Menstruation

 

Menstrual Hygiene Practices:

·      Use clean materials to absorb or collect blood.

·      Product Changes: Change sanitary pads every few hours; tampons every 4-8 hours. Empty menstrual cups every 8-12 hours.

·      Cleaning: Wash the genital area with warm water 2-3 times a day. Avoid harsh, scented soaps, and do not douche.

·      Disposal: Wrap used pads/tampons in paper and place in a dustbin; never flush them down the toilet.

·      Reusable Products: Wash reusable pads or menstrual cups thoroughly and dry them in direct sunlight to kill bacteria.

·      Infection Prevention: Change products frequently to prevent rashes and infections.

·      Physical Care: Combat cramps and PMS with a balanced diet, reduced caffeine, reduced salt intake, and light exercise.

·      Skin Care: Avoid tight-fitting clothing to reduce humidity and potential fungal infections.

Managing painful periods (dysmenorrhea):

·      Heat Therapy: Apply a heating pad, hot water bottle, or heat patch to the lower abdomen or back to relax contracting muscles.

·      Pain Relief Medication: Take NSAIDs like Ibuprofen or Naproxen, as they reduce the production of prostaglandins that cause cramps. Paracetamol can be used if NSAIDs are not suitable.

·      Massage & Relaxation: Gently massage the lower abdomen or back, and use techniques like deep breathing, yoga, or meditation to reduce stress.

·      Warm Bath/Shower: Taking a warm bath or shower can help relax muscles and ease pain. 

·      Gentle Exercise: Activities like walking, swimming, or yoga can increase blood flow and release endorphins, which are natural pain relievers.

·      Dietary Adjustments: Consider adding foods rich in Omega-3 fatty acids, or magnesium, which may help with cramps. Staying hydrated is also crucial for reducing fatigue and pain.

·      Herbal Teas: Ginger, chamomile, or fennel teas have anti-inflammatory properties that may ease discomfort.

·      Avoid Smoking: Smoking is known to increase the risk of more severe period pain. 

·      Seek Medical Advice: Consult a GP if the pain is severe, disrupts daily life, or is accompanied by heavy bleeding, fever, or pain during sex. Severe pain may indicate underlying conditions like endometriosis or fibroids.

 

Polycystic ovary syndrome (PCOS):

It is a common hormonal disorder affecting 10–13% of women of reproductive age, characterized by irregular periods. It is a leading cause of infertility that tends to run in families. Overweight or obesity can worsen symptoms, although not all individuals with PCOS are overweight.

Symptoms and Clinical Manifestations:

·      Irregular Periods: Infrequent, absent, or prolonged menstrual cycles, or bleeding without ovulation.

·      Hyper-androgenism: High level of insulin (due to insulin resistance) leads to increased androgen (male hormone) production. High levels of "male" hormones leading to physical signs like excess facial/body hair (hirsutism), severe acne, and oily skin.

·      Polycystic Ovaries: Ovaries may appear enlarged and contain many small, fluid-filled sacs (follicles) surrounding the eggs.

·      Other Symptoms: Difficulty losing weight, pelvic pain, chronic inflammation, fatigue, and potential thinning hair on the scalp.

·      Long-Term Health Risks: Without management, PCOS can increase the risk of type 2 diabetes, cardiovascular diseases, including high blood pressure, cholesterol and may cause endometrial cancer (due to thickened uterine lining from lack of menstruation).

 

Premenstrual syndrome (PMS):

It is a combination of physical and emotional symptoms that occur in the one to two weeks before a period starts and usually disappear within a few days of it beginning. It affects over 90% of menstruating women at some point in their lives. Risk factors include high stress levels, a history of depression (including postpartum depression), and lifestyle factors like smoking.

Symptoms vary between individuals and can change month to month:

Emotional & Behavioral: Mood swings, irritability, anxiety, depressed mood, crying spells, food cravings, and trouble sleeping.

Physical: Abdominal bloating (the most common physical symptom), breast tenderness, headaches, joint or muscle pain, acne flare-ups, and fatigue.

The exact cause is unknown, but several factors are believed to contribute:

Hormonal Fluctuations: Significant changes in estrogen and progesterone levels during the menstrual cycle.

Chemical Changes: Shifts in brain chemicals like serotonin, which plays a major role in mood states.

Most cases can be managed with lifestyle adjustments or over-the-counter care:

Lifestyle Changes: Get regular aerobic exercise, aim for eight hours of sleep, and reduce stress through yoga or meditation.

Dietary Adjustments: Eat smaller, frequent meals and limit salt, caffeine, sugar, and alcohol in the two weeks before your period.

Medications: Over-the-counter pain relievers (ibuprofen) can help with cramps and headaches. For severe cases, doctors may prescribe hormonal birth control or antidepressants (SSRIs).

Seek medical advice if your symptoms are severe enough to interfere with your daily life, work, or relationships.

A small number of women (under 5%) experience a severe form called Premenstrual Dysphoric Disorder (PMDD), which involves disabling emotional symptoms.

Doctors often recommend keeping a symptom diary for at least two to three menstrual cycles to confirm the pattern.