Menstruation refers to the cyclic shedding of the mucous layer lining the uterine cavity, resulting in the emission of blood through the vagina. It occurs regularly during a woman’s fertile period. 

The menstrual cycle, on the other hand, encompasses the time between periods and typically lasts from 21 to 35 days. But what about the duration of a period itself? 

Understanding the Phases of the Menstrual Cycle 

The complete menstrual cycle is measured from the first day of menstruation to the first day of the subsequent menstruation. It generally spans between 21 and 35 days. Throughout the menstrual cycle, different phases occur.

The Follicular Phase 

The follicular phase marks the menstrual cycle’s beginning, from the first day of menstruation to ovulation. During this phase, the follicle housing the egg cell gradually grows and matures. As the follicle develops, estrogen hormones increase, leading to the thickening of the uterine lining (endometrium) and the production of transparent and abundant cervical mucus, particularly in the ovulatory phase. 

Ovulation 

Ovulation occurs when the mature egg is released from the follicle and travels through the fallopian tube towards the uterus. In an ideal 28-day cycle, this usually happens around day 14, approximately two weeks after the cycle begins.

The Luteal Phase 

During the luteal phase, the body prepares for a potential pregnancy, leading to an increase in levels of:

  • Progesterone 
  • Estrogen

If fertilization does not occur, this phase ends approximately 14 days after ovulation, triggering the onset of menstruation. 

Menstruation 

During menstruation, the thickened uterine lining is shed through vaginal bleeding. 

Typically, menstruation occurs every 28 days, although a menstrual cycle is considered regular if it falls within the range of 21 to 35 days. The duration of menstruation itself usually lasts from 4 to 7 days. However, it is important to note that menstruation can individually vary in:

  • Duration
  • Associated symptoms
  • Intensity 

Irregular Menstrual Cycle and Gynecological Examination 

It is common for young women to experience irregular menstrual cycles during the early years of menstruation, with cycles varying in duration, either very long or very short. However, these cycles often stabilize as they grow older. 

Nevertheless, irregularities in the menstrual cycle can also occur in women of older age groups.

If menstruation occurs less than 21 days apart or more than 35 days apart, it may indicate an underlying issue that requires investigation by a gynecologist. A gynecological examination is crucial to identify potential causes and find appropriate solutions.

Factors Affecting Menstruation 

Various factors can influence your menstrual cycle. As we age, menstruation often becomes more regular and lighter. 

The use of new contraceptives – such as birth control pills, vaginal rings, or IUDs – may initially cause irregularities in the menstrual cycle, which can also occur in case of discontinuation. 

Specific contraceptive methods can also temporarily or persistently suppress menstruation while using the contraceptive itself. 

Additionally, other factors that can impact the menstrual cycle include: 

  • Severe weight loss;
  • Excessive exercise;
  • Infections in the reproductive organs, such as pelvic inflammatory disease;
  • Conditions like polycystic ovary syndrome (PCOS);
  • Increased stress levels;
  • Changes in diet;
  • Hormonal issues involving the thyroid or prolactin.

How to Regulate the Menstrual Cycle 

Regulating the menstrual cycle involves implementing strategies and treatments to ensure that a woman’s period occurs within a specific time frame and lasts for an appropriate duration.

Underlying factors influencing the menstrual cycle include: 

  • Weight fluctuations
  • Stress
  • Anxiety
  • Daily habits

Addressing such factors can positively impact the regularity of the menstrual cycle. 

Moreover, supplements like inositol may be beneficial in regularizing the cycle, particularly when irregularity is associated with polycystic ovary syndrome (PCOS). 

In some cases, a gynecologist may prescribe progesterone therapy. This treatment clinically mimics the natural post-ovulatory production of the hormone, leading to regular menstrual bleeding. 

The contraceptive pill can also induce regular bleeding, typically during the designated ‘withdrawal pause’ when the drug’s effects are temporarily ceased. 

When to Schedule a Gynecological Examination 

While every woman is unique, specific symptoms may indicate the need for a visit to the gynecologist:

  • Irregular Menstruation: If your menstrual cycle becomes irregular after being stable for an extended period, it is advisable to seek medical attention;
  • Absence of Menstruation: If your menstruation suddenly stops for 90 days or more without a known pregnancy, it is essential to consult with a healthcare professional. There could be an ongoing pregnancy or an underlying issue that needs to be addressed;
  • Prolonged Menstruation: If your menstruation lasts more than eight days, mainly if this occurs in multiple cycles, it is worth discussing with a gynecologist. Extended periods may indicate an underlying concern that requires evaluation;

Excessive or Profuse Bleeding: If you experience unusually heavy bleeding that is significantly more profuse than your usual pattern, and if it persists for an extended period, it is recommended to seek medical advice.