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For women and girls: Here I am discussing a taboo subject. But I am doing this for your own benefit. So just relax and sit tight!

Menstruation is a woman's monthly bleeding. When a woman menstruate, her body sheds the lining of the uterus (womb). Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina. Menstrual periods normally last from 3 to 5 days. When periods (menstruations) come regularly, this is called the menstrual cycle.

There are many myths and false beliefs associated with this process and they are used to discriminate against women. They are also excuses that people use to ban women from certain places and doing some things. Many girls and women are subject to restrictions in their daily lives  in this part of the world simply because they are menstruating.

There are health and hygiene issues also to consider relating to girls and menstruation. Over 55% of menstruating girls and women in India use an old cloth, which is often reused for soaking up of blood. Further, thousands of poor and illiterate women in India sometimes resort to using ashes, newspapers, dried leaves and husk sand to aid absorption. Poor protection and inadequate washing facilities may increase susceptibility to infection. Using clean and hygienic things during periods is very important to protect a woman's health.

What is very important to know about it is - it is not bad blood or impure blood that flows out of a woman's body when she is menstruating. It is the normal blood that flows in a woman's body that comes out during menstruation. To understand this process correctly, we should first know all about it and why it happens.

Reproduction is the main aim of nature developing this biological cycle in women. Having regular menstrual cycles is a sign that important parts of her body are working normally. The menstrual cycle provides important body chemicals, called hormones, to keep a woman healthy. It also prepares her body for pregnancy each month.

A cycle is counted from the first day of 1 period to the first day of the next period. The average menstrual cycle is 28 days long. Cycles can range anywhere from 21 to 35 days in adults and from 21 to 45 days in young teens. The rise and fall of levels of hormones during the month control the menstrual cycle.

The menstrual cycle is the hormonal driven cycle; day 1 is the first day of period (bleeding) while day 14 is the approximate day a woman ovulate and if an egg is not fertilized, hormone levels eventually drop and at about day 25; the egg begins to dissolve and the cycle begins again with the period at about day 30.

In the first half of the cycle, levels of estrogen (the “female hormone”) start to rise. Estrogen plays an important role in keeping a woman healthy, especially by helping her to build strong bones and to help keep them strong as she gets older. Estrogen also makes the lining of the uterus (womb) grow and thicken. This lining of the womb is a place that will nourish the embryo if a pregnancy occurs. At the same time the lining of the womb is growing, an egg, or ovum, in one of the ovaries starts to mature. At about day 14 of an average 28-day cycle, the egg leaves the ovary. This is called ovulation.

Photo credit: Alila Medical Media

 

After the egg has left the ovary, it travels through the fallopian tube to the uterus. Hormone levels rise and help prepare the uterine lining for pregnancy. A woman is most likely to get pregnant during the 3 days after the day of ovulation. However, women with cycles that are shorter or longer than average may ovulate before or after day 14.

A woman becomes pregnant if the egg is fertilized by a man's sperm cell and attaches to the uterine wall. If the egg is not fertilized, it will break apart. Then, hormone levels drop, and the thickened lining of the uterus is shed during the menstrual period.

During a woman's period, she sheds the thickened uterine lining and extra blood through the vagina. Her period may not be the same every month. It may also be different than other women's periods. Periods can be light, moderate, or heavy in terms of how much blood comes out of the vagina. This is called menstrual flow. The length of the period also varies. Most periods last from 3 to 5 days. But, anywhere from 2 to 7 days is normal.

A girl can start her period anytime between the ages of 8 and 15. For the first few years after menstruation begins, longer cycles are common. A woman's cycle tends to shorten and become more regular with age. Most of the time, periods will be in the range of 21 to 35 days apart.

Women usually have periods until menopause. Menopause occurs between the ages of 45 and 55, usually around age 50. Menopause means that a woman is no longer ovulating (producing eggs) or having periods and can no longer get pregnant. Like menstruation, menopause can vary from woman to woman and these changes may occur over several years.

The time when a woman's body begins its move into menopause is called the menopausal transition. This can last anywhere from 2 to 8 years where periods become irregular. 

Problems with periods include the following: amenorrhea (no period), dysmenorrhea  (painful period), and abnormal bleeding.

A week or two before their period starts, women may notice bloating, headaches, body pains - especially back pain, mood swings, or other physical and emotional changes called collectively Premenstrual syndrome or PMS. Acne is one of the most common signs of PMS. Hormonal changes can cause glands in the skin to produce more sebum. This oily substance may clog the pores, triggering a breakout -- a visible reminder that your period is on its way. About 85% of women experience some degree of PMS. A few have more severe symptoms that disrupt work or personal relationships, known as premenstrual dysphoric disorder (PMDD). These changes are believed to be the result of hormonal changes in a woman's body. Levels of estrogen and progesterone drop during the week before the period. Many doctors believe this decline in hormone levels triggers the symptoms of PMS. Changes in brain chemicals or deficiencies in certain vitamins and minerals may also play a role. Too many salty foods, alcohol, or caffeine may make symptoms worse as well.

These are not signs of insanity. Foods rich in B vitamins may help fight PMS. In some studies, researchers followed more than 2,000 women for 10 years. They found that women who ate foods high in thiamine (meat, Brazil nuts) and riboflavin (eggs, dairy products) were far less likely to develop PMS. Complex carbohydrates, such as whole-grain breads and cereals, are packed with fiber. Eating plenty of fiber can keep your blood sugar even, which may ease mood swings and food cravings. Salt can increase bloating, caffeine can cause irritability, sugar can make cravings worse while alcohol can affect mood. So avoiding these during PMS can help control the symptoms.

Myths and misconceptions associated with menstruation...

1. One shouldn't wash one's body during this period.   There’s no reason for any girl to change any of her regular grooming and hygiene habits just because she is having her period. In fact, a warm bath or shower will help her stay clean, and it helps with her cramps, too. Women can take their regular baths normally during their periods.

2. Bed rest is a must during a woman's period (and that is why she would be asked to stay away from normal household work).  A woman should get plenty of good sleep during her period as usual, but she should also get plenty of exercise, too. Women feel better if they get up and get out there  and work especially since exercise has been shown to alleviate cramps and brighten  the mood.

3. Hot water increases period flow. The only thing that will change the flow is a woman's own body. So one can’t make it lighter or heavier with water used outside of a body. And a nice warm bath or shower, or a hot water bottle wrapped in a towel can help with cramps.

4. A woman cannot get pregnant during her period. The answer is both yes and no! The probability is that one would not get pregnant having sex during one's period. Apart from being more messy and less desirable, having sex during a woman's period will more than likely not result in getting pregnant.  More than likely, a girl's ovulation is several days away decreasing any chances of conceiving during this time.

However, there are exceptions. The above applies for women who have typical 28 to 30 day or longer cycles. If a girl happens to be one of the individuals who has a shorter cycle there is a chance she could get pregnant while having sex during her period.

“How does that happen?” is the Q asked by many. The answer is: If your cycle is shorter, for example every 21 to 24 days, this means you are ovulating earlier in the cycle. Sperm can live inside you for 2, 3 and even up to 5 days sometimes. You could have sex towards the end of your bleeding and then actually conceive 4 or 5 days later with your early ovulation.

The probabilities of getting pregnant while on your period are low, but the possibilities are definitely there! 

The likelihood of getting pregnant right before a girl's period is extremely low. For women who have a typical cycle of 28 to 30 days or longer and their cycles are regular, it is fairly safe to say that her ovulation occurred between Day 11 and Day 21. The egg is only available for 12 to 24 hours for conception.

This would mean that the days right before her period are the safest for having sex for a woman without the expectation of getting pregnant. The number of “safe days” right before her period go up with longer cycles and lessen with shorter cycles.

5. You can shorten or delay a period by ­­­­­ using drugs. You shouldn’t try to fight your body’s natural menstrual cycle. Doing so could potentially cause other health problems ( However, I must add here that in fact, not only have female astronauts already tried out the continuous-pill method for obvious reasons,  but more women on Earth are opting out of periods too.  And the pills do come with some risks—blood clots in the legs and lungs, breast cancer which are a main concern). 

6. Menstrual blood is different from regular blood and therefore  is 'bad blood'. Menstrual blood is regular blood. This myth probably gained traction because menstrual blood flows from the vagina which is placed between anus and urethra. And because vaginas are a normal part of the female body, there’s nothing unusual or wrong with menstrual blood. And  it has no odour on its own too.

7. Some types of food are bad for women when they have their periods. Not true. When it comes to eating during a girl's period the same rules apply as when she doesn't have her period: She can eat anything she wants, but remember that healthy food is called healthy for a reason. There is no need to drastically change  a girl's diet during her period. However, she might need more iron if she tends to lose a lot of blood during her period and should take foods that contain iron like green leafy vegetables.

8. A girl is definitely pregnant when she doesn't get her period. There can be many reasons for absence of periods. While the main reason could be pregnancy, the other explanations for absence of a period can be : stress, travelling between time zones, strenuous exercise, illness, drastic weight change, and not eating well. One should consult a doctor and conduct tests to asses the right basis. 

9. Women having their period are more likely to be attacked by bears, sharks, etc. that get attracted to her menstrual blood. There is no evidence that supports this myth. Blood CAN attract sharks, but so can urine, sweat and all types of bodily fluids. 

10. Pre-menstrual syndrome is an imagined disease. Modern medicine proves that this is simply not the case. It's for real, and as many as 85% of all women experience some sort of symptoms.

11. Menstruation should not be discussed with young girls. Wrong. Each and every mother should discuss things with their daughters and get them  prepared for the inevitable things they have to face in their future lives. Young girls here often grow up with limited knowledge of menstruation because their mothers and other women shy away from discussing the issues with them. Adult women may themselves not be aware of the biological facts or good hygienic practices to pass them on to their children. The bad practices have to be reversed  to make their daughters confident about themselves and their bodies.

12. Everything about menstruation is bad and dirty. Untrue. It is a natural biological process evolved by Nature for the right purpose. If the correct procedures are used for protecting the body, there is nothing dirty about it. 

Some questions women and girls asked me after reading this article and my replies to them...

Q: Isn't  it dirty blood that comes out when you are menstruating? 

Krishna: No! Like I have said in my article it is 'good blood' that is circulating in your body which happens to be in your womb at the time of menstruating, that flows out. It is in no way dirty.

Menstrual blood, unlike urine and faeces, is not an excretory product but in reality is the endometrium which gets prepared every month for pregnancy, which if unused, gets shed. It is not unclean and unhygienic when they menstruate. Whether you menstruate or not, hygiene depends on many other factors.

Q: Can we do all the things  we do when we are normal during our periods too?

Krishna: Yes! According to several scientists and doctors I spoke to ... if "holy people" in prayer houses feel "unclean" menstruating women should not be allowed inside, then anybody who urinates or goes to latrine shouldn’t be allowed inside too. Because if "cleanliness" is the main issue, those are the real excretory materials which are harmful and "unclean".

Q: My periods are very painful and debilitating. How can I deal with it?

Krishna: Most of the women face this situation. According to some doctors you can manage it  by taking NSAIDs (nonsteroidal anti-inflammatory drugs). It doesn't reduce fertility like some people believe. Prostaglandins cause period pain by causing uterine contractions and taking medicines which temporarily block prostaglandins does not have any effect on a woman’s fertility. NSAID’s can make  period pain bearable enough to continue working on those days.

Q: I get very moody before I get my periods. Is this common?

Krishna: Most women face this situation. These emotional changes occur because of hormonal changes. You need not worry about them but learn to manage mood swings efficiently so that you wouldn't disturb others around. Or at least request them to understand and co-operate by explaining things to them. 

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