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| Factors That Influence The Length Of The Menstrual Cycle |
In
other cases, although people usually have regular cycles that do not present
problems, there may be specific vital moments in which irregularities arise in
their menstrual cycle. There are different causes for these problems and it is
important to know them and to know what we can do and when to seek medical
help.
The menstrual cycle is the hormonal process that a woman's body goes through every month to prepare for a possible pregnancy. Regular menstrual periods during the years between puberty and menopause are often a sign that your body is functioning normally.
What Is The Menstrual Cycle?
The
menstrual cycle is a natural process that all women go through month after
month during their reproductive stage. It is a biological process that consists
of a series of hormonal, physiological, and emotional changes, which serve to
adapt the woman's body to carry out a pregnancy.
Duration of Normal menstrual cycle
It
happens every 28 days, although sometimes it can come sooner or later. That is,
in a range that goes from day 21 to day 35. As long as it is within these dates
and month after month it is considered as a regular or normal menstrual cycle.
Irregular Menstruation
When
menstruation occurs outside the aforementioned days, that is, before the 21st
or after the 35th, or in very long periods such as every two months, etc. it
is considered an irregular menstrual cycle.
What Are The Phases Of Menstruation?
To understand the factors that disturb the regular menstrual cycle, we better need to understand the phases of menstruation. Menstruation is divided into four phases: 1) menstruation; 2) follicular phase; 3) ovulation, and 4) luteal phase. Each of these phases does comprise a period of time and of course function.
1. Menstruation Phase: The first stage is the menstrual cycle, which lasts from day 1 to 5. The bleeding that occurs at this stage, as the uterus sheds its inner mucous lining (endometrium) through the vagina in form of discharge. Women usually have menstrual cramps caused by a contraction of the uterine wall during this stage. The muscles of the uterus contract on numerous occasions to get rid of the mucosa and the egg that was not fertilized by a sperm. In this stage, there are many hormonal changes, mood swings, discomfort, and more.
2. Follicular Phase: The follicular phase begins at the same time as the menstrual cycle but ends on the 13th day i.e. from the first day that the period begins until the day of ovulation. At this stage, the brain releases hormones into the bloodstream to the ovaries, which increase the production of follicles. Of the 15 to 20 eggs produced in the ovaries, only one matures and continues to produce the hormone estrogen.
3.
Ovulation Phase: Usually, this stage happens on the 14th day of the
menstrual cycle but can vary from woman to woman. At this stage, the pituitary
gland releases a hormone that causes the ovary to release a mature egg cell.
The released egg cell enters the fallopian tube by the cilia of the fimbriae.
The fimbriae are imaginary fingers found at the end of the fallopian tube
near the ovaries. Sometimes women feel a small lump in their right abdomen as
the egg is released. A mature egg will remain in the fallopian tube all day. In
the event of sexual intercourse, sperm cell reaches the mature egg to fertilize
it. When the egg is fertilized, it grows in the fallopian tube for about four
days and then moves slowly to the uterus by the 5th day. If the sperm cells
fail to fertilize the egg, the egg gradually disintegrates. During the time of ovulation,
testosterone is also released which increases the woman's libido.
4.
Luteal Phase: This phase lasts from day 15 to day 28.
The luteal phase begins a few hours after the ovulation process takes place and
the follicle itself will have a morphological change to give rise to the corpus
luteum also called the yellow body. The corpus luteum will begin to secrete
progesterone and less estrogen (female hormones). This secretory phase of the
endometrium helps to prepare the uterus, to adapt itself for possible
implantation.
When
the egg is fertilized, progesterone is released to the thickened lining of the
uterus for implantation. After 14 days, the hormone HCG is produced.
In the event that fertilization does not occur, progesterone decreases slightly and the body will begin to prepare for menstruation. In the following days, the process of disintegration of the ovum will begin and the endometrium will begin to shed, preparing the body for the next menstrual cycle.
Factors That Influence the
Length of the Menstrual Cycle
1. Age
Factor
Age is the first factor that influences the length of the menstrual cycle. A girl attends
her menarche or first rule at an age between 11-15 years and it is normal for a
young girl who is starting to have her period to have irregular period. At a
young age, a 5-day delay for discharge should not be a cause for concern. This
is due to the enormous fluctuation of hormone levels at this time of life, and
it sometimes takes several years for it to set in. It normalizes at the age of
around 20.
A woman in her thirties enjoys a normal length of the menstrual cycle. The age of forties is marked as the beginning of premenopause, a period again manifested by hormonal changes, which will accentuate the irregularity of the cycles. With each new month, menstruation will be delayed, which will gradually increase until it stops completely. She will then be menopausal. Menopause is a time when process delay is due to a natural and inevitable process, and you should take it calmly. The average indicator of the onset of menopause in women is 44-50 years of age.
2. Hormonal
Causes
One of
the most common reasons for irregularities in the menstrual cycle is hormonal
alterations. Proper hormonal balance is necessary to maintain a regular
menstrual cycle. The balance between estrogen and progesterone gets hampered
during puberty, menopause, pregnancy, and childbirth, and breastfeeding,
resulting in alteration of the menstrual cycle. Elevation in the level of the
prolactin hormone, which is produced by the pituitary gland to help the body
make milk, can cause irregular periods.
Having
problems with the thyroid hormone, specifically deficiencies (hypothyroidism),
can be one of the causes of these problems. Polycystic ovary syndrome (PCOS)
can also affect adequate hormone release and directly influence our menstrual
cycle. During PCOS a woman unusually has high levels of the male sex hormone,
androgen, or testosterone.
3. Certain
Diseases
Beyond
hormones, there are some diseases such as diabetes, liver, or kidney diseases
that can disturb the normal menstrual cycle.
Fibrosis
within the uterine cavity which is a benign growth of the uterine muscle may
cause irregular periods. Like fibrosis endometrial polyps i.e. overgrowth
of the lining of the uterus causes prolonged or heavy menstrual bleeding.
Blood
disorders, such as leukemia, platelet disorders, clotting factor deficiencies,
or less commonly, von Willebrand disease, prolong the period of menstrual
bleeding.
Uterine
or cervical cancer, in rare cases, can cause bleeding between menstruation or
during intercourse.
Urogenital infections (trichomoniasis, chlamydia, gonorrhea) can be a possible cause of menstrual absence.
4. Strenuous
and Demanding Sport-Related Amenorrhea
If you
do too much sport, your estrogen level, directly linked to the level of fat
mass, risks decrease to the point of causing irregular periods or even causing
them to disappear.
There
are various mechanisms that explain the appearance of amenorrhea: a shortening
of the luteal phase, low levels of estrogens, alterations in the secretion of
luteinizing hormone, etc. The body is an incredible machine that constantly
regulates itself by sending signals to the brain; your body will feel that it
does not have enough to feed a baby and suddenly take a break to save energy!
The problem will be the same if your body fat is insufficient due to a diet
that is too strict. According to research carried out in this regard, sports
that require a low body weight and a low level of fat are those with the
highest risk of affecting the menstrual cycle.
Of course, not all sports or exercise normally affect our menstrual cycle. However, there may be cases in which it influences the loss of menstruation. Some of these sports would be figure skating, rhythmic gymnastics, swimming, long-distance running, or cycling. The intensity and demand of these sports influence this effect, of course. Along with athletes women whose professional activities involve strenuous physical labor may also face alteration in the menstrual cycle.
5. Nutritional
Deficiencies
Disturbances
in eating behavior, and in particular anorexia or bulimia, automatically
disturbances of the menstrual cycle, or even cause amenorrhea.
Malnutrition
is another cause of irregularities in the menstrual cycle. On the one hand,
being too underweight (around 10% below normal weight) and with a very low
percentage of body fat can cause alterations in the menstrual cycle and even
the appearance of amenorrhea. Anorexia in fact generates a severe estrogen
deficiency, causing ovulation to stop and atrophy of the uterine lining.
On the
other hand, the very high body weight and the presence of overweight can also
influence the alterations of the menstrual cycle. In the case of obesity, the
absence of ovulation is associated with a high and stable level of estrogen,
without cyclic secretion of progesterone, which causes a permanent thickening
of the endometrium, which must be monitored. Being overweight can affect
hormonal production and this influences the menstrual cycle.
This can cause difficulties when trying to get pregnant, among other things. Without going to these extremes, it is obvious that the right food balance contributes to the regularity of the cycles.
6. Effect
of Stress and Anxiety
Your
menstrual cycle is governed by your hormonal system whose fragile balance can
be shaken by the slightest psychological shock: stress, fatigue, depression,
state of shock, sleep disorders, but also more simply fear of an examination or
excitement on the eve of an expected party, are all states or circumstances
which, depending on the sensitivity of each, will disrupt the regularity of the
cycles.
Stress can directly affect your body, causing hormonal alterations, and these influence our menstrual cycle. The most common cause is hypothalamic alterations. High levels of stress can affect the release of the hormone GnRH (Gonadotropin-releasing hormone) which impacts the release of the hormones FSH and LH and impacts ovulation. During constant stress, the brain “goes on strike” – HGH (Human growth hormone) does not produce the hormone that is responsible for menstruation and disrupts the menstrual cycle. To prevent this from happening, you need to relax, be less anxious, if necessary you may need to consult a psychologist or neuropsychiatrist.
7. Consumption
of Some Medications
In addition to physical causes, the consumption of some medications can affect the menstrual cycle. Specifically, the use of antidepressants, antipsychotics, psychotropic drugs for depression, or antihistamines for allergies can block the onset of menstruation by increasing the level of prolactin. Hormonal therapies, corticosteroids, chemotherapy, or blood pressure medication also can cause similar complications. To resolve the issue, you need to consult your doctor about reducing the dose.
8. Refusal
To Take Hormonal Contraceptives
If a
woman has been taking contraceptives for a long time, which
"deceives" the pituitary gland and hypothalamus, forcing the ovaries
to cease functioning, the body cannot rebuild quickly as soon as it stops
taking synthetic hormones. It causes ovarian hyper-inhibition syndrome and
requires a little time for the ovaries to become fully functional and
synchronized. The use of certain pills or IUDs that contain progestins tends to reduce or even stop menstrual flow.
What Can You Do When These Alterations Of
The Menstrual Cycle Occur?
The
first thing to do when you face alterations in your menstrual cycle is to know the
cause so that you know what to do.
As for
what you can do, there are some keys to our lifestyle that can help you to
prevent or reduce the risk of these alterations of the menstrual cycle from
appearing. When the causes are excessive sports or malnutrition, regulating
caloric intake, adapting nutritional needs, and ensuring we have a healthy lifestyle can help balance hormonal function.
In the
case of athletes with a very high level of demand and a sport that places great
importance on bodyweight, you need to consult your trainer or physiotherapy to
recalibrate your diet or exercise regime.
It may be necessary to receive psychological help if the cause is stress. Counseling can help as well. In these cases, learning relaxation techniques, such as diaphragmatic breathing, Jacobson's relaxation, can be of great help.
When to See a Doctor?
It is
possible that you have irregularities once or twice and then your cycle returns
to normal, but if this is not the case it is important that you should go to
the doctor so that she can assess the causes of these alterations.
It is
important that if you observe any of the symptoms listed below, you contact
your gynecologist:
·
You
haven't had your period in 3 months.
·
You
have your period more often than every 21 days.
·
You
have your period less often than every 35 days.
·
Your
period lasts more than a week.
·
You
bleed between your rules.
·
You
experience a lot of pain.
Your gynecologist will first assess whether the person is pregnant. If pregnancy is ruled out, other tests may be done, such as blood tests, thyroid function evaluation, hormonal analysis, ultrasounds, CT scans, etc. Depending on the results, your doctor will indicate the treatment to follow.
Although
we all experience the menstrual cycle differently, you are not alone. There
will be times when you will have less energy, but that is not why you should
stop living your life to the fullest. Now that you know, take advantage of each
phase of your cycle to enhance your qualities and enjoy yourself and your
surroundings more. You deserve the best.
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