On 26th October 2018, Cloud nine launched a Facebook Live on Irregular Periods on its Facebook page @CloudnineCare. It was led by Dr Manjula Deepak, Obstetrician & Gynecologist at Cloud nine Hospital, HRBR Layout, Bangalore, and Swathi Kulkarni, Co-founder, Nua.
The forum, conducted in a question-and-answer format, cast a spotlight on various aspects of irregular menstruation.
Excerpts are included below.
Specialist Details: Dr Manjula Deepak
Specialty: Obstetrics & Gynecology
Clinical Focus and Expertise: Infertility evaluation, infertility treatment, high-risk pregnancy care, breast care, hysterectomy, laparoscopy, sexual health, reproductive medicine
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Periods are often considered a pain point, and irregular periods, even more so. Traumatizing as they are, irregular periods are very common – and can start at any age, from puberty through to menopause. Menstruation is not just governed by the uterus.
It is achieved via synchrony of 5 different organs, from the brain to the vagina. When all of these work in harmony, menstruation occurs in a normal manner. However, factors like stress and cancer can hamper this process.
Menstruation should not be perceived as an inconvenience, but rather as a gift of nature that enables the circle of life.
A normal menstrual cycle is approximately 28 days, plus or minus 7 days, and bleeding usually lasts between 2 to 7 days. The amount of blood loss varies from woman to woman. Losing up to 80 ml of blood is considered normal, as is the appearance of blood clots on the first day.
The length of a period cycle typically hinges on age. It is perfectly normal for a young girl who has just attained puberty to observe abnormal cycles for the first 2 years. This is because hormonal glands still need time to attain maturity. In such cases, where the hormonal equilibrium isn’t yet formed, bleeding can occur once every 2-3 months, and can be very heavy.
If you identify with this, observe your menstrual cycle for 2 years. If you have 3 consecutive 60-day cycles, consult a doctor.
Periods are dependent on a range of environmental, emotional and physical factors. So, some months, you may observe prolonged bleeding, especially when you’ve had a delayed menstrual cycle. If you see prolonged bleeding for more than 14 days straight, please see a doctor.
Yes, it is. Each woman has a different threshold for pain. While some women are able to handle it well, others throw up, have weakness or feel tired. Leg pain usually manifests as pain in the calf muscles or persistent pain from the hip to the toe. Leg pain is mainly caused by a deficiency of vitamin D3 and can be corrected through the right supplements.
In PCOS, high oestrogen levels impede ovulation, leading to anovulatory cycles. Generally, when you ovulate, your uterus receives a signal on when to bleed. However, in anovulatory cycles, the uterus fails to receive these signals and continues to collect blood, in turn, developing a very thick lining.
When you do eventually menstruate, the endometrial walls shed so much that sometimes, the flesh comes out along with the blood, causing a significant amount of pain. Treatment for PCOS typically entails lifestyle modifications. Consult a doctor for guidance.
There are 8 types of irregular periods, all of which require medical intervention:
Regular periods are not a barometer of fertility. Infertility can occur even if both the man and the woman are perfectly healthy. Likewise, irregular periods need not mean that you are unfit for pregnancy. Having irregular periods is fine, but noting how irregular the periods are is very important.
Between puberty and menopause, our bodies are governed by a reproductive graph. During this time, factors like childbirth and breastfeeding cause large shifts in hormone levels. Pregnancy, for instance, causes the pituitary glands to work harder than normal and also elevates endorphin levels. All these factors have an impact on the uterus, leading to irregular periods.
Mood swings are very common during PMS, especially in the age band of 30 to 40. PMS is primarily triggered by mental stress, which causes a hormonal imbalance. In rare cases, it could lead to depression.
Polycystic ovaries impede ovulation due to significantly low amounts of oestrogen in the body. This in turn, leads to irregular periods and often, infertility. Breaking this cycle is very important.
Fibroid s are muscular bumps or eruptions that sometimes appear inside the uterus. Women between 30 and 40 years of age are most susceptible to them. There are 3 types of fibroids. Depending on where they are and how they are, the symptoms vary. Small fibroids can be especially dangerous and cause significant bleeding. They can grow up to 12 cm in length. Fibroid s can be detected via an ultrasound scan and can be removed.
Thyroid disorder can affect the pituitary gland, and consequently, derail periods. The thyroid gland secretes a hormone called thyroid-stimulating hormone, or TSH. When you have hyper or hypothyroid issues, the hormones responsible for the ovulatory mechanism are disturbed. So, if you treat your thyroid levels, you can also treat your ovaries, and hence start ovulating regularly again.
Irregular periods are a symptom of uterine fibroids. An ultrasound scan is the only way to definitively detect a fibroid.
The attainment of menopause depends on your genetics. If you have attained early puberty, you most likely will attain early menopause as well. Hormonal and uterine changes can cause painful menstrual cycles. Take heart in knowing that pain-relief tablets will not have any effect on future pregnancies.
A monthly calendar recording period regularity[/caption]This is totally normal, as long as you get your periods every 21-35 days.
Pick products that are chemical-free. Also, make sure the surface of the product is soft and smooth, has no perfume, and is clean. Bigger pads are ideal for a heavy flow and medium-sized ones, for a lighter flow.
About every 6-8 hours. Menstrual hygiene is very important because any rough or toxic products can lead to rashes. They can also cause a lot of discomforts. Changing pads once every 6 hours is a hygienic practice unless you experience very heavy flow, in which case you may want to wind down this window.
Oral contraceptive pills can affect period regularity, and give rise to anovulation. You may also notice the duration and flow of your period reducing. However, contraceptive pills are also advantageous because they reduce the occurrence of breast and ovarian cysts.
Copper- Ts are excellent contraceptive devices. However, the body recognizes a copper-T as a foreign body and in turn, compromises hormone production. It is not uncommon for you to experience irregular or heavy cycles in the first 3-6 months of having one inserted.
In post-abortion cases, it is advisable to wait for at least 3 months before trying to conceive again.
When you over-exercise and lose an inordinate amount of weight, you lose a lot of oestrogens. This can reduce your period flow.
I Pill should never be used as a contraceptive. There are many alternative tablets you can take as contraceptives.
Follicular scans can shed light on whether you are ovulating.
Brufen (we start this as a non-steroidal drug), Meftal Spas, Drotin-M and Cyclopam are some options.
You have nothing to worry about. Regular cycles of 40-45 days are normal.
Try to stay calm, take things easy, don’t burden yourself with stress over periods. Share your pain with your near and dear ones and stay positive. Eat well and exercise well. Pain is usually caused by cervical expansions. A happy and healthy life with plenty of exercises and outdoor activity is a proven formula for reduced pain.
Yes! You can exercise during your periods, but it’s best to avoid sexual activity in the first 3 days. This is because sexual activity can push menstrual fluid back inside the uterus, causing a retrograde menstrual flow into the endometrial cavity. This can lead to endometriotic cysts. Other than this, no other normal activity will affect your cycle.