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Periods.…from the desk of Fertility Nurse Pam

Periods.…from the desk of Fertility Nurse Pam

Many people are uncomfortable talking about things like periods and premenstrual symptoms. Despite growing media coverage of reproductive issues, female biology remains a taboo topic within many homes and relationships. Periods are a completely normal biological function and given that about half the population spends roughly 40 reproductive years with a menstrual cycle, adding up to about 450 periods over one person’s lifetime, it’s really important that women feel comfortable talking about this topic and their bodies, and reaching out for help when they need it. So here is everything you need to know about periods!

 

The basics…

The menstrual cycle is more than just bleeding from the vagina that occurs roughly every 28 days and last for about 5 days. It’s how the female body prepares to get pregnant!  Hormonal changes happen on every day of the cycle, creating symptoms that are subtle (cervical fluid) and not so subtle (menstrual cramps). Every cycle, extra blood and tissue are added to the lining of the uterus  (the endometrium) until an ovary releases an egg for fertilisation (ovulation).  If there is no fertilised egg and pregnancy doesn’t occur, the extra blood and tissue are expelled from the body. That’s what the period is, it’s not just blood, but also lots of endometrial tissue that is not needed that cycle.

The stats…

The length of a menstrual cycle is counted from the first day of one period until the first day of the next. The average menstrual cycle is around 28 days, however it can range from 21 days to 35 days and you can still be ovulating normally.

The average length of bleeding is around 5 days but can range between 2 and 7 days.

It’s common to have longer cycles when you first get your period (menarche) they then become shorter and more regular. Menarche usually occurs at 12 or 13, while some girls can be as young as 9 and others won’t have their first period until they are 16.

The bleeding…

Most women will lose between 10-35 ml of blood during a period. Each soaked normal size pad or tampon holds about 5ml of blood so it’s normal to soak 2 to 7 pads or tampons in a whole period.

The amount of bleeding certainly varies between women and individual women are often surprised when they have a period that is much lighter or heavier than usual. Given that there is such variation it’s hard to know what is normal.

Officially, flow of more than 80ml (or 16 soaked sanitary products) is considered menorrhagia. Most women bleeding this heavily during each period (as opposed to a one off episode, say after surgery or a miscarriage) will have anaemia or evidence of iron deficiency. Heavy bleeding is most common in teen and perimenopause years as a result of the hormonal changes at that time and maybe ‘normal’ apart from the inconvenience and potential for iron deficiency. Menorrhagia in women out of their teens and not yet menopausal is typically due to easily treatable uterine issues such as fibroids, polyps and adenomyosis. However, other problem such as uterine cancer, bleeding disorders, medication side effects and liver or kidney disease must be ruled out.

Sanitary protection

The menstrual flow tends to be heaviest at the beginning of the cycle, becoming less after a day or two (medium flow) and then tapers off (light flow). The choice of feminine products or sanitary protection has to do with the level of flow one experiences.  Some women prefer to use pads and others are comfortable using tampons. Menstrual cups can be used and are inserted into the vagina to catch the flow, and there are now ‘period pants’,  absorbent undies that give leak proof protection and can be washed and reused again and again.

A word about tampons…

Tampons are very useful and have certainly dramatically changed the lives of many women and provided the freedom to continue with activities such as sports and swimming; however we have all heard those horror stories of tampon usage going wrong.

Not following proper tampon hygiene can lead to an increased risk of infection or toxic shock syndrome, a complication of a Staph bacterial infection. Wash your hands before inserting a tampon and change them regularly, every 4 to 8 hours.

There are some circumstances when you should not use a tampon:

– If you sleep for longer than 8 hours its best to use a pad or menstrual cup

– If you don’t have your period but have increased vaginal discharge its best to use a liner and if the discharge is smelly or itchy you should have a chat with your doctor

– If you are pregnant and have bleeding you should always use a pad or liner and be sure to let your doctor know of the bleeding

– If you have just had a baby you shouldn’t use a tampon until after the 6 week check-up and your doctor has given you the okay

– If you have just gynaecological surgery use a pad until your post op review and as advised by your doctor

– If you are using any vaginal medication

– And obviously, if you have had toxic shock syndrome previously, you should not use tampons

PMT (Pre Menstual Tesion) and  PMS (Pre Menstrual Syndrome) are topics for another article, in the meantime if you have any concerns you can book a free fertility nurse phone chat with me or book an appointment to see Dr Talmor.

Many people are uncomfortable talking about things like periods and premenstrual symptoms. Despite growing media coverage of reproductive issues, female biology remains a taboo topic within many homes and relationships. Periods are a completely normal biological function and given that about half the population spends roughly 40 reproductive years with a menstrual cycle, adding up to about 450 periods over one person’s lifetime, it’s really important that women feel comfortable talking about this topic and their bodies, and reaching out for help when they need it. So here is everything you need to know about periods!

 

The basics…

The menstrual cycle is more than just bleeding from the vagina that occurs roughly every 28 days and last for about 5 days. It’s how the female body prepares to get pregnant!  Hormonal changes happen on every day of the cycle, creating symptoms that are subtle (cervical fluid) and not so subtle (menstrual cramps). Every cycle, extra blood and tissue are added to the lining of the uterus  (the endometrium) until an ovary releases an egg for fertilisation (ovulation).  If there is no fertilised egg and pregnancy doesn’t occur, the extra blood and tissue are expelled from the body. That’s what the period is, it’s not just blood, but also lots of endometrial tissue that is not needed that cycle.

The stats…

The length of a menstrual cycle is counted from the first day of one period until the first day of the next. The average menstrual cycle around 28 days, however it can range from 21 days to 35 days and you can still be ovulating normally.

The average length of bleeding is around 5 days but can range between 2 and 7 days.

It’s common to have longer cycles when you first get your period (menarche) they then become shorter and more regular. Menarche usually occurs at 12 or 13, while some girls can be as young as 9 and others won’t have their first period until they are 16.

The bleeding…

Most women will lose between 10-35 ml of blood during a period. Each soaked normal size pad or tampon holds about 5ml of blood so it’s normal to soak 2 to 7 pads or tampons in a whole period.

The amount of bleeding certainly varies between women and individual women are often surprised when they have a period that is much lighter or heavier than usual. Given that there is such variation it’s hard to know what is normal.

Officially, flow of more than 80ml (or 16 soaked sanitary products) is considered menorrhagia. Most women bleeding this heavily during each period (as opposed to a one off episode, say after surgery or a miscarriage) will have anaemia or evidence of iron deficiency. Heavy bleeding is most common in teen and perimenopause years as a result of the hormonal changes at that time and maybe ‘normal’ apart from the inconvenience and potential for iron deficiency. Menorrhagia in women out of their teens and not yet menopausal is typically due to easily treatable uterine issues such as fibroids, polyps and adenomyosis. However, other problem such as uterine cancer, bleeding disorders, medication side effects and liver or kidney disease must be ruled out.

Sanitary protection

The menstrual flow tends to be heaviest at the beginning of the cycle, becoming less after a day or two (medium flow) and then tapers off (light flow). The choice of feminine products or sanitary protection has to do with the level of flow one experiences.  Some women prefer to use pads and others are comfortable using tampons. Menstrual cups can be used and are inserted into the vagina to catch the flow, and there are now ‘period pants’,  absorbent undies that give leak proof protection and can be washed and reused again and again.

A word about tampons…

Tampons are very useful and have certainly dramatically changed the lives of many women and provided the freedom to continue with activities such as sports and swimming; however we have all heard those horror stories of tampon usage going wrong.

Not following proper tampon hygiene can lead to an increased risk of infection or toxic shock syndrome, a complication of a Staph bacterial infection. Wash your hands before inserting a tampon and change them regularly, every 4 to 8 hours.

There are some circumstances when you should not use a tampon:

– If you sleep for longer than 8 hours its best to use a pad or menstrual cup

– If you don’t have your period but have increased vaginal discharge its best to use a liner and if the discharge is smelly or itchy you should have a chat with your doctor

– If you are pregnant and have bleeding you should always use a pad or liner and be sure to let your doctor know of the bleeding

– If you have just had a baby you shouldn’t use a tampon until after the 6 week check-up and your doctor has given you the okay

– If you have just gynaecological surgery use a pad until your post op review and as advised by your doctor

– If you are using any vaginal medication

– And obviously, if you have had toxic shock syndrome previously, you should not use tampons

PMT (Pre Menstual Tesion) and  PMS (Pre Menstrual Syndrome) are topics for another article, in the meantime if you have any concerns you can book a free fertility nurse phone chat with me or book an appointment to see Dr Talmor.