There have been many myths and taboos associated with menstruation. Some cultures isolated women or thought the menstrual flow "unclean" or a "curse." More recent taboos against exercise or sexual intercourse during menstruation are slowly lifting. Some scientists have asked why menstruation occurs at all—why the uterine lining does not remain in place, regenerating itself as other parts of the body (such as the skin and digestive tract) do. One theory is that menstruation is a defense against microbes that enter the uterus with incoming sperm.
In the first phase of each cycle, the lining, or endometrium, of the uterus undergoes rapid proliferation of cells and venous channels in preparation for pregnancy. Midway through the cycle an ovum (egg) is released from an ovary. If, while passing through the fallopian tube the ovum is fertilized by a sperm, implantation in the uterus occurs and the thickened lining helps support the pregnancy. When the ovum is not fertilized, this tissue and blood are shed. The proliferation of the uterine wall then begins once more in expectation of the next release of an ovum, and if conception does not take place, it sloughs off again. The process continues monthly until pregnancy occurs or until ovulation ceases at menopause.
The natural rhythm of the menstrual cycle may be broken or temporarily halted by hormonal imbalance, malnutrition, illness, or emotional disturbance (see amenorrhea). Menstruation is controlled by the hypothalamus and the pituitary gland and hormones, such as estrogen, which prepares the lining of the uterus, and progesterone, which helps maintain a pregnancy.
Many women experience painful menstruation, or dysmenorrhea. The uterine contractions that result in the cramps experienced by these women appear to be caused by hormones called prostaglandins that are produced in the second half of the cycle. Oral contraceptives and other drugs that reduce the production of prostaglandins are sometimes used in treatment. Other women experience symptoms such as behavioral changes, breast tenderness, and fatigue during the week immediately preceding menstruation, a condition referred to as premenstrual syndrome, or PMS.
See publications of the National Institute of Child Health and Human Development; Boston Women's Health Book Collective, Our Bodies, Ourselves for the New Century (1998).
Periodic discharge from the vagina of blood, secretions, and shed mucous lining of the uterus (endometrium). The endometrium prepares to receive a fertilized egg by thickening and producing secretions. If the egg released by the ovary is not fertilized, the endometrium breaks down and is expelled by contractions of the uterus. The first menstruation (menarche) occurs after other changes of puberty, usually at 11–13 years of age, apparently triggered by the passing of a weight threshold. Bleeding may be irregular or heavy at first. In adult women, menstrual periods begin at an average interval of 28 days and last about five days; some variation among women and in the same woman is normal. Uterine contractions are felt as cramps. The amount of blood lost is usually less than 1.7 oz (50 ml). Menstruation ends with menopause. Menstrual disorders include dysmenorrhea (painful menstruation) and amenorrhea (no bleeding), heavy or light bleeding, and uterine bleeding. Seealso premenstrual syndrome.
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Menstruation is the shedding of the uterine lining (endometrium). It occurs on a regular basis in reproductive age females of certain mammal species. Overt menstruation (where there is bleeding from the vagina) is found primarily in humans and close evolutionary relatives such as chimpanzees. The females of other placental mammal species have estrous cycles, in which the endometrium is reabsorbed by the animal (covert menstruation) at the end of its reproductive cycle. Many zoologists regard this as different from a "true" menstrual cycle.
During pregnancy and for some time after childbirth, menstruation is normally suspended; this state is known as amenorrhoea, i.e. absence of the menstrual cycle. If menstruation has not resumed, fertility is low during lactation. The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this may be done intentionally as birth control (lactational amenorrhea method).
Many have questioned the evolution of overt menstruation in humans and related species, speculating on what advantage there could be to losing blood associated with dismantling the endometrium rather than absorbing it, as most mammals do. The ancient writer Hippocrates considered that menstruation was intended to cleanse the body of "evil humours", and modern evolutionary biologist Margie Profet contends that the primary function of menstruation is to remove sperm-borne pathogens from the uterus. In support of this hypothesis, she has pointed to the relatively high levels of macrophages in menstrual blood.
Beginning in 1971, some research suggested that menstrual cycles of co-habiting human females became synchronized. A few anthropologists hypothesized that in hunter-gatherer societies, males would go on hunting journeys whilst the females of the tribe were menstruating, speculating that the females would not have been as receptive to sexual relations while menstruating. However, there is currently significant dispute as to whether menstrual synchrony exists.
Humans do, in fact, reabsorb about two-thirds of the endometrium each cycle. Strassmann asserts that overt menstruation occurs not because it is beneficial in itself. Rather, the fetal development of these species requires a more developed endometrium, one which is too thick to completely reabsorb. Strassman correlates species that have overt menstruation to those that have a large uterus relative to the adult female body size.
Many religions have menstruation-related traditions. These may be bans on certain actions during menstruation (such as intercourse in orthodox Judaism and Islam), or rituals to be performed at the end of each menses (such as the mikvah in Judaism and the ghusl in Islam). Some traditional societies sequester females in residences ("menstrual huts") that are reserved for that exclusive purpose until the end of their menstrual period.
Since the late 1960s, some women have chosen to prevent menstruation with long-acting hormonal birth control. Injections such as depo-provera became available in the 1960s, progestogen implants such as Norplant in the 1980s and extended cycle combined oral contraceptive pills in the early 2000s.
Women may experience emotional disturbances associated with menstruation. These range from the irritability popularly associated with Premenstrual Syndrome (PMS), to tiredness, or "weepiness" (i.e. tears of emotional closeness). A similar range of emotional effects and mood swings is associated with pregnancy.
In addition to products to contain the menstrual flow, pharmaceutical companies likewise provide products — commonly non-steroidal anti-inflammatory drugs (NSAIDs) — to relieve menstrual cramps. Some herbs, such as dong quai, raspberry leaf and crampbark, are also claimed to relieve menstrual pain; however there is no documented scientific evidence to prove this.