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Q & A - Menstruation


For many women, menstruation is a painful and debilitating experience. Instead of seeking professional advice, many women choose to keep their worries to themselves. This edition of Q&A answers readers’ questions about menstruation.

What signs should I look for to know if my menstruation is abnormal?

From time to time, most women notice some type of change in their routine period pattern. It’s important to know which changes or symptoms may indicate a potentially serious health problem and to follow up with a visit to your doctor. You may be experiencing an abnormal period if you have any of the following symptoms:
  • Your menstruation cycle (i.e. the time from the beginning of one cycle to the beginning of the following cycle) is longer than 35 days or shorter than two weeks;
  • You need to change sanitary pads every one or two hours;
  • Your period lasts longer than seven days;
  • You experience sudden, severe menstrual cramps;
  • You experience vaginal bleeding before the age of 11 or after the onset of menopause;
  • You are 16 or older and have yet to have your first period.
The best thing to do when you experience any abnormal period symptoms is to see your healthcare professional for further investigation.

Are menstrual cramps a normal part of healthy menstruation?

It’s normal to experience some amount of cramping during an otherwise healthy period. However, severe menstrual pain that impacts your normal daily routine and activities, like working or studying, is not normal and requires medical attention.

Doctors typically prescribe Ibuprofen or other pain relievers to help reduce symptoms such as abdominal pain, back pain, and migraine headache symptoms. In more serious cases, your doctor may recommend contraceptive pills to control and adjust the menstruation and to help reduce the severity of the symptoms.

If the medication still doesn’t relieve the symptoms, more thorough diagnostic testing may be required to see if the severe pain symptoms are being caused by a more serious problem.

My period is almost always late and sometimes disappears. What might be causing this?

The normal menstrual cycle occurs about every 28 days, with a seven day variation (i.e. the normal range is 21 to 35 days between cycles). There are many possible causes for abnormal menstrual cycles. Before you become filled with worry, re-check the time between your last two cycles to confirm whether it was within or outside the normal range.

Birth control medication can affect the menstrual cycle, and becoming pregnant is one cause of a “missed” period. Individual health and lifestyle factors can also impact a woman’s menstrual cycle. Pregnancy, breast feeding, eating disorders, extreme exercise and sports activities, stress, anxiety, drug use, and some hormonal medications such as oral contraceptives have all been shown to affect the menstrual cycle.

In addition, reproductive and endocrinal disorders (namely ovarian cysts, uterine tumors, premature ovarian failure) can also affect the normal menstruation cycle. Be sure to have regular check-ups and see your doctor whenever you notice any menstruation abnormality.

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