATION BUT IF THE SYMPTOMS MATHC YOU TO AN EXTENT CONSULT A DOCTOR. THE INFORMATION PROVIDED IS FOR GENERAL AWARENESS
Periods, unfortunately, have become a topic that is rarely publicly discussed. As a result, many menstruators are unsure of what is typical and what is unhealthy in terms of their menstrual cycle.
Listed below are some common medical problems in menstruation
Fibroids
Fibroids are noncancerous lesions that form in or around the uterus (womb). Muscle and fibrous tissue make up the growths, which vary in size. They're also called uterine myomas or leiomyomas. Usually, fibroids have no symptoms and thus many women are unaware that they have fibroids. They most often occur in women aged 30 to 50.
Fibroids do not need to be treated if they are not causing symptoms. Over time, they'll often shrink and disappear without treatment, particularly after menopause.
Endometriosis:
It is a condition in which the tissue that borders the uterus develops outside of it. The tissue of endometriosis can be seen on the ovaries, fallopian tubes, and intestines. Hormone therapy and excision surgery are two effective therapies
Symptoms include :
Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain.
Pain with intercourse. Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination. You're most likely to experience these symptoms during a menstrual period.
Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility.
Other signs and symptoms. You may experience fatigue, diarrhoea, constipation, bloating or nausea, especially during menstrual periods.
Hormone therapy and excision surgery are two effective therapies to help with Endometriosis.
Anaemia:
Severe or lengthy menstrual bleeding can result in a variety of health problems, particularly anaemia. Anaemia can damage blood vessels due to a decrease in the amount of circulating red blood cells
Depending on the causes of your anaemia, you might have no symptoms. Signs and symptoms, if they do occur, might include:
Fatigue
Weakness
Pale or yellowish skin
Irregular heartbeats
Shortness of breath
Dizziness or lightheadedness
Chest pain
Cold hands and feet
Headaches
Many types of anaemia can't be prevented. But you can avoid iron deficiency anaemia and vitamin deficiency anaemias by eating a diet that includes a variety of vitamins and minerals.
Excessive or Heavy bleeding:
Bleeding is considered heavy when it prevents people from going about their daily lives. About one-quarter of menstruators experience such heavy bleeding during their cycles that they are unable to accomplish daily chores inability to engage with the bleeding. Hormonal changes, structural abnormalities in the uterine (such as poles or fibroids), and other medical disorders (such as thyroid difficulties and anaemia) can all contribute to heavy menstrual bleeding
Amenorrhea:
Amenorrhea is a condition in which a menstruator does not have any menstrual cycles at all. When this happens to a 16-year-old menstruator who hasn't begun menstruating, it's most likely due to a problem with the endocrine system, which regulates hormones. The pituitary gland, which controls the menstrual cycles along with the hypothalamus, maturation is sometimes hindered as a result of low body mass. Sometimes faces hindrance while maturing as a result of low body mass.
Premenstrual Syndrome (PMS):
PMS is a term that refers to a group of physical and psychological symptoms that are linked to a menstruator's menstrual cycle. PMS affects about 40% of women to the point where it interferes with their everyday lives. PMS can manifest itself in a variety of ways, the most frequent of which is depression. Bloating, headaches, tiredness, exhaustion, irritability, anxiety, mood swings, weeping, and depression are some of the symptoms of PMS. These symptoms usually occur around a week before your period and go away as soon as your period starts or shortly after.
Ways to comfort period pain
· Putting a heating pad on your belly or lower back
· Resting and sleeping
· Drinking water and eating
· Start hormonal birth control
· Take pain killers, crocin, Aspirin, Ibuprofen or Naproxen Sodium. Some herbs can help with period pain too. Make sure to consult your doctor for better advice.
· Massage your belly with oils. We recommend starting a few days before your period begins.
You can comfort period cramps by putting a heating pad on your belly or lower back;
eating ‘comfort’ food and drinking water, and resting and sleeping. Some herbs can help with period pain too. Make sure to consult your doctor for better advice.
Taboo in India with regard to periods:
The word “Menstruation” tends to cause an awkward silence. But Why? It is a biological process that happens to every woman. In fact, not having regular periods or not having periods at all is a health concern! In India, people are hushed while talking about periods because it is seen as unclean, unnatural and a sin. Due to these beliefs, many women are not allowed to enter kitchens, enter temples, they are excluded from social/religious events and are kept in isolation during their periods.
Chhaupadi is a period taboo practised among Hindu communities in India and Nepal, in which females who are on their periods are forced to live outside their homes in shacks. As if that's not extreme enough, some women are barred from interacting with anyone in the community, are prohibited from eating certain foods, and sometimes must wear special clothes or eat with certain utensils during their period. Chhaupadi comes from a belief that menstruating women are filthy and that they bring misfortune to their community.
The isolation that women and girls experience can have negative psychological effects and catastrophic consequences. Women and girls have been known to die from paramount cold or brutal animal attacks that took place while they were living in the menstruation hut. Other times, women and girls living in the huts have reported that they have experienced sexual violence, while living in the huts, away from family and community members whose presence, they believe, might have discouraged the violence in the first place.
In India, a woman without a man by her side is considered vulnerable and open to the violence of any form. Young girls are told not to ask their fathers to shop for sanitary napkins are also refrained from giving a reason as to why they are in pain because that would mean explaining to their male family members about periods.
In Rajasthan, India, 15-year-old Priyanka Meena sleeps outside her home, in a space cordoned off by a sari, when she has her periods. She wears the same clothes and uses the same utensils when she menstruates; these are believed to be unclean and cannot be taken into the home, even after her period is over.
Why should I know about the menstrual cycle?
It is important for all genders to learn about the menstrual cycle even if it’s something that doesn’t directly affect them on a monthly basis. Even if someone doesn’t physically face the effects of a menstrual cycle, it is very likely that their friends, mothers, sisters and many more face the problems of the menstrual cycle much too often. It is important that they stay informed on what goes on around them too so that they can lend a hand when needed. It is also great to have general knowledge about the menstrual cycle during reproduction. There are certain phases in the menstrual cycle that relate to reproduction that all genders should know so that if a couple is trying to reproduce, they can properly coordinate for that to happen. Therefore, all genders should at least have basic knowledge of the menstrual cycle.
Menstruation is associated with smells, mess, blood, gore, impurity and disgust. This is probably why many women say they feel uncomfortable talking about their periods. This leads to women suffering in silence when it comes to “that time of the month” – hiding away from what some deem a “dirty secret ”.
This is in part why a recent report has called for boys, as well as girls, to learn about periods and the menstrual cycle at school. Plan International UK, the charity behind the report, suggests there is a need to talk more about the issue as many girls feel embarrassed – with the menstrual cycle tarnished with stigma and taboo.
Their findings also reveal that one in seven of the girls and women interviewed said they did not know what was happening when they first started their period – clearly demonstrating a need for more to be done to teach young women about what’s to come.
Because men, boys are unaware of what actually happens while women and girls are on their periods, they make comments like “you smell funny”, you are so moody.
In front of the girls, boys tend to be more disrespectful and unsympathetic about the issues associated with periods for girls – and primarily see any association with the vagina as sexual.
This is one step towards taking the taboo out of menstruation, because to achieve gender equality on this issue, girls need to feel able to talk about their periods and challenge the discrimination that is associated with menstruation and developing girls bodies. And boys can play a big role in this – if they also get the right support and resources .
Adaptation for women in workspace and schools:
Workplace adaptation for menstruators in schools, offices and public places (stigma around menstruation)
The constant stigma that is wrapped around menstruation continues to prevail in areas of work and education too. Menstruators are afraid that someone might see their sanitary pad or tampon thus hide it in a newspaper or their pocket, they are afraid to take menstrual leaves because it has been labelled an “invalid” reason and most of all they are afraid to talk about menstruation. This constant fear is one of the main contributors to the stigma.
Women are not provided with the right tools and facilities in workplaces and schools. Periods at times are irregular for women and come unannounced, in such situations it becomes difficult for a woman to face her cycles head-on. She may or may not be carrying a sanitary napkin and many a time girls feel shy and ashamed to ask fellow females for one. In such situations, it is evident for the school administration or workplace administration to keep such facilities and accessories available for women.
There are small steps we can take to encourage the breakdown of stigma around menstruation in schools, workplaces or public places.
Don't hide!
Be it your sanitary product or some blood on your pants, if you want, there is no need to hide them! Menstruation is normal and those who can’t accept that will have to. Don’t wrap your sanitary products in a newspaper when you buy them, don’t hide your sanitary products as you walk out of the classroom and don’t be afraid to ask a peer for a pad or a tampon.
Additionally, if you are in charge of a workplace, office or a school then you can do many things to help with the same.
A station for sanitary products for menstruators. Near the washrooms, there should be a sanitary products station where someone could pay rs.10 for one tampon or pad.
Menstrual leave, which allows a menstruator to take time off if they are unable to attend work due to menstruation, is a policy that could affect menstruators in many ways, including their status in the workplace. The question is whether such a policy would benefit or disadvantage a menstruator’s well-being. In spite of progressive aims, could menstrual leave policies actually increase discrimination and negative attitudes toward menstruators?
Many people might tag women as “weak” and say unnecessary things but as periods are a basic function of a women’s body it also becomes a basic right.
Allowing menstruators to take leaves if they are not feeling well should also be allowed, and their wages shouldn’t be cut down.
In schools, especially co-ed schools, the school faculty should take charge to make the school environment more cycle-friendly for girls who are menstruators.
There should be sanitary napkins in the washrooms as well as extra clothes if required by the girls.
Girls on their periods should also be exempted from their Physical education activities.
In conclusion, to work towards breaking down this stigma we shouldn’t be scared. We shouldn’t be scared or embarrassed to talk about menstruation, we shouldn’t be scared to carry a sanitary product, and we should not be scared to ask for leave because of menstruation. Menstruation is normal!
Marketing of sanitary napkins:
Despite being a basic necessity for half the world population, people have made a business out of it due to which many women suffer and do not have access to the right accessories.
What we are saying is not to make sanitary napkins free, but to reduce the cost. The same goes for medical facilities but that is a discussion for the future.
In the marketing industry of sanitary napkins and other products related to periods, a blue liquid is used to represent the symbolistic red colour of blood. The colour red is associated with strength, life, vigour, courage, and passion. Red represents life and pride. On the other hand, the colour blue is often associated with depression, sadness, shame and weakness. Having a colour of weakness representing period blood is not only disrespectful but also wrong. Periods don't make menstruators weak or shameful, they make a person strong, courageous and full of passion.
Keeping in mind the importance of female hygiene and menstruation products, something that has always been amusing is the fact that women are forced to shell out a lot of money every month, for something they have no control over.
Despite the fact that this 88 per cent does not have access to menstrual hygiene products, the government, in 2017, slapped a GST rate of 12 per cent on sanitary napkins The move outraged women across the country, with several protesting that menstrual hygiene was a necessity, not a luxury. However, nothing was done to alleviate the financial burden.
The argument here is not that women who can afford it should pay for it – such a myopic view does not account for a large section of the population who cannot afford these products. The point is that it is an unfair economic burden because menstruation is not a choice.
And while we’re at it, it is no secret that women are paid lesser than their male counterparts. To add to that, women are charged higher prices when it comes to availing of similar items and services. Asking us to pay our way through womanhood is honestly the last thing we need.
Sanitary napkin hygiene:
CORRECT WAY TO THROW AWAY PADS AND TAMPONS:
Roll up a used pad, wrap it in the wrapper of the new pad or in toilet paper, then throw it away. Don’t flush your used pad or tampon as it will clog a pipe or a sewer. For tampons, you just have to wrap them in toilet paper. Wrapping sanitary hygiene products minimise their smell and prevent the spread of bacteria that builds up over time.
TAKING CARE OF YOUR VAGINA:
While you are on your periods’ experts suggest washing your genitals twice a day: Morning and evening. You should wash them from front to back, and there’s no need to wash the inside of your vagina. If you are using wet wipes instead of toilet paper make sure they are free from alcohol and fragrance; make sure they have a balanced (7) Ph. Wash your hands after changing a sanitary product to help prevent the spread of bacteria.
FUN FACT- A healthy vagina’s Ph is from 3.8 to 4.5.
MORE ABOUT SANITARY NAPKINS:
During the day you should change your pad every 3-4 hours depending on your flow. Whereas, you can wear a period throughout the night as your blood flow is comparatively less because your bodily functions slow down. Although, you cannot wear a tampon for more than 8 hours because it can cause severe infections.
Extra information:
Average period length/duration:
“Regular” periods happen every 24-38 days. This means your period does not have a cycle lower than 24 days and that it doesn’t have a cycle higher than 38 days. Periods typically occur in 28-day cycles. Some people’s periods are so regular that they can predict the day and time that their periods will start. Others can only predict the start of their period within a few days because of post-period symptoms like moodiness, depression, bloating, cravings, etc.
Does not having periods always mean you are pregnant?
If you did not use a contraceptive the last time you had sexual intercourse or you forgot to take the pill and you miss your period, it might be that you are pregnant, but irregular periods don’t always mean you are. If you are a virgin or used a condom while having sexual intercourse you might have iron deficiency. Get a blood test taken. If your results show that you have iron deficiency, start taking iron pills. Low body mass or stress could also lead to irregular periods because it hinders the timings when progesterone and estrogen are excreted.
Should you track your periods?/Benefits of tracking your period:
If your periods are regular, tracking them will help you know when to expect your next period to start. If your periods are not regular, tracking them can help you detect any problems and share them with your doctor/nurse.
Myths vs reality:
Myth: other people can smell your periods
Reality: Normally people cannot smell others' period blood. But remember to maintain good hygiene.
Myth: If you are on your periods, you can’t touch a pickle as it will go bad. In addition, you cannot prepare sushi, go inside or touch anything in the kitchen, bathe in the same tub as your family, or drink cow’s milk, because you might poison the entire herd.
Reality: When you are on your period you are not “dirty”. You can eat, touch or go anywhere you would if you were not on your period.
Myth: Tampons take away your virginity
Reality: Even though using a tampon might cause a girl's hymen to stretch or tear, it does not cause a girl to lose her virginity. Only having sex can take away your virginity. Tampons are safe to wear. Although, it may take some practice the first few times you wear them. I strongly suggest wearing tampons if you don’t want to miss out on going to the beach or pool while on your period.
What different period blood colours mean about your health:
Black blood is usually old blood or blood that is taking longer to leave the uterus. Black blood also indicates the beginning or end of someone’s period or blockade inside someone’s vagina.
Brown/dark red blood can be old blood that appears at the beginning or end of someone’s period. Brown blood or spotting can sometimes be an early sign of pregnancy that experts refer to as implantation bleeding. During pregnancy, it can mean a miscarriage or an ectopic pregnancy. An ectopic pregnancy is when the fertilized egg implants in a fallopian tube instead of the uterus. If you are a pregnant woman and experiencing spotting or vaginal bleeding please consult a doctor or obstetrician. If you have spotting or brown vaginal discharge after giving birth it is called lochia/postpartum bleeding. Lochia is absolutely normal. It’s the body's way to remove excess blood and tissues from the uterus. Lochia usually begins with bright red blood and then becomes darker as blood flow decreases. If you experience very heavy bleeding after giving birth you should see a doctor. Not all women experience lochia after giving birth. Some women may experience irregular periods due to changes in hormone levels.
Bright red blood indicates fresh blood and a steady flow. Unusual spotting or bleeding between your menstrual cycle can be a sign of sexually transmitted diseases. Rarely, bright red blood might be a sign of cervical cancer.
Pink blood can occur when period blood mixes with cervical fluid. In addition, it can also occur due to birth control, sexual intercourse, significant weight loss, unhealthy diet and anaemia. If your vagina is leaking pink blood that contains tissues and occurs alongside cramps during your pregnancy it indicates a miscarriage.
Orange blood appears when blood is mixed with cervical fluid. Moreover, it often indicates an infection. If you spot orange blood or discharge you should consult your doctor or gynaecologist.
Grey blood is usually a sign of bacterial vaginosis (a condition that occurs due to an imbalance between beneficial and harmful bacteria in the vagina). Doctors usually prescribe antibiotics to treat bacterial vaginosis. Grey discharge containing clots during the late stages of pregnancy indicate a miscarriage. If you spot bleeding during your pregnancy, please consult a doctor.
Course Writers:
Pranjal Reen
Aadya Srivastava
Rhea Goel
Anvitha Kollipara
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