MENSTRUAL CYCLE AND

CRAMPS (DYSMENORRHEA)
ADEKOYA ADEMILOLA
What is menstruation?

Menstruation is the monthly shedding of the lining of a woman’s uterus (more commonly
known as the womb). Menstruation is also known by the terms menses, menstrual period,
cycle or period. The menstrual blood—which is partly blood and partly tissue from the inside
of the uterus—flows from the uterus through the cervix and out of the body through the
vagina.
 
WHY DISCUSS MENSTRUAL CYCLE?

 Teaching a girl about menstruation before she has her first period is the best way to make
sure she knows what will happen, explain why she should not be scared. It’s also a great
time to combat social taboos and false information about menstruation that can hurt a girl’s
well-being.
 While most girls get their first period at about 12 years old, some girls will start
menstruating as young as nine - so it’s a good idea to start talking early about how your
body changes as you grow up. 
What is a normal menstrual cycle?

 The menstrual cycle is a term used to describe the

sequence of events that occur within a woman’s body as
it prepares for the possibility of pregnancy each month.
A menstrual cycle is considered to begin on the first day
of a period. The average cycle is 28 days long; however,
a cycle can range in length from 21 days to about 35
days.
 
How does the menstrual cycle work?

The menstrual cycle is controlled by a complex orchestra of hormones, produced by two structures in the brain, the pituitary gland and the hypothalamus
along with the ovaries.
The cycle begins again on Day 1 menstrual
bleeding.
Female Reproductive System
• The steps in the menstrual cycle are triggered by the rise and fall of chemicals in the body
called hormones. The pituitary gland in the brain and the ovaries in the female reproductive
tract manufacture and release certain hormones at certain times during the menstrual cycle
that cause the organs of the reproductive tract to respond in certain ways. The specific
events that occur during the menstrual cycle can be described as follows:
 
1. The menses phase
2. The follicular phase
3. The Ovulation phase
4. The luteal phase
The menses phase: This phase, which typically lasts from day one to day five, is the
time when the lining of the uterus is actually shed out through the vagina if pregnancy
has not occurred. Most women bleed for three to five days, but a period lasting only
two days to as many as seven days is still considered normal.
The follicular phase: This phase typically takes place from days six to 14. During this time, the level of the
hormone estrogen rises, which causes the lining of the uterus (called the endometrium) to grow and thicken. In
addition, another hormone—follicle-stimulating hormone—causes follicles in the ovaries to grow. During
days 10 to 14, one of the developing follicles will form a fully mature egg (ovum).
Ovulation: This phase occurs roughly at about day 14 in a 28-day menstrual cycle. A sudden increase in another hormone—
luteinizing hormone—causes the ovary to release its egg. This event is called ovulation.
After release, the egg enters the fallopian tube where fertilization may take place, if sperm are present. If the egg is not fertilized, it
disintegrates after about 24 hours. Once the egg is released, the follicle seals over and this is called the corpus luteum.
The luteal phase: This phase lasts from about day 15 to day
28. The corpus luteum produces progesterone, if
fertilization has occurred. The level of the hormone
progesterone rises to help prepare the uterine lining for
pregnancy. If fertilization has not occurred, the corpus
luteum disintegrates, which causes progesterone levels to
drop and signals the endometrial lining to begin shedding.
If the egg becomes fertilized by a sperm and attaches itself
to the uterine wall, the woman becomes pregnant. If
pregnancy does not occur, estrogen and progesterone levels
drop and the thickened lining of the uterus is shed during
the menstrual period.
Your period lasts for 3-8 days

Your period comes again every 21-35 days (measured from the first day of one period to the first day of the next). To know one’s cycle, check for three consecutive months
and find average.

The total blood loss over the course of the period is around 2-3 tablespoons but secretions of other fluids can make it seem more
At what age does menstruation typically begin?

 Girls start menstruating at the average age of 12. However, girls can begin
menstruating as early as 8 years of age or as late as 16 years of age. Women
stop menstruating at menopause, which occurs at about the age of 51. At
menopause, a woman stops producing eggs (stops ovulating). Menopause is
defined as one year without periods, and after this time a woman can no
longer become pregnant.
 
 
 
What are some of the symptoms of a normal menstruation?

Moodiness
Trouble sleeping
Food cravings
Cramps in the lower abdomen and back
Bloating
Breasts swelling, pain and tenderness
Acne
Weight gain
Headache
 
 
It’s normal. 
Menstruation is a normal process that should happen to every girl once
she reaches puberty – usually somewhere between the ages of 9 and
16.
Menstruation is not a sickness.
Girls can live their normal life during menses – they can go to school, play with their sisters
 

and friends, eat and drink everything they normally would, and attend social gatherings.
Girls can have irregular cycles in their
first few years of menstruation. 
But each girl can learn to understand how her own body works by
watching the small changes that happen each month. It may take a few
years to settle into a regular monthly pattern. This means girls often
feel unprepared or are caught short without pads or cloths. It’s really
helpful if girls learn to start observing their menstrual cycle, so they
can start to predict fairly accurately when they will get a period and
can be ready with a pad or cloth in their school bag.
Girls experience many changes around
the time they get their first period. 
Girls experience many changes around the time they get
their first period. A girl’s breasts grow, she grows hair on her
body, and her hips widen. Sometimes hormones make both
girls and boys a bit more emotional than usual. There is no
reason to be scared or ashamed of any of these changes.
Menstruation does not have to be a
secret.
There is a big difference between being discreet and keeping
something secret because you are scared or ashamed. Once
a girl is informed, she can be of help to other girls even if
they are younger than her. She can also help older women in
her family who didn’t have the opportunity to learn what
she knows. She can be a girl leader.
 Sometimes menstruation can be
painful!
It’s a very common condition. More than half of women who menstruate report some pain
from period cramps each month, according to the American Congress of Obstetricians and
Gynecologists (ACOG).
 The amount of pain can differ a lot from girl to girl and from month to month. Most pain can
be eased by going on a short walk, getting eight hours of sleep every night, drinking lots of
water and some gentle pain medicine. There are some things a girl can look out for that will
tell her if something is wrong and she needs to get help. If a girl’s period is so painful she can’t
stand or walk; if she bleeds much more than she usually does; or if she stops bleeding for a
long time, or bleeds between periods, she needs to get medical help from a community health
worker, midwife or doctor.
While cramps are not usually a sign of a serious health condition, they could be. And they
undoubtedly put a crimp in your lifestyle, since you can’t go out with friends or even go to
work when you’re doubled over.
The main question doctors ask when determining whether your cramps are normal is “Are
they normal for you?”
“Don’t be ashamed if something seems wrong. Get help.”
Exercise is really good for girls, no matter
which time of the month.
There are many benefits to exercise, including the mental boost you get from feeling fit. Exercise is a good way to help
prevent cramps, and gentle exercise like a walk can also help relieve pain.
 
A girl’s body will be healthy if she practices good
hygiene during her period.
  Girls must continue to wash normally during menses. Not being clean can leave girls at risk of
infections.
A girl should wash outside her genital area at least once a day. If she does not have access to a
shower or bath, she use a small amount of plain water, soap and a soft cloth
She should always wash her hands with soap after she uses the toilet or changes a pad or cloth.
A used pad should always be placed in the bin, and never down the toilet. And when a girl
changes her cloth at school, she should take the soiled one home in a bag to wash. She can
make a simple menstrual cloth bag at the same time she learns how to make reusable
menstrual hygiene cloths, so she can carry her used cloths home discreetly.
It is okay to use either pads or cloths.
Some girls prefer pads or cloths, but both can be a safe and
clean way to manage a period. Disposable pads can be more
expensive so girls may need to be understanding if their family
cannot afford them.
 
Disposable pads need to be changed regularly, at least every six
hours. If a girl uses pads, she can bring a few spare in her
school bag so she’s ready if her period suddenly starts or a
friend needs help.
 
Reusable cloths also need to be changed at least every six
hours, or earlier if they feel full. After a girl is done with her
cloth, she needs to wash it with soap and water and hang it
What is Dysmenorrhea?
Dysmenorrhea is the medical term for painful menstrual periods which are caused by uterine contractions. Primary dysmenorrhea
refers to recurrent pain, while secondary dysmenorrhea results from reproductive system disorders. Both can be treated.
 
Primary dysmenorrhea is the name for common menstrual cramps that come back over and over again (recurrent) and aren’t due to other diseases. Pain usually begins one
or two days before you get your period or when bleeding actual starts. You may feel pain ranging from mild to severe in the lower abdomen, back or thighs.
Pain can typically last 12 to 72 hours, and you might have other symptoms, such as nausea and vomiting, fatigue, and even diarrhea. Common menstrual cramps may become less painful as one gets older and may stop entirely if one has a baby.
 
Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and
lasts longer than common menstrual cramps. You usually don’t have nausea, vomiting,
fatigue or diarrhea.
What causes painful menstrual cramps?

 Menstrual cramps happen when a chemical called prostaglandin makes the uterus contract
(tighten up). The uterus, the muscular organ where a baby grows, contracts throughout
your menstrual cycle. During menstruation, the uterus contracts more strongly. If the uterus
contracts too strongly, it can press against nearby blood vessels, cutting off the supply of
oxygen to muscle tissue. You feel pain when part of the muscle briefly loses its supply of
oxygen.
What are the symptoms of menstrual cramps?

 Aching pain in the abdomen (pain may be severe at times).

 Feeling of pressure in the abdomen.
 Pain in the hips, lower back and inner thighs.
How can you relieve mild menstrual cramps?

 To relieve mild menstrual cramps:

 For the best relief, take ibuprofen as soon as bleeding or cramping starts. Ibuprofen belongs to a
class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). They reduce the output of
prostaglandins. If you can’t take NSAIDs, you can take another pain reliever like acetaminophen.
 Place a heating pad or hot water bottle on your lower back or abdomen.
 Rest when needed.
 Avoid foods that contain caffeine.
 Avoid smoking and drinking alcohol.
 Massage your lower back and abdomen.
 Women who exercise regularly often have less menstrual pain. To help prevent cramps, make
exercise a part of your weekly routine.
Can you prevent menstrual cramps?

 Can you prevent menstrual cramps?

 The answer is “probably not.” However, eating a balanced diet and getting regular exercise
may help stop cramps from being as intense.
 Your diet makes a difference to your well-being. You might be to avoid certain food and
drinks when they have their period. The truth is, whether a girl is menstruating or not, she
can eat and drink anything that’s included in a well-balanced diet. A girl will only feel
pain, weakness and sickness if there is something missing from her diet. If girls do not eat
lots of different foods, especially foods rich in iron and folic acid, they may face increased
difficulty concentrating at school, and may feel tired and depressed.
 As a teacher, you can help tell girls the truth. Explain why you, as a teacher, neither follow
the taboos about what girls can’t eat and drink during menstruation, and why you don’t
want the girls in your class to be influenced by them either.
When should you contact your healthcare provider about
menstrual cramps?

 Bad cramps keep some women from working and going to school. You don’t have to suffer
and you don’t have to put your life on hold. Contact your healthcare provider if you have
painful periods.
 It may be helpful to keep track of your periods and the days on which pain is the worst so
you can make a complete report. If you notice other symptoms, like headaches or heavy
flows, you should keep track of those, too.