What is mensuration or periods?   

• Menstruation is normal vaginal bleeding that occurs as part of a woman's monthly cycle  
• The onset of menstruation is a sign that a female body is prepared for normal reproductive function  

What is menarche?

• Menarche is the occurrence of the first menstrual period  
• It usually starts between the age of 11 and 14 and continues until menopause at about age 51  
• The length of a normal menstrual cycle is around 24-38 days with bleeding around 4-7 days  
• It is the result of the interaction between various hormones, that is the hypothalamic, pituitary, and ovarian hormones  

How does mensuration happen?  

• When ovulation is not followed by fertilization, the endometrium sheds its functional layer. The process is called mensuration.  

Does a girl undergo physiological changes at the age of menarche?  

• Yes. Physiological changes occur at the age of menarche
• Generally, the first experience would be fear, shame, or embarrassment
• Pain and severe cramps
• Heaviness in the lower abdomen
• Hygiene issues, infection
• Anemia due to heavy bleeding
• Lethargy  

What are the factors that affect the pattern of mensuration?  

• Genetic factors  
• Age of menarche  
• Nutrition  
• Race, Geographical location, and Environmental conditions  
• Health status, Psychological factors  
• Body Mass Index (BMI)  
• Socio economic status  
• Education and occupation of parents  
• Loss of parents  
• Child sexual abuse  
• Physical stress and Smoking  

Does mensuration hold a sociological relevance?  

• It is very important in health planning  
• Studies indicate that the average age of menarche has reduced significantly in the last few years  
• There’s a trend of early onset of menarche in developing and developed countries  

What is the Indian scenario?  

• About 50% of girls in India know nothing about their period until they start their periods  
• Only 18% of women of menstruating age have access to sanitary products  
• 82% lack awareness about menstrual hygiene  
• Disposable pads are costly and not always available in rural areas. Only 5% of rural women can afford to buy disposable pads.  

How can we create awareness of menstrual hygiene?  

• Every girl should be taught about menstruation before their first period  
• Girls should be educated by their mothers and teachers  
• They can be taught about menstrual hygiene from the time of thelarche or the appearance of breast buds, pubic, and axillary hair  
• Girls should be taught the need to change sanitary napkins every 4 to 6 hours  
• They should know how to properly discard used sanitary napkins  
• They should know to wash, wear clean and dry undergarments  
• Those using clothes should know how to use clean clothes and change these at frequent intervals  
• The clothes should be properly washed, dried, and stored in a clean and dry place  
• Provide a separate storage facility to keep these clothes  
• If clothes are not maintained properly, it will lead to the growth of microorganisms that cause infection  

What is the role of schools?  

• Do not consider it a taboo subject  
• Provide sufficient facilities to change and dispose of their menstrual products and clean themselves  
• Provide sanitation facilities that are safe. Ensure privacy  
• Provide access to clean water, soap and dustbin  
• Create an environment where a menstruating girl is treated respectfully  
• It is prudent to integrate sex education into the school curriculum  
• Create an environment where girls and boys learn about it at a very young age  
• Schools can make facilities for sanitary napkin vending machines  

Menstrual hygiene tips  

• Change your pads frequently  
• Try to use cotton sanitary pads  
• Clean reusable pads properly  
• Keep the perineal area clean  
• Wear comfortable, clean underwear  
• Use correct washing techniques  
• Discard used sanitary pads properly  
• Consult a gynecologist in case of irregular or heavy bleeding  
• Menstruation should be considered normal  

Consult your doctor at Amrita Hospital for a detailed medical examination and treatment.