Disclaimer: The content of this article is written with authoritative information combined with personal opinions, the text has not marked the source of the literature and screenshots, in order to better explain the relevant content, the names and other information involved in the opening story are fictitious, please be aware.
Aunt Li is a retired teacher who is over 50 years old, has a regular life, and there is nothing wrong with her health. Recently, however, she has noticed some changes, with her menstrual cycle getting shorter and shorter, sometimes ending in just a few days.
This morning, Aunt Li went to the park for morning exercise as usual. During the break, Aunt Li casually mentioned her troubles: "Recently, my menstrual cycle has become so short, sometimes it only takes a few days to end, which is really strange. ”
After hearing this, her friend Aunt Wang's expression became serious: "Sister Li, you can't be careless about this. Doesn't normal menstruation come about a week or so? You might as well go to the hospital for a check-up. I've heard people say that if there is a problem with the ovaries, menstruation will become shorter. I have a neighbor who has ovarian cancer, and she only starts menstruating for a day or two. ”
After listening to Aunt Wang's words, Aunt Li couldn't help but start worrying.
When she was younger, her period took about seven days to get clean. Now that her period has become so short, it makes her feel very uneasy. The more Aunt Li thought about it, the more scared she became, and after a few days, she finally made up her mind to go to the hospital for professional advice.
The doctor patiently listened to Aunt Li's description and conducted a detailed examination.
After the results of the examination came out, the doctor said to Aunt Li, "You don't have to worry too much. Based on the results of the examination, there is nothing wrong with your body. You are in this situation because you have entered menopause, which is a natural physiological change in women. ”
Aunt Li breathed a sigh of relief, it turned out that such a short menstrual period is normal for some people.
Although menstruation is not popular, it is indeed a "barometer" of women's health.
Don't treat uterine bleeding as menstruation, and seek medical attention if you have the following problems
Menstrual blood and uterine bleeding are so similar that they can easily be confused. Sometimes, long or irregular menstruation can indeed indicate something is wrong with the body.
is like the well-known Wang Xifeng in "Dream of Red Mansions".
In the second half of the book, Sister Feng suffers from "red disease". According to the description of the maid Ping'er next to her, Sister Feng's menstruation "has not stopped for a month". Mandarin duck guessed that Sister Feng had a "blood landslide".
We don't know what kind of illness Sister Feng has. Fortunately, with the development of medical technology, the cause of this abnormal uterine bleeding has basically been discovered by scientists.
The International Federation of Obstetrics and Gynecology classifies the causes of abnormal uterine bleeding as PALM-COEIN. This is an acronym for each etiology and represents structural and non-structural causes, respectively.
结构性病因指的某个器官中有明显的病灶，一般能通过影像看见异常的病变结构。 PALM指的就是五个常见的子宫疾病——息肉（Polyp）、子宫腺肌病（Adenomyosis）、子宫肌瘤（Leiomyoma）和以子宫内膜癌为主的恶性肿瘤和增生（Malignancy and hyperplasia）。
Uterine bleeding is naturally a problem with the uterus, which is well understood for most people, but sometimes it is not entirely the case, and there are some causes that can cause abnormal uterine bleeding although it is difficult to find obvious structural abnormalities in imaging examinations, which is the cause of abnormal uterine bleeding.
非结构病因缩写COEIN涵盖了凝血功能障碍（Coagulopathy）、排卵功能障碍（Ovulatory dysfunction）、子宫内膜问题（Endometrial）、医源性因素（Iatrogenic）和一些未知的原因（Not yet classified）这五种主要分类。
Compared with the former, the diagnosis and treatment of non-structural causes may be more challenging for doctors because they are difficult to observe. However, no matter what the cause is, it needs to be tested by certain medical equipment to confirm the diagnosis.
Therefore, for ordinary people, do not easily treat yourself. If you find that you have irregular menstruation, it is best to seek professional advice from the hospital.
However, then again, who ages faster for a woman with 3 days of clean menstruation or 7 days of clean menstruation?
Women with clean menstruation for 3 days and clean menstruation for 7 days, who ages faster?
From a medical point of view, menstruation refers to the periodic exfoliation of the endometrium from the vagina under the control of hormones. The hormones responsible for menstruation come from the pituitary gland and ovaries, but the length of menstruation does not depend solely on these two organs. Everyone's physiological condition is very different, and the menstrual cycle is naturally different.
Menstrual bleeding may occur every 21 to 35 days and last 2 to 7 days. In other words, for non-pregnant women, whether it is a clean menstrual period for three days or a clean menstrual period for seven days, as long as there are no other abnormalities, then it is normal.
So, can we judge how fast or slow women age based on this?
Not really! You should know: even for the same person, it is common for the first few years of menstruation to have long menstrual bleeding cycles.
However, as women age, their periods are slightly shorter and more regular. When entering menopause, menstruation may become shorter and slowly become a state of menopause.
Normal menstrual periods fluctuate in a wide range, and it is not reliable to judge the speed of aging or the degree of health just by looking at the length of menstruation.
However, doctors recommend everyone about another issue: menstrual cycle length!
What health message does the length of the menstrual cycle contain?
Women menstruate at the age of fertility, and the menstrual cycle is considered the fifth most important vital sign for women. This "good friend" was unwell when she came, but she panicked when she didn't come. Indeed, many studies have pointed out that menstruation is indeed inseparable from all aspects of women's health. However, our focus is not only on the days when this "good friend" comes, but also on how often she visits us – the length of the menstrual cycle.
The length of the menstrual cycle refers to the first day of menstruation, and the day before the second menstrual period, which is generally about 28 days. If it exceeds 35 days, it is considered to have infrequent menstruation, and it is generally accompanied by the problem of light menstrual flow.
Many diseases, especially endocrine diseases, are likely to cause menstrual disorders, such as hyperthyroidism, polycystic ovary syndrome, hyperprolactinemia, etc. These diseases can be complex, with different symptoms depending on the course of the disease, such as excessive and too little menstrual flow, frequent menstruation or amenorrhea.
In fact, diabetes, which is highly prevalent in middle-aged people, is not only a chronic disease, but also an endocrine disease. There is more evidence of a causal relationship between changes in sex hormone levels and type 2 diabetes.
In 1994, it was reported that nearly 25%~30% of diabetic women of childbearing age suffered from menstrual abnormalities.
In 2009, a review in the academic journal Women's Health pointed out that the most common menstrual abnormalities in women with diabetes are secondary amenorrhea and oligomenorrhea.
In 2003, a team of researchers from the University of Pittsburgh in the United States evaluated menstrual cycle differences in 143 diabetic women, 186 non-diabetic sisters and 156 normal control women.
The results show that women with type 1 diabetes, especially between the ages of 20~30, are prone to some menstrual problems. These patients had long menstrual periods, which typically lasted more than 6 days, and the cycle length was longer than that of their sisters or controls.
In addition, the results of a large prospective study spanning more than 20 years showed that women with a menstrual cycle of 40 days or more were more likely to develop type 2 diabetes.
The prospective study is called the Nurses' Health Study (NHS). The study, which focused on nurses, began in 1989 and ended in 2017 with more than 10,000 healthy premenopausal women participating.
Through follow-up surveys, the researchers tracked the women's menstrual cycles as well as their health. In addition to discovering the relationship between the menstrual cycle and diabetes, the cohort study also shed light on the relationship between women's menstrual cycles and other common chronic diseases.
Professor Jorge Chavarro of the Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital at Harvard Medical School is a key participant in the study. In 2020, the team used phase II data to analyze the relationship between the menstrual cycle and early death (death below life expectancy of 70 years).
The article, published in the authoritative journal United Kingdom Medical Journal, pointed out that women with irregular menstrual cycles have a higher mortality rate than women with very regular cycles. People with a menstrual cycle of 40 days or more in adolescence (18~22 years old) and adulthood (29~46 years old) are more likely to die prematurely than women with a normal menstrual cycle of 26~31 days. This association is particularly pronounced in smokers.
Subsequently, the research team focused on cardiovascular disease and cancer. Two high-quality analyses of relevant studies were published in 2022.
In the first study analysis, researchers found that menstrual irregularities appeared to be closely related to premature death from cardiovascular disease.
Sure enough, the risk of cardiovascular disease in women aged 18~22 or 29~46 with a cycle length of 40 days or longer or a cycle that was too irregular to be estimated was 1.44 times and 1.30 times that of women with normal cycles, respectively.
When it comes to cancer, women with irregular menstrual cycles are also not doing well.
Women who report irregular menstrual cycles at the age of 29~46 have an 11% higher overall invasive cancer risk than women with very regular cycles. This association is most pronounced in endometrial cancer. Women with irregular menstrual cycles have a 1.39 times higher risk of developing this cancer than normal women.
A lot of "health problems" may just be normal changes in menstrual periods
The above studies tell us that we should not only pay attention to the well-known menstrual bleeding period, but also take a broader view and pay more attention to our "menstrual cycle" (in addition to the bleeding period, the menstrual cycle also includes the follicular phase, ovulation and luteal phase, etc.).
At each stage, a woman's body undergoes a series of physiological changes due to changes in hormone levels. These changes may be mistaken for a health problem at some point, but in reality, they are normal physiological reactions.
When menstruation is clean, the body enters the follicular phase to prepare the eggs for the next conception. During this period, estrogen levels gradually rise, and the eggs begin to enlarge in the ovaries and "compete" with each other, and finally only one or occasionally two follicles become "winners" and become dominant.
These dominant follicles release eggs in the middle of the menstrual cycle (around day 14). After ovulation, the remaining follicle turns into the corpus luteum and enters the final stage of the menstrual cycle, the luteal phase.
It is believed that many women experience various discomforts before menstruation, and this condition is called "premenstrual syndrome", which generally occurs during the luteal phase.
The reason why the luteal phase is so "difficult" is that the progesterone (also translated as progesterone) released by the corpus luteum is the culprit. Progesterone certainly has its raison d'être, such as thickening the lining of the uterus so that it can implant into an embryo.
But at the same time, the increase in progesterone will have a certain negative impact on women, and sleep is one of the most impactful aspects. Numerous studies have shown a link between premenstrual (or luteal phase) and an increased frequency of multiple sleep problems.
These studies have shown that some women are not only prone to insomnia during the luteal phase, but also tend to wake up in the middle of the night and often have vivid and clear nightmares.
Why is this strange phenomenon happening?
No definitive answer has been found, but some experts believe that elevated progesterone levels shorten the REM period during sleep and make it easier for people to wake up during this period.
The REM brain is very similar to the waking state, so if you wake up during this period, you can easily recall the dream you just had. This is why luteal women are prone to have dreams that feel very real.
In addition, progesterone can also cause an increase in body temperature. Since people prefer a cool environment for sleep, the rise in body temperature may also be one of the reasons for being prone to wakefulness and nightmares.
In addition to sleep, during the menstrual and luteal phases, many women experience an increased appetite, especially when cravings for high-calorie and high-carbohydrate foods become apparent.
Some women also experience edema before menstruation, which is actually the result of changes in hormone levels in the body. Knowing the normal changes in these menstrual periods not only reduces unnecessary worries but also helps women better cope with various discomforts.
For example, during the luteal phase, if sleep problems occur, they can be improved by adjusting the sleep environment and sleep schedule. In terms of diet, choose healthy high-fibre and high-protein foods to satisfy your cravings and avoid excessive intake of high-calorie foods.
A woman's menstrual cycle is a complex and natural process.
Many phenomena that are considered "health problems" are actually just normal changes in the menstrual cycle. Of course, if these discomforts persist, or if they seriously affect your life, you should go to the hospital for examination and consultation as soon as possible.
Xiao Yanshen: Do men also have menstrual periods?
The moon is cloudy and sunny, and the river has its ebb and flow. Menstruation is actually the result of regular changes in hormone levels in a woman's body over a certain period of time. Although men do not menstruate, their hormone levels can also change regularly, producing similar effects.
Women's menstrual cycles are evident and experience large fluctuations in hormone levels every month. In men, there is no such significant change, and there are fewer studies on it. Some hormonal experts believe that there are no periodic changes in male hormone levels. But Jed Diamond, author of "Male Menopause" and a leading expert in gender medicine and men's health, takes the opposite view.
He points out that men's testosterone levels typically peak in the morning and then gradually decline throughout the day, reaching their lowest point in the evening. Research from Duke University also noted that male hormones change seasonally, with testosterone concentrations highest in the fall and lowest in the summer.
Testosterone levels in men are also affected by age, just as women enter menopause. When men reach the age of 40, testosterone levels drop by an average of 1% per year, but testosterone generally remains within the normal range.
Testosterone has a huge impact on both men's physical and mental health. Higher levels of testosterone can make men feel energetic and emotional. Athletes are not allowed to use testosterone in sports because it can improve their fitness and is unfair to other athletes.
If testosterone levels are too low, then the body will experience the opposite symptoms, including exhaustion, low mood, and irritability. Some studies have also suggested that a drop in testosterone levels may be associated with depressive symptoms in men.
This sounds very similar to the premenstrual situation in women, since men may also have hormonal cycles, will men also have "aunts"?
There is indeed such a possibility.
In 2001, biologist Gerald A. Lincoln discovered that when testosterone secretion is rapidly suppressed, rams develop symptoms of "irritable male syndrome."
Specifically, these rams become nervous, irritable, lethargic, and depressed.
Jed Diamond's 2004 book of the same name, Male Irritability Syndrome, also details the argument that changes in male hormone levels can affect mood. Cyclical changes in testosterone can also cause men to have symptoms of premenstrual and menopausal in women.
However, when it comes to hormones, women are often associated with them.
Studying male hormones may sound like a joke. In addition, there are no obvious symptoms of hormonal changes in men compared to women. Therefore, there have not been many related studies at home and abroad, and there is even a tendency to avoid talking about them.
Although the existence of the "Great Aunt" is yet to be confirmed, we are all very sure that everyone, whether male or female, has hormones. These tiny chemical molecules affect every aspect of our body. Therefore, everyone should maintain a regular sleep schedule and a healthy lifestyle to help stabilize hormone levels and maintain their normal cycle changes.
Women should pay more attention to their menstrual cycles in their daily lives.
Similarly, even if a man does not have a "big aunt" to visit, he should pay more attention to his physical state and emotions. If you feel unwell physically or emotionally, you should actively communicate with your doctor to protect your hormonal health.
Bibliography:
Mihm M, Gangooly S, Muttukrishna S. The normal menstrual cycle in women. Anim Reprod Sci. 2011; 124(3-4):229-236.
Jain V, Chodankar RR, Maybin JA, Critchley HOD. Uterine bleeding: how understanding endometrial physiology underpins menstrual health. Nat Rev Endocrinol. 2022 May; 18(5):290-308.
Wang YX, Stuart JJ, Rich-Edwards JW, et al. Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease. JAMA Netw Open. 2022; 5(10):e2238513. Published 2022 Oct 3.
Wang S, Wang YX, Sandoval-Insausti H, et al. Menstrual cycle characteristics and incident cancer: a prospective cohort study. Hum Reprod. 2022; 37(2):341-351.
Wang YX, Arvizu M, Rich-Edwards JW, et al. Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study. BMJ. 2020; 371:m3464. Published 2020 Sep 30.
Lincoln GA. The irritable male syndrome. Reprod Fertil Dev. 2001; 13(7-8):567-76.
Jehan S, Auguste E, Hussain M, et al. Sleep and Premenstrual Syndrome. J Sleep Med Disord. 2016; 3(5):1061.
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