Menstrual cycle is a process a female body goes through every month as it prepares for the possibility of pregnancy. In this interview, Dr Sabahat Khan, a gynecologist & infertility expert at Doctors Hospital and Medical Centre Lahore talks about issues related to periods
SN: What is a healthy menstrual cycle? sni
It is a process a female body goes through every month as it prepares for the possibility of pregnancy. If pregnancy does not occur, body releases hormones which cause bleeding from the uterus (organ where baby grows). This cycle begins on the first day of bleeding and ends on the first day of next period. Its length ranges from 21 to 35 days and bleeding lasts for two to eight days.sni
SN: When is the cycle considered irregular? sni
If the length of cycle or gap between periods keeps changing, it is considered irregular. Having irregular periods occasionally is common. But if the cycle is often very long or short, or changes every month then there is a problem. You need to consult a doctor if you also experience missed periods, intermenstrual bleeding, heavy bleeding or blood clots.sni
SN: Which health issues are caused by menstrual irregularity? shifanews
Hormonal imbalance is the main reason behind irregularity. Health issues include depression, acne, weight gain, increased facial and body hair growth and infertility. shifanews
SN: What does spotting before period indicate? sni
Spotting means small amount of bleeding before, during or after periods. It can be an early sign of pregnancy, side effect of medicine, hormonal imbalance, infection, uterine or cervical polyp (abnormal tissue growth) or stress.sni
| Having irregular periods occasionally is common. But if the cycle is often very long or short, or changes every month then there is a problem |
SN: At what age can periods begin? sni
It varies individually. However, first period can start between 8 to 17 years and average age is 12 to 13 years. Factors influencing it are still unclear but genes, socio-economic status, general health and certain exercises can play a role. Seek help if they start before or after this age. sni
SN: What matters more; quantity or duration of periods? sni
Both are important. Issues which require examination include spotting, heavy flow with clots or bleeding for less than two or more than eight days. sni
SN: Why do women experience mood swings and irritability before and during periods?sni
These and some other symptoms are termed as premenstrual syndrome (PMS). Hormonal fluctuation in second half of menstrual cycle is responsible for it. After ovulation (when the egg releases), estrogen level drops, progesterone rises and then drops. This effects serotonin levels too. Low amount of which causes mood swings, irritability and sleep disorders.sni
SN: What causes pain and discomfort before and during menses? Also how are vomiting, diarrhea and bloating related to it? sni
Prostaglandins are hormone like substances involved in pain and inflammation. They cause uterine muscles to contract and expel innermost layer of the uterus, leading to menstrual cramps. When some of these substances get into blood stream they result in vomiting, diarrhea, bloating and headache.sni
| First period can start between 8 to 17 years and average age is 12 to 13 years. Seek help if they start before or after this age |
SN: Why does the intensity of pain differ?sni
It is usually due to increased amount of estrogen and progesterone along with prostaglandins. Other serious causes are disorders like cervical stenosis (narrowing of neck area of spine), adenomyosis (growth of tissue in uterus muscles) and endometriosis (tissue growth outside the uterus). Consult your physician if the pain starts disturbing routine activities.sni
SN: Suggest some remedies to reduce pain. sni
Heat therapy on lower abdomen has a soothing effect. Gentle exercises and walk can also reduce bloating and cramps. Over the counter painkillers and increased fluid intake can relieve pain. Herbs for example vitex, also known as chaste berry help balance hormones. Magnesium due to its muscle relaxing property is beneficial too. Its sources are dark green leafy vegetables, dried beans, nuts and low fat milk and yogurt.sni
SN: What causes abnormal bleeding? sni
Uterine structural abnormalities, fibroids (non-cancerous growth), adenomyosis, endocrine disorders like hypo or hyperthyroidism, hyperprolactinemia, hormonal imbalance, intrauterine contraceptive devices, ovulatory disorder, erratic use of exogenous hormones, infection of genital tract and genital tract cancer. sni
SN: What causes late or missed periods after menarche? sni
Most common ones are polycystic (fluid-filled sacs) ovaries, sudden weight loss or gain, stress, tough exercises, erratic intake of some medicines, pregnancy and breastfeeding. All of these cause hormonal imbalance and affect monthly cycle.sni
| High absorbency pads are safer than tampons and cups. They can be changed according to need but avoid using them for more than six hours |
SN: Why is it necessary to keep track of monthly cycle? sni
Every woman should keep track of her cycle. It helps her handle the situation well. Also allows her to identify unusual changes in periods or the cycle itself.sni
SN: Which menstrual product has minimum side effects? Also, how often should one change them?sni
High absorbency pads are safer than tampons and cups. They can be changed according to need but should not be used for more than four to six hours. Otherwise they may cause rashes, irritability and infection.sni
SN: Are feminine hygiene products like scented soaps, safe to use?sni
Yes, according to the United States Food and Drug Administration, they are safe to use.sni
SN: What is menstrual hygiene? sni
It means using clean material to collect period blood, changing it as per need, washing one’s self properly with soap and water and properly disposing of used napkins. This practice can help prevent reproductive and urinary tract infections.sni
SN: Some women think taking shower during periods is unsafe. Your take on this? shifanews
No, it is not true. In fact, warm bath can reduce cramps and create a feeling of freshness.sni
| Normal leucorrhea is a colorless or milky white discharge. Seek help if it is malodorous, blood tinged, colorful and causes itching |
SN: Is it true that menstrual blood is not part of normal blood?sni
No. Menstrual blood is from the blood circulating in our entire body. So excessive bleeding results in anemia and its complications.sni
SN: How can mothers educate their daughters regarding this natural change?sni
They should discuss unhesitatingly. Also, educate them about menstrual cycle and hygiene management before their first period. It helps young girls to cope with anxiety, depression and other issues related to pubertal changes.sni
SN: What is the difference between normal and abnormal leucorrhea?sni
Normal leucorrhea is a colorless or milky white discharge. If it is malodorous, colorful (green, curdy white or yellow), blood tinged and causes itching, then medical attention is required.sni
SN: What causes abnormal discharge? sni
Pathogenic (disease causing) bacteria or fungus are responsible for infective discharge. Reproductive tract cancers may cause blood tinged discharge.sni
SN: What can be done to prevent vaginal infections? sni
Menstrual hygiene management, changing wet clothing as soon as possible and wearing breathable under garments can help prevent them. Also, women should avoid using deodorants or cleaning inner area of private parts with water and other solutions.sni
SN: Suggest some tips to maintain good reproductive health.sni
Women must practice good hygiene, take healthy diet with low sugar content and increase vegetable consumption. Apart from that moderate exercise, stress management, avoiding alcohol and smoking and taking proper sleep is important.sni
