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What is Menstruation? Definition, Cause, Clinical features, Symptoms, Management

Mensuration 
Definition : 

It is a phenomenon of cyclical discharge of blood, mucus, cellular and usually a dead ovum from uterus per vagina of a sexually matured women during her reproductive life, usually at an interval of 28 days + or - 2 days.

Cycle : 

The average cycle lasts 28 days but may vary from 21 to 35 days.

Duration :

3 to 5 days but anything between 2 to 7 days is normal. Cycle and duration are less regular into extremes of life. Example: in post-menarcheal girls and peri-menopausal women. 

Flow :

It begins as a pink discharge and becomes heavy on 2nd and 3rd day. It consists of blood, endometrial debris, cervical and endometrial secretion, bacteria, RBC, WBC, alkaline and acid phosphate, plasminogen, fibrinolysin and a degenerated ovum. It has got a characteristic odour. The menstrual blood differs from normal blood in that it lakes prothrombin and fibrinolysin and therefore does not clot. It clots appear it means bleeding has been excessive and fibrinolytic enzymes have been unable to resolve the clothes before they are discharged from the uterus. 

Amount :

The amount of blood loss has been estimated to be between 50 ml and 200 ml.

Absent :

It is absent in the following cases :
  • Before puberty 
  • During pregnancy 
  • Sometime during lactation  
  • After menopause 
Cause :

The exact cause is unknown suggestions are modern theories that following below :
  • Stroder and Maye's theory 
  • Allen & Corner's theory 
  • Hartners's theory
  • Smith & Smith theory
Urine cycle :

It is essential that change in endometrium and starts at the onset of mensuration and ends in recurrence of next mensuration. The cycle consists of following phases :
  • Proliferative phase 
  • Secretory or pre-menstrual phase 
  • Menstrual phase 
  • Postmenstrual or resting or regenerative phase 

Clinical features :

Usually, vary in severity from individual to individual, but not ever incapacitating. 

Symptoms :
  • Heaviness and discomfort of the pelvis 
  • Fullness of breasts 
  • Frequency of urination 
  • Constipation 
  • Lassitude 
  • Irritability 
  • Depression 
  • Headache 
  • Rarely bleeding from the nose may occur
Signs :
  • Sudden fall of temperature 
  • Pulse & B.P. drop 
  • Weight gain ( During premenstrual fortnight )
  • Reddish blood with tissue bits etc 
Management :
  • Proper education on mensuration is important that is not the drainage of noxious substance from the body but a normal psychological manifestation. 
  • During menses - should carry on normal activities including daily bathing, playing games etc. Personal hygiene is maintained by changing the sanitary pads at regular intervals. Even a healthy couple may perform sexual intercourse.
  • Antihistamine - It helps to balance the sympathetic nervous system. 
  • Reassurance. 
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