The menarche is a late feature of puberty.The first period may be short or long,thereafter the cycle is often irregular,periods occuring sometimes every few month,sometimes too frequently.A more or less regular rhythm is usually established within 2-3 years.
During active reproductive era menstruation occurs at approximately 28-day interdals.Each woman tends to have her own rhythm although it may change after marriage or chieldbearing.Any regular cycle of 3-5 weeks is arbitrarily accepted as normal.
There are wide variations in the duration and amount of blood loss.The duration is the most often from 3 to 5 days.
The menstrual flow is called menses.It begins as a pink discharge consisting of cervical mucus and blood and is rich in leucocytes.It is havier in the second and third days when it is dark red in colour and consists of blood,endometrial and cervical secretion,endometrial debris and bacteria.
The discharge has a chracteristic odour caused partly by bacterial action and degeneration,and partly by accompanying secretions of sebaceous and apocrine glands on the vulva.
The total loss of blood varies from 5 to 60 or 80 ml.Small clots are noticed occasionally by 50% of women.
General disturbances associated with menstruation:
Menstruation is frequently accompanieted by minor physical and nervous disturbances.It is estimated that only 20% of wemen are completely free from disconfort.general manifestations mainly occur premenstrually and include a feeling of lethargy and tiredness,malaise,depression,excitability and irritability,headache,fullness and tenderness of the breasts,inability to concentrate and impairment of efficiency and both mental and physical activities.
Other changes:tendency to constipation(with abdominal distention) premenstrually and more frequent motion during menstruation.Nausea and vomiting may occur.Skin changes include shadows under the eyes and few acne spots on the face,back or chest.
One-third of women temporarily gain 1,4kg or more in weight premenstrually.
Management of normal menstruation:
The menstrual discharge is contained either by menas of sanitary pad applied to the vulva or by an absorbant tampon placed within the vagina.In either case regular and frequent chanfge are necessary.
Intravaginal tampons are popular becose they are confortable.It is said that they shorten the apparent duration of the period by 24 hours becose the last day of the flow ordinarily consists only of drainage from the vagina.Their disavantages are:
-they cannot be used unless the hymen is torn or streched
-they are inefficient if the flow is heavy
-you can do toxic shock syndrome(TSS).it can be reduced by using pads at night.
Vaginal douching with deodorant powders or sprays as a hygienic measure at the end of a period,or at any other time,is unnecessary and potentially hurmful becose is washed away the natural protective discharges.The vagina can take care of itself.
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