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What Your periods speak about your health
 Paying
attention to the patterns of your menstrual cycle offers a window into your
overall health.
What's a normal period? The typical healthy cycle ranges from 22 to 35 days in
length. And while the period that arrives a day late or seems heavier one
month than another may worry you in the short term, that's in the range of
normal. What should concern you are changes that persist for three months or
more and mark a radical departure from what you know as your normal period
behavior. Abnormal periods aren't just wacky; they may be clues to your health
— signaling that you're at higher risk for
osteoporosis,
heart disease,
infertility, or certain
cancers.
Here are five period patterns that should send you straight to your OB-GYN
for advice.
Heavy bleeding or menorrhagia:
If your period seems to be lasting
longer than seven days, you pass large clots, or you routinely start soaking
through a maxi pad or a super tampon in an hour, you have menorrhagia, the
medical term for heavy menstrual bleeding.
Causes: could range from an over- or under-active thyroid, fibroids (non-cancerous
growths in the uterus) or benign uterine polyps. Another possibility:
adenomyosis, a condition in which uterine endometrial tissue migrates into the
muscle wall. Another cause for heavy periods is endometriosis. In this
condition there is a formation of womb lining tissue outside the uterus. A
doctor should be consulted and investigations like laproscopy and sonography
will confirm the diagnosis. A IUD device may have irritated the uterine wall —
heavy bleeding is a common IUD side effect. Marital disharmony, domestic
quarrels, undue anxiety, stress
and tension are some of the other occasional
causes for heavy bleeding.
Treatment options:
Your doctor can remove polyps during an outpatient procedure and medication
can regulate an over- or under-active
thyroid.
Fibroids that are painful or
causing anemia may warrant a myomectomy (surgery that removes the growths but
keeps your uterus intact), endometrial ablation (which uses heat, cold,
electrical energy or laser beams to destroy the lining of the uterus) or uterine
artery embolization (blocking of blood flow to the fibroid).
If the degree of bleeding is mild, all that may be sought by the woman is the
reassurance that there is no sinister underlying cause. If anemia occurs then
iron tablets may be used to help restore normal haemoglobin levels. Treatment
may be given for a fixed period of time to replenish the body stores.
Alternatively therapy may be continued long-term, often in a cyclical regimen on
the days of menstruation.
A definitive treatment for menorrhagia is to perform hysterectomy (removal of
the uterus).
Long intervals between bleeding or oligomenorrhea:
 Up to 35 days between periods is
considered normal. If yours are much more spread out, so you end up getting
six or fewer periods each year (a condition called oligomenorrhea), have your
doctor check it out.
Causes: Polycystic ovarian syndrome (PCOS), a
disorder that affects up to 7 percent of premen-opausal women. It occurs when
the ovaries make excess testosterone, so you ovulate irregularly or not at all.
Other signs are acne, excessive facial or body
hair growth and
weight gain.
Sometimes, the cause is a thyroid abnormality or hyperprolactinemia, where the
pituitary gland releases excessive prolactin (the hormone that stimulates breast
milk production).
Treatment options: Oral
contraceptives can
help normalize your periods and minimize other symptoms in women with PCOS.
Losing weight, exercising regularly and possibly taking an insulin-sensitizing
drug (like metformin) can also help manage the condition. In case of prolactin
abnormality, consult your gynecologist.
Missing periods:
If your normally punctual period turns up missing
for three or more months and you haven't been under any extreme stress (and
you're sure you're not pregnant), you need to get to the bottom of your
amenorrhea.
Causes: ZPerimenopause or the beginning of
menopause (if you're in your mid-40s or older), a hormonal imbalance or
pregnancy. A rare possibility is that you have a pituitary tumor (usually
benign). Some of the symptoms could be an ovarian cysts. Stress, rapid
weight loss or gain, illness, drugs (certain tranquilizers) can lead to
disrupted cycle. This can be a side effect of progestin-only
methods of birth
control.
Treatment option: If you're in perimenopause,
going on the pill might regulate your cycle. If you have a pituitary tumor, your
doctor may treat it with drugs that suppress prolactin or, in rare cases,
recommend surgery.
Scanty bleeding or hypomenorrhoea:
 The medical term for less blood flow during a period
is 'hypomenorrhoea'. Some perfectly normal women only bleed for three days.
But when bleeding is uncharacteristically scanty (say, your pads get only a
quarter-size spot) or gets much lighter than it has been (a seven-day period
becomes two), it deserves a checkup.
Causes:
Less blood flow may be genetic and, if enquiries are made, it may be found
that the woman's mother and/or sisters also have decreased blood flow during
their periods. Too-light periods can be signs of missed ovulation, PCOS, the female athletic triad, a pituitary tumor, or thyroid dysfunction,
so expect blood, glucose, and
bone-density testing. Scanty menses can also
occur after long term use of oral contraceptives as a result of progressive
endometrial atrophy. In a condition called Sheehan's Syndrome, there is
pituitary insufficiency leading to scanty or complete loss of periods
(amenorrhea). Emotions and stress can act on the centers in the brain that
stimulate the ovaries during the ovarian cycle to secrete hormones like
estrogen and progesterone which are mainly responsible for the growth of the
endometrium. If these centers in the brain are suppressed due to stress,
they fail to stimulate the ovaries leading to less or no production of
estrogens and hence scanty menses or periods.
Treatment option: A full and thorough history of previous menstrual cycles
should be taken to diagnose constitutional causes. Hormonal problems can
usually be treated by prescribing hormones. Eating too much of fatty,
greasy food, processed food, ready-to eat packets, debilitate and
de-vitalize the system.
Consume loads of fresh fruits and vegetables. Ensure that you get a daily
helping of dried fruits as well. Restructuring your diet is very important.
Good stress management is the key to most of the disorders. Take time out to
de-stress and unwind. It will yield good results.
Between-Period Bleeding:
It's not uncommon to get a small amount of so-called breakthrough
bleeding, because estrogen drops slightly in the middle of your cycle. But
tell your doctor if bleeding is heavy or persists from cycle to cycle.
Causes: stress; It can be a side-effect of a pill. Another possibility is that you're taking a
medication that decreases the pill's effectiveness. Or it might be
due to a result of inflammation by a IUD
 device. Light spotting in the week before your period
could signal a luteal phase defect, meaning that your progesterone levels
are too low during the second half of your cycle. If bleeding only occurs
after you have sex, it could be an infection, cervical polyps or warts or
cervical cancer.
Treatment option: For women on the pill, breakthrough bleeding usually
occurs just as they start taking it or in those who have been taking it but
have missed pills. Expect a pelvic exam: If you're not on the Pill or
haven't missed any pills, she may want to look for polyps. If you are not
monogamous or if you have a new sexual partner, ask to be tested for
sexually transmitted diseases.
Chlamydia (a bacterial infection that is
often symptom less in women) can cause breakthrough bleeding. Undiagnosed,
chlamydia can result in pelvic inflammatory disease and infertility. A luteal phase defect can be treated with
vaginal progesterone or fertility drugs.
In most cases your doctor might recommend a series of test to come to a
conclusion and then follow it with the appropriate treatment. For
example, he/she might do a pelvic exam to look
for polyps and a Pap smear to test for cervical abnormalities, including
warts. She also may test you for other sexually transmitted diseases. To
get a closer look at your cervix, she may perform a colposcopy (a visual
inspection of the cervix with a small viewing instrument). In some cases
you might be adviced to take a blood tests for hormone levels, (thyroid
hormone, estrogen, progesterone, testosterone and prolactin) and fasting
glucose (blood-sugar) levels. If PCOS is suspected, you may need an ultrasound
to look for ovarian cysts. If you have high levels of prolactin, which is
released by the pituitary gland, an MRI or CT scan can confirm or rule out
obvious tumors.
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