Inadequate awareness around menstrual health and hygiene has a always been a matter of concern, its unfortunate that we as a society are much more aware about the false myths around menstruation rather than facts. We sat down with Dr. Yuvrajsingh Jadeja, M.D Obstetrics and Gynaecology to discuss menstruation, it’s abnormalities, matters of concerns and more.

Dr Yuvraj Jadeja (Source: Instagram | @doctoryuvi)

While its true that your menstrual cycle can say a lot about your health, it can also cause unnecessary distress if we don’t know what’s normal and what’s not.

What is menstrual cycle?

The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone. The uterine cycle governs the preparation and maintenance of the lining of the uterus (womb) to receive a fertilized egg. These cycles are concurrent and coordinated, normally last between 21 and 35 days in adult women, with a median length of 28 days-30days.

What’s normal?

It is important, The menstrual cycle, which is counted from the first day of one period to the first day of the next, isn’t the same for every woman. Menstrual flow might occur every 21 to 35 days and last two to seven days. For the first few years after menstruation begins, long cycles are common. However, menstrual cycles tend to shorten and become more regular as you age.

Your menstrual cycle might be regular — about the same length every month — or somewhat irregular, and your period might be light or heavy, painful or pain-free, long or short, and still be considered normal. Within a broad range, “normal” is what’s normal for you.

Your cycles again during peri menopausal period might become irregular, so one shouldn’t panic, but during those years it is always better to make a visit to your gynecologist  earlier.

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Whats abnormal?

Abnormal vaginal bleeding may occur in association with or independent from menstruation. Bleeding related to the cycle may be abnormal in timing, duration, or quantity. Polymenorrhea (frequent menses) refers to a menstrual interval of less than 21 days. In oligomenorrhea (infrequent menses) the interval is greater than 37 days but less than 90. Amenorrhea (absence of menses) refers to failure to menstruate for 90 days or longer. Metrorrhagia is an increased duration of menstrual flow beyond 7 days and continuous with the cycle. Intermenstrual bleeding occurs between menses, discontinuous with the cycle. Hypomenorrhea is the term for abnormally low bleeding, substantially less than 30 ml per menstrual cycle, and hypermenorrhea refers to excessive bleeding, over 90 ml, in a cycle of normal duration.

Menstrual cycle irregularities can have many different causes, including:

1)Puberty: your periods might be irregular for the first year or two.

2)Perimenopause: usually between 45 to 55yrs

3)Pregnancy and breast feeding.

4)Contraception: Pills or IUD

5)Stress, extreme weight loss/gain.

6)Medical conditions such as PCOS, hormonal imbalances of Thyroid, Prolactin etc

7)Fibroid/Endometriosis

8)Local diseases such as Cervical or endometrial polyp, cervical erosion, PID etc

9) Premature menopause.

When should one consult your health care provider if:

  • Your periods suddenly stop for more than 90 days — and you’re not pregnant
  • Your periods become erratic after having been regular
  • You bleed for more than seven days
  • You bleed more heavily than usual or soak through more than one pad or tampon every hour or two
  • Your periods are less than 21 days or more than 35 days apart
  • You bleed between periods
  • You develop severe pain during your period
  • You suddenly get a fever and feel sick after using tampons

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