Menstrual Symptoms

What is it?

Menstrual symptoms are the discomfort that a woman experiences because of her menstrual cycle. Symptoms may include menstrual pain ("period pains"), ovulation pain ("mittelschmerz") and premenstrual syndrome (PMS).

Menstrual symptoms in the past were dismissed as psychological, but we now know that they have a physiologic basis. They are caused by the dramatic hormonal changes that occur in a woman's body during her menstrual cycle. The menstrual cycle lasts approximately 28 days, although some women experience a longer or shorter cycle.

During the first 5-10 days of the menstrual cycle, the lining of the uterus is shed and women experience menstruation, or "their period". The muscle contractions of the uterus during this phase of the menstrual cycle are caused by an increase in chemical substances called prostaglandins. Prostaglandins can bring on menstrual pain, or dysmenorrhea (pronounced dis-men-o-REE-uh), by making the contractions too long and strong, temporarily depriving the uterus of oxygen.

After menstruation, estrogen levels rise. At around day 14 an egg is released from the ovary, a process called "ovulation." Ovulation is painful for some women because a small amount of blood escapes from the ovary into the abdominal cavity and irritates other organs.

After ovulation, estrogen levels continue to increase, as do levels of progesterone, another hormone. If the egg is not fertilized (i.e. the woman does not become pregnant) estrogen and progesterone start to plummet around 4 days before the next period. This rapid hormonal rollercoaster may be the cause of PMS.