Menstrual cycle, menstruation and hygiene

Menstrual cycle is the cyclic changes in the reproductive tract of primate females. Menstruation is the periodic shedding of endometrium of the uterus with bleeding. In healthy human female, menstruation occurs at an interval of 28 days. The fertility period extends from the age of puberty i.e. about 12-13 years to menopause i.e. 45-50 years. The age of puberty is marked by the appearance of secondary sexual characteristics. The onset of menstruation is called menarche. It starts at an age about 12-13 years.  Menstrual cycle consists of menstrual phase, proliferative phase (follicular phase) and secretory phase.  During menstrual cycle, an ovum (egg) is matured and released once every 28 days. However, many a times, due to some reasons, this period may increase or decrease.

Ø The menstrual cycle starts with the menstrual flow, during which the cellular lining of uterus with blood is shed off. This process continues for a period of 3-4 days, sometimes up to 7 days. This phase is called menstrual phase and it is the toughest phase for a woman in menstrual cycle. They need ample physical and mental support as they suffer huge cramp in lower abdominal cavity as well in lower limbs. Women need to be respected and supported throughout their life. It is the pain a woman bears when she doesn’t become pregnant but a woman has to bear a huge unbearable pain during child birth if she becomes pregnant. A woman sacrifices her health, body and mind to become a mother. Without women, the human civilization of the world will no longer exist like today’s generation after generation.

Ø The next phase is proliferative phase (5th to 14th day) consists of growth of endometrium of uterus, fallopian tube and vagina. In ovary, a Graaffian follicle matures and secretes estrogen during this phase. Graaffian follicle is the final stage in the maturation of an ovum (egg) in the ovary. It consists of an ovum ans a mass of cells surrounding it. Estrogen is the hormone that remain active during proliferative phase and stimulate the uterus to prepare itself to receive the ovum if fertilized and Follicle Stimulating Hormone (FSH) from pituitary gland stimulates follicular growth.

Ø Ovulation takes place on 14^th day or midway of menstrual cycle. Ovulation is the ejection of ovum from the Graafian follicle. Ovulation takes place under the direct influence of Luteinizing Hormone (LH) which is secreted by pituitary gland. The Graafian follicle ruptures and releases ovum. The cells of the ruptured Graafian follicle form the corpus luteum which secrets a hormone called progesterone which is essential for the maintenance of endometrium. This is called secretory phase. Endometrium is necessary for the development of fertilized ovum i.e. zygote and the events of pregnancy.

During pregnancy, all the events of menstrual cycle stop and there is no menstruation. In the absence of fertilization i.e. if no sperm is received by the ovum, the corpus luteum degenerates. This cause the disintegration of the endometrium leading to menstruation, starting a new menstrual cycle. The menstrual cycle is controlled by FSH, LH, Estrogen, Progesterone. The permanent stoppage of menstruation is called menopause. It occurs at an age of about 45-50 years. At the time of menopause, ovulation and menstruation stop and the reproductive organs decrease in size.

STEPS TO BE TAKEN TO MAINTAIN HYGIENE DURING MENSTRUAL PERIOD:

Ø Daily bathing along with regular/daily washing of the genital area with antiseptic or anti-fungal medicine is essential.

Ø Sanitary pads or cloths used should be changed at least twice a day.

Ø It is important to maintain menstrual hygiene in order to reduce the risk of contracting an infection of the female reproductive tract.

Ø Home-made sanitary napkins should be washed thoroughly with hot water and soap/Dettol and should be dried in a sunny and airy place. They should be stored in a clean and dry place to prevent microbial infection.

When a girl begins menstruating, it may take some time for her period to become regular. Sometimes her menstrual cycle may become irregular and her periods may be delayed or may occur earlier than the expected date because of illness or mental tension such as stress or depression. Irregularities in the menstrual cycle is quite common among young girls who have just begun to menstruate. However, if someone doesn’t menstruate for long period then it is necessary to consult a physician (Gynaecologist).