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Menstruation: why menstruation

Menstruation, also known as a period or monthly,[1] is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina.[2] Up to 80% of women report having some symptoms prior to menstruation.[3] Common signs and symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes.[4] These may interfere with normal life, therefore qualifying as premenstrual syndrome, in 20 to 30% of women. In 3 to 8%, symptoms are severe.[3]

The first period usually begins between twelve and fifteen years of age, a point in time known as menarche.[1] However, periods may occasionally start as young as eight years old and still be considered normal.[2] The average age of the first period is generally later in the developing world, and earlier in the developed world. The typical length of time between the first day of one period and the first day of the next is 21 to 45 days in young women, and 21 to 31 days in adults (an average of 28 days).[2][5] Menstruation stops occurring after menopause, which usually occurs between 45 and 55 years of age.[6] Bleeding usually lasts around 2 to 7 days.[2]

The menstrual cycle occurs due to the rise and fall of hormones. This cycle results in the thickening of the lining of the uterus, and the growth of an egg, (which is required for pregnancy). The egg is released from an ovary around day fourteen in the cycle; the thickened lining of the uterus provides nutrients to an embryo after implantation. If pregnancy does not occur, the lining is released in what is known as menstruation.[2]

A number of problems with menstruation may occur. A lack of periods, known as amenorrhea, is when periods do not occur by age 15 or have not occurred in 90 days. Periods also stop during pregnancy and typically do not resume during the initial months of breastfeeding. Other problems include painful periods and abnormal bleeding such as bleeding between periods or heavy bleeding.[2] Menstruation in other animals occurs in primates, such as apes and monkeys, as well as bats and the elephant shrew.[7][8

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