WHAT IS A PERIOD?

What is a Period?

A period is also called menstruation and is when blood and tissue that was building on the uterus gets released out of the body though the vagina. Periods happen during your monthly menstrual cycle. Periods last for an average of five days and can range from two to seven days. Your flow will be heavier the first two days of your period. Heavy flows will have red blood, and lighter flows will have pink or brown blood. You will lose a few tablespoons of blood when on your period.

What is Your Menstrual Cycle?

Your menstrual cycle is a monthly hormonal cycle that prepares you for pregnancy. There are changes with the hormones in your body. Hormones are chemical messengers. The hormones estrogen and progesterone are released from your ovaries which causes the lining of your uterus to thicken. When the lining of your uterus thickens, it prepares to support a pregnancy and to hold an egg. The hormones also cause an egg to leave an ovary. The egg travels down the fallopian tube which is a thin tube to the uterus. If the egg is fertilized by a sperm cell in the fallopian tube, it is called a zygote and continues traveling down the fallopian tube to the uterus where it attaches itself to the uterine wall. The zygote eventually grows into a baby. However, if no fertilization occurs, the uterus lining breaks down, causing your period/menstruation. If you are not pregnant, the levels of estrogen and progesterone will start to decrease. This signals your endometrium, the uterus lining, to break down.

How Often Do Periods Occur?

Periods usually occur about every 28 days, but can occur more frequently or less frequently. A good range can be every 23 days to every 35 days.

Within the first year you start your period, it may not come every month, but this is normal. However, after two to three years, your period should become more regular and occur every 4 to 5 weeks

When Will You Get Your Period?

Girls usually get their periods between the ages of 8 to 15. The average age of when girls get their periods is 12. Some clues that may tell you your period may happen soon is when:

Your breasts start developing (Your period will usually happen about 2 years afterwards).
Pubic Hair is growing (Your period will usually happen about 2 years afterwards).
You receive vaginal discharge which is a kind of mucous that you see/feel on your underwear. This happens about 6 to 12 months before you get your first period.

Symptoms When on Your Period

Symptoms when you are on your period include:

Cramps in your abdominal area or your pelvis
Lower back pain
Bloating
Craving certain foods
Headaches
Tiredness

Several girls experience cramps when on their period. Try placing a warm heating pad on your belly or taking ibuprofen. Before taking ibuprofen or any medication, please follow instructions on the package for the correct dosage and/or contact your doctor for instructions on how to take the medication.

PMS

PMS, also called premenstrual syndrome, is when girls experience emotional and physical symptoms before their period. The symptoms include mood swings, sadness, stress, acne, and bloating. The symptoms will end a few days after your period begins. Not everyone who menstruates experiences PMS.

Douching

Douching is when you clean out the inside of your vagina with water or fluid mixtures made of water and vinegar, baking soda, or iodine. The mixture usually comes in a bottle that is inserted into your vagina to clean out excess blood. This is different from rinsing the outside of your vagina when bathing or showering. Douching may lead to several different health complications.

The majority number of doctors do not recommend that women douche. It may change the balance of the vaginal flora which is bacteria in the vagina, and it may change the natural acidity of a vagina that is healthy. Healthy vaginas have good and bad bacteria, and the balance of the bacteria contributes to an acidic atmosphere which prevents the vagina from feeling irritated or getting an infection. Douching can cause the bad bacteria to overgrow which could lead to a yeast infection or bacterial vaginosis. If you have a vaginal infection already and you are douching, the douching may cause the bad bacteria to go up into the uterus, fallopian tubes, and ovaries which could lead to pelvic inflammatory disease.

The best way for vaginal cleaning is to let the vagina naturally clean itself. The vagina will clean itself by making mucous. Wash the outside of your vagina with warm water when bathing or showering. You may use mild soap to clean the outside of your vagina. However, if you have sensitive skin or an already present vaginal infection, the mild soap my cause dryness of irritation of your vagina. Also, it is recommended to refrain from using tampons, pads, powders, and sprays as they could increase your chances of getting a vaginal infection.

Bacterial Vaginosis

Bacterial Vaginosis (BV) is when there is pain in the vagina because your levels of natural bacteria, or vaginal flora, are unbalanced. Normally, the good bacteria, lactobacilli, outnumber the bad bacteria, anaerobes, in your vagina. Having this balanced level of bacteria keeps the vagina healthy, but if too many anaerobes bacteria grow, it can lead to getting BV. Bacterial vaginosis is usually common during the reproductive age range. Since your hormones are changing, the bad bacteria have an easier chance to grow.

Some symptoms indicative of BV can include the presence of gray, white, or green vaginal discharge, a fishy odor coming from your vagina, vaginal itching, or a burning sensation when urinating. If you are experiencing any of these symptoms, you should visit your doctor.

Some complications of Bacterial Vaginosis lead to a increased chance of getting sexually transmitted diseases such as herpes simplex virus, chlamydia, or gonorrhea. Having BV can also increase your chances of getting an infection after gynecological surgeries including hysterectomies and dilations. BV may also lead to Pelvic Inflammatory Disease which is an infection of the uterus and fallopian tubes.

Some ways to help prevent contracting BV is to use unscented products to wash your vaginal area or just clean your vaginal area with warm water, You should also use unscented tampons or pads and avoid douching. Practicing safe sex or abstinence (not having sex at all) are other ways to help prevent getting BV.

Toxic Shock Syndrome (TSS)

Toxic Shock Syndrome (TSS) is a rare bacterial infection caused by Staphylococcus aureus (staph) bacteria or Streptococcus pyogenes (strep) bacteria. More cases of TSS are caused by staph bacteria with half the cases of TSS that are related to staph bacteria occurring in women that are menstruating. The other cases of TSS caused by staph bacteria may occur in older women, men, and children. TSS related to strep bacteria can occur in people of all ages. TSS is linked to the use of very absorbent tampons, but changing the tampon very often has led to a decreased number of TSS cases. TSS has also been associated with having skin wounds, recent surgery, or a viral infection. The use of contraceptive sponges, diaphragms, and menstrual cups have also been linked to TSS. Complications of TSS include shock, kidney failure, or possibly death.

Some symptoms of TSS include high fever, vomiting, diarrhea, muscle aches, mental confusion, lethargy, decrease in urination, low blood pressure, and rash on the palm of hands and soles of feet. Other symptoms of TSS may include redness of eyes, throat, inside of mouth, and inside of the vagina.

Make sure to notify your doctor immediately if you have any symptoms of TSS. This is important especially if you have used tampons lately or you have a skin or wound infection. If the doctor diagnose you with TSS, they will make sure you have IV fluids and antibiotics as soon as possible. Patients with TSS will usually stay in the hospital and possibly the ICU for several days. Doctors will monitor their blood pressure, breathing, and check for organ damage.

Prevention methods include washing your hands thoroughly to stop bacteria from spreading. When females are on their periods, prevention methods include washing your hands thoroughly before and after inserting a tampon. It is also suggested to not use tampons or limit your tampon use by wearing pads certain on certain days. It is also better to use tampons that have a lower absorbency level. You should also change the tampon often (every 4 to 8 hours), and using pads instead of tampons when you have a light flow. When not on your period, place your tampons in a place where bacteria are not able to grow (do not place tampons in warm and moist areas). The U.S Food and Drug Administration orders that manufacturers print the absorbency levels and recommendations on the boxes. If you have had TSS or a serious staph or strep infection in the past, do not use tampons. If you have a skin wound, make sure to treat it as soon as possible. If the wound shows signs of infection or you have a fever, call your doctor.

Urinary Tract Infection (UTI)

A Urinary Tract infection (UTI) is an infection that can occur anywhere in the urinary system which includes your kidneys, ureters, bladder, and urethra. Most Urinary Tract Infections will occur in the lower urinary tract which are the bladder and the urethra. If left untreated the infection may travel to the kidneys.

UTIs occur when bacteria enter the urinary tract through the urethra and spread in the bladder. Although the urinary system is supposed to prevent bacteria from entering, the defenses can fail which leads to bacteria entering and growing into an infection in your urinary tract.

Symptoms of UTIs include frequent urination, a burning sensation when urinating, urine that is red, bright pink, or brown, urine with a distinct odor, unusual discharge, cramps in the lower abdomen, pain in your back or side, pelvic pain, fever, vomiting, trembling, and chills.

The common UTIs usually occur in women and affect the urethra and bladder:

A urethra infection can occur if bacteria spreads from the anus to the urethra. A urethra infection can also be caused by sexually transmitted infections (STIs). Sexually transmitted infections include herpes, gonorrhea, chlamydia, and mycoplasma. STIs can happen because women’s urethras are close to their vagina.

Bladder infections are typically caused by Escherichia Coli (E. Coli) which is a type of bacteria that is usually found in the gastrointestinal (GI) tract. Being sexually active may increase increase your chances of a bladder infection. However, all women are susceptible bladder infections because of their body structure. In women’s bodies, the urethra is close to the anus, so bacteria from the anus can easily enter the urethra and enter the bladder.

UTIs commonly occur in women. Here are some risk factors that affect women specifically:

Female anatomy: Women have shorter urethras compared to men , so bacteria can enter the bladder faster.

Sexual activity: Being sexually active increases your chances of getting a UTI.

Birth control methods: Using diaphragms for birth control or spermicidal agents can raise the risk of UTIs.

Menopause: After women reach menopause, there is a decline in estrogen that will cause changes in the urinary tract which increases the chances of getting UTIs.

Additional risk factors include:

Urinary tract problems: If an infant is born with a problem in the urinary tract, there may be trouble urinating because the urine gets backed up in the urethra, increasing the chances of getting a UTI.

Urinary tract obstacles: Kidney stones or an enlarged prostate may trap urine in the bladder which increases the chance of getting UTIs.

Immune system problems: Having diabetes or other diseases weakens the immune system which is the body’s protection against germs, leading to an increased risk of UTIs.

Catheter usage: People that cannot urinate by themselves usually use a tube called a catheter to urinate, but this increases the risk of UTIs.

Urinary procedures that were recent: If you have had a recent urinary surgery or an examination of your urinary tract that used medical instruments, there is a higher chance of getting a UTI.

Complications of a UTI can happen if they are not treated properly:

Repeated infections means that you have at least two UTIs within six months or at least three in a year. Women are likely to have repeated infections.
Lasting kidney damage caused from a kidney infection because of a UTI that was not treated properly.
When a UTI occurs during pregnancy, this could result in the infant being born prematurely or being born with a low birth weight.
Repeated urethra infections in men can cause a narrowing of their urethra.
If the infection of the urinary tract spreads to the kidneys, this may result in sepsis, which is a life threatening complication.

Prevention of UTIs:

Drinking plenty of water: Drinking water will dilute the urine which will help you urinate more often. Urinating frequently will cause the bacteria to be removed from your urinary tract before the bacteria causes an infection.

Wipe from front to back: Do this motion after you have urinated and after you have had a bowel movement. This helps stop the spread of bacteria from the anus to the vagina and the urethra.

After sexual activity: Urinate right away to empty your bladder and drink a full glass of water to get rid of the bacteria.

Do not wear products that may be irritating: Using the irritating products in the genital area could irritate the urethra. Examples of the products include deodorant spays, douches, and powders.

Switch birth control methods: Using diaphragms, unlubricated condoms or condoms that have spermicide can increase bacterial growth.

Menopause

Women will reach menopause which is when their periods permanently stop and they cannot get pregnant anymore. Your body will transition to menopause over a few years. Perimenopause is the transition to menopause. This transition usually starts when a women is in her mid-to-late 40s. Perimenopause lasts about four years before periods stop permanently. During this time, your hormone levels are changing unexpectedly which may cause random menopause symptoms. Additionally, your ovaries are making different levels of hormones (Estrogen and Progesterone) than normal. Unusual periods occur during the transition because ovulation may not be occurring every month. Your periods and your menstrual cycle may randomly be shorter or longer, and sometimes you will get your period several months later since the last one. Your flow during your period could be lighter or heavier compared to past periods, and you may experience hot flashes and have trouble sleeping.