THE MENSTRUAL CYCLE
While a man’s hormonal profile might be visualized as a straight line that starts at birth, is underlined at puberty and then stretches indefinitely onwards, a woman’s is characterized by a series of even, regular loops that begin at puberty, run in approximately 28-day cycles, revolve around one key event ovulation affect every single cell in her body and can have considerable repercussions on the way she feels and looks.
The word ‘menstrual’ derives from the Latin menstruus, meaning monthly, but, in fact, few cycles run the classical 28-day course. Some may run for as many as 35 days, others for as few as 21. All are normal. There are wide variations, too, in the length of time the period lasts and the amount of blood lost. Some last for just a day or two (they are especially likely to be brief if you are taking the combined contraceptive pill) while others may persist for up to 14 days actually half the cycle. This condition can be aggravated by the IUD (coil) and, if bleeding is excessively heavy, may even lead to anemia.
The average woman can expect to menstruate for 30 to 35 years of her life and, in that time, to menstruate between 300 and 500 times for between two and five days at a time. In almost all periods, 90 per cent or more of the menstrual blood will be lost in the first three days. Although periods may be infrequent and/or irregular in early adolescence while the body is switching to a new hormonal gear, a regular pattern of intervals between each bleeding should soon establish itself. The cyclical nature of the menstrual cycle is caused by fluctuations in the hormones controlling it.
The Premenstrual Phase:
It has been estimated that nine out of 10 women have some clue that a period is on its way. Common signs are poor concentration, a dragging feeling or ache in the abdomen, weight gain, loss of libido and sore, tender breasts. These, together with tension, irritability, tearfulness, bloating and headache, constitute the major symptoms collectively known as the premenstrual syndrome (PMS). These symptoms are suffered in moderate to severe form by about 10 per cent of women.
Ever since the term ‘premenstrual tension ‘was coined in 1931, more and more symptoms, both vague and specific, have been attributed to the fluctuating hormone levels over the three to 10 days before the onset of menstruation. The withdrawal of the ovarian hormone progesterone is most commonly thought to be the aggravating cause. Before 1931, the tendency was to blame menstruation rather than the few days preceding it. The 1892 Dictionary of Psychologies/ Medicine, for example, lists the following ‘side-effects’ of menstruation: ‘Kleptomania, pyromania, dipsomania, suicidal mania, erotomania, nymphomania, delusions, acute mania, delirious insanity, impulsive insanity, morbid jealousy, lying, calumny, illusions, hallucinations and melancholia…’. Apart from melancholia, PMS is unlikely to be the cause of any of these.
Less dramatic but, nonetheless, disruptive physical and psychological symptoms may indicate PMS, if they appear regularly each month over the premenstrual phase. If you think that you suffer from PMS, on the day or days they occur in a special diary. But bear in mind that your symptoms may have no connection with the cycle at all. Research has shown that women encouraged to believe that they are entering the premenstrual phase tend to ascribe unconnected problems to the syndrome. If you do spot a definite cyclical connection, see your doctor and take the diary with you. PMS can be effectively treated both through hormone and vitamin therapy and with diuretics, if bloating is a problem. Find further details in the A-Z. Self-help can also do much to relieve tension. Keep as physically fit as possible throughout the month and protect the few ‘bad’ days before your period by keeping them as free as possible. Arrange exacting appointments, interviews and tasks for other days when you are likely to be feeling stronger.
|Day of Cycle|
Other effects of the premenstrual period may include an increased tendency to oiliness of the skin and hair due to extra hormonal stimulation of the sebaceous glands. If you suffer from spasmodic outbreaks of acne, it may be worth charting the appearance and disappearance of these spots. If there is a cyclical link, try adapting your beauty routines about halfway through the cycle. Use a medicated soap and/or a fairly strong astringent from about the tenth day after your last period finished and see if you notice an improvement.
The premenstrual phase is not a ‘bad ‘time of the month for all women. One study, analyzing the standard of work in a girls’ boarding school and correlating the results with the stages of the cycle, revealed that, while 27 percent of the girls showed a drop in standard over the premenstrual period, over 50 per cent showed no appreciable change and 17 per cent actually showed an improvement. Such apparent contradictions indicate that different women respond differently to the monthly ebb and flow of key hormones, such as estrogen and progesterone. The hormone levels do not appear to differ greatly from woman to woman. The threshold of sensitivity is probably the determining factor. This is borne out in clinical practice, where analysis of the blood of patients with very severe PMS often do not reveal anything demonstrably ‘different’ or ‘wrong’ with the hormones themselves. Nevertheless, their symptoms will