Gynecology Book


Menstrual Bleeding

Aka: Menstrual Bleeding, Menses, Menarche, Menstruation
  1. See Also
    1. Menstrual Cycle
    2. Amenorrhea
    3. Abnormal Uterine Bleeding
  2. Definitions
    1. Normal Cycles
      1. Cycle Duration: 28 days (21-35 days)
      2. Days of Flow: 4.6 days (2-8 days)
      3. Estimated Blood Loss: 35 ml per cycle (20-80 ml)
    2. Abnormal Cycle Length
      1. Polymenorrhea: Cycle less than 21 day cycles
      2. Oligomenorrhea: Cycle greater than 35 day cycles (>45 days in adolescents)
      3. Metrorrhagia: Irregularly frequent Menses
    3. Abnormal Menstrual Flow
      1. Menorrhagia (Hypermenorrhea)
        1. Over 80 cc blood loss per cycle
        2. Change pad or tampon every 1-2 hours
        3. Blood clots >1 inch (2.5 cm)
        4. More than 7 days of menstrual flow
      2. Menometrorrhagia (Metrorrhagia and Menorrhagia)
        1. Prolonged, irregularly frequent, heavy Menses
    4. Dysfunctional Uterine Bleeding
      1. Excessive, prolonged, or irregular uterine bleeding
  3. Physiology: Ages of Menstrual Landmarks
    1. Thelarche: (10.2 to 11.3 years)
      1. See Tanner Girls Breast Development Stage
      2. Onset of secondary Breast development (marks the start of Puberty)
      3. Precedes Menarche by 24 months
    2. Menarche: 12.8 years (9.1 to 17.7 years)
      1. Precedes regular Menses by 12 months
      2. Anovulatory Cycles predominate initially
        1. Years 1 to 2 after Menarche: 55-85% of cycles
        2. Years 3 to 4 after Menarche: 30-50% of cycles
        3. Years 5 to 6 after Menarche: <20% of cycles
    3. Menopause: 51.4 years (48 to 55 years)

Menarche (C0025274)

Definition (GO) The beginning of the menstrual cycle; the first menstrual cycle in an individual. [GOC:curators, PMID:16311040]
Definition (NCI) Onset of menses.
Definition (MSH) The first MENSTRUAL CYCLE marked by the initiation of MENSTRUATION.
Concepts Organism Function (T040)
MSH D008572
SnomedCT 20016009
English Menarche, menarche (symptom), menarche, first menstrual cycle, Menarche (finding)
Czech menarche, menstruační cyklus první, Menarché, první menstruace, menarché
Finnish Menarke
French Ménarche, Première menstruation, Ménarque
Swedish Menarke
Japanese ショケイ, 初経
Croatian MENARHA
Polish Rozpoczęcie miesiączkowania, Pierwsza miesiączka
Hungarian Menarche
Spanish Menarca, menarca (hallazgo), menarca, Menarquia
Dutch menarche, Menarche
German Menarche
Italian Menarca
Portuguese Menarca
Derived from the NIH UMLS (Unified Medical Language System)

Menstruation (C0025344)

Definition (ICF) Functions associated with the menstrual cycle, including regularity of menstruation and discharge of menstrual fluids.
Definition (ICF-CY) Functions associated with the menstrual cycle, including regularity of menstruation and discharge of menstrual fluids.
Definition (CHV) relating to period
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (CHV) menstruation
Definition (GO) The cyclic, physiologic discharge through the vagina of blood and endometrial tissues from the nonpregnant uterus. [GOC:curators, PMID:8693059]
Definition (MEDLINEPLUS)

Menstruation, or period, is normal vaginal bleeding that occurs as part of a woman's monthly cycle. Every month, your body prepares for pregnancy. If no pregnancy occurs, the uterus, or womb, sheds its lining. The menstrual blood is partly blood and partly tissue from inside the uterus. It passes out of the body through the vagina.

Periods usually start between age 11 and 14 and continue until menopause at about age 51. They usually last from three to five days. Besides bleeding from the vagina, you may have

  • Abdominal or pelvic cramping
  • Lower back pain
  • Bloating and sore breasts
  • Food cravings
  • Mood swings and irritability
  • Headache and fatigue

Premenstrual syndrome, or PMS, is a group of symptoms that start before the period. It can include emotional and physical symptoms.

Consult your health care provider if you have big changes in your cycle. They may be signs of other problems that should be treated.

NIH: National Institute of Child Health and Human Development

Definition (NCI_NCI-GLOSS) Periodic discharge of blood and tissue from the uterus. From puberty until menopause, menstruation occurs about every 28 days when a woman is not pregnant.
Definition (NCI) The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus.
Definition (MSH) The periodic shedding of the ENDOMETRIUM and associated menstrual bleeding in the MENSTRUAL CYCLE of humans and primates. Menstruation is due to the decline in circulating PROGESTERONE, and occurs at the late LUTEAL PHASE when LUTEOLYSIS of the CORPUS LUTEUM takes place.
Concepts Organism Function (T040)
MSH D008598
SnomedCT 248957007
English Menstruation, Menstruations, menses, Menstrual, Menstruation, function, Menstruation functions, menstruations, flow menstrual, menstrual flow, catamenia, menorrhea, period, menorrhoea, periods, menstrual, Menstrual period, Period, menstrual period, menstruation, Catamenia, Menorrhea, Menses, Periods, Menorrhoea, Menstrual flow, Menstruation, function (observable entity), Menstruation (qualifier value)
Swedish Menstruation
Czech menstruace, měsíčky, menses
Finnish Kuukautisvuoto
French Règles, Menstruation
Polish Miesiączkowanie, Menstruacja, Miesiączka
Norwegian Menstruasjon
Portuguese Catamênio, Período Menstrual, Menorreia, Mênstruo, Menstruação
Spanish catamenia, flujo menstrual, menorrea, menstruación (calificador), menstruación (entidad observable), menstruación, períodos, Menstruación
German Menstruation
Italian Mestruazione
Dutch Menstruatie
Derived from the NIH UMLS (Unified Medical Language System)

Menstruation Disturbances (C0025345)

Definition (MSH) Variations of menstruation which may be indicative of disease.
Definition (CSP) variations of menstruation or the menstrual cycle which may be indicative of disease.
Concepts Pathologic Function (T046)
MSH D008599
SnomedCT 156033006, 9649008, 198432005, 3148008, 266606008, 386803005, 266675008, 156057006, 156047005, 156040007, 386804004, 289896006
English Disorder, Menstruation, Disorders, Menstruation, Menstruation Disorder, Menstruation Disorders, MENSTRUAL DISORDER, menstrual cycle disorder, Menstruation disorder, Menstruation disorder NOS, Menoxenia, MENSTRUATION DIS, Menstrual disorders NOS, Menstruation Disturbances, abnormal menstruation, abnormal periods, abnormal menses, abnormal menses (symptom), Menstruation abnormal, Disorder menstrual, Menstrual disorder NOS, Menstrual disturbance NOS, Disturbance, Menstruation, Disturbances, Menstruation, Menstruation Disturbance, Menstrual disorders, Menstruation Disturbances [Disease/Finding], disorder periods, cycle disorders menstrual, menstruation problem, menstrual disturbance, menoxenia, period problems, disorders menstrual, Problem;menstrual, problem period, disorder menstruation, disorders period, menstrual disorders, problem menstrual, disturbances menstrual, menstruation abnormal, menstrual problems, periods problems, disorder period, menstrual disorder, menstruation disorders, menstruation disturbances, syndrome menstruation, menstrual problem, disorders menstruation, disorders periods, menstruation problems, Abnormal menstruation (finding), Menstruation disorder NOS (disorder), Problem of menstruation (disorder), Menstruation disorder (disorder), Paramenia, Menstruation disorders, Period disorder, Menstrual problem, Period problem, Menstrual disorder, Disorder of menstruation (disorder), Disorder of menstruation, Problem of menstruation, disorder; menstrual, abnormal; periods, menstruation; disorder, menstruation; syndrome, paramenia, periods; abnormal, Abnormal menstruation, NOS, Problem of menstruation, NOS, Menstrual disorder, NOS, Menstrual Disorders, Menstrual Disorder, Abnormal menstruation, Menstrual problem (navigational concept), Menstrual problem (finding), Menstruation disorder NOS (finding)
Italian Disturbo mestruale, Disturbo mestruale non specificato, Mestruazioni anormali, Anomalia della mestruazione, Disordini mestruali, Disturbi mestruali
Dutch menstruatiestoornis NAO, menstruele stoornis NAO, afwijkende menstruatie, stoornis menstruatie, menoxenie, abnormaal; menstruatie, menstruatie; abnormaal, menstruatie; stoornis, menstruatie; syndroom, stoornis; menstruatie, menstruatiestoornis, Menstruatiestoornis
French Trouble menstruel SAI, Trouble des règles SAI, Menstruation anormale, Menoxenie, TROUBLE MENSTRUEL, Problèmes menstruels, Trouble menstruel, Troubles de la menstruation, Troubles menstruels
German Menstruationsstoerung NNB, Stoerung menstruell, Menstruation anomal, Zyklusstoerung, MENSTRUATIONSSTOERUNG, menstruelle Erkrankung, Menstruationsstörungen, Störungen der Menstruation
Portuguese Perturbação menstrual NE, Menstruação anormal, Menoxenia, ALTERACAO MENSTRUAL, Transtornos Menstruais, Distúrbios da Menstruação, Perturbação menstrual, Distúrbios Menstruais, Transtornos da Menstruação
Spanish Trastorno menstrual NEOM, Menstruación anormal, Alteración menstrual NEOM, problema menstrual (hallazgo), trastorno de la menstruación, SAI (hallazgo), Menoxenia, MENSTRUACION, TRASTORNO, menstruación anormal (hallazgo), trastorno de la menstruación, SAI, trastorno de la menstruación, SAI (trastorno), menoxenia, Menstruation disorder NOS, menstruación anormal, alteración menstrual, problema menstrual (concepto no activo), paramenia, problema menstrual, trastorno menstrual (trastorno), trastorno menstrual, Trastorno menstrual, problema menstrual (concepto para navegación), Trastornos de la Menstruación, Trastornos Menstruales
Japanese 月経障害NOS, 異常月経, ゲッケイショウガイ, ゲッケイショウガイNOS, イジョウゲッケイ, 月経過少, 月経障害, 月経-逆行性, 逆行性月経, 月経頻発, 頻発月経, 過少月経, 月経異常
Swedish Menstruationsstörningar
Finnish Kuukautishäiriöt
Czech Porucha menstruace NOS, Menoxenie, Abnormální menstruace, Porucha menstruace, menstruace - poruchy, menstruační poruchy, poruchy menstruace
Polish Patologia cyklu miesiączkowego, Zaburzenia miesiączkowania, Zakłócenia miesiączkowania
Hungarian Menoxenia, menstruatiós eltérés, Menstruatiós zavar, Kóros menstruatio, Menstruatiós eltérés k.m.n., Menstruatiós zavar k.m.n.
Norwegian Menstruasjonsforstyrrelser, Uregelmessige blødninger
Derived from the NIH UMLS (Unified Medical Language System)

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