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https://www.keystagewiki.com/index.php/Menstrual_Cycle

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1. Day 1-5: The cycle begins with the onset of menstruation or menses which is the monthly discharge of blood from the uterus via the vagina. The endometrium of the uterus breaks down.

The hypothalamus secretes gonadotrophin releasing hormone (GnRH) that stimulates the anterior pituitary gland to secrete follicle stimulating hormone (FSH) into the bloodstream which travels to the ovaries. FSH stimulates the development of a small number of follicles in the ovaries. One follicle will become the Graafian follicle. FSH also stimulates the cells of the growing follicles to secrete oestrogen.

2 Day 6-10: Oestrogen causes the growth and repair of the uterine lining (endometrium). Oestrogen also inhibits the secretion of FSH from the anterior pituitary gland, thus preventing the development of more follicles.

3 Day 11-17: When oestrogen levels increase to a high level, it triggers the secretion of luteinising hormone (LH) from the anterior pituitary gland that travels in the blood to the ovaries. LH causes the follicular wall of the Graafian follicle to rupture, releasing the secondary oocyte into the oviduct funnel (ovulation). This happens on the 14th day from the beginning of menstruation. After ovulation, LH causes the formation of an active corpus luteum from the ruptured follicle. The corpus luteum secretes progesterone and also some oestrogen.

4 Day 18-28: The progesterone secreted by the active corpus luteum keeps the uterine lining (endometrium) thick, well-supplied with blood (vascularised) and stimulates formation of glands secreting nutrients to prepare the endometrium for the implantation of the embryo if there is fertilisation. Progesterone also inhibits both FSH and LH production.

If fertilisation does not occur, the drop in LH level in the blood causes the corpus luteum to degenerate. When this happens, progesterone production stops, thus the uterine lining cannot be maintained in a thickened state anymore, so it breaks down. The lining is discharged with blood through the vagina. This is menstruation and it marks the beginning of the next cycle.

If fertilisation occurs, the menstrual cycle is disrupted. The zygote develops into an embryo which implants itself in the uterine lining. The embryo produces a hormone, hCG (human chorionic gonadotrophin), which prevents the corpus luteum from degenerating so that the corpus luteum continues to secrete progesterone and oestrogen until the placenta takes over the production of these hormones.

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https://www.miun.se/en/Research/research-centers/swsrc/news/2019-2/the-menstrual-cycle-and-female-athletic-performance/

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https://courses.lumenlearning.com/boundless-ap/chapter/physiology-of-the-female-reproductive-system/

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Factors:

Uterine fibroids

Hormonal imbalances

Clotting disorders

Cancer

Sexually transmitted infections (STIs)

Polycystic ovary syndrome (PCOS) - cysts on the ovaries

Genetics

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Symptoms of premenstrual syndrome:

bloating

breast swelling, pain, or tenderness

mood changes

headache

weight gain

changes in sexual desire

food cravings

trouble sleeping

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Eg India
States schools provide pack of sanitary napkins every month to all female students in middle and senior school under a government scheme to promote menstrual hygiene. It's an important campaign in a country where only 36% of its 355 million menstruating females use napkins (the remaining use old cloth, rags, husk or ash to manage the flow) and nearly 23 million girls drop out of school annually after they start their periods.

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Period symptoms:

cramps

tender breasts

bloating

mood swings

irritability

headaches

tiredness

low back pain

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The key methods to increase access to menstrual hygiene products are through
improving their availability and affordability, and improving understanding of this topic in the community. To increase availability, various national and international initiatives have distributed free or subsidised menstrual hygiene products. However, while this approach can be used in the short term to quickly improve access to menstrual hygiene products in a community and is vital in humanitarian crises, in more stable development contexts it is not ideal as it creates dependency on external assistance. It is far more sustainable to work to ensure that an affordable and consistent supply of the reusable menstrual hygiene product(s) of choice is available, which can be done through private sector development by working with local suppliers and supporting the supply chain, with investment to overcome key bottlenecks and technical assistance to produce an effective yet low cost product where required.

Once the supply side is in place, the demand side can be built through education. Targeted, culturally sensitive education – of men and boys as well as women and girls – works to decrease stigma and increase understanding of the usage, benefits and cost effectiveness of menstrual hygiene products such as reusable pads and menstrual cups. Greater understanding also decreases the stigma that women and girls may feel regarding buying menstrual hygiene products from a shop, and increases the likelihood that men in charge of a family’s finances will provide menstrual hygiene products to their female family members. Improved awareness among teachers can make it easier for girls to change/empty menstrual hygiene products in schools, though support from donors may also be required to fund the creation of suitable toilet facilities in schools for this to take place

https://www.heart-resources.org/blog/challenges-facing-women-girls-accessing-menstrual-hygiene-products-developing-countries-effective-approaches-increasing-access/.