Period pain specialist Perth

Period problems

Dr Richard Murphy

Period problems

Period problems can affect your daily life and may need the attention of an experienced gynaecologist. We look for underlying conditions, and my goal is to work out the best option to manage your symptoms depending on your circumstances. Part of that process is about making sure you understand your cycle and what causes period problems.
Obstetrics and gynaecology consultations at my private practice in Subiaco.

Fertility consultations at Genea Hollywood Fertility

Delivering at the Labour Ward of SJOG Subiaco Hospital

Period problems

Worried about your period?

Variety of period problems

When we talk about a normal period, we mainly talk about regularity. A period occurring every 21 to 35 days, lasting for 2 to 7 days, is considered regular. Most women will have a period every 26-32 days and bleed between 3 and 5 days.

The regularity of your cycle reflects what is happening in your body. Your normal menstrual cycle prepares your body for a potential pregnancy. An egg develops in the first part of your cycle as you prepare to ovulate at midcycle. Following ovulation a corpus luteum forms in your ovary, producing progesterone to support the development of any pregnancy.

The actual bleed is a way for your body to reset the process if you are not pregnant. Your hormones fall back to baseline, the endometrial lining is shed and you have your period.

As you get older, it is normal to experience a shorter period length. In your late 30s and into your 40s, you may well have a shorter cycle compared to your 20s or early 30s. It is never normal to have bleeding between your periods or after intercourse. Bleeding in these situations should be investigated to exclude disease such as infection and cancer.

"Periods can be abnormal in many different ways. They can be irregular, infrequent or absent, heavy or painful. As a gynaecologist, my role is to explore if your symptoms need attention to assess the risk of any underlying conditions, or potential fertility problems"

Dr Richard MurphyPerth Gynaecologist
period problems Perth gynaecologist

Let’s say you just don’t get your period. Or they are very infrequent. In this case, we want to look at the bigger picture: a potential increased risk of endometrial cancer, and difficulties falling pregnant, if you are planning to have children.

Another reason to come and see me as your gynaecologist is a sudden change in your periods after a surgical procedure. Examples include Ashermann’s syndrome, where the endometrium is damaged after a D+C or cervical stenosis after surgery on the cervix.

Other period problems I can assist with are:
  • Heavy periods with large blood clots or flooding: If you need to change sanitary pads or tampons overnight.
  • Painful periods: Excessive period pain can be disabling and distressing, and often comes with stress and anxiety, missing time at work, education or social activities.
  • Bowel pain (dyschezia) associated with your period
  • Irregular bleeding between periods
  • Bleeding after intercourse
Whatever the symptoms or discomfort, I can help you with routine tests and investigations so we can identify or exclude underlying conditions and discuss the best possible way to manage your period problems.

What are some of the symptoms of a normal period?

To understand what is abnormal, it is useful to take a moment and consider what a normal period is, as mentioned. And what is considered a symptom of a normal period?

In the second half of your cycle the rise in progesterone can cause premenstrual symptoms:

  • Breast tenderness
  • Abdominal bloating
  • Bowel changes
  • Acne
  • Fatigue
  • Poor sleep
  • Mood changes: anxiety, irritability or low mood.
  • Abdominal cramps are common, reflecting uterine contractions, as your period bleed starts. Periods are usually heaviest in the first 2 days.

My patients from around the Perth metro area and remote Western Australia tell me that it is often useful to gain a better understanding of the human body. Understanding your symptoms will help you find peace-of-mind, and will help you define if what you are experiencing is normal or needs further investigation by a qualified gynaecologist.

Seeing gynaecologist for period pain

When should you see a gynaecologist?

We know that your period reflects what is happening in your body, and in some situations, it is important to see a doctor.
If your periods are irregular or stop altogether, for example. This is being associated with infertility and risks of endometrial cancer, which is why your GP may refer you to my clinic for further tests and investigations.

"If you are bleeding between your periods or after intercourse, it is important to know that this is not part of a normal menstrual cycle or a normal period."

Dr Richard MurphyPerth Gynaecologist
period problems gynaecologist Perth

It is hard to describe what is a normal period pain level and what is abnormal. If your pain is interfering with day to day activities or worsening then it is wise to see a gynaecologist. Endometriosis and adenomyosis get more common and severe with time. Even if you are diagnosed with a condition that affects your period, there are good management plans available.

If you experience large blood clots, heavy periods, flooding or you need to change pads and tampons overnight, there are good treatments available for this type of discomfort.

Causes period pain and abnormal menstruation

What causes abnormal periods?

Your period can be a reflection of your general health. It may stop altogether if you are under pressure, or if you have lost a lot of weight. Major illness can also disrupt your normal cycle.

Polycystic ovarian syndrome or PCOS is a very common cause of abnormal periods and seeking clear medical advice from an experienced gynaecologist can reduce some of your anxiety and uncertainty when you receive this diagnosis.

Other causes of abnormal menstrual cycles are:

  • Endometrial or endocervical polyps (structural abnormalities)
  • Fibroids
  • Cervical ectropion/erosion

Excessive pain can point our investigations toward conditions such as endometriosis and adenomyosis. Both conditions are treatable.

And if you experience both pain, abnormal bleeding and difficulties conceiving, we may want to look for any current or past pelvic infection.

diagnosing period pain

How do we diagnose abnormal menstruation?

Many women tell me that they were not always aware of the help they could get and the tests that are available to investigate abnormal periods.

We use a combination of information to make an accurate diagnosis:

  • Your history
  • Blood tests
  • Ultrasound images

Where possible, we work to restore regular ovulation and we focus on managing any problems that may occur due to your menstrual cycle.

Sometimes a surgical procedure is required to get a full diagnosis. This may include biopsying the cervix or endometrium, hysteroscopy to look inside your uterus, or laparoscopy to look inside your abdomen and pelvis.

Perth gynaecologist for treating period pain

How is abnormal menstruation treated?

Together, we will discuss the best possible treatment for your period problems. The options will vary depending on your symptoms, pain levels, bleeding and whether you want to become pregnant or avoid pregnancy.

Medical management can be useful for endometriosis, adenomyosis, pelvic infection, irregular or absent periods.

Surgery can help with polyps, fibroids, endometriosis and adenomyosis.

Ovulation induction is the first-line treatment for irregular or absent periods, achieving very good pregnancy rates. The correct treatment for you needs to be tailored for your specific diagnosis and situation.

When there is no underlying medical condition

Sometimes there is nothing to see on ultrasound images and you may require a more invasive procedure such as laparoscopy to make a diagnosis. If the symptoms are mild, it is often best to trial medical nonsurgical treatment first.

If this allows us to manage and control your symptoms, surgery or a more detailed diagnosis may not be needed. Managing your periods is often a balance between risk and benefit.

I use my experience to aim for the best improvement in your symptoms with the least invasive treatment possible.

Perth Gynaecologist Richard Murphy for period pain

Why Dr Richard Murphy?

I use my experience in women’s health to carefully assess your symptoms and situation. I believe that you deserve a clear diagnosis, and an open conversation about possible management or treatment options, for your circumstances.

"You can count on my experience, to make decisions about the best possible treatment. If you have concerns about heavy, painful or irregular periods, please book a consultation to see me and I look forward to helping you."