What are the symptoms during menstruation?

Menstruation is a normal physiological phenomenon for women. It starts from puberty and will not disappear until women are in their 50s or 60s. It can be said that menstruation is a woman’s closest friend. If it is not affected by pregnancy or disease, it will come on time every month. However, some women do not have a deeper understanding of menstruation. So, what are the symptoms during menstruation?

There are usually no special symptoms during menstruation. Some women may have a feeling of heaviness in the lower abdomen and lumbosacral area. Some may have bladder irritation symptoms such as frequent urination, mild symptoms of nervous system instability such as headache, insomnia, mental depression, irritability, gastrointestinal dysfunction such as nausea, vomiting, constipation or diarrhea, and nasal mucosal bleeding. In general, menstruation does not affect work and study. However, they should not engage in heavy physical labor or strenuous exercise, avoid taking cold showers and working in paddy fields, refrain from sexual intercourse, and pay attention to menstrual hygiene.

From puberty to menopause, the endometrium is affected by ovarian hormones, undergoing cyclical changes and producing menstruation. The cyclical changes of the endometrium are caused by the cyclical effects of ovarian hormones and can be divided into the following 4 stages:

(1) Proliferative phase: approximately from the 5th to the 14th day of the menstrual cycle, which corresponds to the stage of follicle maturation. After the endometrium is exfoliated during menstruation, under the action of estrogen, the basal cells of the endometrium proliferate and thicken, and the glands increase in number and become curved; the stroma gradually proliferates and becomes dense; and the endometrial blood vessels proliferate in a spiral shape.

(2) Secretory phase: approximately the 15th to 23rd day of the menstrual cycle, which is equivalent to the corpus luteum maturation stage after ovulation. The large amount of estrogen and progesterone produced by the corpus luteum causes the endometrium of the uterus to continue to thicken during the proliferative phase, and the glands to further expand and bend, and secrete. The interstitium is loose and edematous, the blood vessels grow rapidly, become more curved, and the endometrium is soft and rich in nutrients, which is suitable for the implantation and development of the fertilized egg.

(3) Premenstrual period: approximately the 24th to 28th day of the menstrual cycle, which is equivalent to the corpus luteum regression stage. When the corpus luteum degenerates, the levels of estrogen and progesterone drop rapidly, the interstitial edema disappears and becomes dense, the blood vessels are squeezed and bend, causing blood stasis. 4 to 24 hours before menstruation, the endometrial blood vessels contract spasmodically, causing ischemia and necrosis of the endometrium. The blood vessels contract and then dilate, causing rupture and bleeding, forming scattered small hematomas in the endometrial layer, causing endometrial exfoliation and bleeding, which is the onset of menstruation.

(4) Menstrual period: This is approximately the 1st to 4th day of the menstrual cycle. During this period, small scattered hematomas form in the functional layer of the endometrium, causing the endometrium to peel off in flakes or small pieces and be discharged along with the blood. In clinical practice, the onset of menstruation is generally regarded as the beginning of the next cycle.