Period problems
Fertility consultations at Genea Hollywood Fertility
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.
"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"
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.
- 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
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?
"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."
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.
Causes period pain and abnormal menstruation
What causes abnormal periods?
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?
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.
Perth gynaecologist for treating period pain
How is abnormal menstruation treated?
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?
"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."
