I don’t know why I felt compelled to start this blog post today. I might have an idea, but I’m not sharing it with you. What? Stop looking at me.
This is a uterus. Kind of.
Inside the peritoneum (I don’t have time to explain this organ-wrapper but I’m just letting you know that I know I’m leaving it off to save you emailing me saying actually there’s another part called the peritoneum. I know. I just don’t have time to write about it right now, geez.), the uterus is made up of two layers, which are, in turn each made up of additional layers, so really there are 5 layers and I don’t know why they they don’t just say five instead of two.
Anyway, the uterus is formed by a muscular layer (the myometrium) resulting in a shape I like to think of as an upside-down gourd. Like a gourd your uterus is hollow inside (unless you’re currently occupied by a fetus or seven). The muscular wall has three separate layers of muscle, each layer containing fibers running in a unique direction — right to left, up and down, and crisscross — a series you see over and over again in the body (e.g. the layers of your abdominal and rib-moving muscles are oriented like this as well). (Image from the Free Dictionary.)
The innermost layer(s) of the uterus is called the endometrium. The endometrium is the non-muscle part of the uterus and is typically the part we think of shedding each month during a period, but that’s not exactly what happens.
The endometrium also has two layers (see rant moment above), the bottom (up against the muscle layer) layer called the stratum basalis (base layer). This layer does not shed during your cycle but is responsible for re-growing the new layer when it’s time. The innermost layer of the gourd-uterus is the stratum functionalis. This is the layer shed every month. BUT HOW DOES THAT SHEDDING HAPPEN? Don’t you want to know? I mean, how does it shed? Why does it shed? WHAT’S ACTUALLY BLEEDING?
Here’s how it works. Right before you get your period, blood vessels to the endometrium contract, shutting off oxygen to the lining which — as weird as it sounds — kills the lining by starving it of oxygen (ischemia). In response to the dying tissue, white blood cells (WBCs) are released to process and remove the now-dying functional layer of the endometrium. This process is called desquamation, which means to scrape the scales off a fish. Nice. You already know that your body, like a snake, is constantly desquamating, right?
The WBCs secrete digestive enzymes that break the dead tissue away, a process that also removes some of the blood vessels just beneath the dying lining. These freshly exposed vessels on the surface are what is bleeding during your period.
But the WBCs don’t digest the entire functional layer. There are “stumps” left here and there — imagine a forest burnt almost all the way to the ground, but not entirely. And, just like a forest after a fire, as soon as the “fire” (WBCs) stop, re-growth begins immediately. Just as grass and moss and ferns start popping up from what’s continues to live beneath the forest that used to be, cells that will become the new lining spring up close, at first, to the left over stumps, and then spread out to create an entire new forest floor (er lining of the uterus) in a matter of days.
Dysmenorrhea — that is periods that don’t go as smoothly as what I’ve just described here — can occur for a couple of reasons. When the WBCs DON’T stop breaking down the functional layer, they chew through a lot more blood vessels and bleeding becomes excessive and prolonged, and the re-growth of the lining becomes problematic.
Also, I forgot to mention that, as the cells of the functional layer begin to lose oxygen (e.g. start to die), they begin to produce a protein called hypoxia inducible factor (HIF). Hypoxia Inducible Factor is what gets the “forest” re-growing, but amounts of produced HIF seem to vary between women. The more HIF you produce, the faster you repair and the less you bleed. The less you produce, the more you bleed. (Not really a side note, but for some reason I feel compelled to put this in parenthesis, research shows hyperglycemia — too much blood sugar — interferes with the function of HIF.)
As a member of this species, I find it totally disturbing that the prevalence of primary dysmenorrhea (cramping in the lower abdomen occurring just before or during menstruation) is 90% and that most of these women take either NSAIDs (like aspirin or ibuprofen) or are prescribed oral contraceptive pills to cope, every month, beginning in their teens. TEENS! Drugs to cope with a biological function. Does this strike anyone else as odd? And I don’t mean it’s odd that we want drugs to cope with something uncomfortable, but that a biological function has become painful enough to require the regular taking of drugs — which is a different thing altogether.
As I’m writing about in my upcoming book Move Your DNA, the way we move (or don’t) impacts our body, head to toe. For decades, menstrual cramps have been associated with the temporary reduction in blood flow to the uterus (necessary to kill the lining). But here’s the thing. As confirmed by research using Doppler radar, women who experience painful periods aren’t only having problems with the blood flow to their uterus during their period, the blood flow is too low to their uterus all of the time. The time of the month to reduce it further merely highlights the problem.(Full disclosure: I have no idea my period is coming because I no longer have any physical discomfort to alert me. This wasn’t always the case, I used to be a “four Tylenol the first two days” kind of gal. My husband would like to add that he can always tell when I’m about to start my period, but whatever, he’s pretty much an idiot, especially today.)
As with any issue, consider how you move (not just do you move or not) as a mechanism of blood flow regulation. The distribution of blood throughout the body is directly a result of your movement patterns.
A couple years ago I wrote a post telling one woman’s story of how five exercises got her off some dangerous pain meds. If you’re having painful periods, read Aching for an Answer. My friends Kate Hanley and Ellen Barret have also just written a book ALL ABOUT YOUR PERIOD called the 28 Days Lighter Diet.
Seriously. It’s a great book with a ton of info that everyone should consider. I also contributed a couple of essays to it! I’m giving THREE copies away today — one on this blog, one on the Aligned and Well Facebook page, and one on Twitter.
1) To enter on the blog: leave your favorite time of the month “coping mechanism” below (guys, that goes for you too) today (April 28th, 2014) until midnight, Pacific Standard Time. I’ll pick a random winner tomorrow.
2) To play on Facebook, share the post on your Facebook page (tag Aligned and Well) and come back to comment on the contest thread that you did so! Share until midnight tonight, and I’ll pick a random winner tomorrow.
3) To play on Twitter, share this post (tag @AlignedandWell) and include hashtag #MoveYourDNA until midnight tonight. I’ll pick a random winner tomorrow.
Update: Winners have been picked and notified!
Spread the knowledge. It really is power.
References: http://www.ncbi.nlm.nih.gov/pubmed/2064187, http://www.ncbi.nlm.nih.gov/pubmed/21616486, http://diabetes.diabetesjournals.org/content/53/12/3226.short, http://europepmc.org/abstract/MED/10465224http://informahealthcare.com/doi/abs/10.1080/00016340009169273?journalCode=obs, http://www.ncbi.nlm.nih.gov/pubmed/15916208