Menstruation: Common questions answered

In conversation with Dr. Mohini Patil, OBGYN, SRV Mamata Hospital

In India, more than half the female population has irregular menstrual cycle. What are most common reasons leading up to this?

Irregular periods may be seen in a wide range of conditions like:

• Ovulation dysfunction/PCOS
• Drugs given for some other diseases
• Having an intrauterine device (IUD)
• Stress – physical and mental
• Breastfeeding
• Fibroid, polyp in uterus or adenomyosis
• Uterine cancer
• Pelvic infection

All the above mentioned factors are also responsible for variation in flow of menstrual blood.

What happens if the periods don’t start at the right age?

The onset of first period in life is called Menarche and it may occur anywhere between 10 and 16 years, peak time being 13 years. It is associated with changes in breast, pubic and axillary hair, growth in height. It depends upon a variety of factors like genetic/ familial tendency, nutrition, cultural and social background.

If these changes do not occur within this age window then one a visit to your gynecologist for investigation is in order.

What is the usual frequency for a normal cycle?

The range of normal menstrual cycle is about 21-35 days, average being 28 days.

What are the chances of developing Uterine Cancer if this frequency is not normal?

Actually, there are other factors which are implicated in the causation of uterine cancer. It may or may not be related to irregular periods. However, irregular periods are a sign that something is not right, sometimes, quite simply it’s your lifestyle and must be corrected.

Do we induce periods in cases where the frequency is highly irregular and say someone has not gotten their periods for months at a time?

It depends. We primarily focus on correcting the lifestyle first. This essentially involves transitioning to a healthier day time routine of exercise, well planned meals, some stress free me-time and sufficient sleep. However, if periods are irregular and not getting corrected with lifestyle modification, it may be necessary to give hormonal medicines to regularize the cycles.

A lot of people tend to take drugs to induce or delay their menses, what effect does this have on the cycle?

Medicines used for modifying the duration of menstrual cycle may not be always advisable. They may not temporarily affect the body physiology/ function, but, in the long run, they may cause certain adverse effects like weight gain, heart and kidney diseases, acne, etc.

What happens when periods stop completely?

Permanent cessation of menses for more than a year is termed as menopause. It is the time when ovulation (release of female egg from ovary) stops and has effects on the entire body – degenerative changes in female genital organs, osteoporosis and fractures, hot flushes and wrinkling of skin.