A regular experience in every woman's life

What is menstruation?

Menstruation is a regularly recurring bleeding from the uterus that occurs in girls and women of reproductive age. In everyday language it is often referred to as the period, the monthly cycle or ‘the days’. This event is part of the menstrual cycle, which on average repeats about every four weeks.

The first bleeding, called menarche, usually occurs between the ages of 10 and 16 and marks the beginning of sexual maturity. From that point a woman is generally capable of becoming pregnant. The bleeding itself happens when the uterine lining prepared for a possible pregnancy is not needed and is shed along with some blood.

The menstrual cycle covers the time from the start of one bleed to the start of the next. Although the average is around 28 days, variations can occur depending on the woman and her life circumstances. Menstrual fluid consists of blood and shed parts of the uterine lining.

What happens during menstruation?

During menstruation the female body undergoes a precisely regulated process closely linked to the hormonal fluctuations of the cycle. In the first half of the cycle, the so-called follicular phase, the uterine lining builds up to create a favourable environment for a fertilised egg. A follicle grows in the ovary, its development stimulated by the follicle-stimulating hormone (FSH).

At ovulation (ovulatory phase) a mature egg is released from the ovary and transported via the fallopian tube towards the uterus. At the same time, the corpus luteum in the luteal phase produces important hormones such as progesterone, causing progesterone levels to rise and the lining to thicken further in preparation for possible implantation.

If fertilisation does not occur, the corpus luteum regresses and hormone concentrations fall. As a result of this decline, the lining begins to detach. Small blood vessels in the uterus open, allowing the shed tissue to be expelled together with blood. This expelled tissue and blood make up the menstrual blood.

What complaints can occur during menstruation?

Many complaints can occur during menstruation, affecting both the body and the mind. The most common are cramp-like pains in the lower abdomen, caused by contractions of the uterine muscle. Back pain or headaches are also typical. Some women experience breast tenderness, triggered by hormonal fluctuations and felt as pulling or pressing pains.

There are often skin problems such as acne or spots, because hormone levels change during the cycle and influence sebum production. Many women also report bloating and fluid retention, noticeable as a bloated abdomen or tighter clothing. Digestive problems such as diarrhoea or constipation can accompany these symptoms, as the bowel also reacts to hormonal changes.

Another common symptom is fatigue, which can be worsened by blood loss, changes in blood sugar or sleep disturbances due to pain and restlessness. There are also emotional symptoms: mood swings, irritability or even depressive feelings are common, especially as part of premenstrual syndrome (PMS). In more severe cases, such as premenstrual dysphoric disorder (PMDD), the psychological burden can be very pronounced.

How long does a period last?

The length of menstrual bleeding varies from woman to woman, but is usually between three and seven days. The intensity of bleeding can change during this time: it is often heavier at the beginning and decreases towards the end, and there can sometimes be short interruptions.

Besides individual rhythm, factors such as hormonal fluctuations, lifestyle, age or genetic predisposition play a role in the duration of the period. During times of increased stress, puberty or changes in eating habits, the duration can shift. If bleeding is regularly shorter than three days or longer than seven days, it is sensible to have this checked by a doctor, as it may indicate cycle disorders or other health issues.

The menstrual cycle proceeds in several phases controlled by hormones. In the follicular phase a follicle matures in the ovary, stimulated by the follicle-stimulating hormone (FSH). Ovulation marks the ovulatory phase, during which there is a release of an egg. This is followed by the luteal phase, where the corpus luteum raises the progesterone level to prepare the uterine lining for a possible pregnancy. If pregnancy does not occur, hormone levels fall and menstruation begins.

When is a cycle considered irregular?

A menstrual cycle is considered irregular when the intervals between periods fall outside the usual range. For example, if bleeding occurs again less than 25 days after the start of the last period or is delayed by more than 35 days.

Complete absence of periods, very frequent or prolonged bleeding are also signs of a cycle disorder. Variations can occur where the cycle is once very short and another time considerably longer.

Can you get pregnant during your period?

During menstruation pregnancy is less likely but not impossible. Each woman's cycle is different and factors such as cycle length, bleeding duration or timing of ovulation influence fertility, so pregnancy during menstruation is theoretically possible.

Especially with shorter cycles or longer periods, fertile days and menstrual bleeding can overlap. Sperm can survive in the body for several days, so they may meet an egg that has matured early. On average, the fertile window is between the 11th and 21st day of the cycle, but variations are always possible. Unprotected sex at the end of the period can therefore lead to pregnancy if ovulation occurs shortly afterwards.

When do women stop having periods?

The end of menstruation is a natural stage in every woman's life, initiated by the hormonal changes of menopause. With age, ovarian activity decreases and less oestrogen and progesterone are produced. As a result, cycles first become irregular, bleeding may become lighter or there may be longer gaps between periods. These are typical signs that the fertile phase is coming to an end.

From perimenopause to postmenopause, the body goes through several stages in which menstrual bleeding gradually changes until it finally stops altogether. Menopause is defined retrospectively as the last menstrual bleeding after a woman has gone twelve months without bleeding. On average this occurs around the age of 51, but it can happen earlier or later for individuals.

Afterwards comes the postmenopause, when hormone production has permanently dropped to a minimum and menstruation no longer occurs. In rare cases bleeding can occur after this time and should be medically assessed. Some women enter menopause much earlier and have their last period before the age of 40.

What you can do about severe menstrual complaints: useful tips

• Place a hot water bottle or a cherry stone cushion on your lower abdomen. Heat relaxes the muscles, improves blood circulation and can significantly relieve cramps. A warm bath with essential oils, for example lavender oil, can be additionally soothing.
• Certain yoga poses, such as child's pose or cobra, help release tension and gently massage the abdominal organs.
• Deep, conscious breathing reduces stress hormones that can intensify menstrual complaints. Regularly practise diaphragmatic breathing: inhale deeply, hold briefly and exhale slowly.
• Nuts, seeds, oats and spinach are rich in magnesium. This mineral relaxes muscles and can naturally relieve menstrual cramps.
• Coffee, cola and heavily sugared snacks can worsen fluid retention and mood swings. Prefer herbal teas or water instead.
• Peppermint or chamomile tea soothes the stomach, while ginger tea reduces inflammation and helps against nausea. Drink several small cups throughout the day.
• Although rest is tempting, walks, cycling or gentle stretching are recommended as they stimulate circulation, promote endorphin release and act as a natural pain reliever.
• During sleep your body regenerates particularly intensively. Ensure a calm sleeping environment and enough hours of rest so your body can better compensate for discomfort.
• Pack a small on-the-go kit with pads or tampons, a change of clothes, painkillers and wet wipes. This helps you feel secure and relaxed even if your period suddenly becomes heavy.
• Heavy bleeding can lower iron levels. Pay attention to iron-rich foods such as lentils, beetroot or meat. In cases of marked iron deficiency, iron tablets may be necessary.
• If home remedies are insufficient, ibuprofen or diclofenac can help. These medications not only relieve pain but can also reduce bleeding. Avoid acetylsalicylic acid (ASA), as it can increase bleeding.
• Comfortable, breathable clothing that does not constrict the abdomen can improve well-being. Period underwear also offers security and comfort, especially during sports.
• Chaste tree (vitex) and lady's mantle are traditional medicinal plants that can regulate the cycle and reduce heavy menstrual bleeding. Consult your doctor before taking them.
• If the pain is particularly severe or you regularly become very weakened, consider a gynaecological examination. This can identify causes such as fibroids, hormonal imbalances or cycle disorders like amenorrhoea, polymenorrhoea, spotting or intermenstrual bleeding and allow targeted treatment.

Menstruation is a natural process that brings many physical and emotional changes, yet it is often tabooed. Open detabooing and better education can help menstruating girls and women accept support more easily and develop a more conscious relationship with their bodies.