Menstruation
Updated: 03.08.2023
Approved by: General Practitioner, Alice Pan
Menstruation, colloquially referred to as a "period", is a natural monthly process that results in vaginal bleeding. It occurs due to the shedding of the endometrium, the lining of the uterus, when no pregnancy takes place.
Menstrual Cycle
The average menstrual cycle lasts for 28 days, although it can vary between 24 to 38 days. It's advisable to track your menstrual cycle on a calendar to understand your unique pattern. Start counting from the first day of one period to the first day of the next period. Doing this for several months can help you identify your average cycle length.
Period Blood Loss and Pain
Women typically lose between 2-3 tablespoons of blood during each period. While period pain is common, the severity of the pain and the amount of blood loss can vary significantly between individuals.
When to Consult a Doctor?
It's important to consult a doctor if:
- Your periods last longer than 7 days or are so heavy that you need to change your pad or tampon every hour.
- Your periods become irregular, you bleed in between periods, or you have foul-smelling discharge or pain during intercourse.
- You miss three or more periods consecutively, and you're sure you're not pregnant. This could indicate an underlying health issue.
- Severe period pain disrupts your everyday life. There might be a treatable underlying issue causing the excessive pain.
Understanding PMS (Premenstrual Syndrome)
PMS is a collection of symptoms that women can experience in the weeks leading up to their period. Most women experience PMS at some point, and there are various resources available if it's impacting your daily life.
Symptoms of PMS
Each woman's PMS symptoms are different and can vary from month to month. Common symptoms include mood swings, feeling upset or anxious, tiredness, trouble sleeping, bloating, tummy pain, breast tenderness, headaches, spotty skin, greasy hair, and changes in appetite and sex drive.
Managing PMS
Do:
- exercise regularly
- eat a healthy, balanced diet
- get plenty of sleep
- reduce stress through yoga or meditation
- take painkillers, such as ibuprofen or paracetamol, to ease the pain
- keep a diary of your symptoms for at least 2 to 3 menstrual cycles
Don't:
- smoke
- drink excessive amounts of alcohol
If self-management strategies aren't effective, or if your symptoms are significantly impacting your daily life, you should see a GP for further advice.
Treating PMS
Various treatments can help manage PMS, including hormonal medicine, cognitive behavioural therapy, antidepressants, and dietary supplements.
Understanding PMDD (Premenstrual Dysphoric Disorder)
A small number of women may experience more severe symptoms of PMS, known as premenstrual dysphoric disorder (PMDD). Symptoms of PMDD can significantly impact daily activities and quality of life and may include physical symptoms (cramps, headaches, joint and muscle pain), behavioural symptoms (binge eating, problems sleeping), and emotional symptoms (anxiety, anger, depression).
If you're feeling that you may harm yourself, call 999 for an ambulance or go straight to A&E, or ask someone else to call 999 or take you to A&E.
Remember, while menstruation is a normal part of a woman's life, it's crucial to stay informed and consult a healthcare professional if you notice any changes or if menstruation is causing significant distress.
