Menstruation is one of the life-altering, biological phenomena that occurs in females. Its onset is an indication that the reproductive system has reached a stage where pregnancy is biologically possible, although regular ovulation may not occur immediately after the first menstrual period.
Interestingly, many women, young and old do not have better understanding on these remarkable changes in their bodies. For instance, here in Ghana to be precise, they call the entire menstrual cycle ‘menstruation’. Through the activities of my public health organization-Bernajis Preventive Health Education (BPHE), I have been educating young people including males in SHS and other public places on this important subject.
The menstrual cycle is more than just the monthly flow of blood. It is an important indicator of a woman's reproductive health and can provide valuable insights into her overall well-being.
Men, too, should take an interest in understanding the menstrual cycle so they can better support their wives, partners, sisters, daughters, and other female loved ones. For example, couples who choose natural family planning methods rely on a proper understanding of the woman's menstrual cycle to identify fertile and less fertile periods.
Today’s topic of discussion is menstruation and pregnancy but before we delve into that, let me draw the distinction between menstruation and menstrual cycle.
What is the difference between menstruation and menstrual cycle?
There are four distinct stages that occur in turn to bring about what we call menstrual cycle. They are cyclical in nature and menstruation is just one of them. These include: follicular phase, ovulation phase, luteal phase and menstrual phase or simply menstruation.
Again, all of these four changes occur each within specific period or timeline, giving a normal menstrual cycle in adults usually between 21 and 35 days, with an average of about 28 days.
Cycles that are consistently lower than 21 days and above 35 days need medical examination although conditions such as stress, hormonal changes, adolescence can cause temporal variations.
What is follicular phase?
This is the phase where several ovarian follicles develop and one matures, preparing egg for ovulation.
What is ovulation phase?
This phase brings about the release of mature egg. Ovulation occurs around the middle of menstrual cycle. This means if a woman’s menstrual cycle lasts for 28 days, release of a mature egg is likely to take place around the 14th day.
What is Luteal phase?
Luteal phase is the second half of the menstrual cycle that begins just after ovulation. The main purpose of this stage is to prepare the uterus for potential implant and nurturing of fertilized egg (pregnancy).
What is menstrual phase?
Menstrual phase is the most obvious stage in the menstrual cycle and that is why most people use it to denote the entire four changes that occur to make up menstrual cycle. When fertilization did not occur, the major preparation done at the luteal phase to prepare the womb to support zygote implant and nurturing of foetus to term is disintegrated. The rich blood supply, thickening of the wall of the uterus and other changes are let off once pregnancy does not occur. The shedding of the uterine lining, blood and tissues through the vagina is termed menstruation or period.
Can You Have a Period While Pregnant?
The simple answer is No.
A true menstrual period does not occur during pregnancy because the uterine lining is needed to support the growing baby. Once pregnancy begins, menstruation stops.
However, some women experience vaginal bleeding during pregnancy, especially in the early weeks. This bleeding is often mistaken for a menstrual period but has different causes.
Causes of Bleeding During Pregnancy
Bleeding during pregnancy may result from:
- Implantation bleeding when the fertilized egg attaches to the lining of the uterus.
- Hormonal changes during early pregnancy.
- Changes in the cervix, which becomes more sensitive during pregnancy.
- Vaginal infections or irritation.
- Pregnancy complications such as miscarriage or ectopic pregnancy.
Any bleeding during pregnancy should be reported to a healthcare provider for proper evaluation.
Can You Get Pregnant During Your Period?
Yes, although the chances are lower.
Sperm can survive inside the female reproductive tract for up to five days. If a woman has a short menstrual cycle and ovulates soon after her period ends, sperm may still be alive when the egg is released, making pregnancy possible.
For this reason, unprotected sexual intercourse during menstruation can still result in pregnancy.
Early Signs of Pregnancy
Common signs of early pregnancy include:
- A missed menstrual period.
- Nausea or morning sickness.
- Breast tenderness.
- Fatigue.
- Frequent urination.
- Mood changes.
- Increased sensitivity to smells.
- Food cravings or food aversions.
How is pregnancy confirmed through laboratory test?
Oestrogen and progesterone are the two hormones produced by a structure called corpus luteum. These hormones play major role in directing preparation in the uterus for potential pregnancy after release of mature egg. When no fertilization occurs, the corpus luteum ceases to exist and hence end of production of the two hormones leading to menstruation.
However, if fertilization occurs, the uterus needs to maintain its life-supporting preparation and that requires the activities of the two hormones-oestrogen and progesterone.
In order not to lose the corpus luteum, developing embryos lead to release of a hormone to maintain its presence and that hormone is called human chorionic gonadotropin (HCG). The lab test then picks up this hormone to confirm pregnancy because without pregnancy HCG would not be produced.
A home pregnancy test or laboratory blood test can help confirm pregnancy.
Differences Between Implantation Bleeding and a Period
Implantation bleeding is usually:
- Light pink or brown in colour.
- Much lighter than a normal menstrual flow.
- Short-lasting, often one to two days.
- Not associated with the heavy flow or clots seen during a typical period.
A normal menstrual period usually involves a heavier flow and lasts several days.
When Should You See a Healthcare Provider?
Seek medical attention immediately if you experience:
- Heavy vaginal bleeding during pregnancy.
- Severe abdominal or pelvic pain.
- Dizziness or fainting.
- Passing large blood clots.
- Persistent bleeding after a positive pregnancy test.
These symptoms may indicate a medical emergency that requires prompt treatment.
Tips for Maintaining Reproductive Health
Women can protect their reproductive health by:
- Keeping track of their menstrual cycle.
- Practising safe sex.
- Using reliable contraception if pregnancy is not desired.
- Attending regular reproductive health check-ups.
- Seeking medical advice whenever menstrual patterns change unexpectedly.
Conclusion
A woman cannot have a true menstrual period while pregnant. Although some women experience light bleeding during pregnancy, this should never be assumed to be a normal period. Understanding the differences between menstruation and pregnancy-related bleeding can help women recognize potential health concerns early and seek timely medical care. Staying informed is one of the most effective ways to protect reproductive health and ensure a healthy pregnancy.
Disclaimer: This article is intended for educational and public health awareness purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Although every effort has been made to ensure the accuracy of the information presented, readers are encouraged to consult a qualified healthcare professional for personalized medical advice. If you experience unusual symptoms, persistent menstrual irregularities, bleeding during pregnancy, or any other reproductive health concerns, seek prompt medical evaluation.
The writer is Bernard Agbonoshie, a registered nurse with several years of clinical practice and he is involed in public health education in communities and institutions as well.
