How menstruation works

Menstruation as we simply know and understand is the bleeding from the vagina which females from ages 11-45/50 undergo every month and that is correct but that's not all it entails. There are a lot of processes that lead to the final bleeding from the vagina and I will be explaining them in this article.

Menstruation can be defined as the cyclic changes that occur in the endometrium which is the innermost lining layer of the uterus. The purpose of menstruation is to prepare the endometrium for the reception of a fertilized ovum and when that doesn't work, the bleeding occurs. Menstrual bleeding causes the endometrium to shed off bit by bit and the blood along with shreds of the endometrium flow out through the vagina. It can also be called the uterine cycle. The sites of menstruation are the ovaries, uterus, cervix, vagina and breast.

The duration of the menstrual cycle is usually 28 days and it can vary from 20-45 days. The menstrual cycle has four stages and they are:

• The destructive stage(menstruation) which is usually takes 1-5 days.

• The follicular/proliferative stage which takes 5-14 days.

• Ovulation which is on the 14th day.

• Progestional/secretory/luteal stage which takes 14-28 days.

I'll be explaining each and every one of these stages but first you need to know the hormones involved in menstruation because they are important and I'll explain the roles they play in the different stages of the menstrual cycle. These hormones are:

• Gonadotropin Releasing Hormone(GnRH)

• Follicular Stimulating Hormone(FSH)

• Luteinizing Hormone (LH)

• Estrogen

• Progesterone

1. The destructive stage (menstruation): this is the first stage of the menstrual cycle and when the bleeding starts. This stage starts when any egg from the previous cycle isn't fertilized stopping the pregnancy. This will cause the estrogen and progesterone to reduce to low levels leading to shedding of the thickened lining of the uterus(endometrium) which was supposed to support the pregnancy and menstrual bleeding. During this stage, ladies usually have cramps, enlarged and tender breasts which can be painful sometimes, headache, tiredness, irritability, mood swings and even pimples. It ranges from 1-5 days.

2. Follicular phase: it starts on the first day of the period. Here, the endometrium increases in thickness. The arteries of the endometrium increase in length during this phase. The hypothalamus sends a signal to the pituitary gland to release the Follicular Stimulating Hormone (FSH) which stimulates the ovaries to produce about 5-20 follicles. Each of these follicles contain an immature egg and when the healthiest egg matures, the others are reabsorbed into the body. This mature egg increases the estrogen which further causes the thickening of the endometrium (uterus lining). This phase lasts for about 16 days but it ranges from 11-27 days depending on your cycle.

3. Ovulation: it out occurs 14 days after the onset of menstruation. Here, the ovary releases a mature egg and the egg is swept into the oviduct. Fertilization usually occurs in the ampulla of the oviduct within 24hrs of ovulation. After 24hrs, the egg will dissolve if it isn't fertilized. A woman is most fertile during ovulation and so, she is more likely to conceive in this phase. During ovulation, you experience a slight rise in basal body temperature and the release of a white thick discarge from your vagina.

4. Luteal phase: after ovulation, the corpus luteum secretes progesterone and estrogen which cause cellular proliferation, swelling and secretary development of the endometrium for the implantation of a fertilized egg. If a woman gets pregnant, her body will produce chorionic gonadotropin which is what maintains the corpus luteum and keeps the endometrium thick and it also happens to be the hormone that pregnancy tests detect. If she doesn't get pregnant, the corpus luteum will shrink away and be reabsorbed which will lead to a decrease in estrogen and progesterone. This decrease will cause the shedding off of the superficial parts of the endometrium, leading to the menstrual bleeding. Progesterone is the dominant hormone of this phase.

Causes of heavy bleeding

1. Local conditions e.g uterine or cervical cancer, polyps or infections.

2. Disturbed cyclic hormone production by the ovaries.

3. Elevated estrogen levels and deficient progesterone levels can lead to the absence of periods and/or excessive bleeding.

4. High level of prolactin interferes with the regulation of the ovaries

5. Ovarian disturbance for example lack of eggs in the ovary which lead to the increase of FSH which try to stimulate an ovary which is no longer capable of working.

I really hope this was helpful and informative to everyone especially the ladies because we all need to know what goes on during our monthly cycle. Thanks for reading!