When was the last period, when was the first, and at what interval does it occur at all? With these questions the gynecologist usually opens the consultation interview with his patient. A guide to menstruation, periods and ovulation.
Period, menstruation and menstruation
Already in the newborn girl, there are about 400,000 urei in the two ovaries (ovaries). If one considers in addition that there are for the rule still terms such as menstruation, Mensis, period, monthly bleeding or uneasiness in the everyday language use and in former times about this strangely one was not allowed to speak, then from this already the necessity may arise to fathom this complicated important happening in the life of each woman and its causes. Unfortunately, we experience again and again that even professionally very hard-working, generally open-minded women still pay too little attention to this natural process and are often only insufficiently able to answer these questions. Therefore, the necessary demand is already expressed here, which she should bring to all medical consultations and examinations. With periodic recurrence at intervals of about 3 to 4 weeks, menstruation sets in approximately from the 12th, 13th, 14th to the period between the 45th and 50th year of life and makes itself felt by bleeding from the uterus. In the past, it was considered a periodic cleansing of the body from “impure juices” or even toxins, but this was completely devoid of scientific basis. Years of scientific research have shown that menstruation is a continuous sequence of processes in the uterine mucosa, from its formation to its destruction or rejection, in interaction with hormonal influences and events in the ovary under the control of the central nervous system. Therefore, it is called an ovarian-mental cycle or simply the cycle.
Maturation of the ovaries
Already in the newborn girl, in the two ovaries (ovaries) there are about 400,000 urei of minute size, each consisting of a large loose cell body with vesicular nucleus best and surrounded on the outside by a membrane together with cells (follicular epithelia). This whole structure is called primary follicle. Over the years, the cell layer increases and secretes the follicular hormone, which controls typical female development, as well as fluid. Egg follicles eventually develop, but they perish repeatedly within the ovary until sexual maturity. Later, with the onset of puberty, the follicle maturation hormone is released by impulses from the central organ of sexual functions, the diencephalon, to the pituitary gland, the anterior lobe of the pituitary gland. This now allows the follicle to develop fully. It can mature, and in addition, follicular hormone production is increased. This in turn results in an enlargement of the fallopian tubes, uterus and vagina. The endometrium in particular receives numerous growth and development stimuli, so that it develops from just under one millimeter to 3 to 4 millimeters thick and becomes more glandular (proliferation phase). At the same time, the follicle in the ovary grows to 1 to 1 ½ centimeters in diameter, reaching the outer surface where it usually bursts between the 13th and 16th day, counting from the beginning of the last period. This process is called follicular or ovulation. Since the egg remains fertile for only a few hours, this is the time for fertilization. Male sperm is known to reach the fallopian tubes 1 to 2 hours after sexual intercourse and remains capable of fertilization for about 2 days.
Symptoms and signs of ovulation
Some women can self-report their ovulation by feeling tightness in the abdomen, faintness, swelling of the nipples, and the like. Some women can self-report their ovulation based on feelings of tightness in the abdomen, faintness, swelling of the nipples, and the like. However, exact information can only be obtained from a basal temperature curve that is kept for several months and shows a clear increase in temperature at the time of ovulation. However, a precondition is that the temperature is measured regularly every morning after awakening, before getting up, if possible at the same time and with the same thermometer for about 5 minutes at the anus.The second half of the cycle or secretory phase shows further growth and engorgement of the uterine mucosal glands to a thickness of about 5 to 6 millimeters by the time of bleeding, with a saw-shaped, jagged edge observed in the glandular tubes. After this swelling, the glands clearly begin to prepare and secrete secretions from about day 19 to 20, which contain virtually all the nutrients needed to maintain the eventually fertilized egg. The egg bed, literally prepared in the form of the uterine mucosa, thus has sugars, proteins, fats and even minerals. Again, neuro-hormonal control occurs for these preparations, i.e. impulses from the diencephalon passed on to the pituitary gland cause the pituitary gland to secrete another hormone which causes the follicular epithelial cells to be transformed into corpus luteum cells. Fatty substances are formed and stored in the emptied, closed follicular cavity, which show a yellow discoloration, hence the name corpus luteum. In addition, as the corpus luteum grows (blossoms), it secretes the corpus luteum hormone to the uterus, which promotes its mucosal growth in the manner already mentioned, along with secretion.
Failure to fertilize
If fertilization fails to occur, i.e. the egg dies, then the corpus luteum regresses within 14 days in the ovary and eventually scars over. This regression is accompanied at the same time by a decrease in hormone production. The uterine lining receives no further growth stimuli and collapses, so to speak. With the simultaneous onset of bleeding, it is shed and expelled except for a very narrow strip that rests on the uterine muscles. This process alone is called menstruation. It is therefore the absence of pregnancy. Normal menstrual bleeding lasts 3 to 5 days, with a total of 50 to 100 grams of blood being secreted. This corresponds to a daily consumption of 3 to 6 sanitary napkins or tampons. If it exceeds 7 days, a medical examination is indicated. Menstrual blood is not known to clot and usually has a foul odor. If it becomes distinctly malodorous, decomposition phenomena are in progress. In order to prevent this, one should be careful in the use of tampons during menstruation, that is, change them at least 5 to 6 times a day. The menstrual cycle alternates from the onset of bleeding to the last day before the next one and lasts on average 28, rarely only 21 days. It often fluctuates by several days even in healthy women, and large deviations may indicate hormonal imbalances as well as psychological influences.