Menstruation: Challenges and Coping Mechanisms

What is Menstruation?

Menstruation, more commonly known as periods or bleeding, is a normal biological process, in which there is monthly expulsion of blood and cellular fragments from the uterus.
Menstruation is a process in woman where they discharge (through the vagina) blood and other materials from the lining of the uterus at about one-month interval.
Menstruation is a normal vaginal bleeding that takes place as a part of women’s monthly cycle. It lasts for around 3-5 days.
Menstruation is a natural process of being cleared of what the womb no longer needs.
It is also considered as a hormonal process that a woman’s body goes through each month to prepare for a possible pregnancy.
Menstruation occurs when the uterus or womb sheds its lining, if the pregnancy does not occur.
Menstruation is necessary to rid the body of the uterine inside layer that has built up in preparation for pregnancy.
Menstruation usually starts (in female) at the age of 11-14 and stops at about the age of 45-55 years.
During menstruation, a female can undergo various physical and mental difficulties/challenges. Some of them are:
- Lower back pain
- Bloating
- Sore breasts
- Abdominal and pelvic cramping
- Mood swings
- Irritability
- Headache
- Fatigue
- Food craving
- Anxiety
- Insomnia

PMS occurs 1-2 weeks before the period begins. PMS can cause different symptoms like;

Dysmenorrhea refers to severe menstrual pain.
Possible causes include uterine fibroids, endometriosis, and excessive levels of a hormone called prostaglandin.
There are two forms of dysmenorrhea:
- Primary dysmenorrhea– which is excruciating cramping (with or without nausea and diarrhea) not linked with any other pelvic disorder. Primary dysmenorrhea is more common and normally starts in the teen years.
- Secondary dysmenorrhea– is pain linked with the additional pelvic problem. For instance; endometriosis, pelvic inflammatory disease, or fibroids.

Heavy menstrual bleeding (which could contain clots of blood) or bleeding on outside the common cyclic menstruation is stated to as abnormal uterine bleeding (AUB).
Heavy period is also known as menorrhagia.
During heavy bleeding, period can be longer than the average of five to seven days.
Some of the common causes of heavy periods are:

Not having period or absent period is also known as amenorrhea.
If you don’t get the 1^st period by the age of 16 years, it is considered as primary amenorrhea.
Secondary amenorrhea occurs when you stop getting your regular periods for six months or more.
Some of the common causes of amenorrhea are:

Studies indicate that women with an anxiety disorder or substance use disorder are about to have limited menstrual cycles (shorter than 24 days).
Irregular cycles are likewise associated with eating disorders and depression.
Women with bipolar disorder are similarly even more about to have irregular periods.

Mood change is common during pre-menstruation and menstruation.
It is not surprising to experience mood changes before period, comprising a certain level of depression and emotional irritability.
Alternatively, girls or women might have realistic expressions of emotional state that are not generally calm enough or protected enough to express.

It is a more severe form of PMS, disturbing 5-10% of women in their reproductive years.
PMDD is categorized by more substantial premenstrual mood disorder that can extremely affect relationships and weaken functioning.
Several women with PMDD experience clinical intensities of depression or anxiety throughout the week or two before every single menstrual cycle.

Menopause is defined as the long-lasting end of the menses.
Perimenopause is defined as the temporary period from normal menstrual periods to no periods in the least.
At this time, menstrual periods slowly lessen and turn out to be less recurrent. The change to complete menopause might last anywhere from a limited month to a few years.

The term ‘PMS’-premenstrual syndrome, is frequently used with words like “symptoms” and “treatments,” as although premenstrual changes are an ailment. This does not reveal the actual and important difference in experiences.
‘Premenstrual dysphoric disorder’ (PMDD), is used to define a severe and uncommon form of premenstrual depression.

Oncoming middle age regularly passes bigger stress, anxiety, and fear. This can partly be endorsed to physical variations, such as decreasing levels of estrogen and progesterone. Hot flashes, perspiring, and further symptoms of menopause could cause interferences.
There can also be emotional fluctuations, such as uncertainties about getting older, losing family memberships, or family’s separation.
For particular women, menopause might be a phase of isolation or obstruction. Family and friends may not constantly appreciate what a person is going through, or provide support in the time of need.

During PMS and menstrual mood swings family members and partners should provide necessary assistance and have empathy while dealing with them.
Couples counseling reduces symptoms of reasonable to severe premenstrual symptoms.

One-on-one therapy can lessen symptoms of premenstrual stress. The emphasis is on assisting the woman to realize the backgrounds of her symptoms and improve coping strategies.
Therapy also includes taking time-out for self-care, dodging conflict, articulating necessities for upkeep, and decreasing life stress.
Medical management, such as antidepressant SSRIs (selective serotonin re-uptake inhibitors), can be effective to aid women dealing with premenstrual stress, psychological therapy is more operational in the long run.
Couple-based therapy is also considered as the furthermost effective in refining relationships and lessening premenstrual misery.

Yoga and meditation is also very effective to deal with physical and mental stresses during menstruation.
It helps to relieve the pain and creates mental positivity

About 40% of women report modest to severe premenstrual stress in the three to four days in advance to their menstrual cycle.
For women who undergo from moderate to severe premenstrual stress, these problems can be left to seethe for three weeks of every single month, when they can be suppressed or unnoticed.
Thus, family members and spouse should ensure that they provide enough care and support to the female during these times.