Periods and Menstruation

2025/02/14

I have irregular periods and should I go see a gynaecologist?

Healthy women would generally have one menses per month, involving cycles of between 21 and 35 days, heavier bleeding with some pain on the first one to two days, and menstrual bleeding lasting no longer than one week. Variations depend on age, body weight, stress and other health problems. It is useful to keep a menstrual diary to assist your doctor in evaluating your menstrual pattern. If you experienced or suspect any problems, it is recommended to consult a gynaecologist who specialises in reproductive endocrinology.

Is it normal to experience itchness of the private parts when I use a sanitary pad?

Yes, itchiness in the genital region, particularly during menses, can be a result of skin irritation. However, there is a possibility of increased fungal growth or other infections. In the human body, there exists different types of common ‘tenants', including non-pathogenic bacteria and fungus in the vagina and vulva. When the balance is compromised or affected by the presence of other infections, further examination is needed, which usually involves a simple swab test and an examination by a gynaecologist. It is advisable to keep the genital region dry in hot and humid climates. Applying plain talcum powder after shower and avoiding conditions that induce excessive sweating may be helpful.

What can I do to cope with the PMS symptoms (tiredness and bloating) before and after my period?

Pre-menstrual syndrome (PMS) can be uncomfortable. To address the issue, investigations of hormone levels and the gastrointestinal system may be conducted to determine the best treatment. The best option is to see a gynaecologist who specialises in reproductive endocrinology.

Is it normal to have dark brown spotting before my period?

When very light bleeding occurs, blood travels slowly from the womb, via the neck of the womb, through to the vagina. During this process, red blood cells are broken down and iron, which is dark brown or black in colour, is released. This usually happens when female hormones fluctuate between high and low levels or at very low levels, leading to irregular bleeding. Dark brown spotting may also suggest erosion of the neck of the womb, presence of polyps or infection, which may occur after sex and menopause. In most cases, general gynaecologic examination and information on medical history should suffice in determining the cause. The doctor will decide if treatment is needed. It is advisable to seek medical attention promptly and to undergo regular Pap smears.

I'm on a diet and I'm not sure if ithis had affected my menses cycle as my period has stopped. May I know how I can readjust my cycle?

This may be due to 'crash dieting', which may affect both the reproductive system and the body's metabolic rate. The brain received the 'wrong message' that the body is undergoing starvation and an emergency response is warranted. This leads to cessation of all non-essential processes, starting with those in the ovaries. The consequences include decreasing levels of female hormones in childhood, missing menstruations for months and osteoporosis in old age.

Knowing your body weight and height, birth before and after diet, will enable the doctor to calculate your ideal weight and to determine the best type of treatment. Hormone replacement treatment spanning several months may be needed while the weight stabilises. While measures to lose weight does not necessarily cause negative consequences, it must be undertaken gradually and stays in a range that allows the body to function optimally. It is advisable to consult a gynaecologist who specialises in reproductive endocrinology.

What kind of exercises can I do to relieve my cramps? Besides taking warm drinks, what can I do?

Menstrual cramps, or dysmenorrhea, is a common condition in adolescence. It is usually due to the presence of prostaglandins in menstrual blood, which causes the womb to contract, causing blood to be released. In young females, the neck of the womb can be very tight, which takes time to open. Menstrual cramps may also be due to other causes, which some being linked to serious conditions. Hence, it is advisable to consult a doctor if frequent menstrual cramps are affecting your life. Taking over-the-counter medications such as Panadol Menstrual or Ponstan can help to neutralise prostaglandins. While consuming warm drinks and exercising have been found to have no direct association with pain, these activities may increase blood circulation. It is important to note there taking painkillers periodically carries no risk of developing dependency. Painful cramps generally self-resolve without any medical intervention. However, if the pain still persists, please seek prompt medical advice and treatment.