Welcome to period.com - Information on Women Menstruation Cycle

Whether you call it the crimson tide, your monthly bill or a visit from Aunt Flo, the menstrual cycle is an integral part of your life. But considering how much time we spend on that time of the month--from puberty to menopause, the average woman menstruates almost seven whole years--many of us know surprisingly little about it. So ESSENCE asked science reporter Harriet A. Washington to put together this primer to help take the mystery out of menstruation.

WHAT'S A NORMAL MENSTRUAL PERIOD?

Though the average menstrual cycle is 28 days long and produces about 2.7 ounces of blood (a cycle is the number of days between the start of one period and the first day of the next), a healthy cycle can be anywhere from 21 to 35 days and can produce as little as a few tablespoons of blood to as much as a half cup. "Whatever your body has set for its own rhythm is what's normal for you," says Barbara A. Duncan-Cody, M.D., an OBGYN in Memphis. But radical changes are cause for concern. These three menstrual woes could signal problems:

HEAVY FLOW If your period lasts longer than seven days or you soak through a maxipad in an hour, see your doctor. Possible causes may be an ectopic pregnancy, a hormonal imbalance, an underactive thyroid, fibroids (which occur in up to 50 percent of African-American women), endometriosis or polyps.

LIGHT FLOW Taking birth-control pills can cause your period to become lighter and shorter. However, if you're not on the Pill and your flow is suddenly lighter than usual, see your gynecologist. Your light flow may be due to an overactive thyroid, stress, weight loss or pregnancy.

SKIPPED PERIODS Too much stress, prolonged bouts of serious exercise or sudden weight gain or loss can disrupt your normal rhythm as well. Or you could be pregnant. But if your period is a no-show for two months and you notice hair growth on your chest, face and arms and you develop acne, call your doctor. You may have polycystic ovary syndrome (PCOS), a disorder that affects 5 to 10 percent of American women of childbearing age. If left untreated, PCOS can increase your risk for infertility, diabetes, heart disease and endometrial cancer.

PUTTING YOUR PERIOD ON PAUSE

You've saved up the time and money to take a weeklong vacation when the inopportune happens--your period. In the past, you had two choices: Postpone your trip or pack lots of pads to last your whole vacation. But there's another option.

"Birth-control pills can be used to alter your cycle," says Nancy Roberson Jasper, M.D., an assistant clinical professor of obstetrics and gynecology at Columbia University's College of Physicians and Surgeons in New York City. Oral contraceptives, which contain hormones, are typically taken for three weeks and then stopped for one week, or a distinctly colored placebo is taken the fourth week. It's this hormone-free week, when you take the placebo or no pills at all, that induces menstruation. But if you take the active pills continuously throughout the month, you can put off your period.

Although doctors have long known about the ability to postpone menstruation, it wasn't until recently that a pill was developed specifically for this purpose. Seasonale, an oral contraceptive designed to allow women just four periods a year, is being tested and could be on the market by 2003.

Some have criticized menstrual manipulation as unnatural and raise concerns about the long-term effects of taking synthetic hormones. However, those in favor of altering women's cycles counter that the number of periods a woman has today is more unnatural. Historically, women had fewer than 150 periods over their lifetime compared with 350 to 400 today. Women used to undergo puberty at a later age, had more pregnancies and spent a longer time breast-feeding than they do now.

"Among the many positive aspects of birth-control pills are decreases in ovarian and endometrial cancers because the Pill suppresses hormones," Jasper adds. Early studies suggest that delaying your period has few short-term side effects, but few studies have been done on the possible long-term effects. Still, even proponents caution that delaying a period isn't right for every woman. It's not recommended for those for whom taking the Pill is risky--smokers and women with high blood pressure, among others. Check with your gynecologist before you try it.

CURB MENSTRUAL WOES

If you're like nine out of ten women who suffer from cramps or experience bloating, irritability and breast tenderness during menstruation, these natural measures may offer relief:

TURN UP THE HEAT. A recent study found that applying heat to your lower abdomen relieves cramps as does ibuprofen. For a high-tech twist on the hot-water bottle, try ThermaCare, a wafer-thin disposable pad worn against the skin (a 3-pack retails for $6.99 in drugstores).

GET MOVING. Even gentle, nonaerobic movement like yoga can lift your mood by releasing endorphins, which are natural antidepressants.

GO FISH. As a regular part of your diet, eat salmon, tuna or other deep-sea fish that contain cramp-reducing, mood-enhancing omega-3 fatty acids.

CURB CAFFEINE. Studies have shown that women who reduce their caffeine intake two weeks before menstruation suffer less premenstrual breast tenderness.

VEG OUT. Adding more fruits, vegetables and whole grains to your diet may reduce discomfort.

PICK HERBS. Herbal remedies such as Vitex (Vitex agnus-castus), black cohosh (Cimicifuga racemosa) and St. John's wort have shown some usefulness in relieving PMS.

BUT IF YOU NEED A PILL ... Severe cramps may be relieved by taking nonsteroidal anti-inflammatory drugs like ibuprofen (Motrin, Advil), Naproxen (Aleve) or a specialty medication such as Women's Tylenol Menstrual Relief Caplets. Taking birth-control pills can also reduce the severity of PMS, but "if menstrual pain causes you to miss work or school," Duncan-Cody says, "consult a physician."

THE DIABETES LINK

If your menstrual cycle is 40 days or longer, or you have fewer than six to eight periods a year, you may be experiencing changes in your body that can predispose you to diabetes, according to a study conducted at Brigham and Women's Hospital in Boston. The report suggests that women with very irregular or very long menstrual cycles are at greater risk for developing adult-onset, or Type 2, diabetes. Researchers suspect that the same metabolic defects that disrupt the menstrual cycle also interfere with the body's ability to use insulin properly.

If your cycle is erratic and you have other risk factors for diabetes (a family history of the disease, excess weight or a history of pregnancy-related diabetes), get regular diabetes screenings and take extra care to keep your blood sugar within healthy limits through diet and exercise. If you're diabetic, make sure you take your medications on time and ask your doctor whether you should adjust the dosage during your period.

ARE TAMPONS REALLY SAFE?

You may have received the widely circulated E-mail that seems to crop up every few months accusing tampon makers of doctoring their products with asbestos to trigger excessive menstrual bleeding (and greater demand for their product). The letter also claims that tampons contain the substance dioxin, which has been linked to cancer. But according to the Food and Drug Administration, no tampon made in the United States harbors even trace amounts of asbestos, and the process used to make tampons in the United States does not produce dioxins as a by-product--period.