Menstrual Cycle: What’s Normal and What’s Not

Editor's Note: This article has been recently updated with latest information and research studies.

What is Menstruation?

Menstruation is the monthly sloughing off and discharge of blood as well mucosal tissues from the endometrial lining of the uterus. This is often episodic having the average length of four to six days. About thirty to eighty milliliters of blood is lost during a normal menstrual cycle.

What is The Menstrual Cycle?

The Menstrual Cycle is an episodic uterine bleeding in response to cyclic hormonal changes. It is a method wherein it prepares a woman’s body for conception and implantation to form a new life. The purpose of which is to lead an ovum (egg cell) into maturity as well as to renew a woman’s uterine tissue bed which will be in charge for the growth of the ova if ever it will be fertilized by a sperm cell.

What is a Normal Teenage Menstrual Cycle?

The menstrual cycle typically varies among women of different ages. In a normal teenager, menarche is the term used to describe their very first menstruation. Typically, a normal cycle is composed of twenty eight days.

How Does Your Menstrual Cycle Work?

Menstrual cycle in four phases: the proliferative phase, secretory phase, ischemic phase and the last is the menstrual phase. These phases work in a successive fashion:

  • The first phase which is so called proliferative phase happens instantly after the woman’s menstrual flow. The endometrium thickens to about eight times than its usual size from approximately day five until day fourteen of a normal twenty eight day menstrual cycle.
  • The second phase which is called the secretory phase happens right after ovulation or the release of the egg cell.
  • The third phase which is called ischemic phase happens if fertilization of the egg cell does not transpire. Thus, it regresses and shrivels off.
  • The last is the menstrual phase where menstruation begin to flow consisting of blood, mucus, fragments of the unfertilized egg cell and other fragments of the endometrium.

What Controls The Menstrual Cycle?

There are four structures in a woman’s body that controls the menstrual cycle: the hypothalamus, the pituitary gland, ovaries and of course the uterus. In order for a woman to have a complete menstrual cycle, all the four structures must perform their purpose; otherwise, this will result to a deficient or an ineffective menstrual cycle. Here the roles of each body structure:

  • The Hypothalamus

    : This gland initiates the woman’s menstrual cycle through its release of the so called Gonadotropin Releasing Hormone. This release of this hormone is cyclic thereby resulting to a monthly menstrual period which is cyclic as well.

  • The Pituitary Gland

    : This gland produces* two hormones such as the Leutinizing Hormone and the Follicle Stimulating Hormone which targets the woman’s ovary to promote menstrual cycle.

  • The Ovaries

    : Monthly, a woman naturally experiences a fertile period where she releases an ovum or egg cell which swims freely on the surface of the ovary. This process is called ovulation which occurs usually at the fourteenth day prior to the onset of the next menstrual cycle.

  • The Uterus

    : The endometrial lining of the uterus increases* by eight times before menstruation occurs. However, during menstruation, its lining sheds off if the ovum is not fertilized. This results to the sloughing off of the endometrium with blood consisting of about 30 to 80 ml.

Reasons behind Painful Menstrual Periods

Dysmenorrhea or painful menstrual period varies from being a slight discomfort to rigorous pain. Usually, the cause of painful menstrual period is ischemia and muscular spasms. Moreover, during a normal menstruation, the hormone prostaglandin is released. The over secretion of this hormone may result to painful menstruation which is often called primary dysmenorrheal. There are also secondary dysmenorrhea which results from pelvic inflammatory disease, infection and other disorders of the uterus.

How Does The Menstrual Cycle Change As A Woman Gets Older?

As a woman gets older, she reaches the time of life where she experiences cessation of her menstrual cycle called menopause. This usually occurs due to age, hormonal influence, and other factors involving a woman’s lifestyle prior to menopause such as heavy smoking and drinking.

At roughly about forty to fifty-five years of age, a woman undergoes a change in her life wherein her child bearing ability ceases because here ovaries begin to atrophy or deteriorate. Her sexual hormones, especially estrogen, which is very essential for reproduction started to decrease* its production. This is the reason why an older woman experiences physiologic stress which includes the following symptoms:

  • Hot flashes
  • Vaginal dryness
  • Osteoporosis due to lack of bone density
  • Urinary Incontinence
  • Tiredness and irritability
  • Lack of concentration
  • Loss of libido or sex drive
  • Aching muscles and joints and
  • Palpitations

How to Manage Menstrual Symptoms and Bleeding?

A woman who is actually prepared for menstruation and tends to view it positively knowing that menstruation is a natural occurrence results in effective coping mechanisms if they experience menstrual discomforts. However, since menstrual disorders such as dysmenorrhea or painful menstruation is inevitable, here are the important points to ponder on to manage the unwanted pain:

  • Exercise

    : It is a must for a woman to moderately exercise during menstruation since it enhances* her general well being and causes relaxation. Thus, cramping is avoided.

  • Rest

    : It is advisable to slow down for a bit, lie down and rest. This will alleviate* dysmenorrhea especially if it becomes intolerable for the woman.

  • Eat Nutritious Foods

    : Since menstruation causes sloughing of blood, it is important for a woman to eat foods rich in iron to replace the iron that may have been lost during menstruation.

Treatment Depends On Reason Of Causing Pain

The treatment for menstrual symptoms and bleeding usually varies depending on the reasons why there is pain. If there is painful menstrual cramps which results from muscle contractions and ischemia, drugs may be given to inhibit the cramping. However, there are secondary dysmenorrhea which results from disorders such as endometriosis, pelvic infections and other disorders involving the uterus. Prompt treatment depends on the mechanism of the disorder and this should be given proper treatment in order for the pain to subside.


When a woman truly understands the normal parameters of menstruation, its physiology and how it works, can she be able to adapt in this natural monthly occurrence. The key to a stress-free menstrual period is thorough and adequate knowledge and understanding.