Q & A

January 22, 2010

Q & A

Women face unique health issues at different stages of life. For this edition of Q & A, Dr. Parichart Thanasitthichai, a board certified gynecologist and obstetrician, answers reader questions about important women’s health topics.

Q: My 55-year old mother urinates frequently and is worried about her health. Should she be concerned?

A: Frequent urination can have a number of possible causes. In your mother’s case, she should keep a written diary for a few days to provide her doctor details on the times and frequency of urination plus information on her eating and drinking habits. That information can help her doctor determine if it’s simply a matter of your mother drinking too many liquids – especially caffeinated drinks like coffee and tea – or whether it’s health-related and requires further testing and possible treatment.

In general, urination is considered too frequent if a person urinates many times both during the day and at night while also feeling as if the bladder doesn’t fully empty after urinating. Excessive urination can be a sign of a serious condition like diabetes or a tumor, so it’s best to diarize your habits for a few days and then consult your doctor.

Q: What’s the best way to know if the amount of menstrual bleeding is normal or excessive? And which is considered more serious – heavier than normal or lighter than normal bleeding? 

A: Doctors look at three factors to assess or measure menstrual bleeding, beginning with the duration of the menstrual period, with two to six days considered the normal range. Second is the length of the cycle, counting from the first day of one menstrual period to the first day of the next, with cycles of 21 to 35 days considered normal. The third factor is the volume of menstrual bleeding; the volume is generally considered excessive or heavy when pads or tampons need to be changed very frequently or reveal blood clots.

Some people still believe the myth that heavy menstrual bleeding is good for a woman’s health. While the myth is false, heavier than normal bleeding doesn’t automatically mean there’s a medical problem. Heavy may be normal for some women. In cases where heavy isn’t normal or routine, the most common health risk is anemia, which causes exhaustion and leaves the body more susceptible to infections.

Lighter than normal bleeding is often related to changes in hormone levels that may result from other health problems such as thyroid and hypothalamus disorders and certain types of tumors. If you notice anything unusual or concerning about your menstruation, consult your doctor as soon as possible.

Q: I think I am entering menopause as my period has become irregular recently. Is it okay to continue taking oral contraceptives to keep from becoming pregnant?

A: The onset of menopause causes the ovaries to cease functioning, so becoming pregnant will no longer be possible (though there have been a few reports of menopausal women in their mid-forties whose ovaries were still functioning). To be sure, your doctor may suggest a hormonal blood test to confirm your menopause status and to rule out other conditions such as pregnancy or a medical problem. Ovarian disorders and hormone instability can cause changes in normal menstruation patterns.

If you wish to continue taking birth control pills as you approach the onset of menopause, it’s best to wait until one or two days after each period ends, to be sure the bleeding is from menstruation rather than from something else. Women age 40 and older should consult their doctor before taking any medication, and it’s also a good idea to consider non-hormonal birth control options such as condoms or diaphragms.

Have a question?
You can submit your question for possible inclusion in future issues of Better Health, by e-mail [email protected] or by mail to Editor, Better Health Magazine, Bumrungrad International, 33 Sukhumvit 3, Wattana, Bangkok 10110 Thailand.


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