Early menstruation VS delayed menstruation, which one is healthier?

Many women have been troubled by menstrual problems. Especially when it comes two days early or never comes, they will inevitably subconsciously wonder if there is something wrong with their body.

In addition, in discussions about women's health, we often hear questions like: What are the causes of early and late menstruation? In comparison, which one is better?

Before discussing this issue, we need to make one thing clear: what many people mean by early and late menstruation may not really be menstrual disorders.

Advance and postponement

It's all normal

Some women are accustomed to using specific dates as a basis for judging whether their menstruation is regular.

However, this calculation method is not scientific because it assumes that the menstrual cycle is a standard natural month. But in reality, women's menstrual cycles are generally 28 days, with a fluctuation of about a week.

The menstrual cycle is divided into the follicular phase, ovulation phase, luteal phase and menstrual phase. Among them, the ovulation phase and luteal phase are relatively fixed in time, namely 1 day and 14 days respectively. The duration of the follicular phase varies from person to person and is determined by the speed of follicle development.

The starting point is the date of the first menstrual period, and the end point is the day before the next menstrual period. As long as the interval is between 21 and 35 days, it is normal.

The female friend in the picture has a regular menstrual cycle of 25 days, which is not really delayed.

Early or delayed menstruation means that it is more than seven days early or late based on the fixed menstrual cycle. If her period came on June 25 last month and on July 13 this month, the interval between the two periods is 18 days, which is seven days shorter than the previous interval. This is true early menstruation.

So, instead of recording the exact date your period arrives, it's better to just calculate the time between each period.

It is worth noting that menstruation will be affected by the body's endocrine system. If you take birth control pills or other hormone-containing drugs, or if your emotions change drastically in a short period of time, your menstrual cycle will change.

If this is the case, don't worry too much. It doesn't mean that there is a serious problem with your body. It's just that the related events will eventually affect your menstruation. As long as you make timely adjustments, your menstruation will return to normal.

You thought it was ahead of time

Maybe not really in advance

After clarifying the meaning of "early menstruation", we also need to pay attention to another special situation: some women may bleed multiple times during a regular menstrual cycle. For example, they have their period on the 15th of every month, but suddenly they have their period again on the 30th of a certain month, and they think that their period is early.

In fact, these may not be real menstrual blood. If you have organic diseases such as endometrial polyps, uterine fibroids, or because of fluctuations in hormone levels during ovulation, you will also have vaginal bleeding.

Menstrual blood refers to the bleeding caused by the cyclical growth and shedding of the endometrium due to the monthly ovulation and secretion of estrogen and progesterone from the ovaries. Patients with endometrial polyps often have endocrine disorders and excessively high estrogen levels, which lead to abnormal proliferation of the endometrium in the uterine cavity and the formation of polyps. At the same time, due to asynchronous shedding and abnormal proliferation of blood vessels, abnormal bleeding occurs.

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To put it bluntly, although the source of bleeding is the endometrium, the bleeding principle of patients with endometrial polyps is different from the monthly cyclical ovulation and endometrial exfoliation bleeding of women.

Uterine fibroids are also very common clinically. They are benign growths of the uterus. The cause is still unknown. Many scholars believe that their origin may be related to the abnormal division and proliferation of a stem cell in the uterine smooth muscle tissue, which eventually turns into a mass of hard rubbery substance that is different from the nearby tissues, thus becoming a uterine fibroid.

Although uterine fibroids rarely become malignant and most people do not have any symptoms, they may also cause menstrual abnormalities (such as increased menstrual flow, prolonged menstrual periods, vaginal bleeding between menstruation, etc.), increased leucorrhea, lower abdominal discomfort, compression symptoms, etc.

Typically, fibroids may be located in different parts of the uterine wall, and the causes of bleeding caused by fibroids in different locations are also different.

Submucosal fibroids: They grow below the surface of the endometrium and can develop individually or in groups. They may not only increase the area of ​​the endometrium, but also cause abnormal uterine contractions, endometritis, etc., resulting in menstrual abnormalities.

Intramural fibroids: The most common fibroids grow in the uterine muscle wall. During each menstrual period, the uterus contracts, compressing the blood vessels and controlling blood flow. However, if the intramural fibroids are large, they may affect uterine contraction and lead to increased bleeding.

In addition to endometrial polyps, uterine fibroids and other conditions that may cause menstrual abnormalities, abnormal vaginal bleeding caused by abnormal endometrial hyperplasia, endometrial malignant tumors, cervical lesions, etc. may sometimes be confused with menstrual abnormalities.

If there is abnormal bleeding, you can judge whether it is menstrual blood by the texture and color of the bleeding. Normal menstrual blood will be bright red or dark red. If it is brown and uneven in texture, it may be related to factors such as the failure to completely discharge the menstrual blood in the previous menstrual period, oxidation, corpus luteum dysfunction, ovulation disorder or polycystic ovary syndrome.

If the blood flow is large and accompanied by blood clots, and the color is dark and deep, purple-red, it is necessary to go to the hospital for examination to see if there are endometrial polyps, uterine fibroids, abnormal endometrial hyperplasia, etc.

Delayed menstruation

It may be endocrine disorder.

We have previously explained that delayed menstruation does not mean that the body is lacking blood, but rather that there are some problems with the body. (Click here to learn more → Is delayed menstruation due to lack of blood in the body? There are more reasons behind it than you think, and the last one should be watched out for!)

Among them, some women experience delayed menstruation simply because of obesity, rapid weight gain or loss, excessive dieting, strenuous exercise, mood changes, etc., which lead to a decrease in the secretion of endometrial hormones, and the follicles cannot develop and ovulate normally, thus affecting the formation and shedding of the endometrium.

In this case, as long as you maintain a scientific and orderly weight loss method, do not overeat, do not excessively diet, exercise moderately, and actively manage your emotions, the phenomenon of menstrual disorders can be alleviated.

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In addition to the situations mentioned above, some women are affected by chronic diseases or endocrine diseases such as polycystic ovary syndrome. At this time, the right medicine should be used.

Summarize:

1. Occasional delays and advances in menstruation are normal. As long as you maintain a regular work and rest schedule and keep your emotions stable, most cases will recover on their own without excessive intervention.

2. If there is unexplained vaginal bleeding, you should carefully distinguish whether it is caused by menstrual bleeding or other diseases.

3. If you have menstrual disorders for a long time, whether it is early or late, it is not a good thing and you should seek medical attention immediately.

References

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[2]"Uterinefibroidsfactsheet".OfficeonWomen'sHealth.January15,2015.

[3]KexinWang, YanhuaLi.(2023).Signalingpathwaysandtargetedtherapeuticstrategiesforpolycysticovarysyndrome.FrontiersinEndocrinology.DOI:10.3389/fendo.2023.1191759.

[4] Njume Peter Nijkang, Lyndal Anderson, Robert Markham, Frank Manconi. (2019). Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med.

[5]Women'sGynecologicHealth.Jones&BartlettPublishers.2011:94[2015-07-13].ISBN9780763756376.

[6] Zhou Jianhong, Ma Linjuan. Causes and diagnosis and treatment of frequent menstruation[J]. Journal of Practical Obstetrics and Gynecology, 2016, 32(12): 892-894.

This article is a work of Science Popularization China-Starry Sky Project

Produced by: Science Popularization Department of China Association for Science and Technology

Producer｜China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Wu Zhaodi, popular science writer

Reviewer: Lan Yibing, deputy chief physician, Department of Obstetrics and Gynecology, Zhejiang University Hospital