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Surprisingly: although a woman’s acquaintance with the cyclical transformations of her body occurs as early as adolescence, not every woman, even in her mature years, is able to clearly explain to her sister, daughter about what happens to her every month and why … Let’s try to answer the most frequently asked questions of women , simple and not so. So,

What is it?

The menstrual cycle is various changes repeated from month to month not only in the uterus, ovaries and vagina. Mammary glands, hair follicles, skin, bones, adipose tissue, in a word, the whole organism as a whole are also subject to cyclic changes. The external manifestation of these processes is menstruation.

At what age does she “arrive”?

The first menstruation (menarche), which normally appears at 11-16 years old, means that the girl’s body is ready to conceive and carry a pregnancy. This ability persists on average up to 45-50 years, and sometimes much longer.

What happens on the first day?

The first day of spotting (menstruation) is considered to be the first day of the female cycle, its beginning. Then – the second, third, and so on until the beginning of the next menstruation, the first day of which is the beginning of a new cycle.

Longer and shorter

The duration of the menstrual cycle is very individual. A normal cycle is considered when at least 21 days pass from the beginning of one menstruation to another, but not more than 35, most often (in 60% of cases) a 28-day menstrual cycle occurs.

Should I be worried if the cycle length is different?

The lack of regularity of the cycle is permissible only for some time after the arrival of the first menstruation (up to one – one and a half years). In the future, menstruation should “come” at regular intervals, only small fluctuations are possible (1-3 days).

How many days does it take?

As for the bleeding itself, their duration normally ranges from 2 to 7 days.

How much blood is lost?

Menstruation should not be very meager or excessively abundant, gynecologists believe that the volume of blood that a woman loses during these days normally corresponds to 20-80 ml.

Painful periods – is it normal?

In the normal course of the menstrual cycle, a woman should not experience pain. Perhaps only a feeling of discomfort in the lower abdomen or in the lumbar region. In any case, the unpleasant or painful sensations that make a woman take painkillers should be alarming.

What does “cycle phase” mean and what is “ovulation”?

The menstrual cycle is usually divided into two phases, the conditional boundary between which is the “birth” of the egg, the so-called ovulation.

What is a follicle?

The release of the egg comes from a special formation resembling a rounded vial, consisting of cells arranged in a circle. This is a follicle.

How many follicles are in the female body
And at what age do they form?

There are about 500 million such “houses”, from where an egg can appear, that nature puts into the body of an unborn girl. But up to 90% of them do not receive further development over the entire life of a woman, remaining in a “rudimentary” state. It’s kind of a reserve. But by adolescence, their number is halved. For the entire period when a woman has her period, that is, until she is able to become a mother, only about 400 follicles reach their full development.

Why is an egg “born” from a follicle?
And where do estrogens come from?

The first phase of the menstrual cycle – from 1 to 14 days – folliculin. In this phase, special glands located in the brain begin to release hormones into the blood that are consonant with the name of the phase itself – follicle-stimulating, acting on the ovaries. Already from the name of these hormones it is easy to understand that their action provokes the growth of several follicles in the ovary at once.

They grow, as it were, in a race, ahead of each other, until a “leader” is revealed among them. As soon as this happens, the growth of the remaining “lagging behind” follicles slows down, and as a result, they are destined to return to their original state.

But the follicle that has become a leader begins to ripen, like a fruit or vegetable, accumulating nutrients in itself. Sometimes its dimensions reach 20-28 mm. But instead of aroma, it releases the well-known hormones – estrogens – into the bloodstream.

What is estrogens for?

I must say that estrogens play a very important role in a woman’s body, starting from adolescence. Here are some of the “works” of estrogen:

• The development of a woman’s secondary sexual characteristics during puberty (development of the mammary glands; a special type of hair growth and distribution of fatty tissue characteristic of the female body).

• Improve the blood supply to the uterus.

• Promote the growth of the uterine lining (endometrium) in the first phase of the menstrual cycle.

• They increase a woman’s sexual desire in the middle of the cycle, which corresponds to the moment the egg leaves the follicle, and therefore, contributes to the implementation of the process of conception laid down by nature.

• Facilitates the penetration of spermatozoa into the uterine cavity during ovulation through the mucus inside the cervical canal, as it reduces the viscosity of this very mucus.

Do estrogens affect other organs in a woman?

In addition to affecting the genitals and mammary glands of women, estrogens are also active participants in various processes in the body as a whole.
They make the skin beautiful, smooth and elastic, prevent the formation of acne and excessive development of the hairline. Estrogens (like progesterone, which will be discussed below) provide bone strength. They also affect the functioning of the heart, blood vessels, brain and other organs.

What causes a follicle to rupture?

The formation of estrogen by the follicles is a kind of signal for the brain, which begins to release luteinizing hormone into the blood.
Only at his “order” does the follicle rupture and ovulation occurs, that is, the release of the egg. And for her, again thanks to the “efforts” of estrogen, the path from the ovary to the uterine cavity has already been paved along the thin “petal” (fimbria) of the fallopian tube.

When does ovulation occur?

This usually happens in the middle of the menstrual cycle. That is, if 28 days pass from the beginning of one menstruation to the beginning of another, then ovulation occurs approximately on the 14th day.

How long does an ovum live?

The lifespan of an egg is only 12-24 hours. If during this time she does not meet with the sperm, she dies. Only one day or even less is allotted for fertilization (conceiving a child).

How does the egg from the ovary get to the uterus?

Promotion of the egg into the uterus is facilitated by special contractions of the fallopian tubes, which, as it were, push it to the uterine cavity. Small “hairs” inside the fallopian tubes also contribute to this.

The length of the egg’s journey to the uterine cavity is very important. If its progress is accelerated, then the egg may “leave” the uterus ahead of time without meeting the sperm; if it slows down, then the fertilized egg may “stick” not in the uterine cavity, but in the tube itself, which in some cases can lead to the development of an ectopic pregnancy. In other words, everything should be exactly on schedule, which in particular contributes to the normal functioning of various hormones.

What is a “yellow body”?

After the egg has left the follicle, it begins to fill with special cells – luteal. This happens under the incessant “guidance” of the hormone already known to us – luteinizing (again, the consonance in the names). From this moment on, the ruptured follicle and its “new inhabitants” are called the “yellow body”.

What is it for?

The “yellow body” is also very active, it continues to secrete estrogens in a small amount, but to a greater extent – progesterone, which, as they increase, cause the brain to reduce the production of follicle-stimulating and luteinizing hormones. The combined actions of the corpus luteum hormones are aimed at preparing the uterus for a possible pregnancy.

Progesterone – what is its role?

Progesterone is a pregnancy hormone that can only be produced by the corpus luteum and placenta. Here are some of his actions:

• Preparing the lining of the uterus (endometrium) for a possible pregnancy.

• Decrease in the activity of the muscles of the uterus, and, consequently, the prevention of abortion.

• An increase in the viscosity of the mucus inside the cervical canal, which prevents the penetration of spermatozoa into the uterine cavity.

• Stimulation of growth of mammary glands.

• Formation of energy necessary for the normal development of the fetus.

Can a woman determine when ovulation will occur this month?

It is on the effect of progesterone on the brain that the method of determining the moment of ovulation is based by daily measurement of the so-called basal temperature in the rectum during the menstrual cycle. A prerequisite for ensuring the accuracy of this method is the measurement of temperature in the morning for 10 minutes with the same thermometer, even before the woman got out of bed. It is recommended to carry out this procedure for at least three months in a row.

How to estimate basal temperature values?

In the first phase of the normal menstrual cycle, the value on the thermometer will not exceed 37 degrees, and in the second – above this mark. Moreover, an increase in temperature by 0.4-0.6 degrees will occur immediately after the release of the egg from the follicle, and will remain at this level for 12-14 days. 1-3 days before the onset of menstruation, the temperature drops again.
These temperature fluctuations characterize a normal biphasic cycle, that is, a cycle in the middle of which ovulation occurred.

What happens to the “yellow body” next?

If the fertilization of the egg has happened, then the “yellow body” begins to intensively supply the pregnancy hormone to the female body. This work is then taken over by the formed placenta.

If the meeting of the female and male reproductive cells did not occur, then the “yellow body” at the end of the cycle (by day 24-27) decreases and gradually stops its activity. It seems to “overgrow”, leaving a barely noticeable scar on the surface of the ovary.

Why does spotting appear at the end of each cycle (menstruation)?

At the end of the cycle, there are no longer follicle-stimulating and luteinizing hormones, and with the cessation of the work of the “yellow body”, estrogens and progesterone decrease and completely disappear. That is, the overgrown endometrium, which has not “sheltered” the fertilized egg, is deprived of the hormones that stimulate its growth and development. He no longer receives the proper amount of nutrients necessary for his continued existence.

This leads to the fact that the upper part of the endometrium (its functional layer) is rejected, exposing the gaps of the vessels enlarged during the period of its growth. Clinically, this process occurs with the appearance of bloody discharge from the female genital tract or the onset of menstruation.

Why do periods end?

Menstruation continues until the entire functional layer of the endometrium leaves the uterine cavity, blood vessels close with microscopic clots.
By the end of menstruation, the uterine cavity will be lined with only a few layers of cells – the basal layer of the endometrium, which, when sex hormones appear in the blood, will not begin to grow again in order to start preparing the uterus for a possible pregnancy again …

Elena VYSOTSKA,
gynecologist

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