CHAPTER II

LITERATURE PREVIEW

2.1 Period and PMS (Pre-Menstruation Syndrome)

2.1.1 Definition of period and PMS

Period or the common word which we usually hear as menstruation is a

womans monthly bleeding. When menstruation occurs, the body sheds the lining
of the uterus (womb) then the menstrual blood flows from the uterus through the
small opening in the cervix and passes out of the body through the vagina.

Pre-menstruation syndrome (PMS) is a group of symptoms linked to the

period cycle. PMS symptoms occur 1 to 2 weeks before the period starts. The
symptoms usually go away after women start bleeding. PMS can affect
menstruating women of any age and the effect is different for each woman. For
some people, PMS is just a monthly bother. For others, it may be so severe that it
makes it hard to even get through the day. PMS goes away when the monthly
periods stop, such as when a woman get pregnant or go through menopause.

2.1.2 Factor that cause period

From the explanation above, we have known the definition of period and
PMS. The factors that affect the occurrence of period are:

a) Hormonal factors c) Vascular

b) Enzymes d) Prostaglandin
e) 2.1.3 Period Cycle

f) When periods (menstruations) come regularly, this is called the

period cycle. Having regular period cycles is a sign that important parts of
your body are working normally. The period cycle provides important
body chemicals, called hormones, to keep you healthy. It also prepares
your body for pregnancy each month. A cycle is counted from the first
day of 1 period to the first day of the next period. The average period
cycle is 28 days long. Cycles can range anywhere from 21 to 35 days in
adults and from 21 to 45 days in young teens.

g)

h) Figure 2.1 Follicles develop on the ovaries (Day 7)

i) (source: womenshealth.gov)

j) In the first half of the cycle, day 7, levels of estrogen (the "female
hormone") start to rise. Estrogen plays an important role in keeping you
healthy, especially by helping you to build strong bones and to help keep
them strong as you get older. Estrogen also makes the lining of the uterus
(womb) grow and thicken. This lining of the womb is a place that will
nourish the embryo if a pregnancy occurs. At the same time the lining of
the womb is growing, an egg, or ovum, in one of the ovaries starts to
mature. At about day 14 of an average 28-day cycle, the egg leaves the
ovary. This is called ovulation.
 k)

l) Figure 2.2 Ovulation (Day 14)

m) (source: womenshealth.gov)

n) After the egg has left the ovary, it travels through the fallopian tube
to the uterus. Hormone levels rise and help prepare the uterine lining for
pregnancy. A woman is most likely to get pregnant during the 3 days
before or on the day of ovulation. Keep in mind, women with cycles that
are shorter or longer than average may ovulate before or after day 14.
 o)

p) Figure 2.3 Egg travels the fallopian tube (Day 14-25)

q) (source: womenshealth.gov)

r) A woman becomes pregnant if the egg is fertilized by a man's

sperm cell and attaches to the uterine wall. If the egg is not fertilized, it
will break apart. Then, hormone levels drop, and the thickened lining of
the uterus is shed during the menstrual period.

s)
 t) Figure 2.4 [left] Hormone drop (Day 25) [right] Period (Day 1-7)

u) (source: womenshealth.gov)

v) 2.2 Period Disruption

w) There are so much reason that affect a womans period cycle, it

could be from the internal of the woman itself either from the external.

x) 2.2.1 Disease that appears during period

y) Women can have a range of problems with their periods, including

pain, heavy bleeding, and skipped periods.

Amenorrhea the lack of a menstrual period. This term is used to

describe the absence of a period in:

o Young women who haven't started menstruating by age 15

o Women and girls who haven't had a period for 90 days, even if they
haven't been menstruating for long

z) Causes can include:

o Pregnancy

o Breastfeeding

o Extreme weight loss

o Eating disorders

o Excessive exercising

o Stress

o Serious medical conditions in need of treatment

 aa) As above, when the period cycles come regularly, this means that
important parts of body are working normally. In some cases, not having
menstrual periods can mean that the ovaries have stopped producing
normal amounts of estrogen. Missing these hormones can have important
effects on womans overall health. Hormonal problems, such as those
caused by polycystic ovary syndrome (PCOS) or serious problems with
the reproductive organs, may be involved. It's important to talk to a doctor
if a woman have this problem.

Dysmenorrhea painful periods, including severe cramps. Menstrual

cramps in teens are caused by too much of a chemical called prostaglandin.
Most teens with dysmenorrhea do not have a serious disease, even though the
cramps can be severe. In older women, the pain is sometimes caused by a
disease or condition such as uterine fibroids or endometriosis.

ab) For some women, using a heating pad or taking a warm bath helps ease
their cramps. Some over-the-counter pain medicines can also help with
these symptoms. They include:

o Ibuprofen (eye-byu-PROH-fuhn) (for instance, Advil, Motrin,

Midol Cramp)

o Ketoprofen (key-toh-PROH-fuhn) (for instance, Orudis KT)

o Naproxen (nuh-PROK-suhn) (for instance, Aleve)

ac) If these medicines don't relieve the pain or the pain interferes with work
or school, the patient should see a doctor. Treatment depends on what's
causing the problem and how severe it is.

Abnormal uterine bleeding vaginal bleeding that's different from

normal menstrual periods. It includes:

o Bleeding between periods

o Bleeding after sex

o Spotting anytime in the menstrual cycle

o Bleeding heavier or for more days than normal

o Bleeding after menopause

ad) Abnormal bleeding can have many causes. Doctor may start by
checking for problems that are most common in the womans age group.
Some of them are not serious and are easy to treat. Others can be more
serious. Treatment for abnormal bleeding depends on the cause.

ae) In both teens and women nearing menopause, hormonal changes

can cause long periods along with irregular cycles. Even if the cause is
hormonal changes, they may be able to get treatment. We should keep in
mind that these changes can occur with other serious health problems,
such as uterine fibroids, polyps, or even cancer. See the doctor if you have
any abnormal bleeding.

af) 2.2.2 Risk factor of period

ag) There are so much thing that could cause an irregular period on
women. A stress and tired woman is tend to have an irregular period. But
what about women who have irregular periods in the long term? Here are
some risk factor of an irregular period:

a) Polycystic Ovaries (PCO)

ah) Polycystic Ovaries or PCO is the disturbance condition of ovarian

function in women who are in the productive age. This disruption disturbs
the fertility of women. The characteristic of this disruption on woman
could be seen from how much the period comes out. A woman should be
aware of this disruption if her bleeding only goes out in a very small
amount. PCO could be cured with surgery and long term treatment.
b) Cyst

ai) Cyst or benign tumor which usually attack women is ovarian cyst. Having
an irregular period is one of the characteristic of women with this
disruption. The period is usually late because the existence of a follicular
cysts. Cysts become bigger when the pain attacks. Women should be
examined further to prevent the worse effect of this disruption.

c) Polyps

aj) You bleed more when menstruation? One of the characteristic of this
disruption is having more bleeding even the period is in the regular cycle.
Another characteristic about this disruption is bleeding after having sex.
Consul immediately with the doctor to know more about your condition.

d) Cancer

ak) Cervical cancer could be initiated with infrequently period cycle while in
the advanced stage it will make a women bleed more than usual. To
indicate this disruption, women could detect it with several tests, such as
PAP test (PAP smear).

al) 2.3 Treatment Method

am) 2.3.1 Internal Media Method

an) 2.3.1.1 Natural Method (Herbs)

A. Ginger

ao) Daftar Pustaka:

ap) Lawrence M. Nelson, M.D. 2017. Menstruation and the

Menstrual Cycle. www.womenshealth.gov [Diakses tanggal 11
Februari 2017]