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Menstruation is part of a woman's monthly hormonal cycle, which results in blood discharging from the vagina. This discharge contains the lining of the uterus, which thickens each month to provide a bed for a fertilised egg (pregnancy). If pregnancy does not occur, this lining breaks down and is released through the vagina. The average duration of menstruation is 5 days and it recurs approximately every 4 weeks throughout the reproductive life of a female.

One of the major changes in any girl's life is the onset of her periods (Menstruation) which occurs at 12 years of age on average but can begin anywhere between the ages of 9 and 17 years. The first time a girl has a period it shows that her body has started releasing eggs (all of which are present from birth) and that she is capable of becoming pregnant.

Each month a woman's ovaries release an egg (ovulation). From the ovaries, the egg moves down through the fallopian tubes and into the uterus (womb). If the woman has intercourse and this egg is fertilised by a male sperm, the egg plants itself in the wall of the uterus where it begins to grow and develop into an embryo. This is called conception and the woman is now pregnant.

Every month the uterus prepares for a possible pregnancy by increasing the thickness of the lining. This lining allows an egg to fertilise and grow into a baby. If a fertilised egg does not arrive, the thickened lining is not needed and breaks down to be discarded from the body. It is this lining, together with some blood, that flows out through the vagina causing the monthly period or menstrual flow.

Menstruation is controlled by the actions of certain hormones in the body. Follicle stimulating hormone (FSH) causes the eggs in the ovaries to mature and each egg produces oestrogen. Luteinising hormone causes the egg to be released from the ovaries (ovulation). The body then produces the hormone progesterone and this causes the lining of the uterus to thicken. At this time if the egg is not fertilised by a male sperm then hormone levels drop and Menstruation occurs. Some women suffer from an imbalance in hormonal levels and because of this the regular menstrual cycle can become dysfunctional.

An entire menstrual cycle normally takes 28 days. Menstruation lasts for approximately 5 days. A girl's periods are usually irregular for the first few months as it takes time for a pattern to be established. Some women continue to have irregular periods and others are as regular as clockwork. Unlike the male, a woman's reproductive life is limited, ceasing when she reaches menopause at around the age of 50.

Your Doctor can answer any queries you may have about the Menstruation process. As with all conditions, your Doctor should be consulted if there is any discomfort or irregularity associated with Menstruation.

• Fish is a good source of essential fatty acids, which have an anti-inflammatory action, which may help to relieve the pain associated with Menstruation.
• Iron can be lost from the body in menstrual blood and deficiencies may occur resulting in tiredness, weakness, a pale complexion, poor concentration, poor memory, infections and irritability. Iron supplementation should always be under the supervision of your Doctor or Pharmacist as some people can absorb too much iron from supplements. Try to include foods in the diet, which are high in iron e.g., lean red meat, green leafy vegetables and chickpeas.
• Due to the hormonal shifts that occur during Menstruation, pimples often occur around the same time as a period begins. Foods which are high in zinc (e.g., oysters, crab and lean beef) may help to improve the healing time of the skin. Try to drink at least 6 to 8 glasses of fresh, filtered water daily. This may also help to keep the skin clear.

Vitamins and minerals may only be of assistance if dietary intake in inadequate.
• Vitamin B complex, (especially vitamin B6 and folic acid), may assist with the tension associated with Menstruation.
• Essential fatty acids from fish oils may relieve menstrual symptoms due to their anti-inflammatory properties.
• Black cohosh and vitex agnus-castus herbs may assist in balancing menstrual hormonal problems.

Ask your MedAux Pharmacist for any information you may need about Menstruation.
1. A wide range of sanitary pads and tampons are available to absorb the menstrual flow. Ask your Pharmacist to recommend the best type for your needs.
2. Some women experience pain around the lower abdomen, especially just prior to and during the first few days of Menstruation. If pain relief is required, ask your Pharmacist for advice.
3. Avoid extreme cold during Menstruation (e.g., icy drinks, swimming in very cold water, cold winds). Spasm of the uterus during Menstruation can lead to discomfort in some women, and cold temperatures may aggravate the symptoms. However, not every woman suffers from this problem.
4. Heat pads or a hot water bottle are available from your Pharmacy. When placed over the lower abdomen, the heat may help to relieve discomfort associated with Menstruation.
5. Adequate sleep and exercise is recommended to promote regular, painless Menstruation.

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