10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Menstruation
FromWikipedia,thefreeencyclopedia

Menstruation,alsoknownasaperiodormonthly,[1]isthe
regulardischargeofbloodandmucosaltissuefromtheinner
liningoftheuterusthroughthevagina.[2]Upto80%ofwomen
reporthavingsomesymptomspriortomenstruation.[3]
Commonsignsandsymptomsincludeacne,tenderbreasts,
bloating,feelingtired,irritability,andmoodchanges.[4]These
mayinterferewithnormallife,thereforequalifyingas
premenstrualsyndrome,in20to30%ofwomen.In3to8%,
symptomsaresevere.[3]
Thefirstperiodusuallybeginsbetweentwelveandfifteen
yearsofage,apointintimeknownasmenarche.[1]However,
periodsmayoccasionallystartasyoungaseightyearsoldand
stillbeconsiderednormal.[2]Theaverageageofthefirst
periodisgenerallylaterinthedevelopingworld,andearlierin
thedevelopedworld.Thetypicallengthoftimebetweenthe
firstdayofoneperiodandthefirstdayofthenextis21to45
daysinyoungwomen,and21to31daysinadults(anaverage
of28days).[2][5]Menstruationstopsoccurringafter
menopause,whichusuallyoccursbetween45and55yearsof
age.[6]Bleedingusuallylastsaround2to7days.[2]
Themenstrualcycleoccursduetotheriseandfallof
hormones.Thiscycleresultsinthethickeningoftheliningof
theuterus,andthegrowthofanegg,(whichisrequiredfor
pregnancy).Theeggisreleasedfromanovaryaroundday
fourteeninthecyclethethickenedliningoftheuterus
providesnutrientstoanembryoafterimplantation.If
pregnancydoesnotoccur,theliningisreleasedinwhatis
knownasmenstruation.[2]
Anumberofproblemswithmenstruationmayoccur.Alackof
periods,knownasamenorrhea,iswhenperiodsdonotoccur
Figureshowingtheprogressionofthemenstrual
byage15orhavenotoccurredin90days.Periodsalsostop
cycleandthedifferenthormonescontributingtoit.
duringpregnancyandtypicallydonotresumeduringtheinitial
monthsofbreastfeeding.Otherproblemsincludepainful
periodsandabnormalbleedingsuchasbleedingbetweenperiodsorheavybleeding.[2]Menstruationinother
animalsoccursinprimates,suchasapesandmonkeys,aswellasbatsandtheelephantshrew.[7][8]

Contents
1 Onsetandfrequency
2 Healtheffects
https://en.wikipedia.org/wiki/Menstruation

1/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

2 Healtheffects
2.1 Cramps
2.2 Moodandbehavior
2.3 Bleeding
2.4 Menstrualdisorders
3 Ovulationsuppression
3.1 Birthcontrol
3.2 Breastfeeding
4 Menstrualmanagement
4.1 Disposableitems
4.2 Reusableitems
4.3 Noncommercialmaterials
5 Societyandculture
5.1 Traditionsandtaboos
5.2 Sexualactivity
5.3 Otheraspects
6 Evolution
7 Seealso
8 References
9 Furtherreading
10 Externallinks

Onsetandfrequency
Thefirstmenstrualperiodoccursaftertheonsetofpubertalgrowth,andis
calledmenarche.Theaverageageofmenarcheis12to15.[1][9]However,it
maystartasearlyaseight.[2]Theaverageageofthefirstperiodisgenerally
laterinthedevelopingworld,andearlierinthedevelopedworld.[5]The
averageageofmenarchehaschangedlittleintheUnitedStatessincethe
1950s.[5]
Menstruationisthemostvisiblephaseofthemenstrualcycleandits
beginningisusedasthemarkerbetweencycles.Thefirstdayofmenstrual
bleedingisthedateusedforthelastmenstrualperiod(LMP).Thetypical
lengthoftimebetweenthefirstdayofoneperiodandthefirstdayofthe
nextis21to45daysinyoungwomen,and21to31daysinadults(an
averageof28days).[2][5]

Diagramillustratinghowtheuterus
liningbuildsupandbreaksdown
duringthemenstrualcycle.

Perimenopauseiswhenfertilityinafemaledeclines,andmenstruationoccurslessregularlyintheyearsleadingup
tothefinalmenstrualperiod,whenafemalestopsmenstruatingcompletelyandisnolongerfertile.Themedical
definitionofmenopauseisoneyearwithoutaperiodandtypicallyoccursbetween45and55inWestern
countries.[6][10]:p.381
Duringpregnancyandforsometimeafterchildbirth,menstruationdoesnotoccurthisstateisknownas
amenorrhoea.Ifmenstruationhasnotresumed,fertilityislowduringlactation.Theaveragelengthofpostpartum
amenorrhoeaislongerwhencertainbreastfeedingpracticesarefollowedthismaybedoneintentionallyasbirth
control.

Healtheffects
https://en.wikipedia.org/wiki/Menstruation

2/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Inmostwomen,variousphysicalchangesarebroughtaboutbyfluctuationsinhormonelevelsduringthemenstrual
cycle.Thisincludesmusclecontractionsoftheuterus(menstrualcramping)thatcanprecedeoraccompany
menstruation.Somemaynoticewaterretention,changesinsexdrive,fatigue,breasttenderness,ornausea.Breast
swellinganddiscomfortmaybecausedbywaterretentionduringmenstruation.[11]Usually,suchsensationsare
mild,andsomefemalesnoticeveryfewphysicalchangesassociatedwithmenstruation.Ahealthydiet,reduced
consumptionofsalt,caffeineandalcohol,andregularexercisemaybeeffectiveforwomenincontrollingsome
symptoms.[12]Severesymptomsthatdisruptdailyactivitiesandfunctioningmaybediagnosedaspremenstrual
dysphoricdisorder.Symptomsbeforemenstruationareknownaspremenstrualmolimina.

Cramps
Manywomenexperiencepainfulcramps,alsoknownasdysmenorrhea,duringmenstruation.Painresultsfrom
ischemiaandmusclecontractions.Spiralarteriesinthesecretoryendometriumconstrict,resultinginischemiato
thesecretoryendometrium.Thisallowstheuterineliningtosloughoff.Themyometriumcontractsspasmodically
inordertopushthemenstrualfluidthroughthecervixandoutofthevagina.Thecontractionsaremediatedbya
releaseofprostaglandins.
Painfulmenstrualcrampsthatresultfromanexcessofprostaglandinreleasearereferredtoasprimary
dysmenorrhea.Primarydysmenorrheausuallybeginswithinayearortwoofmenarche,typicallywiththeonsetof
ovulatorycycles.[13]Treatmentsthattargetthemechanismofpainincludenonsteroidalantiinflammatorydrugs
(NSAIDs)andhormonalcontraceptives.NSAIDsinhibitprostaglandinproduction.Withlongtermtreatment,
hormonalbirthcontrolreducestheamountofuterinefluid/tissueexpelledfromtheuterus.Thusresultingin
shorter,lesspainfulmenstruation.[14]Thesedrugsaretypicallymoreeffectivethantreatmentsthatdonottargetthe
sourceofthepain(e.g.acetaminophen).[15]Riskfactorsforprimarydysmenorrheainclude:earlyageatmenarche,
longorheavymenstrualperiods,smoking,andafamilyhistoryofdysmenorrhea.[13]Regularphysicalactivitymay
limittheseverityofuterinecramps.[13]
Formanywomen,primarydysmenorrheagraduallysubsidesinlatesecondgeneration.Pregnancyhasalsobeen
demonstratedtolessentheseverityofdysmenorrhea,whenmenstruationresumes.However,dysmenorrheacan
continueuntilmenopause.515%ofwomenwithdysmenorrheaexperiencesymptomssevereenoughtointerfere
withdailyactivities.[13]
Secondarydysmenorrheaisthediagnosisgivenwhenmenstruationpainisasecondarycausetoanotherdisorder.
Conditionscausingsecondarydysmenorrheaincludeendometriosis,uterinefibroids,anduterineadenomyosis.
Rarely,congenitalmalformations,intrauterinedevices,certaincancers,andpelvicinfectionscausesecondary
dysmenorrhea.[13]Symptomsincludepainspreadingtohips,lowerbackandthighs,nausea,andfrequentdiarrhea
orconstipation.[16]Ifthepainoccursbetweenmenstrualperiods,lastslongerthanthefirstfewdaysoftheperiod,
orisnotadequatelyrelievedbytheuseofnonsteroidalantiinflammatorydrugs(NSAIDs)orhormonal
contraceptives,womenshouldbeevaluatedforsecondarycausesofdysmenorrhea.[10]:p.379
Whenseverepelvicpainandbleedingsuddenlyoccurorworsenduringacycle,thewomanorgirlshouldbe
evaluatedforectopicpregnancyandspontaneousabortion.Thisevaluationbeginswithapregnancytestand
shouldbedoneassoonasunusualpainbegins,becauseectopicpregnanciescanbelifethreatening.[17]
Insomecases,strongerphysicalandemotionalorpsychologicalsensationsmayinterferewithnormalactivities,
andincludemenstrualpain(dysmenorrhea),migraineheadaches,anddepression.Dysmenorrhea,orsevereuterine
pain,isparticularlycommonforyoungfemales(onestudyfoundthat67.2%ofgirlsaged1319haveit).[18]

https://en.wikipedia.org/wiki/Menstruation

3/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Themedicationsinthenonsteroidalantiinflammatorydrugs(NSAIDs)classarecommonlyusedtorelieve
menstrualcramps.Someherbsarealsoclaimedtohelp.

Moodandbehavior
Somewomenexperienceemotionaldisturbancesstartingoneortwoweeksbeforetheirperiod,andstoppingsoon
aftertheperiodhasstarted.[4]Symptomsmayincludementaltension,irritability,moodswings,andcryingspells.
Problemswithconcentrationandmemorymayoccur.[4]Theremayalsobedepressionoranxiety.[4]
Thisispartofpremenstrualsyndrome(PMS)andisestimatedtooccurin20to30%ofwomen.In3to8%itis
severe.[3]
Moreseveresymptomsofanxietyordepressionmaybesignsofpremenstrualdysphoricdisorder(PMDD).Rarely,
inindividualswhoaresusceptible,menstruationmaybeatriggerformenstrualpsychosis.

Bleeding
Theaveragevolumeofmenstrualfluidduringamonthlymenstrualperiodis35milliliters(2.4tablespoonsof
menstrualfluid)with1080milliliters(16tablespoonsofmenstrualfluid)consideredtypical.Menstrualfluidis
thecorrectnamefortheflow,althoughmanypeopleprefertorefertoitasmenstrualblood.Menstrualfluid
containssomeblood,aswellascervicalmucus,vaginalsecretions,andendometrialtissue.Menstrualfluidis
reddishbrown,aslightlydarkercolorthanvenousblood.[10]:p.381
Unlessawomanhasabloodborneillness,menstrualfluidisharmless.Notoxinsarereleasedinmenstrualflow,as
thisisaliningthatmustbepureandcleanenoughtohavenurturedababy.Menstrualfluidisnomoredangerous
thanregularblood.
Abouthalfofmenstrualfluidisblood.Thisbloodcontainssodium,calcium,phosphate,iron,andchloride,the
extentofwhichdependsonthewoman.Aswellasblood,thefluidconsistsofcervicalmucus,vaginalsecretions,
andendometrialtissue.Vaginalfluidsinmensesmainlycontributewater,commonelectrolytes,organmoieties,
andatleast14proteins,includingglycoproteins.[19]
Manymaturefemalesnoticebloodclotsduringmenstruation.Theseappearasclumpsofbloodthatmaylooklike
tissue.Iftherearequestions(forexample,wasthereamiscarriage?),examinationunderamicroscopecanconfirm
ifitwasendometrialtissueorpregnancytissue(productsofconception)thatwasshed.[20]Sometimesmenstrual
clotsorshedendometrialtissueisincorrectlythoughttoindicateanearlytermmiscarriageofanembryo.An
enzymecalledplasmincontainedintheendometriumtendstoinhibitthebloodfromclotting.
Theamountofironlostinmenstrualfluidisrelativelysmallformostwomen.[21]Inonestudy,premenopausal
womenwhoexhibitedsymptomsofirondeficiencyweregivenendoscopies.86%ofthemactuallyhad
gastrointestinaldiseaseandwereatriskofbeingmisdiagnosedsimplybecausetheyweremenstruating.[22]Heavy
menstrualbleeding,occurringmonthly,canresultinanemia.

Menstrualdisorders
Thereisawidespectrumofdifferencesinhowwomenexperiencemenstruation.Thereareseveralwaysthat
someone'smenstrualcyclecandifferfromthenorm,anyofwhichshouldbediscussedwithadoctortoidentifythe
underlyingcause:

https://en.wikipedia.org/wiki/Menstruation

4/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Symptom

Seearticle

Infrequentperiods

Oligomenorrhea

Shortorextremelylightperiods

Hypomenorrhea

Toofrequentperiods(definedasmorefrequentlythanevery21days)

Polymenorrhea

Extremelyheavyorlongperiods(oneguidelineissoakingasanitarynapkinortamponevery
hourorso,ormenstruatingforlongerthan7days)

Hypermenorrhea

Extremelypainfulperiods

Dysmenorrhea

Breakthroughbleeding(alsocalledspotting)betweenperiodsnormalinmanyfemales

Metrorrhagia

Absentperiods

Amenorrhea

Thereisamovementamonggynecologiststodiscardthetermsnotedabove,whichalthoughtheyarewidelyused,
donothaveprecisedefinitions.Manynowarguetodescribemenstruationinsimpleterminology,including:
Cycleregularity(irregular,regular,orabsent)
Frequencyofmenstruation(frequent,normal,orinfrequent)
Durationofmenstrualflow(prolonged,normal,orshortened)
Volumeofmenstrualflow(heavy,normal,orlight)[23]
Dysfunctionaluterinebleedingisahormonallycausedbleedingabnormality.Dysfunctionaluterinebleeding
typicallyoccursinpremenopausalwomenwhodonotovulatenormally(i.e.areanovulatory).Allthesebleeding
abnormalitiesneedmedicalattentiontheymayindicatehormoneimbalances,uterinefibroids,orotherproblems.
Aspregnantwomenmaybleed,apregnancytestformspartoftheevaluationofabnormalbleeding.
Womenwhohadundergonefemalegenitalmutilation(particularlytypeIIIinfibulation)apracticecommonin
partsofAfrica,mayexperiencemenstrualproblems,suchasslowandpainfulmenstruation,thatiscausedbythe
nearcompletesealingoffofthevagina.[24]
Prematureordelayedmenarcheshouldbeinvestigatedifmenarchebeginsbefore9years,ifmenarchehasnot
begunbyage15,ifthereisnobreastdevelopmentbyage13,orifthereisnoperiodby3yearsaftertheonsetof
breastdevelopment.[5]

Ovulationsuppression
Birthcontrol
Sincethelate1960s,manywomenhavechosentocontrolthefrequencyofmenstruationwithhormonalbirth
controlpills.Theyaremostoftencombinedhormonepillscontainingestrogenandaretakenin28daycycles,21
hormonalpillswitheithera7daybreakfrompills,or7placebopillsduringwhichthewomanmenstruates.
Hormonalbirthcontrolactsbyusinglowdosesofhormonestopreventovulation,andthuspreventpregnancyin
sexuallyactivewomen.Butbyusingplacebopillsfora7dayspanduringthemonth,aregularbleedingperiodis
stillexperienced.
Injectionssuchasdepoproverabecameavailableinthe1960s.ProgestogenimplantssuchasNorplantinthe
1980sandextendedcyclecombinedoralcontraceptivepillsintheearly2000s.
Usingsynthetichormones,itispossibleforawomantocompletelyeliminatemenstrualperiods.[25]Whenusing
progestogenimplants,menstruationmaybereducedto3or4menstrualperiodsperyear.Bytakingprogestogen
onlycontraceptivepills(sometimescalledthe'minipill')continuouslywithouta7dayspanofusingplacebopills,
https://en.wikipedia.org/wiki/Menstruation

5/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

menstrualperiodsdonotoccur.Somewomendothissimplyfor
convenienceintheshortterm,[26]whileothersprefertoeliminateperiods
altogetherwhenpossible.
Somewomenusehormonalcontraceptioninthiswaytoeliminatetheir
periodsformonthsoryearsatatime,apracticecalledmenstrual
suppression.Whenthefirstbirthcontrolpillwasbeingdeveloped,the
researcherswereawarethattheycouldusethecontraceptivetospace
menstrualperiodsupto90daysapart,buttheysettledona28daycycle
thatwouldmimicanaturalmenstrualcycleandproducemonthlyperiods.
Halfusedblisterpackofacombined
Theintentionbehindthisdecisionwasthehopeoftheinventor,JohnRock,
oralcontraceptive.Thewhitepillsare
towinapprovalforhisinventionfromtheRomanCatholicChurch.That
placebos,mainlyforthepurposeof
attemptfailed,butthe28daycycleremainedthestandardwhenthepill
remindingthewomantocontinue
[27]
takingthepills.
becameavailabletothepublic. Thereisdebateamongmedical
researchersaboutthepotentiallongtermimpactsofthesepracticesupon
femalehealth.Someresearcherspointtothefactthathistorically,femaleshavehadfarfewermenstrualperiods
throughouttheirlifetimes,aresultofshorterlifeexpectancies,aswellasagreaterlengthoftimespentpregnantor
breastfeeding,whichreducedthenumberofperiodsexperiencedbyfemales.[28]Theseresearchersbelievethatthe
highernumberofmenstrualperiodsbyfemalesinmodernsocietiesmayhaveanegativeimpactupontheirhealth.
Ontheotherhand,someresearchersbelievethereisagreaterpotentialfornegativeimpactsfromexposingfemales
perhapsunnecessarilytoregularlowdosesofsynthetichormonesovertheirreproductiveyears.[29]

Breastfeeding
Breastfeedingcausesnegativefeedbacktooccuronpulsesecretionofgonadotropinreleasinghormone(GnRH)
andluteinizinghormone(LH).Dependingonthestrengthofthenegativefeedback,breastfeedingwomenmay
experiencecompletesuppressionoffolliculardevelopment,folliculardevelopmentbutnoovulation,ornormal
menstrualcyclesmayresume.[30]Suppressionofovulationismorelikelywhensucklingoccursmore
frequently.[31]Theproductionofprolactininresponsetosucklingisimportanttomaintaininglactational
amenorrhea.[32]Onaverage,womenwhoarefullybreastfeedingwhoseinfantssucklefrequentlyexperiencea
returnofmenstruationatfourteenandahalfmonthspostpartum.Thereisawiderangeofresponseamong
individualbreastfeedingwomen,however,withsomeexperiencingreturnofmenstruationattwomonthsand
othersremainingamenorrheicforupto42monthspostpartum.[33]

Menstrualmanagement
Menstruationismanagedbymenstruatingwomentoavoiddamagetoclothingortoaccordwithnormsofpublic
life.Menstrualmanagementpracticesrangefrommedicalsuppressionofmenstruation,throughwearingspecial
garmentsorotheritems,washingoravoidanceofwashing,disposalandlaundryofstainedmaterials,toseparation
ofmenstruatorstoparticularplacesoractivities.
Menstrualproducts(alsocalled"femininehygiene"products)aremadetoabsorborcatchmenstrualblood.A
numberofdifferentproductsareavailablesomearedisposable,somearereusable.Wherewomencanaffordit,
itemsusedtoabsorborcatchmensesareusuallycommerciallymanufacturedproducts.Indevelopingcountries,
manywomenmaynotaffordtheseproductsandusematerialsfoundintheenvironmentorotherimprovised
materials.

Disposableitems
https://en.wikipedia.org/wiki/Menstruation

6/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Sanitarynapkins(Sanitarytowels)orpads
Somewhatrectangularpiecesofmaterialwornin
theunderweartoabsorbmenstrualflow,often
with"wings",piecesthatfoldaroundthe
undergarmentand/oranadhesivebackingto
holdthepadinplace.Disposablepadsmay
containwoodpulporgelproducts,usuallywith
aplasticliningandbleached.Somesanitary
napkins,particularlyolderstyles,areheldin
Disposablesoftcup
placebyabeltlikeapparatus,insteadof
adhesiveorwings.
TamponsDisposablecylindersoftreated
rayon/cottonblendsorallcottonfleece,usuallybleached,thatareinserted
intothevaginatoabsorbmenstrualflow.
PadettesDisposablewadsoftreatedrayon/cottonblendfleecethatare
placedwithintheinnerlabiatoabsorbmenstrualflow.
DisposablemenstrualcupsAfirm,flexiblecupshapeddeviceworn
insidethevaginatocatchmenstrualflow.Disposablecupsaremadeof
softplastic.

Reusableitems

Disposablesanitarynapkin

Tamponinplasticapplicator

ReusableclothpadsPadsthataremadeof
cotton(oftenorganic),terrycloth,orflannel,and
maybehandsewn(frommaterialorreusedold
clothesandtowels)orstorebought.
MenstrualcupsAfirm,flexiblebellshaped
deviceworninsidethevaginaforabouthalfa
dayorovernighttocatchmenstrualflow.They
areemptiedintothetoiletorsinkwhenfull,
washedandreinserted(washinghandswith
soapbeforedoingsoiscrucial).Menstrualcups
Menstrualcup
Clothmenstrualpad
areusuallymadeofsiliconeandcanlast5years
orlonger.Attheendoftheperiod,theyare
sterilised,usuallybyboilinginwater.
SeaspongesNaturalsponges,worninternallylikeatampontoabsorbmenstrualflow.
PaddedpantiesReusablecloth(usuallycotton)underwearwithextraabsorbentlayerssewnintoabsorb
flow.
Blanket,towel(alsoknownasadrawsheet)largereusablepieceofcloth,mostoftenusedatnight,
placedbetweenlegstoabsorbmenstrualflow.

Noncommercialmaterials
Absorptionmaterialsthatmaybeusedbywomenwhocannotaffordanythingelseinclude:sand,ash,smallholein
earth,[34]clothneworreused,wholeleaf,leaffibre(suchaswaterhyacinth,banana,papyrus,cottonfibre),
paper(toiletpaper,reusednewspaper,pulpedanddriedpaper),[35]animalpelte.g.goatskin,[34]doublelayerof
underwear,skirtorsari.[36]

Societyandculture
Traditionsandtaboos
https://en.wikipedia.org/wiki/Menstruation

7/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

Manyreligionshavemenstruationrelatedtraditions,forexamplethelaws
ofNiddahinJudaism.Thesemaybancertainactionsduringmenstruation
(suchassexualintercourseinsomemovementsofJudaismandIslam),or
ritualsperformedattheendofeachmenses(suchasthemikvahinJudaism
andtheghuslinIslam).Sometraditionalsocietiessequesterwomenin
residencescalled"menstrualhuts"thatarereservedforthatexclusive
purpose.
InHinduism,itisalsofrownedupontogotoatempleanddopooja(i.e.,
pray)ordopoojaatreligiouseventsifyouaremenstruating.Saraswati,the
AmraPadatikIndia,celebrationof
Hindugoddessofknowledge,isassociatedwithmenstruationtheliteral
MenstrualHygieneDayinIndia
translationofhernameis"flowwoman".MetaformicTheory,as
proposedbyculturaltheoristJudyGrahnandothers,placesmenstruationas
acentralorganizingideainthecreationofcultureandtheformationofhumans'earliestrituals.
AlthoughmostChristiandenominationsdonotfollowanyspecificorprescribedritesformenstruation,the
Westerncivilization,whichhasbeenpredominantlyChristian,hasahistoryofmenstrualtaboos,withmenstruating
womenhavingbeenbelievedtobedangerous.[37][38]
Anthropologists,LockandNguyen(2010),havenotedthattheheavymedicalizationofthereproductivelifestages
ofwomenintheWest,mimicpowerstructuresthataredeemed,inotherculturalpractices,tofunctionasaformof
"socialcontrol".[39]Medicalizationofthestagesofwomen'slives,suchasbirthandmenstruation,hasenliveneda
feministperspectivethatinvestigatesthesocialimplicationsofbiomedicinespractice."[C]ulturalanalysisof
reproductionattemptstoshowhowwomenexhibitresistanceandcreatedominantalternativemeaningsabout
thebodyandreproductiontothosedominantamongthemedicalprofession."[39]
InsomepartsofSouthAsia,womenareisolatedduringmenstruation.In2005,inNepal,theSupremeCourt
abolishedthepracticeofkeepingwomenincowshedsduringmenstruation.[40]

Sexualactivity
Sexualintercourseduringmenstruationdoesnotcausedamageinandofitself,butthewoman'sbodyismore
vulnerableduringthistime.VaginalpHishigherandlessacidicthannormal,[41]thecervixislowerinitsposition,
thecervicalopeningismoredilated,andtheuterineendometrialliningisabsent,thusallowingorganismsdirect
accesstothebloodstreamthroughthenumerousbloodvesselsthatnourishtheuterus.Alltheseconditions
increasethechanceofinfectionduringmenstruation.

Otheraspects
Malemenstruationisatermusedcolloquiallyforatypeofbleedingintheurineorfaecesofmales,reportedin
sometropicalcountries.Itisactuallycausedbyparasiteinfestationoftheurinarytractorintestinesby
Schistosomahaematobium,andcasesofitareactuallyschistosomiasis,formerlyknownasbilharziasis.

Evolution
Allfemaleplacentalmammalshaveauterineliningthatbuildsupwhentheanimalisfertile,butitisdismantled
whentheanimalisinfertile.Mostfemalemammalshaveanestrouscycle,yetonlyprimates(includinghumans),
severalspeciesofbats,andelephantshrewshaveamenstrualcycle.[42]Someanthropologistshavequestionedthe
energycostofrebuildingtheendometriumeveryfertilitycycle.However,anthropologistBeverlyStrassmannhas
https://en.wikipedia.org/wiki/Menstruation

8/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

proposedthattheenergysavingsofnothavingtocontinuouslymaintaintheuterineliningmorethanoffsetsenergy
costofhavingtorebuildthelininginthenextfertilitycycle,eveninspeciessuchashumanswheremuchofthe
liningislostthroughbleeding(overtmenstruation)ratherthanreabsorbed(covertmenstruation).[43][44]
Manyhavequestionedtheevolutionofovertmenstruationinhumansandrelatedspecies,speculatingonwhat
advantagetherecouldbetolosingbloodassociatedwithdismantlingtheendometrium,ratherthanabsorbingit,as
mostmammalsdo.Humansdo,infact,reabsorbabouttwothirdsoftheendometriumeachcycle.Strassmann
assertsthatovertmenstruationoccursnotbecauseitisbeneficialinitself.Rather,thefetaldevelopmentofthese
speciesrequiresamoredevelopedendometrium,onewhichistoothicktoreabsorbcompletely.Strassman
correlatesspeciesthathaveovertmenstruationtothosethathavealargeuterusrelativetotheadultfemalebody
size.[43]
Beginningin1971,someresearchsuggestedthatmenstrualcyclesofcohabitinghumanfemalesbecame
synchronized.Afewanthropologistshypothesizedthatinhuntergatherersocieties,maleswouldgoonhunting
journeyswhilstthefemalesofthetribeweremenstruating,speculatingthatthefemaleswouldnothavebeenas
receptivetosexualrelationswhilemenstruating.[45][46]However,thereiscurrentlysignificantdisputeasto
whethermenstrualsynchronyexists.[47]

Seealso
Menstrualcycle
MenstrualHygieneDay

References
1.Women'sGynecologicHealth.Jones&Bartlett
Publishers.2011.p.94.ISBN9780763756376.
2."Menstruationandthemenstrualcyclefactsheet".
OfficeofWomen'sHealth.December23,2014.
Retrieved25June2015.
3.Biggs,WSDemuth,RH(15October2011).
"Premenstrualsyndromeandpremenstrualdysphoric
disorder.".Americanfamilyphysician.84(8):91824.
PMID22010771.
4."Premenstrualsyndrome(PMS)factsheet".Officeon
Women'sHealth.December23,2014.Retrieved23June
2015.
5.AmericanAcademyofPediatricsCommitteeon,
AdolescenceAmericanCollegeofObstetriciansand
GynecologistsCommitteeonAdolescentHealth,Care
Diaz,ALaufer,MRBreech,LL(November2006).
"Menstruationingirlsandadolescents:usingthe
menstrualcycleasavitalsign.".Pediatrics.118(5):
224550.doi:10.1542/peds.20062481.
PMID17079600.
6."Menopause:Overview".http://www.nichd.nih.gov.
20130628.Retrieved8March2015.Externallinkin
|website=(help)
7.KristinH.Lopez(2013).HumanReproductiveBiology.
AcademicPress.p.53.ISBN9780123821850.

https://en.wikipedia.org/wiki/Menstruation

8.MartinRD(2007)."Theevolutionofhuman
reproduction:aprimatologicalperspective".Am.J.
Phys.Anthropol.Suppl45:5984.
doi:10.1002/ajpa.20734.PMID18046752.
9.Karapanou,O.Papadimitriou,A.(2010).
"Determinantsofmenarche.".ReprodBiolEndocrinol.
8:115.doi:10.1186/147778278115.PMID20920296.
10.Ziporyn,KarenJ.Carlson,StephanieA.Eisenstat,
Terra(2004).ThenewHarvardguidetowomen's
health.Cambridge,Mass.:HarvardUniversityPress.
ISBN0674013433.
11.PriceWA,GianniniAJ(1983)."Bingeeatingduring
menstruation".TheJournalofClinicalPsychiatry.44
(11):431.PMID6580290.
12."Waterretention:Relievethispremenstrualsymptom".
MayoClinic.Retrieved20September2011.
13.Dysmenorrhea:MenstrualAbnormalities:Merck
ManualProfessional(http://www.merckmanuals.com/pr
ofessional/gynecology_and_obstetrics/menstrual_abnor
malities/dysmenorrhea.html?qt=dysmenorrhea%20&alt
=sh)
14.MenstrualReductionWithExtendedUseof
CombinationOralCo...:Obstetrics&Gynecology(htt
p://journals.lww.com/greenjournal/Abstract/2001/11000/
Menstrual_Reduction_With_Extended_Use_of.11.aspx)

9/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

15.Marjoribanks,JProctor,MFarquhar,CDerks,RS
32.StallingsJF,WorthmanCM,PanterBrickC,Coates
(20January2010)."Nonsteroidalantiinflammatory
RJ(February1996)."Prolactinresponsetosuckling
drugsfordysmenorrhoea.".TheCochranedatabaseof
andmaintenanceofpostpartumamenorrheaamong
systematicreviews(1):CD001751.
intensivelybreastfeedingNepaliwomen".Endocr.Res.
doi:10.1002/14651858.CD001751.pub2.
22(1):128.doi:10.3109/07435809609030495.
PMID20091521.
PMID8690004.
16."Periodmakeovers:Fixesforheavybleeding,cramps,
33."Breastfeeding:DoesItReallySpaceBabies?".The
PMSCNN.com".CNN.25September2007.
CoupletoCoupleLeagueInternational.Internet
17.Medscape:MedscapeAccess(http://emedicine.medscap
Archive.17January2008.Archivedfromtheoriginal
e.com/article/2041923clinical)
on17January2008.Retrieved21September2008.,
18.SharmaP,MalhotraC,TanejaDK,SahaR(2008).
whichcites:
"Problemsrelatedtomenstruationamongstadolescent
KippleySK,KippleyJF(NovemberDecember
girls".IndianJPediatr.75(2):1259.
1972)."Therelationbetweenbreastfeedingand
doi:10.1007/s1209800800185.PMID18334791.
amenorrhea".Journalofobstetric,gynecologic,
19.Farage,Miranda(Mar22,2013).TheVulva:Anatomy,
andneonatalnursing.1(4):1521.
Physiology,andPathology.CRCPress.pp.155158.
doi:10.1111/j.15526909.1972.tb00558.x.
20."Menstrualbloodproblems:Clots,colorand
PMID4485271.
thickness".WebMD.Retrieved20September2011.
SheilaKippley(NovemberDecember1986and
21.Clancy,Kate(27July2011)."Irondeficiencyisnot
JanuaryFebruary1987)."Breastfeedingsurvey
somethingyougetjustforbeingalady".SciAm.
resultssimilarto1971study".TheCCLNews.
22.KepczykT,CreminsJE,LongBD,BachinskiMB,
13(3):10.Checkdatevaluesin:|date=(help)
SmithLR,McNallyPR(January1999)."A
and13(4):5.
prospective,multidisciplinaryevaluationof
34.Tamiru,S.,Mamo,K.,Acidria,P.,Mushi,R.,Satya
premenopausalwomenwithirondeficiencyanemia".
Ali,C.,Ndebele,L.(2015)Towardsasustainable
Am.J.Gastroenterol.94(1):10915.
solutionforschoolmenstrualhygienemanagement:
doi:10.1111/j.15720241.1999.00780.x.PMID9934740.
casesofEthiopia,Uganda,SouthSudan,Tanzania,and
23.FraserIS,CritchleyHO,MunroMG,BroderM
Zimbabwe(http://www.developmentbookshelf.com/doi/
(2007)."Canweachieveinternationalagreementon
abs/10.3362/17563488.2015.009).Waterlines,Vol.34,
terminologiesanddefinitionsusedtodescribe
No.1
abnormalitiesofmenstrualbleeding?".HumReprod.22
35.House,S.,Mahon,T.,Cavill,S.(2012).Menstrual
(3):63543.doi:10.1093/humrep/del478.
hygienemattersAresourceforimprovingmenstrual
PMID17204526.
hygienearoundtheworld(http://www.susana.org/en/res
24.http://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en/
ources/library/details/2210).WaterAid,UK
25."Delayingyourperiodwithbirthcontrolpills".Mayo
36.Chin,L.(2014)PeriodofshameTheEffectsof
Clinic.Retrieved20September2011.
MenstrualHygieneManagementonRuralWomenand
26."HowcanIdelaymyperiodwhileonholiday?".
Girls'QualityofLifeinSavannakhet,Laos[Master's
NationalHealthService,UnitedKingdom.Retrieved
thesis]LUMIDInternationalMasterprogrammein
20September2011.
appliedInternationalDevelopmentandManagement
27."Doyoureallyneedtohaveaperiodeverymonth?".
http://lup.lub.lu.se/studentpapers/record/4442938
DiscoveryHealth.Retrieved20September2011.
[accessed10August2015]
28.AmyLindStephanieBrzuzy(2007).Battleground:
37.http://ispub.com/IJWH/5/2/8213
Women,Gender,andSexuality:Volume2:MZ.
38.http://ebooks.adelaide.edu.au/f/frazer/james/golden/chapter60.h
Greenwood.p.348.ISBN9780313340390.
39.Lock,M.&Nguyen,V.K.,2010.AnAnthropologyof
29.Kam,Katherine."Eliminateperiodswithbirth
Biomedicine.Oxford:WileyBlackwell.
control?".WebMD.Retrieved20September2011.
40.SushilSharma,"Womenhailmenstruationruling"(htt
30.McNeillyAS(2001)."Lactationalcontrolof
p://news.bbc.co.uk/2/hi/south_asia/4250506.stm),BBC
reproduction".Reprod.Fertil.Dev.13(78):58390.
News,15September2005.
doi:10.1071/RD01056.PMID11999309.
41.AnnInternMed.1982Jun96(6Pt2):9213."Vaginal
31.Kippley,JohnSheilaKippley(1996).TheArtof
physiologyduringmenstruation."
NaturalFamilyPlanning(4thed.).Cincinnati,OH:
42."Whydowomenmenstruate?".ScienceBlogs.2011.
TheCoupletoCoupleLeague.p.347.ISBN0926412
Retrieved15January2013.
132.
43.StrassmannBI(1996)."Theevolutionofendometrial
cyclesandmenstruation".TheQuarterlyReviewof
Biology.71(2):181220.doi:10.1086/419369.
PMID8693059.
https://en.wikipedia.org/wiki/Menstruation

10/11

10/6/2016

MenstruationWikipedia,thefreeencyclopedia

44.KathleenO'Grady(2000)."IsMenstruationObsolete?".
TheCanadianWomen'sHealthNetwork.Retrieved
21January2007.
45.DesmondMorris(1997)."TheHumanSexes".
CambridgeUniversityPress.

46.ChrisKnight(1991).Bloodrelations:menstruationand
theoriginsofculture.NewHaven,Conn:Yale
UniversityPress.ISBN0300063083.
47.Adams,Cecil(20December2002)."Doesmenstrual
synchronyreallyexist?".TheStraightDope.The
ChicagoReader.Retrieved10January2007.

Furtherreading
Howie,GillianShail,Andrew(2005).Menstruation:ACulturalHistory.PalgraveMacmillan.ISBN1
403939357.Retrieved20131109.
Knight,Chris(1995).BloodRelations:MenstruationandtheOriginsofCulture.NewHavenandLondon:
YaleUniversity.ISBN0300049110.Retrieved20131109.

Externallinks
MuseumofMenstruation(http://www.mum.org/)
Retrievedfrom"https://en.wikipedia.org/w/index.php?
title=Menstruation&oldid=733280886"

Wikiquotehasquotations
relatedto:Menstruation

Categories: Menstrualcycle Midwifery

WikimediaCommonshas
mediarelatedto
Menstruation.

Thispagewaslastmodifiedon6August2016,at18:01.
TextisavailableundertheCreativeCommonsAttributionShareAlikeLicenseadditionaltermsmayapply.
Byusingthissite,youagreetotheTermsofUseandPrivacyPolicy.Wikipediaisaregisteredtrademark
oftheWikimediaFoundation,Inc.,anonprofitorganization.

https://en.wikipedia.org/wiki/Menstruation

11/11