Menstruation

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Menstrual cycle

The menstrual (from the Latin menstruatio ) or menstrual bleeding is the recurring bleeding from the uterus of some species of animals and humans with rejection of the endometrium , which colloquially as a period from an average of four to five days for short period is called. The first menstruation is called menarche , the last menstruation is called menopause . They mark the beginning and the end of the physically fertile time in the biological life of the female or woman .

The word derives from the Latin menstruus 'monthly' to Latin mensis 'month' , since the menstrual cycle in humans lasts about 27 days and the lunar month about 28 days. Synonyms are rule , men , days or menorrhea (from ancient Greek μήν 'month' and ῥέω 'I flow' ; medically outdated also monthly flow ).

Menstruation occurs exclusively in mammals and is restricted to a few species . It occurs in the African elephants , some bat species and the higher primates , including humans.

biology

The first day of menstruation defines the beginning of the menstrual cycle , which through its hormonal control circuits leads to the maturation of a Graaf’s follicle , ovulation and the preparation of the uterine lining for the implantation of the finally fertilized egg cell . On average, 65 ml and a maximum of 200 ml of fluid is excreted, which consists not only of blood, but also of secretions and mucous membrane residues. The absence of menstruation is known as amenorrhea . The absence of menstruation after conception is the first clearly noticeable sign of the onset of pregnancy .

If the monthly flow is strong and excessive (over 200 ml), the doctor speaks of hypermenorrhea . Too frequent menstruation with an interval of less than 23 days is called polymenorrhea . If the interval is longer than 35 days, it is called oligomenorrhea . The bleeding is triggered by the periodic rejection of the uterine lining in primates , which in women occurs approximately every 27 days and lasts about five to seven days, with individual fluctuations being possible. For many women, menstruation is associated with symptoms that are commonly grouped under the term menstrual cramps .

Female animals living in the wild rarely menstruate, because even if, like bonobos , they are not ready to conceive just once a year, fertilization usually takes place. One of the reasons for this is that many animals have what is known as induced ovulation. This means that they only ovulate during mating or shortly before.

evolution

There are several theories about the evolution of menstruation. Their adaptive value is questionable due to the rarity of menstruation in the animal world.

One theory suggests that menstruation evolved to clear the uterus and fallopian tubes of pathogens attached to sperm by removing infected parts of the uterine lining as immune cells advance into the uterus.

Another hypothesis is that the uterine lining is shed because cyclical regression and renewal is energetically more beneficial than maintaining the uterine lining in the metabolically active state necessary for a zygote to implant. Therefore, the high bleeding rate in humans and chimpanzees compared to other species could be attributed to the relative size of the uterus in relation to body size and relatively small blood vessels.

It is also considered possible that menstruation prepares uterine tissue in the sense of a “preconditioning” for the high level of inflammation and oxidative stress that is associated with deep placentation in humans.

Another theory suggests that menstruation is a mechanistic consequence of spontaneous decidualization (remodeling of cells in the uterus), which is supported by the correlation between spontaneous decidualization and menstruation in different species.

In most species, decidualization does not happen spontaneously, rather it is triggered by embryonic signals, but spontaneous decidualization could facilitate the rejection of defective embryos, i.e. that is, it developed in higher primates, likely due to a mother-fetal conflict resolved by female primates preparing for pregnancy without signals from the fetus.

history

In Western medicine, menstruation has long been considered an indispensable prerequisite for maintaining the health and fertility of women. Even if there are negative attitudes associated with menstruation in many places, there are also traditions in which positive feelings, pride in being a woman and happiness about fertility are associated with menstruation.

According to the Torah and Jewish tradition, not only does contact with menstrual blood make objects and living beings impure for a defined period of time, but the fact that (according to Jewish belief) a dying process has taken place in the woman's body means that she is considered "impure" and this impurity can also transmit.

“If a woman has blood flow and there is such blood on her body, she should remain in the impurity of her period for seven days. Anyone who touches them is unclean until evening. "

- 3 Mos 15.19  EU

In Hindu traditions, a woman's presence during her days in a religious rite can render it ineffective or, worse, reverse it. In Judaism and Islam , the spouses are not allowed to have sexual intercourse with each other during the period, during this time the Muslim woman is also not allowed to perform typical ritual prayer.

Superstition

To this day, some of the centuries-old superstitions that menstrual blood or body fluids are harmful to menstrual women persist. Accordingly, menstruating women should, for example, not whip cream, as it would otherwise go bad, do not boil down fruit and vegetables, not help with slaughter, only clean with household gloves, do not have a water or perm, et cetera.

In this day and age, menstrual myths are increasingly dying out. Scientifically speaking, there is nothing that can support this superstition . Menstrual secretions do not normally contain any toxins or viruses that would not be found in normal blood, although substances such as menotoxin have long been discussed. However, it also follows that pathogens that can be transmitted through contact with infectious blood, e.g. B. hepatitis B or HIV , can very well lead to infections through menstrual secretions and used hygiene products. The menstrual secretion also contains the germs of the vaginal flora, which decompose the secretion and thus lead to an unpleasant odor.

In the historical context, some menstrual commands can be understood. In the Middle Ages there was no running water in houses and apartments, neither underwear nor disposable sanitary towels. Textiles were expensive, so that even simple cloth bandages were largely unknown. The menstrual secretion ran down the inner thighs to the feet and could also stain everyday objects. Women of fertile age were not allowed to take part in the winemaking process, as the grapes were trampled barefoot in a large vat.

hygiene

For the collection of menstrual secretions, mainly disposable articles have prevailed in the present. Including sanitary towels that are worn in underwear and thus catch the blood outside the body; as well as tampons and, more rarely, foam sponges ( soft tampons ), which are inserted into the vagina and suck up the blood there. There are also reusable items such as washable sanitary towels made of cotton fabric , natural sponges or menstrual cups made of latex or medical silicone . In contrast to all other hygiene articles, the blood is not sucked up in them, but rather caught in a cup inside the vagina, which can then be poured out, washed out and used again immediately.

literature

  • Julia Becket: Ruby Red Time - Beginning of Menstruation. “Do you remember…” women between the ages of 19 and 90 tell stories . Diametric, Würzburg 2007, ISBN 978-3-938580-09-7 .
  • Sabine Brehme: Illness and gender: syphilis and menstruation in the early medical journals (1801–1809) of Samuel Hahnemann . Tectum, Marburg 2006, ISBN 978-3-8288-9233-0 (dissertation, University of Witten / Herdecke 2005, 301 pages, under the title: Gender-specific therapy of venereal diseases and classification of menstruation in the early days of homeopathy).
  • Helene Fels: Contributions to the doctrine of menstruation from the beginning of the cell theory to the beginning of the doctrine of internal secretion . Berlin 1961, DNB  481875042 (42 p., Dissertation Free University of Berlin, Medical Faculty, August 22, 1961).
  • Sabine Hering , Gudrun Maierhof: The unfit woman. Social history of menstruation and hygiene . 2nd Edition. Mabuse, Frankfurt am Main 2002, ISBN 3-933050-99-5 (first edition: Centaurus, Pfaffenweiler 1991, ISBN 3-89085-633-0 ).
  • Elisabeth Höfinger-Hampel: Topics for girls in physical education: menstruation and breast growth . Budrich, Opladen / Farmington Hills MI 2010, ISBN 978-3-940755-69-8 (Dissertation Uni Erlangen-Nürnberg [2010], 176 p., Under the title: About dealing with menstruation and breast growth in physical education for girls, especially Consideration of the role of the PE teacher ).
  • Kristina Hohage: menstruation. An exploratory study on the history and meaning of a taboo (=  Socialia series . Volume 31 ). Kovač, Hamburg 1998, ISBN 3-86064-845-4 (Dissertation Westfälische Wilhelms-Universität 1998, 347 pages).
  • Lois Jovanovic, Genell J. Subak-Sharpe: Hormones. The medical manual for women. (Original edition: Hormones. The Woman's Answerbook. Atheneum, New York 1987) From the American by Margaret Auer, Kabel, Hamburg 1989, ISBN 3-8225-0100-X , pp. 83 ff., 258 ff. And 381.
  • Erica Mahr: Menstruationserlebenis: a medical-psychological investigation (=  results of women's research . Volume 6 , Beltz Research Reports ). Belz, Weinheim / Basel 1985, ISBN 3-407-58277-3 (Dissertation FU Berlin 1985, 230 pages).
  • Dagmar Margotsdotter-Fricke: Menstruation - from powerlessness to power: how the wonderful thing about the female cycle can be regained for our self-image as a woman [for every woman of every age] . Göttert, Rüsselsheim 2004, ISBN 3-922499-76-7 (211 pages, diploma thesis [above] 2002).
  • Hans Georg Müller-Hess: The doctrine of menstruation from the beginning of modern times to the foundation of the cell theory . Reprint of the edition Ebering, Berlin 1938 (=  treatises on the history of medicine and natural sciences . Issue 27). Kraus-Reprint, Nendeln (Liechtenstein) 1977 (license from Matthiesen-Verlag Lübeck, dissertation Universität Berlin 1938, 102 S, DNB 580788296 ).
  • Rosemary L. Rodewald: Magic, Healing and Menstruation . Frauenoffensive, Munich 1978, (Original title: Yes, Virginia, There Really is a Cure , translated by Trude Baum), ISBN 3-88104-045-5 (Dissertation o. O., [USA], o. J., 240 pp .).
  • Luisa Stömer / Eva Wünsch: Ebbe & Blut. Everything about the tides of the female cycle , Graefe and Unzer, Munich 2017, ISBN 978-3-8338-6112-3 .
  • Jutta Voss: The Black Moon Taboo: The Cultural Meaning of the Female Cycle . Kreuz, Stuttgart 2006, ISBN 978-3-7831-2594-8 .
  • Renate Waschek: That little piece of cotton wool. Advertising and taboo using the example of pads and tampons. Taboo, tampons and sanitary towels in advertising (=  Der Grüne Zweig . Band 194 ). The Grüne Kraft ( Werner Pieper MedienXperimente), Löhrbach 1997, ISBN 978-3-925817-94-6 .
  • Sabine Zimmermann: The Roman women's book: an investigation into Codex 200 from Farfa . DNB  1045776025 , urn : nbn: de: gbv: 7-webdoc-3704-0 (dissertation, Georg-August University of Göttingen 2012, reviewers: Volker Zimmermann, Martin Oppermann; supervisors: Volker Zimmermann, 88 p., 620 kB).
  • Sabine Zinn-Thomas: Menstruation and monthly hygiene: dealing with a physical process (=  international university publications . Volume 245 ). Waxmann, Münster / New York / Munich / Berlin 1997, ISBN 3-89325-523-0 ( dissertation , Johann Wolfgang Goethe University Frankfurt am Main 1996, 256 pages).

Web links

Commons : Menstruation  - collection of pictures, videos and audio files
Wiktionary: Menstruation  - explanations of meanings, word origins, synonyms, translations
Wiktionary: menstruation  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ^ Elisabeth Raith-Paula: Dangerous half-knowledge about the fertile time . In: Business magazine for the gynecologist 3/2016, p. 3
  2. ↑ a b c d e f D. Emera, R. Romero, G. Wagner: The evolution of menstruation: a new model for genetic assimilation: explaining molecular origins of maternal responses to fetal invasiveness. In: BioEssays: news and reviews in molecular, cellular and developmental biology. Volume 34, number 1, January 2012, pp. 26-35, doi: 10.1002 / bies.201100099 , PMID 22057551 , PMC 3528014 (free full text).
  3. ↑ Michael Stolberg : Menstruation. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 971 f.
  4. ↑ Sabine Zinn-Thomas: Menstruation and monthly hygiene: for dealing with a physical process , Waxmann, Münster 1997, ISBN 978-3-89325-523-8 , p. 235, preview in the Google book search
  5. ↑ Menstrual sponges (instructions). kulmine.de; Retrieved December 30, 2012
  6. ↑ 4 editions - a particularly hotly debated publication in feminist circles