A Gynaecologist answers everything you have ever wanted to know about periods but been too embarrassed to ask
Although India has made significant progress in the field of menstrual hygiene management, entrenched social stigmas surrounding menstruating women and girls continue to pose substantial obstacles to attaining period equity. For those who feel hesitant to inquire about their menstrual cycle or sexual well-being, relying solely on Google searches or unverified information shared by friends should not be your primary source of knowledge about your own body. While the ideal age for your first visit to a gynecologist may vary, as you mature and become sexually active, it becomes crucial to establish a trusting relationship with a gynecologist with whom you can comfortably share intimate details.
We spoke to Dr. Ankesh Sahetya (DNB, DGO, MNAMS, FICOG) a gynecologist, obstetrician and infertility specialist to get the answers for your most-asked questions about periods. Here’s what we learned.
1. What are the most common period issues you encounter in your practice
Most prevalent concerns among my patients are experiencing missed or irregular periods. From a young age, girls are taught that regular monthly periods, occurring every 30 days, is a symbol of their femininity. Consequently, when this natural cycle is disrupted, such as not having a period for 35 days, it often triggers anxiety. For those who are sexually active, the fear of pregnancy prompts them to take a pregnancy test. Some women, particularly those grappling with conditions like PCOS or approaching menopause, may suffer from heavy, painful periods lasting more than seven days, necessitating a pad change every two hours. This tends to affect older women. On the other hand, younger girls often face issues with scanty or irregular periods, coming in 2-3 months or surpassing the 35-40 day mark. These are the most commonly observed menstrual issues.
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2. What factors can cause irregular periods, and when should a woman be concerned about them?
The primary cause often revolves around one's lifestyle, encompassing three critical aspects: diet, exercise, and sleep. Your dietary choices can notably impact your body weight, as reflected by your Body Mass Index (BMI). Individuals exceeding their appropriate BMI weight range due to an unhealthy lifestyle, characterized by inadequate sleep, consumption of junk food, and a lack of physical activity, tend to experience irregular or missed periods. Additionally, those who have irregularly used contraceptive pills, such as emergency contraceptives like i-pill or pill 72 without proper guidance, may also encounter menstrual irregularities. Patients who have inconsistently adhered to their gynecological medication regimen can likewise face irregular periods. In essence, it predominantly boils down to one's lifestyle, adherence to advice, and adherence to a routine. These factors play a pivotal role in causing irregular periods.
When menstrual cycles occur more frequently than every 21 days or are significantly prolonged, such occurrences are considered abnormal. Similarly, if your menstrual cycle exceeds 35-40 days, resulting in scanty or irregular bleeding, it warrants consultation with a doctor. Experiencing periods lasting longer than seven days, accompanied by the passage of clots, heavy bleeding, weakness, or potential anemia, is a concern that requires attention. Furthermore, if you haven't had your period for 2-6 months or are enduring severe incapacitating pain that hinders your daily activities, it's imperative to seek the guidance of a gynecologist.
3. Are there any lifestyle changes or home remedies that can help manage menstrual cramps and discomfort?
There is no harm in taking a painkiller or a muscle relaxant. Many people have concerns about taking medications, but it's perfectly safe. If a woman needs to take one or three tablets per day for those two or three days each month, it's considered a normal and reasonable approach. To maximize effectiveness and safety, it's advisable to take the painkiller after a meal. Additionally, having dark chocolate, increasing fluid intake, eating fruits or anything that builds up your dopamine and endorphins can ease menstrual discomfort. alleviating discomfort. . Using a heating pad has always been gold standard for alleviating discomfort. Adequate rest and these simple measures are often sufficient to provide relief.
4. What are some common myths or misconceptions about periods that you frequently encounter in your practice?
There is a common misconception that having intercourse during menstruation is a healthy practice. However, this belief is not accurate. Engaging in sexual activity during your period can potentially lead to infections and conditions like endometriosis. It's important to note that having sex during your period is not a reliable method for preventing pregnancy, and there are more effective contraceptive options available. Another topic that often comes up is related to religious customs that restrict individuals from entering the kitchen or a temple while menstruating. However, it's worth mentioning that there is no scientific evidence supporting these customs; menstruation is simply the shedding of the endometrial lining.
In some cases, certain types of foods may impact menstrual regularity, but this is typically associated with a long-term consumption of fatty and unhealthy junk foods. It's important to understand that missing a period is not usually caused by the occasional consumption of a burger or pizza. The question of whether one can get pregnant during their period is a common query. When it comes to intimacy with a partner, if unprotected vaginal intercourse occurs during the fertile phase of your menstrual cycle, there is a risk of pregnancy. However, it's essential to clarify that simply being intimate or friendly with someone will not make you miss a period.
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5. How does hormonal contraception, such as birth control pills, affect the menstrual cycle? Are there any potential side effects to be aware of?
Anyone requiring birth control, period correction, hormone correction, we often prescribe the 21-day birth control pill which is a combination of progesterone and estrogen. While they balance the period, we also inform the patient that it may make the periods a little scantier. So, this is very helpful to treat heavy, painful, irregular periods as it is a one-time fix for everything. The most common side effects are nausea, gastritis, loss of appetite, so this also helps patients to manage their weight specially if they have water retention. So there are many combination pills but majority of them lead to nausea or feeling the need to vomit.
6. What are some red flags or warning signs during menstruation that may indicate a need for immediate medical attention?
If you find yourself experiencing severe and incapacitating pain, even after taking a painkiller, it may be indicative of underlying conditions such as endometriosis or uterine fibroids. In such cases, seeking medical attention is crucial, and a sonography is typically recommended in consultation with a gynecologist. Another concerning sign is excessively heavy and continuous bleeding that doesn't cease. This could potentially signal a hematological disorder or a clotting disorder leading to persistent bleeding. If you haven't had your period for 35 to 40 days, and a pregnancy test is either unnecessary or returns a negative result, it might be related to a hormonal imbalance. Additionally, frequent periods occurring twice or thrice a month should also raise a red flag, necessitating a thorough medical evaluation. In any of these situations, it's important not to delay seeking medical help but instead consult with a healthcare professional to address the underlying concerns.
7. How does age, such as puberty, perimenopause, and menopause, impact a woman's menstrual cycle and associated symptoms?
As women age, hormonal imbalances can arise, often accompanied by increased stress and peer pressure regarding one’s appearance—how the body looks and how the hair appears. Many individuals are influenced by the expectations set by social media, aspiring to look a certain way, including flawless skin, long hair, and the perfect body. It is essential to recognize that these influences can have a profound psychological impact on individuals. These factors, coupled with the discomfort of menstruation, create a complex set of challenges. Furthermore, during the menstrual cycle, there's the added concern of potential pregnancy due to ovulation. In light of these challenges, I recommend incorporating comprehensive sex education, health education, and guidance on adolescent health and hygiene from a young age. While these are topics we are addressing in many schools, it's essential to address both the psychological and physical aspects, ensuring that adolescents are equipped to navigate the complexities of their changing bodies and emotions.
8. Are there any dietary changes that may help regulate or alleviate menstrual irregularities?
To improve your overall health, consider reducing your consumption of junk food and carbohydrates while increasing your intake of protein-rich meals. Minimize your intake of items like pizzas, burgers, and excessive amounts of refined flour (maida). Instead, focus on incorporating more protein, leafy greens, fruits, vegetables, and salads into your diet. Engaging in regular physical activity is essential. Exercise is incredibly beneficial, so aim for at least 40 minutes of a solid workout, which can include activities like yoga, walking, or other forms of exercise. Regardless of how busy you are, prioritizing this time for physical activity is crucial for getting your health back on track. In addition to dietary changes and exercise, staying well-hydrated and maintaining a consistent sleep schedule are also important factors that can contribute to improved health.
9. How often should one do an annual check up?
If you are in a monogamous relationship and sexually active, it is advisable to schedule an annual check-up. During this check-up, various aspects can be addressed, including a pap smear, a general health assessment, a breast examination, and an ultrasonography to evaluate your uterus and pelvis. This is also an opportune time to discuss fertility and contraception options, ensuring comprehensive care. For individuals with multiple partners who engage in unprotected sex, a different set of considerations comes into play. This may involve undergoing STD panels, a pap smear with HPV testing, and considering HPV vaccines. It's worth noting that even monogamous couples can choose to receive the HPV vaccine as a precautionary measure. Regardless of your relationship status, whether you're focusing on contraception or planning for fertility, ongoing discussions about these topics should be an integral part of every gynecological check-up to ensure your health and well-being.
About Dr. Ankesh Sahetya | DNB, DGO, MNAMS, FICOG
Dr. Ankesh Sahetya is a second-generation Gynecologist and Obstetrician based in Lokhandwala Complex, Andheri West, Mumbai. He runs a hospital and IVF center in the area. Dr. Sahetya received his education and training from prestigious institutions, including Nowrosjee Wadia Maternity Hospital, Nair Hospital, Cooper Hospital, and Lilavati Hospital.
With a broad spectrum of expertise, Dr. Sahetya performs a wide range of procedures and offers comprehensive care in Obstetrics and Gynecology (OBGY). His primary areas of specialization include addressing conditions such as PCOS (polycystic ovary syndrome) and managing high-risk pregnancies. Moreover, he is well-versed in handling cases related to infertility, sexually transmitted conditions, and sexual dysfunctions, providing holistic healthcare solutions to his patients.
Book An Appointment: Dr. Ankesh Sahetya has been practicing for over 10 years at Pushpaa Hospital in Andheri West, Mumbai. In addition to in-person consultations, he extends his services to patients residing outside Mumbai through online consultations. This approach offers patients a convenient means of accessing his valuable medical expertise and guidance. Click here to schedule an appointment, or contact the hospital at +91 7715810228
If you'd like to obtain more information about gynecological topics and receive valuable tips, here's the contact information for Dr. Ankesh Sahetya.
Email: [email protected]