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Younger women in particular may find that their menstrual
cycles are irregular the first few years. The typical menstruation
period lasts from three to five days, though many women experience
either shorter or longer periods. The most common characteristics
associated with menstruation include: vaginal discharge, blood
flow, vaginal odor, cramps, bloating, tenderness in breasts,
difficulty sleeping, and moodiness. Although several of these
symptoms are typical of PMS (i.e., premenstrual syndrome),
they often persist throughout menstruation as well.
In
addition to varying menstruation cycles and durations, it
is normal for all women to exhibit vaginal odor, vaginal discharge,
and blood flow during menstruation. Odor is strongest while
perspiring and once ovulation begins and is caused when perspiration
mixes with the bacteria from your skin. Wearing cotton underwear
and a pantiliner, even once menstruation has ended will help
to prevent vaginal odor.
During
menstruation, blood flow can be light, moderate, or heavy.
By the end of menstruation approximately four tablespoons
to a cup of blood will be lost. This flow, which consists
of blood and tissue, occurs in various forms of reds and browns.
Clotting commonly occurs as well. In addition to the blood
flow, women also release small amounts of clear or white vaginal
discharge called leukorrhea. This discharge may alter in color
and consistency during menstruation by becoming heavier and
whiter (similar to an egg white consistency). Leukorrhea is
a normal element of the menstruation cycle and helps to keep
the vagina clean. However, other types of vaginal discharge
can be dangerous. Therefore, it is important to learn the
difference between leukorrhea and its more dangerous cousins
in an effort to prevent vaginal
discharge that can be harmful in the future.
Unhealthy Vaginal Discharge
Unhealthy vaginal discharge is generally associated with bacterial
infections. Although there are several forms of such infections,
each is associated with an unpleasant odor, vaginal irritation,
itching, and painful urination. The most common type of unhealthy
vaginal discharge is bacterial vaginosis. This discharge can
be caused by the organism Gardnerella, an anaerobic bacteria,
which forms in the absence of oxygen. However, Gardnerella
is only one of many bacteria that can be associated with bacterial
vaginosis; others include Prevotella, Bacteroides, Mycoplasma,
Mobiluncus. Bacterial vaginosis can be detected by clear,
milky white, or gray discharge and vaginal odor. The discharge
can be light or heavy. However, symptoms are worse near menstruation
and after having unprotected sexual intercourse. When the
vaginal fluid is mixed with semen, the odor intensifies. Although
women who are not sexually active can develop bacterial vaginosis,
it is more common in women who have had multiple sexual partners.
Women may also be more apt to develop this condition after
engaging in sexual intercourse with a new partner. Douching
and poor feminine hygiene also increase the likelihood of
developing this bacterial discharge and others. Many women
who have bacterial vaginosis do not even notice the symptoms.
Even in the absence of physical symptoms, however, bacterial
vaginosis can be detected during a physical exam and treated
with antibiotics.
A
yeast infection is another form of a bacterial infection that
affects many women and is caused by the fungus Candida. In
fact 75% of women will incur at least one yeast infection
during their lives. Vaginal discharge associated with yeast
infections is white with a cottage cheese consistency. Like
bacterial vaginosis, there are several reasons one may develop
a yeast infection. Hormone changes, wearing tight fitting
clothing or wet bathing suits for extended periods of time,
diabetes, being overweight, and the use of antibiotics seem
to be linked with yeast infections. Taking antibiotics not
only destroys harmful bacterial but useful bacteria as well,
which disrupts the body's balance. However, antibiotics can
still be effective in treating unhealthy vaginal discharge.
Not only are yeast infections common, but approximately five
percent of women develop such infections four or more times
a year. This condition is known as RVVC (recurrent vulvovaginal
candidiasis). "Although RVVC is more common in women
who have diabetes or problems with their immune systems, most
women with RVVC have no underlying medical illnesses."
Whether a yeast infection is reoccurring or infrequent, women
are encouraged to see their health care providers if an infection
is suspected. Yeast infections can be cured through the use
of oral pills, vaginal suppositories, and vaginal creams.
Although anti-yeast creams are effective in curing yeast infections,
they do not cure other types of vaginal infections. Additionally,
some creams may weaken latex condoms and diaphragms.
Another
major type of vaginal infection is trichomoniasis. Women experiencing
this condition will exhibit similar symptoms found in yeast
infections and bacterial vaginosis. However, vaginal discharge
associated with trichomoniasis is typically yellowish green.Trichomoniasis
is a sexually transmitted disease with an increased risk of
contraction for women who have had more than one sexual partner.
Men rarely exhibit symptoms, which increase the probability
of reinfection for women. Like women experiencing bacterial
vaginosis some women may appear asymptomatic. Therefore, taking
safety precautions during sexual intercourse can reduce the
risk of trichomoniasis. Both men and women can be treated
with antibiotics.
The
final common type of bacterial infection that affects one
in five women is a urinary tract infection.Although vaginal
discharge does not occur, irritation during urination is present.
Cloudy and foul smelling urine, blood in urine, lower back
pain, urinating in small amounts, and the need to urinate
frequently are common symptoms of a urinary tract infection.
Urinary tract infections affect both men and women but women
are more likely to develop them. Due to the fact that women
have a shorter urethra, bacteria can infiltrate the bladder
more easily. Women are also more prone to urinary tract infections
if they have had one previously, if their mothers or sisters
have had one, are sexually active, or past menopause. Urinary
tract infections can be treated with antibiotics after tests
are taken from a health care provider.
To
help ensure the prevention of many of the vaginal infections
discussed above, douching and using heavily fragranced soaps
and sprays are discouraged. The vaginal area should be kept
clean by using mild soap outside the vaginal area. Wearing
loose fitting clothing, cotton underwear, and pantiliners
are encouraged. Other ways to reduce the risk of developing
yeast and other bacterial infections include: practicing safe
sex, wiping from the front to the back, reducing stress levels,
and keeping diaphragms and medication applicators clean.
Other Abnormal Conditions
In addition to recognizing unhealthy forms of discharge and
other infections due to bacteria, there are other elements
of menstruation that women should monitor. One major cause
for concern is the absence of menstruation, which is also
known as amenorrhea.Adolescent girls typically begin their
first menstrual cycle between the ages of 11-16. Therefore,
if a girl has not begun menstruating by the age of 16, she
should consult her physician. This type of condition is known
as primary amenorrhea. Other women experience oligomenorrhea,
which is light or infrequent menstruation. This condition
is more common in young girls who have recently begun menstruating.Secondary
amenorrhea occurs when women who previously experienced normal
menstrual cycles have ceased to menstruate for at least three
cycles.1 Extreme weight loss due to a serious disease, stress,
eating disorders, and excessive exercise are potential causes
of this absence.Difficulties with reproductive organs and
hormonal problems can also affect the menstrual cycle in this
way.
Although
women experience varying degrees of symptoms, extreme levels
should be recognized. If bleeding is excessively heavy (an
average loss of blood is two ounces), occurring between menstruation
periods, or periods are occurring too close together, a woman
may be experiencing menorrhagia. However, it is not uncommon
for young girls who have recently started the menstruation
cycle to spot between periods. Extremely long periods, those
lasting longer than ten days, are also characteristic of this
condition. This condition is also known as DUB (i.e., dysfunctional
uterine bleeding). Hormonal imbalances, fibroids and polyps
could also cause these symptoms.
Cramps,
another common condition of menstruation, should only cause
concern if they are frequent, severely painful, and cannot
be relieved with over the counter pain medication, such as
ibuprofen or aspirin.Dysmenorrhea, the cause of such cramping,
can either be caused from very "extreme uterine muscle
contractions" or other medical conditions, such as uterine
fibroids and endometriosis. These extreme contractions usually
begin two to three years after menstruation has started and
can last up to 32-48 hours after bleeding has begun.Treatment
for both dysmenorrhea and menorrhagia is dependent upon further
investigation by a physician.
Toxic Shock Syndrome
Women should also be cognizant of any sudden or major changes
in their bodies during menstruation when using tampons. TSS
(i.e., toxic shock syndrome) is a rare but dangerous condition
that is caused by toxins of certain types of bacteria and
is associated with tampon use.In fact, approximately half
of TSS cases are from women using tampons and teenagers and
women under 30 have an increased risk of developing TSS. Other
cases of TSS have also been linked to infections following
surgeries, insect bites, and burns. The most common symptoms
of TSS are vomiting, diarrhea, high temperature, dizziness,
muscle aches, feeling faint, and a sunburn-like rash. TSS
also causes a loss of blood pressure (called hypotension)
which leads to dizziness, fainting, and ultimately may lead
to a loss of function of the entire organ systems (gastro-intestinal,
nervous, respiratory, etc.). If this condition develops, a
health care professional should be contacted immediately.
Additionally, it is important to choose the lowest necessary
tampon absorbency level and to change the tampon every four
to eight hours (or more if necessary). Alternating the use
of tampons with feminine pads will help to decrease the risk
of TSS.5 However, in women who are predisposed or susceptible
to TSS, even the correct, conservative use of tampons is not
a surefire way of preventing TSS. If you are predisposed to
TSS consult your physician for more information on the best
preventative methods.
Putting it All Together
After reading about these characteristics one may still be
questioning whether her menstrual cycle is normal and healthy.
Answering several questions will help to determine this answer.
Has your cycle undergone any major changes? Although menstruation
may not occur exactly on the 28th day each month (unless you
are using birth control pills), it is important to fall within
the range of 20-45 day cycles consistently. Are your periods
extremely heavier or lighter than usual? It is common for
the flow level to fluctuate during a menstrual period but
it should be somewhat consistent from month to month. If you
experience cramps, are they debilitating? Yes cramps can be
annoying and painful but they should not prevent you from
getting out of bed or participating in normal life activities
each month. Finally, is your vaginal
discharge and odor heavy and strong? If your discharge
is clear and not overly foul outside of your ovulation and
menstruation period, it is a good indication that the discharge
is healthy. Considering all of these factors will assist women
in determining if their menstrual cycles are normal and healthy.
However, all women should actively seek to prevent vaginal
discharge that is outside the norm, get regular physical examinations,
and question medical professionals if concerns arise. Taking
these precautions will help to promote a woman's health.
About
the Author
R.L.
Fielding has been a freelance writer for 10 years, offering
her expertise and skills to a variety of major organizations
in the education, pharmaceuticals and healthcare, financial
services, and manufacturing industries. She lives in New Jersey
with her dog and two cats and enjoys rock climbing and ornamental
gardening.
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