Coping with Menstrual Disorders

Being born a female can literally be a pain. Periods can bring all sorts of problems, but before we indulge in the 'poor me, I hate getting my period' we should feel blessed that it is only the female gender that gets the opportunity to feel another being grow inside her. Now we have given credit to the female body, you can also now complain.

With the commencement of periods comes pain, mood swings, at times inconvenience and embarrassment. This on average is now all starting around the age of 12 years of age (and is actually called the 'menarche'). This is a far cry when we compare it to our ancestors who commenced their periods, on average at 16 years of age (100 years ago).


Normal
A normal menstrual cycle is averaged out to 28 days, however 'normal' can be from 21 to 38 days. The length of a period can also vary, from 3 to 7 days. During this time, although it appears you may be losing a lot of blood, you're not. You lose about 60mls of blood. Also mixed in with this are normal vaginal secretions, which may give the appearance that you are losing more blood. Over your lifetime it is normal to experience changes in your period, however it is always a good idea to check with your doctor if any changes occur. Changes in your life can cause normal deviations in your menstrual cycle; these things include travel, weight changes, stress, illness. If your period does not resume to its normal cycle after a month or so, have it checked out by your doctor.


Disorders
Infrequent periods (oligomenorrhoea) - These are periods that are more than 6 weeks apart. This is quite common when a girl first starts menstruating. It is also common as a woman draws to the end of her childbearing years. As mentioned earlier, a change in your period can also be related to stress etc. If your periods become irregular it's best to see your doctor.

Treatment - unless you are trying to conceive (and everything has been checked out by a doctor and things appear normal then there is no need for treatment.

Painful Periods (dymenorrhoea) - Abdominal cramping, this may be combined with nausea vomiting, or diarrhea or constipation. Painful periods are frequently connected to a chemical imbalance of prostaglandin's (prostaglandin's are related to inflammation and are at a higher level in the body just before and during your period). Other problems that can cause painful periods or periods that start to suddenly hurt are endometriosis, an infection, ovarian cyst, the use of an IUD and fibroid tumors.

Treatment - painkillers such as aspirin or ibuprofen. Speak to your pharmacist about what's available over the counter for period pain. If the pain is severe, or has suddenly started, please visit your doctor so that everything can be checked out. If there is nothing wrong then drink lots of hot fluids, use hot water bottles, and warm baths. Exercising and eating healthy throughout your cycle can also help to reduce pain.

Heavy periods (menorrhagia) - An excessive amount of blood to your normal periods, including blood clots, and bleeding for more than 7 days (heavily). One of the main causes of heavy periods is a hormonal imbalance. Also stopping the contraceptive pill, using an IUD, fibroid tumors, early miscarriage, a pelvic infection, or endometriosis may also be the cause of heavy bleeding. This must be checked out by your doctor.

Treatment - this will depend on what the findings from your doctor are. If it's a hormonal imbalance you may be commenced on the contraceptive pill to control your blood loss (the pill decreases the loss of blood). If there appears to be no underlying cause, the use of antiprostaglandins or NSAI Drugs may be considered. If there is a diagnosis such as an infection the appropriate treatment will be given from your doctor.

Absent periods (amenorrhoea)- If a woman has not menstruated by 18 years of age this condition is known as primary amenorrhoea. If the condition begins after menstruation then it is called secondary amenorrhoea.

Primary amenorrhoea can be caused by late puberty, poor nutrition, an under active thyroid, Turner's syndrome, an endocrine disorder, or for no reason at all.

Secondary amenorrhoea can be caused by a hormonal imbalance, starting or stopping the contraceptive pill, weight loss or excessive dieting.

Treatment - The underlying cause must be found to treat this problem, therefore you must visit your doctor. Hormone treatment may be used to help stimulate ovulation (a period should commence once ovulation has occurred).

Irregular periods - This is when your period is inconsistent. It is most common at the beginning and end of a woman's reproductive years. It also may occur after a woman has given birth (especially if still breast-feeding). Other causes can be weight gain or loss, excessive dieting, stress, diabetes, thyroid disorders, antidepressants.

Treatment - Visit your doctor to see if there is an underlying cause. If found it should be treated correctly. Sometimes there is no reason for this at all and that's ok, unless you are trying to conceive. If you are trying to conceive, then hormonal treatment may be given.


- Louise Ganey