Some young women feel it coming days before they get it. Others are hardly aware they have it. Friends who compare notes about their periods will probably find that menstruation--the monthly shedding of the lining of the uterus--affects each of them a little differently, both physically and emotionally. The menstrual cycle has its ups and downs as different women react differently to hormonal swings. Just before and during menstruation, levels of the female hormones estrogen and progesterone are low. That's when some women feel bloated, irritable or blue, or "just crummy" with cramps, sore breasts, backache, headache or feeling tired. A day or two after a women's period starts they begin to feel better as hormone levels go back on the upswing.
Cramps - A Common Complaint More than half of menstruating women have cramp-like pain during their periods. The medical term for menstrual pain is dysmenorrhea. Cramps are usually felt in the pelvic area and lower abdomen, but can radiate to the lower back or down the legs. Often the cramps are severe enough to keep a teen home from school. Women often go through phases when cramps are severe, then get better for several years, and then maybe worsen again. Mechanically, cramps are like labor pains. Just as the uterus contracts to open up the cervix (neck of the uterus) and push out a baby, it contracts to expel menstrual blood. Often, after several years of menstruating or after childbirth, the cervical opening enlarges. The uterus doesn't have to contract as much to discharge the menstrual flow, so there is less cramping. Menstrual pain may also come from the bleeding process itself. When the uterine lining separates from the wall, it releases chemicals called prostaglandins. Prostaglandins cause blood vessels to narrow, impeding the supply of oxygen to the uterus. Just as the pain of a heart attack comes from insufficient blood to the muscles of the heart, too little blood to the uterine muscle might cause the pain of menstrual cramps. Menstrual pain can have other causes, although these are rare among teenagers. They include tumors, fallopian tube infection, and endometriosis, a condition in which fragments of the lining of the uterus become embedded elsewhere in the body. Sometimes, simple measures are all that's needed to feel better. Cutting down on salt might help reduce fluid buildup, and support hose may alleviate swelling in the legs or ankles. Crawling into bed for some extra rest or sleep is one way to deal with fatigue, and taking along a heating pad or hot water bottle eases cramps for some. Exercising also helps reduce pain in many young women, and may lift a blue mood as well. Exercising during menstruation lessens pain because it causes release of brain chemicals called endorphins, which are natural painkillers. Exercise may also decrease pain by affecting prostaglandin metabolism.
Monthly Changes Menstruation is just one part of the menstrual cycle, in which a woman's body prepares for pregnancy each month. A cycle is counted from the first day of one period to the first day of the next. An average cycle is 28 days, but anywhere from 23 to 35 days is normal. Estrogen and progesterone levels are very low at the beginning of the cycle. During menstruation, levels of estrogen, made by the ovaries, start to rise and make the lining of the uterus grow and thicken. In the meantime, an egg (ovum) in one of the ovaries starts to mature. It is encased in a sac called the Graafian follicle, which continues to produce estrogen as the egg grows. At about day 14 of a typical 28-day cycle, the sac bursts and the egg leaves the ovary, traveling through one of the fallopian tubes to the uterus. The release of the egg from the ovary is called ovulation. Some women know when they're ovulating, because at mid-cycle they have some pain--typically a dull ache on either side of the lower abdomen lasting a few hours. The medical word for this is mittelschmerz, from the German, meaning middle pain. Some women also have very light bleeding, or spotting, during ovulation. After the egg is expelled, the sac--now called a corpus luteum--remains in the ovary, where it starts producing mainly progesterone. The rising levels of both estrogen and progesterone help build up the uterine lining to prepare for pregnancy. The few days before, during and after ovulation are a woman's "fertile period"-the time when she can become pregnant. Because the length of menstrual cycles vary, many woman ovulate earlier or later than day 14. It's even possible for a woman to ovulate while she still has her period if that month's cycle is very short. (Stress and other things can sometimes cause a cycle to be shorter or longer.) If a woman has sex with a man during this time and conception occurs (his sperm fertilizes the egg), she becomes pregnant. The fertilized egg attaches to the uterus, and the corpus luteum makes all the progesterone needed to keep it implanted and growing until a placenta (an organ connecting the fetus to the mother) develops. The placenta then makes hormones and provides nourishment from the mother to the baby. If an egg is not fertilized that month and the woman doesn't get pregnant, the corpus luteum stops making hormones and gets reabsorbed in the ovary. Hormone levels drop again, the lining of the uterus breaks down, menstruation begins, and the cycle repeats
Cramps - A Common Complaint More than half of menstruating women have cramp-like pain during their periods. The medical term for menstrual pain is dysmenorrhea. Cramps are usually felt in the pelvic area and lower abdomen, but can radiate to the lower back or down the legs. Often the cramps are severe enough to keep a teen home from school. Women often go through phases when cramps are severe, then get better for several years, and then maybe worsen again. Mechanically, cramps are like labor pains. Just as the uterus contracts to open up the cervix (neck of the uterus) and push out a baby, it contracts to expel menstrual blood. Often, after several years of menstruating or after childbirth, the cervical opening enlarges. The uterus doesn't have to contract as much to discharge the menstrual flow, so there is less cramping. Menstrual pain may also come from the bleeding process itself. When the uterine lining separates from the wall, it releases chemicals called prostaglandins. Prostaglandins cause blood vessels to narrow, impeding the supply of oxygen to the uterus. Just as the pain of a heart attack comes from insufficient blood to the muscles of the heart, too little blood to the uterine muscle might cause the pain of menstrual cramps. Menstrual pain can have other causes, although these are rare among teenagers. They include tumors, fallopian tube infection, and endometriosis, a condition in which fragments of the lining of the uterus become embedded elsewhere in the body. Sometimes, simple measures are all that's needed to feel better. Cutting down on salt might help reduce fluid buildup, and support hose may alleviate swelling in the legs or ankles. Crawling into bed for some extra rest or sleep is one way to deal with fatigue, and taking along a heating pad or hot water bottle eases cramps for some. Exercising also helps reduce pain in many young women, and may lift a blue mood as well. Exercising during menstruation lessens pain because it causes release of brain chemicals called endorphins, which are natural painkillers. Exercise may also decrease pain by affecting prostaglandin metabolism.
Monthly Changes Menstruation is just one part of the menstrual cycle, in which a woman's body prepares for pregnancy each month. A cycle is counted from the first day of one period to the first day of the next. An average cycle is 28 days, but anywhere from 23 to 35 days is normal. Estrogen and progesterone levels are very low at the beginning of the cycle. During menstruation, levels of estrogen, made by the ovaries, start to rise and make the lining of the uterus grow and thicken. In the meantime, an egg (ovum) in one of the ovaries starts to mature. It is encased in a sac called the Graafian follicle, which continues to produce estrogen as the egg grows. At about day 14 of a typical 28-day cycle, the sac bursts and the egg leaves the ovary, traveling through one of the fallopian tubes to the uterus. The release of the egg from the ovary is called ovulation. Some women know when they're ovulating, because at mid-cycle they have some pain--typically a dull ache on either side of the lower abdomen lasting a few hours. The medical word for this is mittelschmerz, from the German, meaning middle pain. Some women also have very light bleeding, or spotting, during ovulation. After the egg is expelled, the sac--now called a corpus luteum--remains in the ovary, where it starts producing mainly progesterone. The rising levels of both estrogen and progesterone help build up the uterine lining to prepare for pregnancy. The few days before, during and after ovulation are a woman's "fertile period"-the time when she can become pregnant. Because the length of menstrual cycles vary, many woman ovulate earlier or later than day 14. It's even possible for a woman to ovulate while she still has her period if that month's cycle is very short. (Stress and other things can sometimes cause a cycle to be shorter or longer.) If a woman has sex with a man during this time and conception occurs (his sperm fertilizes the egg), she becomes pregnant. The fertilized egg attaches to the uterus, and the corpus luteum makes all the progesterone needed to keep it implanted and growing until a placenta (an organ connecting the fetus to the mother) develops. The placenta then makes hormones and provides nourishment from the mother to the baby. If an egg is not fertilized that month and the woman doesn't get pregnant, the corpus luteum stops making hormones and gets reabsorbed in the ovary. Hormone levels drop again, the lining of the uterus breaks down, menstruation begins, and the cycle repeats
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