Menstrual health overview Moods and premenstrual syndrome (PMS) Cramps In most women, various physical changes are brought about by fluctuations in hormone levels during the menstrual cycle. This includes muscle contractions of the uterus (menstrual cramping) that can precede or accompany<unk> . Many women experience painful cramps, also known as dysmenorrhea, during<unk> . Among adult women, that pain is severe enough to affect daily activity in only 2%–28%. Severe symptoms that disrupt daily activities and functioning may be diagnosed as premenstrual dysphoric disorder. These symptoms can be severe enough to affect a person's performance at work, school, and in everyday activities in a small percentage of women. When severe pelvic pain and bleeding suddenly occur or worsen during a cycle, this could be due to ectopic pregnancy and spontaneous abortion. This is checked by using a pregnancy test, ideally as soon as unusual pain begins, because ectopic pregnancies can be life‑threatening. The most common treatment for menstrual cramps are non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs can be used to reduce moderate to severe pain, and all appear similar. About 1 in 5 women do not respond to NSAIDs and require alternative therapy, such as simple analgesics or heat pads. Other medications for pain management include aspirin or paracetamol and combined oral contraceptives. Although combined oral contraceptives may be used, there is insufficient evidence for the efficacy of intrauterine progestogens. One review found tentative evidence that acupuncture may be useful, at least in the short term. Another review found insufficient evidence to determine an effect. Interactions with other conditions Known interactions between the menstrual cycle and certain health conditions include: * Some women with neurological conditions experience increased activity of their conditions at about the same time during each menstrual cycle. For example, drops in estrogen levels have been known to trigger migraines, especially when the woman who suffers migraines is also taking the birth control pill. * Many women with epilepsy have more seizures in a pattern linked to the menstrual cycle; this is called "catamenial epilepsy". Different patterns seem to exist (such as seizures coinciding with the time of<unk> , or coinciding with the time of ovulation), and the frequency with which they occur has not been firmly established. * Research indicates that women have a significantly higher likelihood of anterior cruciate ligament injuries in the pre-ovulatory stage, than post-ovulatory stage. Sexual activity Sexual feelings and behaviors change during the menstrual cycle. Before and during ovulation, high levels of estrogen and androgens result in women having a relatively increased interest in sexual activity, and relatively lower interest directly prior to and during<unk> . Unlike other mammals, women may show interest in sexual activity across all days of the menstrual cycle, regardless of fertility. There is no reliable scientific evidence that would advise against sexual intercourse during<unk>  based on medical grounds. Fertility aspects Peak fertility (the time with the highest likelihood of pregnancy resulting from sexual intercourse) occurs during just a few days of the cycle: usually two days before and two days after the ovulation date. This corresponds to the second and the beginning of the third week in a 28-day cycle. This fertile window varies from woman to woman, just as the ovulation date often varies from cycle to cycle for the same woman. A variety of methods have been developed to help individual women estimate the relatively fertile and the relatively infertile days in the cycle; these systems are called fertility awareness. Menstrual disorders Infrequent or irregular ovulation is called oligoovulation. The absence of ovulation is called anovulation. Normal menstrual flow can occur without ovulation preceding it: an anovulatory cycle. In some cycles, follicular development may start but not be completed; nevertheless, estrogens will be formed and stimulate the uterine lining. Anovulatory flow resulting from a very thick endometrium caused by prolonged, continued high estrogen levels is called estrogen breakthrough bleeding. Anovulatory bleeding triggered by a sudden drop in estrogen levels is called withdrawal bleeding. Anovulatory cycles commonly occur before menopause (perimenopause) and in women with polycystic ovary syndrome. Very little flow (less than 10 ml) is called hypomenorrhea. Regular cycles with intervals of 21 days or fewer are polymenorrhea; frequent but irregular<unk>  is known as metrorrhagia. Sudden heavy flows or amounts greater than 80 ml are termed menorrhagia. Heavy<unk>  that occurs frequently and irregularly is menometrorrhagia. The term for cycles with intervals exceeding 35 days is oligomenorrhea. Amenorrhea refers to more than three to six months without menses (while not being pregnant) during a woman's reproductive years. The term for painful periods is dysmenorrhea. There is a wide spectrum of differences in how women experience<unk> . There are several ways that someone's menstrual cycle can differ from the norm: Term Meaning Oligomenorrhea Infrequent periods Hypomenorrhea Short or light periods Polymenorrhea Frequent periods (more frequently than every 21 days) Hypermenorrhea Heavy or long periods (soaking a sanitary napkin or tampon every hour,<unk> g longer than 7 days) Dysmenorrhea Painful periods Intermenstrual bleeding Breakthrough bleeding (also called spotting) Amenorrhea Absent periods Extreme psychological stress can also result in periods stopping. More severe symptoms of anxiety or depression may be signs of premenstrual dysphoric disorder (PMDD) with is a depressive disorder. Dysfunctional uterine bleeding is a hormonally caused bleeding abnormality. Dysfunctional uterine bleeding typically occurs in premenopausal women who do not ovulate normally (i.e. are anovulatory). All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems. As pregnant women may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding. Women who had undergone female genital mutilation (particularly type III- infibulation) a practice common in parts of Africa, may experience menstrual problems, such as slow and painful<unk> , that is caused by the near-complete sealing off of the vagina. Dysmenorrhea
Menstruation
Menarche
Vibroejaculation
Electroejaculation
Menstrual leave
Menopause
Anejaculation
Lactational amenorrhea