Primary amenorrhea is characterized by delayed menarche (the onset of menses during puberty). Sneezing while menstruating may result in a sudden vaginal menses emission. Like other menses, menarche may be accompanied by abdominal cramping. Patients with adenomyosis often present with painful menses (dysmenorrhea), profuse menses (menorrhagia), or both. Ovulation and thus pregnancy can begin prior to a return to regular menses. Ovulation is necessary for fertility, but may or may not accompany the earliest menses. The uterine cycle has three phases&colon; menses, proliferative, secretory. Cessation of menses as a result of removal of the ovaries is called "surgical menopause". These symptoms should occur during the week before menses and remit after initiation of menses. The theory has some symmetry, as semen movements carry maleness while the menses carry femaleness. Aristotle's theory has some symmetry, as semen movements carry maleness while the menses carry femaleness. If the next expected menses is late it is important to get a pregnancy test. The father's semen and the mother's menses encode their parental characteristics. Female initiation begins with a girl's first menses. Users of UPA are likely to experience delayed menses after the expected date.