How to end the monthly agony
QI am a 31-year-old woman who has had two Caesarean sections and was sterilised 11 years ago. My son is 14 and my daughter has just turned 11. For the past three months my period has been abnormal and last month it was 10 days late. I normally have a heavy flow that lasts seven to 10 days, but during February and March it lasted for only four days and was a light flow.
I have lots of lower back pain and I constantly feel bloated.
My eating habits have changed, my appetite has increased and I am picking up weight. I feel pressure in my abdomen and am very tired. I used to run half-marathons and averaged 30km a week, but I can’t even complete a tenth of that now.
I don’t know where to turn. I am very worried as I don’t feel like myself any more and it is making me miserable.
My sex drive also seems to be reduced and while my spouse is very understanding, I fear it is creating tension.
ABesides wanting to plan your life in terms of sport and leisure activities, missed or irregular periods are often a key sign of pregnancy – planned or not.
The age and profile of the patient is essential to understanding these abnormalities. In the same vein, investigating for causes is not to be taken lightly.
Chronic pain is known to affect mood, and changes in character and personality due to hormonal imbalance can destroy relationships.
The 28-day menstrual cycle is regulated by hormonal drive. The sex hormones progesterone, estrogen, LH (luteinising hormone) and FSH (follicle stimulating hormone) are in constant dynamic balance facilitating your menses.
Alterations in the balance of these hormone profiles are brought about by many disease processes, including simple infections, ovarian cysts, tumours as well as thyroid problems, medications and the genetic predisposition to endometriosis.
A few typical abnormal patterns are:
Menoragia – abnormal volume of blood loss due to heavy flow.
Metroragia – abnormal rhythm and variable length of cycles.
Dysmennorhea – pain associated with menses.
It often occurs that you can experience abnormal rhythms and flow volumes in combination, which is known as menometroragia. What is a normal cycle? A regular textbook cycle is 28 days, but this ranges between 28 to 32 days in many women.
The length of the menses is usually five to seven days and the flow usually reaches peak volumes on day two and tapers off by day five.
When should one consult a doctor?
Heavy flow and erratic cycles for three months or more should be investigated by a health professional for treatable causes.
Often patients present with anaemia as a complication, with a history of generalised malaise and fatigue and a functional shift of physical ability.
When these problems affect your productivity, as well as your social and sex life, you become an easy target for anxiety and depression .
Do all women have painful menses?
No , the experience differs from person to person and varies from nothing to mild bloatedness, cramps and severe lower back and pelvic pain.
Dysmennorhea can be debilitating and negatively impact your work and play activities. Is period pain genetic ? Unfortunately, there is a strong genetic association and if your mother suffered you are certainly at risk of having similar issues.