Everything you need to know about menstruation

Added on: 27.5.2016
First menstruation and menstrual irregularities


The first menstruation is an event that every woman remembers for the rest of her life. It triggers a wave of emotions, which depend on our psychosocial and cultural factors.

The most important factors affecting girls’ first menstruation are diet, weight, body fat percentage and genetics.

The average age of girls at their first period is twelve and a half, but girls can get their first menstruation (menarche) as soon as nine or ten years of age.

It is required, that the girl reaches a minimum weight of 45 kilograms or 16 to 23,4 percent of body fat.

Women in the Western world have about 400 menstrual cycles in their fertile period of life.

The most visible sign of a normal cycle is the presence of regular menstrual periods.

The menstrual cycle begins with the first day of menstruation. In literature we usually read that the normal menstrual cycle lasts 28 days, but in reality only 15 percent of women have such cycles. A normal cycle is every cycle that lasts between 21 to 35 days. It is also common, that the cycle is slightly longer in puberty and five years before menopause.

The menstrual cycle is caused by hormones, which are released during the cycle by:

  • the hypothalamus (region of intermediate brain)
  • the pituitary gland (hypophysis)
  • ovaries.


Menstrual irregularities are one of the most common reasons why women seek gynecological help.

Absence of menstruation or amenorrhea is a normal physiological state before puberty, during pregnancy, lactation and in menopause. It can be primary or secondary.

Primary amenorrhea occurs with young women, whose menstruation doesn’t come at all. Causes for this can be lack of weight, intensive sports or dancing, as well as pathological eating disorders.

Secondary amenorrhea occurs in women with regular menstrual cycles, who happen to miss more than three of them.

Absence of menstruation can also be caused by contraceptives.

If you experience an absence of your period, we advise you to visit your gynecologist.

Painful menstruation

Painful menstruation is the most common disorder of the menstrual cycle, experienced occasionally by every woman. In the first days of the cycle, pain usually occurs in the lower abdomen in the form of cramps, and occasionally in the lower spine. Painful menstruation is most common between the ages 15 and 25. Sometimes painful menstruations disappear after childbirth and with older age.

Causes for menstrual pain can also be psychological. Some girls are taught by adults that periods are painful, and that it’s best to stay at home and avoid sports activities at that time. This makes girls subconsciously associate menstruation with pain.

In later years painful menstruations can also occur as a result of disease or abnormalities of the uterus.

If you’re experiencing painful menstruations, we advise you to seek professional help.

Irregular menstruation

For women, who are menstruating every 35 to 62 days or at a random pattern, we say that they have rare or infrequent periods. Causes for this vary, from hormonal changes to stress, travel or weight loss. This phenomenon is often observed in young girls, athletes and premenopausal women. Often the cycle gets regulated without any special treatment.

If you have irregular periods, we advise you to consult with your general practitioner or gynecologist.

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