Menstrual cycle provides a good amount of information about the overall health of an adolescent and female. Menstrual issues constitute the largest component of health disorders experienced by women. 

Menstruation, shedding of the uterine lining, starts at the onset of puberty (at the age of 12 – 13 years) and ends at menopause (age of 47 – 52 years). It occurs once every 21-40 days and lasts for about 2 to 7 days usually. 

Some of the changes are natural at puberty:      

  • Increase in height and weight
  • Growth of legs, abdomen, chest and bony pelvis
  • Changes in body shape / contour
  • Development and growth of sex organs
  • Development of breast bud and growth of pubic hairs
  • Onset of menstrual period - menarche

When do you need to consult a Gynecologist?

  • Non-commencement of menstruation by age of 16 years]
  • Periods have suddenly stopped
  • Excessive bleeding
  • Feeling sick after using tampons
  • Bleeding in-between periods
  • Experience severe pain during periods

Common problems of menstruation

  1. Painful menstruation or dysmenorrhea - Most common problem reported in OPD, pain in the lower abdomen. It usually starts with the onset of menstrual flow and lasts for 1 to 2 days. It is mainly due to uterine contractions. It is also usually associated with lower backache and pain in the inner thighs. Some women may also occasionally experience nausea, vomiting, bloating, diarrhoea, fluid-retention, headache and fainting episodes.
  2. Irregular periods - It is common in the first 1-2 years after menarche and is usually anovulatory (ovulation doesn’t occur). It also experienced by ~30%of women in the reproductive age group. It usually occurs as a result of hormonal indications that have been shown by the body out of sync.
  3. Menorrhagia - Abnormally heavy and prolonged menstrual period, with blood loss > 80 ml or which lasts longer than 7 days. You can measure it basis the number of tampons or pads, changed in a day. A fully soaked pad or tampon can hold about 5 ml of blood. 
  4. Premenstrual syndrome - Changes in physical and behavioral condition which starts 1 week prior to the on-set of periods. It is due to extra water content in the body. Physical symptoms include headache, tiredness, lethargy, swelling or pain in breasts, abdomen, appetite changes and increased frequency of urination. Behavioral symptoms such as mood swings, irritability, depression, hostility and anxiety can also be seen. 
  5. Abnormal vaginal discharge - Some pearly white discharge during ovulation period and prior to having menses is normal. If the discharge is smelly, greenish or yellow colored,consult a gynecologist. 
  6. Urinary infection - Frequent urination, itching, burning sensation, fever and chills are presenting symptoms. Drink at least 8-10 glasses of water. Wash the vaginal area properly from front to back after urinating or defecating and do not hold the urge to urinate. Always wear clean cotton underwear and maintain proper menstrual hygiene.

Menstrual hygiene and preventive measures:

  • Maintain good hygiene during menses - It helps prevent infection, itching and bad odor
  • Bath twice daily
  • Wear clean cotton panties
  • Wash hands with soap after using washroom
  • Wash genitalia with water after urination
  • Wash the inner sides of the thighs well with soap and water while bathing
  • Don’t wash vaginal area with soap
  • Dry the genitalia region well
  • Change the napkin at least 2-3 times a day, after every 4-6 hrs