Editing Menstruation (section)

===Menstrual fluid===
[[File:Menstrual fluid in cup 2nd day 40s female.jpg|thumb|[[Menstrual cup]] filled with menstrual fluid]]
The average volume of menstrual fluid during a monthly menstrual period is {{convert|35|ml|UStbsp}} with {{convert|10|-|80|ml|UStbsp}} considered typical. ''Menstrual fluid'' is the correct term for the flow, although many people prefer to refer to it as "menstrual blood". Menstrual fluid is reddish-brown, a slightly darker color than venous blood.<ref name = "Carlson_2004" />{{rp|381}}

About half of menstrual fluid is blood. This blood contains sodium, calcium, phosphate, iron, and chloride, the extent of which depends on the woman. As well as blood, the fluid consists of cervical mucus, vaginal secretions, and [[Endometrium|endometrial tissue]]. Vaginal fluids in menses mainly contribute water, common electrolytes, organ moieties, and at least 14 proteins, including glycoproteins.<ref>{{cite book| vauthors = Farage M |title=The Vulva: Anatomy, Physiology, and Pathology|date=22 Mar 2013|publisher=CRC Press|pages=155–158}}</ref>

Many women and girls notice [[blood clots]] during menstruation. These appear as clumps of blood that may look like tissue. If there was a [[miscarriage]] or a [[stillbirth]], examination under a microscope can confirm if it was endometrial tissue or pregnancy tissue ([[products of conception]]) that was shed.<ref>{{cite web|title=Menstrual blood problems: Clots, color and thickness|url=http://women.webmd.com/menstrual-blood-problems-clots-color-and-thickness|website=WebMD|access-date=20 September 2011|url-status=live|archive-url=https://web.archive.org/web/20110923151848/http://women.webmd.com/menstrual-blood-problems-clots-color-and-thickness|archive-date=23 September 2011|df=dmy-all}}</ref> Sometimes menstrual clots or shed endometrial tissue is incorrectly thought to indicate an early-term miscarriage of an embryo. An [[enzyme]] called [[plasmin]] – contained in the endometrium – tends to inhibit the blood from [[blood clotting|clotting]].<ref>{{citation|author=C. J. Dockeray, B. L. Sheppard, L. Daly, J. Bonnar |date=April 1987 |doi=10.1016/0028-2243(87)90156-0 |issn=0301-2115 |issue=4 |pages=309–318 |periodical=European Journal of Obstetrics, Gynecology, and Reproductive Biology |pmid=2953634 |title=The fibrinolytic enzyme system in normal menstruation and excessive uterine bleeding and the effect of tranexamic acid |url=https://pubmed.ncbi.nlm.nih.gov/2953634/ |volume=24}}<!-- auto-translated from German by Module:CS1 translator --></ref>

The amount of iron lost in menstrual fluid is relatively small for most women.{{better source needed|date=February 2021}}<ref>{{cite web |title=Iron-deficiency is not something you get just for being a lady | vauthors = Clancy K |url=http://blogs.scientificamerican.com/context-and-variation/2011/07/27/iron-deficiency-anemia/ |publisher=SciAm |date=27 July 2011 |url-status=live |archive-url=https://web.archive.org/web/20120317152812/http://blogs.scientificamerican.com/context-and-variation/2011/07/27/iron-deficiency-anemia/ |archive-date=17 March 2012 |df=dmy-all }}</ref> In one study, premenopausal women who exhibited symptoms of [[iron deficiency (medicine)|iron deficiency]] were given [[Endoscopy|endoscopies]]. 86% of them actually had [[gastrointestinal disease]] and were at risk of being misdiagnosed simply because they were menstruating.{{primary source inline|date=February 2021}}<ref>{{cite journal | vauthors = Kepczyk T, Cremins JE, Long BD, Bachinski MB, Smith LR, McNally PR | title = A prospective, multidisciplinary evaluation of premenopausal women with iron-deficiency anemia | journal = The American Journal of Gastroenterology | volume = 94 | issue = 1 | pages = 109–115 | date = January 1999 | doi = 10.1111/j.1572-0241.1999.00780.x | pmid = 9934740 | s2cid = 25975251 }}</ref> Heavy menstrual bleeding, occurring monthly, can result in [[anemia]].<ref>{{cite journal | vauthors = Mansour D, Hofmann A, Gemzell-Danielsson K | title = A Review of Clinical Guidelines on the Management of Iron Deficiency and Iron-Deficiency Anemia in Women with Heavy Menstrual Bleeding | journal = Advances in Therapy | volume = 38 | issue = 1 | pages = 201–225 | date = January 2021 | pmid = 33247314 | pmc = 7695235 | doi = 10.1007/s12325-020-01564-y }}</ref>