Menarche, Menstruation and Menopause: Are We Mistaking Consequences for Physiology?

A woman’s reproductive life is marked by three remarkable events: menarche, menstruation and menopause. We accept them as normal and physiological. But what useful purpose does each event itself serve?

Puberty establishes reproductive maturity, yet menarche occurs relatively late, after many physical and endocrine changes have already occurred. Could the first menstrual bleed therefore be regarded as a biomarker of reproductive maturation rather than an independent physiological objective?

Menstruation raises a more intriguing question. The endometrium prepares for implantation. But if pregnancy does not occur, why must it be shed?

Most mammals do not menstruate. One evolutionary hypothesis proposes that menstruation may no ...