An Introduction of the Menstrual Cycle

Introduction

Women's reproductive health is a diverse issue. It's not just about illnesses; it's about ensuring that women can embrace a life filled with opportunities and experiences, unencumbered by reproductive health issues. According to the International Conference on Population and Development (ICPD), an organization that focuses on reproductive health and rights as human rights, reproductively healthy means the absence of disease and the ability to lead full and satisfying lives free from reproductive limitations. At its core is the complex reproductive cycle. A dynamic interplay of hormonal fluctuations and physiological changes characterizes it. Central to this cycle is ovulation and menstruation, which signify the ability to conceive and profoundly affect women's lives physically, emotionally, and socially (Hilary et al.).

Recognizing the importance of women’s reproductive health is essential not just for understanding bodily changes but also for addressing issues, managing symptoms, and advocating for proper menstrual health education. This awareness is crucial for promoting women’s well-being and enabling them to lead satisfying lives without reproductive constraints.

Menstrual Cycle

The menstrual cycle, underpinned by the ovarian cycle, represents a cornerstone of female reproductive health. It is a complex interplay of hormonal signals, primarily estrogen and progesterone, orchestrated by the hypothalamus-pituitary-ovarian axis. This cycle governs the physiological processes of ovulation and menstruation and has profound implications for women's daily lives, emotional states, and social interactions. Dysmenorrhea, characterized by severe menstrual pain, emerges as a significant concern within this framework, affecting a substantial proportion of women and adolescent girls worldwide.

Dysmenorrhea

Research universally acknowledges the pivotal role of prostaglandins in dysmenorrhea, where their excessive secretion leads to uterine contractions, ischemia, and pain. “Dysmenorrhea occurs in 50% to 90% of adolescent girls and women of reproductive age” (Mckenns & Fogleman, 2021), which is a global concern that affects most women. The physical symptoms associated with menstrual discomfort, including sharp, stabbing pains lasting between 8 and 72 hours, predominantly in the initial days of menstruation, are well documented (Guimarães & Póvoa, 2020). The repercussions extend beyond physical discomfort, influencing academic performance, workplace participation, and daily activities, underscoring the need for comprehensive menstrual health education and management strategies. Research has not yet discovered what the major causes of dysmenorrhea are, suggesting a need for further investigation into the biological, environmental, and psychological factors that may contribute to this common but disrupting condition.

Some researchers argue that the period should not be so painful that it causes women to miss school or other events. However, as noted by a study published in the Journal of Women's Health, reports of cramps described as "sharp," "stabbing," or "throbbing" underscore the intensity of physical distress, often disrupting daily activities and incapacitating individuals from work, school, or engagement in routine tasks (Adams et al.). Also, French, Banikarim, and other researchers agree that it severely impacts the academic and school lives of adolescent girls due to their research that dysmenorrhea, a painful period without pelvic disease, is “the leading cause of recurrent short-term school absenteeism in adolescent girls” (French et al., 2005). The profound effect of dysmenorrhea extends beyond discomfort, and it’s leading to disruptions in academic continuity. Also, it is the leading cause of endometriosis.

Endometriosis

Women don't just suffer from dysmenorrhea, there's a disease that affects 10% of women called endometriosis. “Endometriosis (the presence of endometrial-like tissue outside the uterus) is a chronic disease associated with pelvic pain and subfertility” (Nnoaham et al. 2011). This disease often begins in adolescence but is mostly diagnosed an average of 6.7 years later. This significant gap between onset and diagnosis underscores the challenges of recognizing and addressing endometriosis early, contributing to prolonged suffering and potential complications for those affected. The need for more advanced research into endometriosis treatments underscores the urgency to uncover more effective, less invasive options for the millions of women worldwide grappling with this chronic and often painful condition.

Core Physical Symptoms

There is a misunderstanding about menstruation in the core symptoms associated with it. It is far more than just the shedding of the uterine lining. Based on their study, Guimarães and Póvoa said that the pain typically lasts 8 to 72 hours and is most severe on the 1st and 2nd days of menstruation.

Beyond the physical realm, many researchers agree that the menstrual cycle exerts a profound toll on emotional well-being, influencing mood swings, irritability, poor sleep quality, and, in some cases, precipitating depressive episodes (Gonzalez et al.). These emotional shifts intertwine with social aspects, leading to canceled plans, strained relationships, and limitations in activities as routine as swimming or engaging in sports (Brown & Smith, 2019).

Menstrual Cycle and Sports

Studies have shown that menstrual phases, particularly the early follicular and late luteal phases, are perceived by many athletes to affect their performance negatively, attributing declines to symptoms like fatigue, lethargy, and menstrual pain. Also, the variability in hormone levels across different menstrual cycle phases is suggested to influence physical capabilities, impacting strength, endurance, and overall athletic performance. (Carmichael et al.).

Due to the research by Dadgostar and other researchers, the prevalence of amenorrhea/oligomenorrhea (menstrual cycle irregularities) is high in athletes, especially in weight-class and endurance sports (Torstveit & Sundgot-Borgen). One of the main reasons for this is that weight-class athletes focus on leanness and low body weight because lower weight gives them a higher chance of success, and low BMI, caused by losing weight, can be a risk factor for getting amenorrhea and oligomenorrhea (Dadgostar et. al). It also underscores a broader issue of body awareness and health literacy that begins as early as puberty, where a lack of knowledge and societal pressures contribute to body shaming and health misconceptions.

Puberty

Going through puberty adds even more challenges, like not knowing enough about what's happening to your body and feeling ashamed about those changes. Society and culture can make menstruation a taboo topic, making things harder for young girls. This lack of understanding and negative attitudes can hurt their self-esteem and how they see themselves. We need better education on this topic that's understandable and covers everyone's experiences.

Conclusion

The notion that menstrual pain has no definitive cure highlights a significant area of concern, pointing toward the need for more research into alternative pain management and treatment approaches. Additionally, the variability in individual experiences of menstrual pain and the effectiveness of various interventions suggest that the menstrual cycle is not yet fully understood.