By Dr Bolanle Aderehinwo
Menstruation is a very important aspect of a woman, it’s the monthly flow of blood from the reproductive tract of a sexually matured non pregnant woman. It does not happen in a pre-adolescent and in a woman who has reached menopause.
Menstruation is due to a hormonal controlled cyclical trend called menstrual cycle. History of menstrual flow is important in a woman with infertility and it speaks a lot of what may be happening or going on in the womb and Ovaries of the woman.
This menstrual cycle in most women is about 28+/- 2 days, however the normal is between 21- 35 days with the first day of flow noted as the first day of the cycle.
A cycle above 35 days is considered abnormal so also the one shorter than 21 days. Menstrual cycle has 3 phases. 1. Menstrual phase: This takes an average of about 2-7 days. Blood flowing down is usually about 50 to 80 mls with most women using an average of 2 pads per day under normal circumstances.
The blood contained cellular debris, blood from broken down blood vessels, discharges from the cells lining the womb and the unfertilised egg that was released during ovulation. 2. Follicular phase: starts immediately after the menstrual phase. It takes about 7 to 19 days. Usually difficult to say the number of days but it starts at the end of menstruation and ends with ovulation.
Vaginal discharge at this period is usually Milky, yellowish or off white, like a pap. In this phase the lining of the womb that was shed in the menstrual phase grows back, more blood vessels build up and the womb lining becomes thick in preparation for implantation of a possible conception. At this phase too, estrogen and progesterone starts building up to ensure those processes .
Also the hormone Fsh (follicle stimulating hormone) is at work causing gradual maturation of follicles which will later release an ovum at the peak of the LH (Luteinizing Hormone) another hormone that leads this phase to the next phase. Once the egg is released, we enter the next phase. 3. Luteal phase: This phase starts with ovulation.
It is usually for 14 days, it is the only phase that is fairly constant. It is the phase in which the egg survives for fairly 12hrs, the follicles that releases an egg starts secreting some progesterone and HCG (Human Chorionic Gonadotropin) if conception should occur.
In this phase too the womb lining starts secreting glucose containing fluids and some discharges in order to take care of the expected product of fertilization and in preparation for implantation (the embedding of the product of fertilization in the lining of the womb).
The vaginal discharge starting this phase is the egg white type and after the end of viability of the egg, the vaginal discharge becomes thickened and dry towards the end of the cycle.
This phase ends with the beginning of another menstrual flow. The above description is for under normal circumstances. The Knowledge of this cycle is important for women who are waiting to conceive. Next knowledge you must acquire is that of ovulation and ovulation tracking.
Dr Bolanle Aderehinwo