MENSTRUAL CYCLE: KNOWING YOUR DATES.

Hello everyone,

Today, I thought to share some medical info with you, especially my female readers. An encounter with some female patients made me decide to throw more light on it for the sake of everyone who reads this blog. This is a problem that bugs a lot of females, but as usual, with every other problems of the reproductive tract, they tend to be concealed. I only get to see a few of my female patients who complain about their menstrual cycle, either as a measure for conception or contraception. What that simply means is, they want to know how their menstrual cycle can be calculated to prevent or prepare them for pregnancy. On the other hand, it helps the doctor determine a lot of gynecological problems. Today, however, is all about you, not me. Below is a typical discussion that can ensue between a female patient and her doctor;

• Doctor: When last did you see your period (or when was your last menstrual period)?
• Patient: Last month
• Doctor: When last month (be specific)?
• Patient: I really can't remember, maybe first or second week.
• Doctor: How long does it flow for?
• Patient: Hmmm 3 - 4 days,  on the 5th day, it's very scanty then stops.
• Doctor: Is your flow heavy?
• Patient: I guess, how would I know? It's be same since I first saw it
• Doctor: Ok, how many pads do you use in a day? And how soaked are they? (that's how you know)
• Patient: Emm.. 3 pads and it's normal.
• Doctor: What's your cycle length?\
• Patient: I don't know
• Doctor: How many days is it from one period to the next?
• Patient: Doctor, if it comes on the 1st of this month, I'd expect it on the 1st of next month. It can come on the 1st for about 3 months, then change to 30th or 31st of the same month. Hope it's normal?
• Doctor: It's okay.

And the conversion can go on from there till they arrive at the purpose for the visit, if it hasn't already been stated (which is usually the case).

The Uterus

As an adolescent, I remember vividly, when some people came to teach us about the menstrual cycle and what to expect. That lecture back in my junior secondary school days was of great value to me. I can't say how many of our adolescence have that same opportunity today. Looking back now, with more medical knowledge acquired, I know they didn't give everything, but they gave what was essential for a teenager to know about menstruation. Basically, they alleviated the fear of the unknown (for those who hadn't been given "the talk") and taught us how to calculate the days, to avoid the unnecessary embarrassment of a stained uniform.

To get into this discussion, let us start by defining a few of the sometimes confusing medical terms.

Cycle length: this is the length of time between the beginning of one period to the beginning of the next. It usually is a period of 21 - 35 days, with an average of 28 days.

Flow length: this is the number of days the period flows for. It usually lasts between 2-7 days, with an average of 4-5 days.

Last Menstrual Period (LMP): this is the first day of your last normal menstrual flow.

HOW DO YOU CALCULATE YOUR MENSTRUAL CYCLE

Your menstrual cycle can either be regular or irregular. A regular menstruation is one that comes after the same duration every month e.g. every 28, 29 30 days e.t.c. Most women have irregular cycle length, meaning it can be 28 days this month, and 30 days in the next cycle. This is normal as long as you don't exceed the normal limits stated above. The part of the menstrual cycle that bugs us females most is the ability to know our fertile and non-fertile periods. Knowing the time to expect your next period is just about counting the days, while discerning fertile period requires you to know when you are ovulating. It's still boils down to counting, but now specifically. Lots of women have asked me to please tell them when it will be safe or unsafe to meet with their partners, assuming their period started on a certain date. Now, because many women have a cycle length of 28 - 30 days, they generally assume that their ovulation day is on the 14th day of the cycle. Wrong assumption. Your ovulation can only be on the 14th day of your cycle if you have a regular (constant) cycle length of 28 days. 

For women with irregular cycle length, have no worries, we are not doomed, because even in this irregularity, there will be a range peculiar to you. The reason for the irregularities is mostly because ovulation can be affected by a number of things like stress, illness e.t.c. Remember, it is regulated by hormones. A shift forward would lengthen the cycle and vice versa. There is a constant somewhere to aid you with the monitoring. *Now, regardless of the length of your cycle, the number of days post ovulation, must be 14 days. This then goes to say we can have our ovulation day on day 12 this month (26 day cycle) or on day 16 next month (30 day cycle). 

• With this information in mind, the first step to solving this mystery is through record keeping.  You have to save the date of the first day of each period for about 6 months, in other words, know your LMP. This gives you your range. 
• Next step is to subtract 14 days (post ovulation days) from the shortest and the longest range. This gives you you probable "ovulation day".
• To start counting, Day 1 is the first day your period starts, (not the day it ends). This is the mistake that most of us make. (Even when reporting for antenatal booking).
• Using a 28 day cycle, you are safe (non fertile) from day 1-10. From day 11-16 is unsafe (fertile). This is the time you can get pregnant or abstain/protect your in the otherwise situation.
• You can't lay under the notion the ovulation is just for one day and either abstain or try your luck that single day because the ovulation day is susceptible to change, (can move forward or backward); the sperm can last for up to 48 hours in the female genital tract and fertile the egg. This is the reason for the unsafe period of about 5 -6 days.
• The next safe period is from day 16 - next menses. At this time, no matter how much you meet, you can't get pregnant. This example is for women with regular 28 day cycle.
• For the women with irregular cycles, subtract 2 from the shortest cycle you had in the last 6 months of monitoring and add 2 to the longest. That is your unsafe/ovulation period. For example, for a woman with a range of 26 - 30 days, your unsafe period becomes day 9 -18. 

HOW SURE AM I THAT I AM OVULATING?

Certain changes occur in the body of the female to indicate that she is ovulating. This is how the Catholics came about the natural method of contraception. A few of these signs are listed below;

• The commonest sign is the change in cervical mucous. This simply means the vaginal discharge. During ovulation, it becomes much, thin ad can stretch up to 8 cm. Some schools of thought have claimed that this is unreliable, because a woman can have an infection at that time, so how will she know the difference?
• Another sign is a slight rise in basal body temperature on the ovulation day. This however would require you to have a thermometer and take your temperature every morning once you wake up.
• Some women have lower abdominal pain at this time.
• Some other women have no noticeable signs or haven't taken note of them yet.

Finally, I hope I have being able to answer some of the questions that bug us women to some extent, while letting us know that it is also very helpful to your doctor. If you have any questions, don't forget to ask. Have a blessed day

Cheers......