when does menstruation ( period ) begin?

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Menstruation is the period or the beginning of a cycle when the blood and tissue that created a thick layer in the uterus wall leave the body through the uterus and vagina. Typically, menstruation occurs once a month. With the start of the first menstrual cycle, girls reach sexual maturity, and the reproductive system will be able to bear children. Although periods occur in all girls and women, many women are not fully aware of all aspects of menstruation and some of the events and changes that occur during periods.

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What is menstruation?

The menstrual cycle is a process that occurs and goes through the body every month to prepare for pregnancy. Menstruation and bleeding from a woman’s uterus and vagina means she is not pregnant. Progesterone and estrogen hormones control and regulate women’s menstrual cycle or period. Menstrual periods usually last about 2 to 7 days. However, this time can be variable in women. Usually, women experience periods every 3 to 5 weeks. Long cycles are standard in the first few years after starting monthly habits, but cycles become shorter and more regular as you age.

How is the menstrual process formed?

There are two ovaries in every woman’s body. Each of these ovaries contains several ovules. The ovules in the ovary are tiny and cannot be seen by the naked eye. When the menstrual cycle occurs, the hormones in the woman’s body cause the ovules to mature in the ovaries.

When the ovule matures, it means that the body is ready to get pregnant, and the ovule needs to be fertilized by a sperm in order to get pregnant. Also, estrogen and progesterone hormones increase the thickness of the inner lining of the uterus and turn it into a spongy environment. This is a significant change in the uterus, and in fact, the uterus becomes a bed for accepting and keeping the ovule.

hormones and Menstruation

When does pregnancy start?

When the inner layer of the uterus becomes thick and spongy, it is the right time for the ovule to implant in it, and the pregnancy begins. Like everything else in our body, this thick coating is formed from blood and tissue. This layer is rich in nutrients, and if pregnancy occurs, it helps the growth and development of the fetus during the mother’s pregnancy.

Almost halfway through the menstrual cycle, body hormones stimulate one of the ovaries to release a mature ovule called ovulation. Most women do not experience any unusual symptoms during ovulation, and this process may even be completely asymptomatic in their bodies. However, another group of women experiences symptoms such as spotting, pain in the lower abdomen, and bloating during ovulation.

When the ovule is released from the ovary, it travels through the fallopian tube to the uterus. If fertilization takes place at this time and the ovule merges with a sperm, pregnancy occurs. If the released ovule does not meet any sperm when it reaches the uterus, pregnancy does not occur. In this case, the body does not need this thick covering. Therefore, this coating is damaged and expelled from the body through the vagina as a liquid of blood and tissue. We call these substances removed from the vagina, period blood, or menstruation.

When does pregnancy start?

Period symptoms

Most women experience various symptoms in the last few days of menstruation or the first few days of menstruation when the bleeding flow is more intense. You may experience many different symptoms before and after your period. These symptoms are called PMS or premenstrual syndrome. It is good to know that there are more than 100 symptoms mentioned for the period, so it is likely that your symptoms are different from other women.

Menstruation-related symptoms and discomforts should not be to the extent that they disrupt your everyday life, and if they are, you should take measures to treat and control them. In some women, period symptoms are so severe that it becomes difficult to perform regular life tasks. In the following, we will mention some of the natural physical symptoms that occur during menstruation:

  1. Increased breast sensitivity
  2. Abdominal bloating
  3. Fluid retention in the body and general swelling of the body
  4. Pain in the muscles
  5. Pain in the joints
  6. Migraine headaches
  7. skin acne
  8. Abdominal cramps
  9. Diarrhea and constipation
  10. Pain in the back
  11. Sleep disorder
  12. Decreased energy levels
  13. body fatigue

At what age is the first period for girls?

The first signs that your period is coming are the growth of armpit and pubic hair. Usually, the menstrual cycle starts about two years after the development of breasts and about a year after the white discharge from the vagina. On average, girls experience their first period around 12, although this age varies from person to person and may vary from 10 to 16 years. If your period has yet to start by 16, see a doctor. The doctor prescribes a blood test to check the level of your hormones and prescribes the necessary medicines according to the test results.


Menstrual disorders

Any condition that causes a change in the ordinary course of the period is called a menstrual disorder. Menstrual disorders usually occur for various reasons, such as stress, birth control pills, uterine polyps or fibroids, endometriosis, etc. Some of the menstrual disorders are:

  • Amenorrhea: It is a condition in which menstruation stops completely. The absence of a period for 90 days or more is considered abnormal unless the woman is pregnant, lactating, or postmenopausal.
  • Oligomenorrhea: Irregularity in the menstrual cycle so that the number of periods per year is less than usual due to the lengthening of the menstrual cycle.
  • Dysmenorrhea: It is called painful periods. Of course, there are different ways to relieve period pain, such as massage, supplements, drinking fluids, etc.
  • Abnormal bleeding: Sometimes, period bleeding is heavier. Sometimes we face a decrease in menstrual blood. Sometimes there may be spotting between two periods, and sometimes, the period bleeding may last more than seven days; all the mentioned cases are considered menstrual irregularities.

Diagnosis of menstrual disorders

First, the doctor will ask you about your medical history and menstrual cycle, and then a clinical examination will be performed. For a definitive diagnosis, he may prescribe blood tests to measure hormones (thyroid hormones, prolactin, LH, and FSH) and check blood coagulation disorders. Other examinations include ultrasound to examine the reproductive system and pelvic organs, hysteroscopy to observe the uterus, etc.

Treatment of menstrual disorders

The treatment of menstrual problems depends on their underlying cause, and some of these disorders, such as depression and periods, can have psychological roots. After clinical examination and tests, one of the following methods is prescribed for treatment:

  1. Diuretics
  2. Anti-inflammatory drugs
  3. Hormonal supplements
  4. Hormonal contraceptives
  5. Sedations
  6. Multivitamins
  7. Diet modification
  8. Antidepressants
  9. regular exercise
  10. surgery


Many women are worried about the delay in menstruation or their periods being delayed. Most of them think that the delay in their period cycle is caused by pregnancy, While the delay in their period includes various causes besides pregnancy.


Cause of delay in period

Most people who have not reached menopause; usually have periods every 28 days. However, a healthy menstrual cycle ranges from 21 to 40 days. The delayed period is not always a sign of pregnancy. One of the most common causes can be hormonal imbalance.

  • Stress and anxiety – the cause of delayed periods

Chronic stress and anxiety can affect hormone function and even the hypothalamus, the part of the brain responsible for regulating menstruation. Stress causes a sudden increase or decrease in weight, which also causes disturbances in the menstrual cycle. Try relaxation techniques and lifestyle changes; they can help reduce chronic stress and anxiety.

  • Sudden weight gain or loss – cause of delayed period

Extreme weight changes can disrupt the timing of the menstrual cycle. A sharp increase or decrease in body fat leads to hormonal imbalance, which causes a person’s period to be delayed or stopped.

Also, severe calorie reduction affects the part of the brain associated with the endocrine glands. Endocrine glands produce reproductive hormones. With a sharp decrease in calories, the communication between the brain and this system will be disrupted, and as a result, the period will be delayed.

delayed periods
  • Exercising and heavy physical activity – cause of delayed period

Complex and intense exercise and physical activity cause disruption and delay in menstruation. This is because those who exercise for several hours a day, intentionally or unintentionally, burn more calories than they take in.

The body needs enough energy and calories to keep all its systems active. Exercising more intensely and cutting calories can affect your period. Usually, the period cycle returns to normal as soon as the training intensity is reduced or the calorie intake is increased.

  • Having polycystic ovary syndrome – the cause of delayed periods

Polycystic ovary syndrome (PCOS) is a set of symptoms caused by an imbalance of reproductive hormones. Many people with this syndrome do not ovulate regularly. This syndrome causes a period cycle with the following conditions:

  1. Courses lighter or heavier than regular courses
  2. Delayed period
  3. No period


Other symptoms of polycystic ovary syndrome can include:

  1. Excess hair and acne on the face and body
  2. Thinning hair
  3. Weight gain or loss
  4. dark spots on the skin; Often on the folds of the neck, groin, and under the breasts
  5. A skin tag on the armpit or neck
  6. sterility
Polycystic ovary syndrome (PCOS)
  • Use of contraceptive methods – the cause of delayed periods

You may think that taking birth control pills will help you have regular periods, but taking some pills like Quartette, Seasonique, or Seasonale can cause a delay between periods.

When you stop taking birth control pills, your body returns to its original hormone levels. It may take several months for your menstrual cycle to return to normal.

Also, other types of contraceptive methods that use hormonal methods can cause delays and irregular periods.

If hormonal birth control methods such as; If you are using an intrauterine device (IUD), implant, or injection, your menstrual cycle may stop.

  • Menopause – the cause of delayed periods

Menopause usually begins in the mid to late 40s. Before the onset of post-menstruation (menopause), the menstrual cycle is disturbed. For example, you do not get your period for one month; you get your period for the next three months or vice versa. The amount of weight and the menstrual cycle are also different.

  • Premature ovarian failure – cause of delayed period

Premature menopause, also known as premature ovarian failure. When the ovaries are not functioning correctly, they stop producing many hormones, including estrogen. As estrogen levels drop, you will experience menopause symptoms. Among the symptoms of early menopause and ovarian failure that cause a delay in the period, the following can be mentioned:

  1. Hot flashes, night sweats
  2. Trouble sleeping
  3. vaginal dryness
  4. sterility
  5. Decreased libido
  6. Moral changes
  • Hypothyroidism and hyperthyroidism – the cause of delayed periods

The thyroid is a butterfly-shaped gland in the neck that produces hormones to regulate many activities in the body, including the menstrual cycle. Both hypothyroidism and hyperthyroidism can affect the menstrual cycle. The possibility of delayed menstruation is more in hyperthyroidism.

  • Chronic and underlying diseases – the cause of delayed periods

Some diseases, such as celiac disease and diabetes, cause disturbances in the menstrual cycle. Celiac disease is an autoimmune disease that affects the digestive system. When people with celiac disease eat gluten, their immune system responds by attacking the lining of the small intestine. When the small intestine is damaged, it impairs the body’s ability to absorb nutrients from food. Malnutrition causes disruption and delayed menstruation.

People with type 1 and type 2 diabetes may also, in rare cases, not have periods. However, this only happens when the blood sugar level is not controlled.


When is a delay in period dangerous?

See a doctor when you experience the following symptoms:

  • Abnormal and heavy bleeding for more than seven days
  • Fever
  • nausea and vomiting
  • Bleeding after one year of menopause

As people are different, the menstrual cycle of different people is also different. If you have recently noticed that your cycle has been irregular or have not had a period and know you are not pregnant, see your doctor immediately.

Emergency pill and its effect on the period

The emergency pill is one of the contraceptive tools, and it is obtained from the combination of two hormones that prevent the ovulation process; in this case, even if the sperm enters the uterus, it will not have a chance to fertilize the ovule, and an embryo will not be born. Emergency loans are produced in two types. The first group contains progesterone and estrogen; the second is obtained only from progesterone.


At what age is the last period of women?

The last menstrual cycle in women is symmetrical with the onset of menopause. This period is diagnosed after 12 months of non-menstruation. Menopause may occur at age 40 or 50, but the average age is 51. The cessation of periods and menopause is a natural biological process. Clinical symptoms such as hot flashes and emotional symptoms of menopause may occur in some women and cause temporary disturbances in sleep or mood.

Period hygiene

Note that during your period, if you do not observe your hygiene, you may face serious problems. So keep the following in mind:

Vaginal washing during the period

It is better to wash your genital area once a day during your period to prevent the accumulation of germs and unpleasant odors during bleeding.

  • Bathing during menstruation

  A bath improves your mood and helps you deal with menstrual symptoms. Warm water can help stimulate blood flow and relieve muscle cramps. Enjoy the bath without worry!


Menstrual cup, menstrual tampon and sanitary pad

It would help if you changed your sanitary pad or tampon during menstruation every 4 to 8 hours.

Dos and don’ts during menstruation

  • Minimize the consumption of high-sugar and salty foods.
  • Minimize the consumption of unhealthy foods during this period.
  • Heavy activities and vigorous exercise may disrupt hormones and disrupt the ovulation mechanism.
  • Do not be still for a long time; Because this causes bloating.
  • Consuming too much coffee during a period causes bloating and digestive problems.
  • Do not drink alcohol.
  • Change your tampon or sanitary napkin on time.
  • Do not watch emotional movies; try to keep calm during this time.
  • Avoid sex; it may increase your pain and bleeding at the beginning of your period.
  • Avoid drinking icy water.
  • During this period, your skin may become irritated and sensitive, so it is better to take care of it using homemade masks.
  • Lack of sleep can disturb your hormonal balance by increasing the cortisol hormone. So it is better to rest enough during the period.
  • Do not wait too long to take painkillers. Taking painkillers during your period will not cause any problems for you. Use the medicines mentioned if you feel pain before your body is harmed.


Having a regular menstrual cycle is an indication of your body’s health. So it has a lot of information about your health. By having a regular cycle, you can plan your life, exercise, work, and sex life.

Regular periods indicate that your hormones are at normal levels and your bones, thyroid gland, and metabolic system are functioning correctly. The period makes you age later and keeps your skin and body fresh. According to research conducted in America, researchers think that one of the reasons why women live longer than men is that they lose some iron each month through menstrual bleeding because too much iron in the body can cause disease by producing free radicals.

Moreover, abdominal pain is one of the most common annoying period problems, which may occur before or at the same time as it is experienced by many women routinely. This pain is felt in the lower abdomen and back, and its intensity varies from mild to severe.


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Author and specialist

Dr. Majid Zahrabi,


  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.



  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993


Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.



  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.