Menstruation marks a turning point in every girl’s life, symbolizing the transition from childhood to womanhood. It surrounds the miracle of life and the possibility for a woman to create life within her womb. When we think of menstruation, we think of the monthly bleeding that every woman of reproductive age experiences. But how does it all happen and how does the body react to these changes leading up to this bleeding? How does the body prepare to receive an embryo and nurture a baby? These are common questions that can be easily answered once we delve into the anatomy of the female reproductive system and all the wonders of life happening around women.

What is Menstruation?

Menstruation is the blood expelled by the female body monthly, in each menstrual cycle. In reality, this blood is the shedding of the endometrium, which is housed on the inner uterine walls and comes off when fertilization does not occur. The menstrual flow is composed of blood and waste from the endometrium. This bleeding lasts for an average of 3 to 7 days and can vary from woman to woman. Menstruation usually begins in a woman’s life around age 12 (menarche), sometimes considered early at age 8, and ends at menopause at around 45 to 55 years of age. In some cases, it can end early due to some hormonal problems or even surgical procedures, such as removal of the uterus (hysterectomy), where menstruation ceases and menopause symptoms can occur. While menstruation is present, it means the woman is of childbearing age and can become pregnant at any time. Menstruation is part of the menstrual cycle and of the entire preparation by the female reproductive system to conceive a baby.

Color and Texture of Menstruation

When we talk about menstrual blood, we automatically think of bright red blood, but that’s not always how it looks, even though that’s considered normal. It’s common for women to have flows with different coloring, such as dark red or brownish shades known as brown discharge. Its texture can range from liquid to sticky, and this may signal hormonal changes, such as in estrogen or progesterone levels. In the case of bright red menstruation, even though it’s considered healthy, the presence of small clots may indicate minor hormonal imbalances. If the menstrual blood is scant and pale pink, your endometrium may be thinner than normal and may not have received enough stimulation to thicken and line the uterine walls.

Heavy Menstrual Flow

The amount of menstrual flow varies from woman to woman; there are no strict rules, just as with the number of days the cycle lasts. Some women have a heavier flow that lasts longer, up to 8 days. This may seem scary, especially for those who need to change pads up to 6 times a day, but believe it or not, it isn’t! A heavy flow is not cause for concern except for the obvious discomfort it brings. However, the excessive bleeding can impact a woman’s health if it’s abnormal. Excessive menstrual bleeding can trigger cases of severe anemia, as well as iron deficiency, which can seriously affect your health. Therefore, if you have a very heavy flow, talk to your gynecologist and have regular tests to monitor your health and, if necessary, consider a treatment to control the flow.

Light Menstrual Flow

There are also what some may call lucky women, who besides bleeding for only a few days (3 or 4 days), also have a light flow, without many worries about leaks or frequent pad changes. Generally, light flow occurs in women who use birth control pills, since they reduce endometrial production, which means menstrual bleeding is lighter.

Menstruation Symptoms

It’s not hard to notice the changes in our bodies as menstruation approaches, since the symptoms are quite bothersome and apparent, like abdominal bloating and breast tenderness, as well as the dreaded menstrual cramps. Mood swings, headaches, severe back pain, and in some cases changes in appetite, nausea, and dizziness can also occur. Symptoms can vary from cycle to cycle and each woman typically experiences them differently. In some cycles, symptoms may be more intense and in others, they may barely show up at all.

IMPORTANT: If PMS symptoms are so intense that they interfere with your professional and social life, talk to your gynecologist about management options.

Is It Normal to Menstruate More Than Once a Month?

As we’ve mentioned, menstruation is part of the menstrual cycle and typically occurs once a month. However, some women may get “this visit” more often than expected, happening two or more times within the same month. But is it normal? The answer is: it depends. Considering that a menstrual cycle usually lasts around 28 days, the norm is for menstruation to occur only once per month. But we know that some women have a shorter cycle and depending on the month, menstruation can “call twice” in the same month. For example, if a woman’s cycle lasts 25 days, it’s natural for her to menstruate at both the beginning and end of the month, giving the impression of two periods in one month. But, if that’s not your case and you have a regular cycle of 28 days or longer and start having your period more often or experiencing spotting between periods, it’s best to investigate the cause.

Main Causes of Irregular Menstrual Cycles

One of the main factors responsible for hormonal imbalances in women today is birth control. It can trigger spotting throughout the cycle, especially while the body adjusts to the hormone dosage. If the issue continues for many months, talk with your gynecologist—perhaps switching birth control to help your body adapt to a different dosage. Another common cause is the presence of uterine fibroids. In some cases, fibroids can develop inside or outside the uterus, altering the cycle and causing irregularity, such as spotting between periods. Polycystic ovaries or ovarian cysts are also common reasons for cycle irregularities. With appropriate treatment, they can be controlled and the cycle regulated again. Another important factor is female sensitivity. Women are sensitive to external factors, which can also affect the menstrual cycle. Periods of high stress, anxiety, and even emotional crises can alter cycle function.

How to Regulate Your Menstrual Cycle?

To regulate your menstrual cycle, visiting your gynecologist is essential. To recommend the right treatment, the reason behind the cycle irregularity must be identified, so tests will be ordered. Blood tests to assess hormone levels and specific ultrasounds will be key to the evaluation. If your doctor feels it’s necessary, they may request more detailed tests, but in general, these are enough to get an accurate diagnosis and provide the right treatment. Usually, treatment is based on hormone contraceptives such as those containing progesterone, testosterone, and estrogen. Your gynecologist will determine which method is most appropriate for your body. Menstruation is a part of every woman’s life, so it’s best to know how our bodies work and recognize when something is unusual. Being aware of symptoms and knowing when to seek medical help, as well as maintaining intimate health and regular visits to the gynecologist, are great ways to ensure a healthy life.