Menstruation: Symptoms, Treatment, and Mental Health

Menstruation is a natural process that a woman's body undergoes periodically each month. It is also known as a menstrual period, menses, or monthly bleeding. This process occurs after an egg is released from the ovary. If pregnancy does not occur, the body sheds the uterine lining that was prepared to receive the fertilized egg. It leaves the body as blood containing the mucosal tissue shed from the walls of the uterus. This lining is renewed after the resulting bleeding ends. 

The length of the menstrual cycle is measured from the first day of the current period to the first day of the next one. The average menstrual cycle lasts 28 to 29 days, although it differs from one woman to another. For example, it may be as short as 21 days or as long as 38 days. Menstruation usually begins between the ages of nine and fifteen, around puberty, and continues throughout a woman's natural reproductive years. Its regularity may be disrupted by factors related to pregnancy, stress, or diet, but it officially ends with menopause, which usually occurs in a woman's fifties, or for other, less common health reasons.

You can use a diary or download an app to predict your period and prepare for it in advance, as technological advances provide simple ways to calculate menstrual days and get ready for their arrival.

Menstrual symptoms 

Menstrual symptoms and signs differ from one woman to another, but common symptoms generally include the following:

• Pain: Many women may experience pain in several areas of the body, including the back, thighs, pelvic area, and breasts, before and/or during menstruation.
• Bloating or swelling: This may occur in the palms, legs, and feet before and/or during menstruation.
• Constipation or diarrhea: Digestive function may be disrupted before and/or during menstruation, with effects that differ from one woman to another.
• Headaches: Some women may experience recurring headaches during menstruation.
• Brittle hair: Hair may become weak and sensitive, or oily, before and/or during menstruation because of the hormonal changes that accompany this time.
• Skin irritation: Menstruation may cause facial blemishes or make the skin lose some of its freshness and vitality.
• Low mood: Many women may experience fatigue, weakness, and anger before and/or during menstruation, especially when two or more of the symptoms mentioned above occur together.
• Reduced or absent sexual desire: Or the opposite, particularly in the days before menstruation.
• Bleeding, the most visible symptom: Bleeding occurs during menstruation and may last from 3 to 7 days. It usually becomes lighter over time.

These are some of the most prominent menstrual symptoms, but signs and symptoms may differ from one woman to another. One woman may have a painless period, while another may experience all these symptoms together. Other symptoms, such as nausea, excessive appetite, or sleep disturbances, may occur during some periods but not others. It is worth noting that not experiencing these problems during one period does not mean they will not appear during a later period in the same woman, and vice versa.

Menstruation and mental health conditions 

Premenstrual syndrome (PMS) refers to a group of physical and emotional symptoms that some women experience in the days before menstruation. These symptoms may include sensitivity, mood swings, and feelings of anxiety or depression. The precise cause of premenstrual syndrome has not been fully established, but it is thought to be related to the hormonal changes that occur during the menstrual cycle.

During the menstrual cycle, levels of hormones such as estrogen, progesterone, and serotonin fluctuate. It is thought that these hormonal changes may alter neurotransmitters in the brain, which in turn can negatively affect a woman's mood and behavior in general. Premenstrual syndrome may also cause physical discomfort, including cramps, bloating, and the other symptoms mentioned above, which may contribute to negative feelings.

Many women may experience mood changes during menstruation, and these changes may be more pronounced in women with mental health conditions such as depression and anxiety. Similarly, mental health problems such as anxiety and depression may disrupt the menstrual cycle, making the relationship between menstruation and mental health conditions a two-way one.

It is worth noting that not every woman experiences premenstrual syndrome, and it may cause a wide range of symptoms with varying degrees of severity. Some women may experience stronger symptoms that constitute premenstrual dysphoric disorder (PMDD), a more severe form of PMS that affects a smaller proportion of women.

It is important to recognize that the mood changes some women experience before or during menstruation are not an excuse to dismiss or belittle their feelings. It is essential to ensure that women experiencing premenstrual syndrome are safe and supported, and to seek medical care if the symptoms are severe enough to interfere with daily life.

It is also important to understand and raise awareness that menstruation and mental health conditions are separate and distinct. Experiencing mood changes during menstruation does not necessarily mean that a woman has a mental health condition. If these changes significantly affect her life, it is in her interest to seek the treatment and support needed to manage them and to discuss any worrying or distressing symptoms with a healthcare provider.

What causes emotional distress during menstruation?

Many women experience psychological distress during menstruation, and experts believe the main reason is the hormonal changes that occur at this time. The changes in the hormones mentioned above affect brain chemistry and the nervous system and may lead to mood changes and, consequently, feelings of anxiety, fatigue, and depression.

The following are some other possible causes of psychological distress before or during menstruation:

1. Physical pain: Some women experience severe physical pain during menstruation, which may explain why some feel weak and low.
2. Stress and anxiety: Stress caused by a fast-paced lifestyle may intensify psychological distress during menstruation.
3. Lack of sleep: Too little or irregular sleep may increase stress and strain or burnout, worsening psychological distress during menstruation.
4. An unbalanced diet: Overeating or consuming unhealthy food may cause guilt and fear of gaining weight, adding to the psychological distress mentioned above.
5. A negative view of menstruation: Unhealthy sex education may lead some women to regard menstruation as a source of embarrassment or shame. They may approach it with pessimism and disgust, which may unconsciously intensify other psychological difficulties.

If psychological distress during menstruation is confirmed, women experiencing it for any reason should contact a specialist. A doctor may recommend treatment for the woman's specific physical or psychological symptoms, using suitable hormonal medications, medicines that counter those symptoms, or psychological therapies.

Treatment for menstrual symptoms 

Many different treatments may be used to reduce the severity of symptoms associated with menstruation, depending on the type and severity of the symptoms a woman experiences. Treatments used to ease common menstrual symptoms include:

• Pain relievers: Pain relievers such as aspirin and ibuprofen may be taken to ease menstrual pain.
• Nutritional supplements: Some nutrients may work wonders for the body, particularly calcium, vitamin B6, and magnesium.
• Hormonal treatment: Hormonal treatments such as birth control pills or other hormonal medications may be used to regulate the body's hormones and reduce symptoms associated with menstruation.
• Exercise: Regular exercise may have a positive effect on women's mental and physical health, and on human health in general.
• Psychological therapy: You can consult a specialist in mental health for psychological support and to discuss any emotional difficulties that may be related to menstruation.
• Improving your lifestyle: Following a healthy lifestyle, eating a healthy and balanced diet, and getting enough rest and sleep may help reduce symptoms associated with menstruation.

Mothers and grandmothers also have practical, experience-based advice for naturally and safely reducing menstrual pain and speeding up the period. Among the most effective suggestions are:

• Drink plenty of fluids: Drinks and liquid foods, such as soup or broth, may help menstruation proceed more easily without harming the body.
• Avoid swimming and bathing: Because of water pressure, immersing the lower body in water may cause blood retention and consequently increase pain, particularly in the abdomen. However, taking a hot shower is recommended.
• Use suitable menstrual products: While sanitary pads cause itching and irritation for some women, they may be the best option for others. Many types of menstrual products suit different lifestyles and offer women a sense of freedom and security.
• Keep the body warm: Menstrual pain may sometimes intensify when body temperature drops. Wearing warm, comfortable clothing during this time and placing a bottle of boiled water over the uterine area are therefore recommended.

It is also helpful to keep a symptom diary for at least 2 to 3 menstrual cycles and bring it to a doctor's appointment. A woman experiencing any unusual menstrual symptoms, such as an interruption in bleeding or a change in the color and/or volume of blood, should speak with a healthcare provider to identify the cause and receive appropriate treatment.

Treating menstrual depression 

Although menstruation does not directly cause depression, its symptoms may make depression more severe; here, depression refers to the mental health condition. There is, however, a different form of depression that accompanies menstruation, and its treatment may vary according to the severity and cause of the condition. Nevertheless, the following suggestions may apply in most cases:

1. Do light exercise: Contrary to what some people believe, exercising during menstruation can be helpful. Light exercise, such as aerobics, prompts the body to release endorphins, hormones that contribute to feelings of happiness and satisfaction with oneself.
2. Follow a healthy diet: What you eat may affect your mood. Try including foods rich in vitamins, minerals, and fiber in your meals, such as vegetables, fruit, and whole grains, and reduce the amount of salt and fat in your food.
3. Avoid stimulants and alcohol: The caffeine in black tea and coffee, as well as smoking and drinking alcohol, may have an adverse effect during menstruation. Try healthy alternatives such as milk, fresh juice, and green tea.
4. Get enough sleep: Try to get between 7 and 8 hours of sleep each night. Lack of sleep may cause fatigue and stress, which can worsen depression.
5. Relaxation and meditation: Stepping away from sources of stress and practicing meditation through activities such as yoga and focused breathing exercises may help ease depression. Aromatic oils with scents such as lilac or jasmine may also help improve mood and relieve stress.
6. Psychological support: Talk to a friend or family member, or seek help from a mental health professional if you feel that you need psychological support. You can also join an in-person or online support group.
7. Herbal remedies: Some wild herbs, such as thyme and ginger, have natural properties that may help lessen depression through their positive effects on the body. 
8. Medication: In some cases, a doctor may prescribe nutritional supplements or antidepressant medications to help ease symptoms. Remember that you must consult a doctor before taking any medication.

In general, adopting a healthier way of life can help overcome any psychological or physical ailment. Instead of fearing menstruation and its side effects, it can be viewed as a time of recovery and renewal for the body and an opportunity to make better decisions about habits and preferences.

 If your wife, sister, or another woman close to you is experiencing menstrual depression and you would like to help her, do the following:

• Offer to help her with housework and other tasks whenever possible.
• Give her emotional and moral support, and listen as she talks through her problems and feelings.
• Avoid provoking or arguing with her, and try to be considerate of her feelings, especially negative ones, as much as possible.
• Help her follow the treatment approaches mentioned above, for example by providing the necessary resources or offering activities such as massage and preparing the bathroom.
• Be aware that her temperament and behavior during menstruation do not represent her true personality; rather, they reflect several internal and external pressures.

Always remember that she will be grateful for anything you do to help her through this difficult time, and this will positively affect your relationship with her, whatever its nature.

In summary

Menstruation is a natural cycle that a woman's body goes through each month. It involves changes in hormone levels and their effects on the body and mind. Some women may experience changes in mood and emotional well-being during menstruation, including depression, anxiety, stress, and irritability.

To manage these difficulties, women can take practical steps such as exercising regularly and eating foods rich in nutrients, vitamins, and minerals. They may also use relaxation techniques such as meditation, yoga, deep breathing, and acupuncture, while avoiding stress, reducing tension, and setting priorities.

Although menstruation can be challenging for women, it is important to recognize that it is a natural process and a sign of fertility, and women should not feel ashamed or embarrassed by it. Women can obtain the support they need from friends, family, and healthcare professionals to manage effectively the psychological challenges that may arise from menstruation.