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What exactly happens when a woman menstruates? What are the most common problems with the menstrual cycle? And where does ovulation fit in? Read our "back to basics" information if you think you missed out somewhere.

What exactly is menstruation?

Menstruation is, obviously, the monthly bleeding that most women of fertile age experience. The average menstrual cycle lasts between 28 and 32 days, and may last between three and seven days. During menstruation, a portion the lining of the uterus is expelled from the body.

The endometrium which is what that lining is called is soft tissue that covers the inside of the womb during the fertile stages of the cycle, to give any potential fertilized egg a place to nestle. When that doesn't happen, and the woman doesn't become pregnant during that cycle, a significant part of the endometrium leaves the body and the uterus is totally cleaned out for the next cycle. The part that is not expelled is absorbed (broken down) by the body. This is menstruation.

A woman typically loses between 10 and 80 mililiters of menstrual fluids, which includes blood, uterine lining, mucus, and sometimes even embryonic tissue from a chemical pregnancy a very early pregnancy that didn't succeed. Some women also have other menstrual symptoms cramping, mood swings, and tender breasts are all relatively common. Women can catch their menstrual fluids, and prevent their clothes from getting dirty, in several ways. Hygienic pads and tampons are the most common means of collecting menstrual fluids. Cloth pads, which are reusable, are making a comeback in western countries and are popular in some developing countries as well. Then there is the Diva Cup, a small silicone cup that is inserted into the vagina, where it collects blood. The Diva Cup is reusable.

Who menstruates?

The median age at which menstruation begins worldwide is 14, according to research. This is called menarche, and Asian girls are generally later with starting menstruation than girls in other parts of the world. In the United States, many girls will start menstruating during the year they turn 12, but menarche can also occur at 10 or even earlier. Girls who reach 16 without menstruating are considered to be late, and may have medical problems. Menstruation is not, by itself, a sign that a girl is fertile ovulation often follows a few years after menarche, and a sign that a girl has become fertile and is able to get pregnant is having regular menstrual periods. Menstruation is interrupted during pregnancy and often while a woman is breastfeeding, and finally stops when she enters the menopause. The menopause, preceded by a transitional period with many menopause symptoms, is officially reached when a woman hasn't had a menstrual period for a year. This generally happens during a woman's early 50s.

Common problems with menstruation

Cramping and mood swings are normal during menstruation (and slightly before the flow actually starts), but some women have problems with their menstrual cycle that deserve medical attention. Heavy and painful bleeding, bleeding in between periods, and irregular periods (periods that don't come at regular, predictable intervals) are the most common menstrual problems. If you experience any of these issues, you should always consult your doctor about them, and undergo further diagnostic testing where necessary.

The menstrual cycle and ovulation

Along with menstruation, ovulation is the other significant event that happens during the female cycle. Ovulation occurs when an egg (it's usually one) is released by the ovaries after a follicle has matured. In the majority of cases, one mature egg will be released, enabling pregnancy if the egg is fertilized. Scientists estimate that as many as 400 follicles can be "lost" in some way during a menstrual cycle, however. Ovulation, like menstruation, comes at different times for different women. Many will ovulate around 14 days before their next period is due, but this can vary. Women who ovulate less than 10 days before their next period is due have a Luteal Phase Defect, meaning there is not enough usually time between ovulation and menstruation for a fertilized egg to implant. This makes pregnancy very difficult.

Women who are trying to conceive will succeed faster in most cases if they monitor their ovulation. The woman's fertile window can be said to open five days before ovulation, because sperm has the ability to survive inside the uterus and female reproductive organs during those days. This means that you can get pregnant even if you have intercourse five days before your ovulation, because egg and sperm may meet at the right time. Tracking ovulation is handy for those women who are hoping for a baby, but also for those who are not. Ovulation tests, an ovulation calendar, charting to conceive (or avoid) using basal body temperature, and tracking cervical mucus are all possible ways to detect ovulation.

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