Friday 30 September 2016

15 things to know about periods

It's a constant in a woman's life, yet many of us are happy to let our menstrual cycle run its course each month without giving it much thought. But getting more familiar with your cycle can offer a wealth of health information, says fertility nurse specialist Mary McAuliffe

Published 16/08/2016 | 02:30

Get familiar with your menstural cycle

Getting to know your menstrual cycle can provide a wealth of information on your reproductive and fertility health, according to fertility nurse specialist Mary McAuliffe. For couples who are trying for a baby, she says that keeping a diary of your monthly cycle can be a valuable method of boosting your chances of conception. Here are 15 things to note about your menstrual cycle.

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1 Get to grips with your cycle

Every woman should get to know their menstrual cycle and become familiar with the subtle changes their body goes through on a monthly basis. A regular cycle is usually 28-30 days long with ovulation occurring on day 14-16. I encourage all the women I see to keep a menstrual diary. Take note of the length of your cycle, taking 'day one' as the first day of your period. Keep track of how many days your period lasts for, and how many days from day one of a cycle to day one of the next cycle.

Any pain, vaginal discharges, or other symptoms should also be noted. This information can be helpful if you need to seek assistance when pin-pointing fertile days of your cycle, or if you are attending the GP for health concerns or pregnancy delay.

2 The biology

At the beginning of your cycle, your body starts producing oestrogen, which is necessary for the lining of the uterus to thicken in preparation for pregnancy. Once the oestrogen reaches a certain level, your body triggers an 'LH surge' - the release of the Luteinising Hormone. Within 48 hours of the LH surge, your ovary releases an egg (ovulation) which travels into one of your fallopian tubes. If fertilised by sperm, the fertilised egg may implant and hopefully a healthy pregnancy will follow. If there is no fertilisation, the womb lining is shed and the cycle, day one, begins.

3 PMS

Premenstrual syndrome affects the majority of women. It is caused by the changes in hormone levels that occur during the menstrual cycle. Common symptoms include bloating, cramps, headache, irritability, food cravings and fatigue.

Using a menstrual diary to record PMS symptoms will get you in tune with how your body normally reacts during your cycle, and will alert you to any new symptoms, as well as methods that help you cope.

For some, exercise and dietary changes along with supplements can make a big difference to negative hormonal symptoms.

4 Ovulation

If you have a regular 28-day cycle, ovulation will occur on day 14. If your cycle is longer or shorter, count back 14 days from day one to find the day on which you ovulate. Your 'fertile window', or the time frame in which you have the best chance of conceiving, is two days before the day you ovulate through to two days after, so days 12 to 16 in a regular cycle. Remember that sperm lives for much longer than the egg.

5 Irregular periods

With the exception of women who are pregnant, going through menopause, on the contraceptive pill, or women who are known to have polycystic ovaries, every woman should have a period once a month. If you find you are skipping months and your periods are very erratic, you should see your GP or a fertility specialist. Very irregular periods can be an indication of an underlying health problem that your GP can investigate. Often a simple blood test can help shed light on the cause for irregularities. If you are concerned about your fertility, consider a fertility check which can give you reassurance or arm you with more knowledge for the future.

6 Amenorrhea

A diagnosis of secondary amenorrhea will be made after missing at least three periods when a woman was previously menstruating. This can either be caused by an issue with reproductive organs, or problems with glands that regulate hormones. Over-exercising, extreme weight loss, excessive stress or illness are also triggers.

Normally, treating the underlying issue will resolve secondary amenorrhea. Primary amenorrhea is when menstruation has not occurred by age 16 and should be investigated. Anyone who experiences either primary or secondary amenorrhea should seek medical advice.

7 Family history

Ask your mother or any older sisters about their menstrual history. For example, if your mum went through an early menopause, then there is a risk that this may happen for you too.

8 Your period after the pill

Seek medical advice if you have not started menstruating again within four to six months of stopping the contraceptive pill. Also pay attention to the length of your cycle. Has it changed? This can be especially important if you are trying for a baby, as your 'fertile window' might be different to what it was before you were on the pill. Keeping a menstrual diary will help with this.

9 Foods that can help regulate your period

Ensure your diet includes plenty of omega-3 essential fatty acids, found in oily fish such as salmon, flaxseed, walnuts and avocados. This helps with blood flow which will assist in the movement of the egg from the ovary. Eat plenty of plant protein, found in legumes and nuts, which will help with regulating your hormones.

Try to increase your vitamin D intake by getting out in the sunshine or taking a supplement - this can help with healthy egg development. Eating a little 70pc dark chocolate, which contains flavonoids, can help with increasing microcirculation in the ovaries. A healthy diet and plenty of water will also help with relieving PMS symptoms.

10 Lifestyle tips that can help regulate your period

There are a number of simple lifestyle tips which can help to regulate your period, and will also improve your reproductive and general health. First of all, quit smoking. The blood vessels in your ovaries are tiny and can be damaged easily by smoking, which can affect your blood flow. Also maintain a healthy weight; obesity can negatively affect ovulation, while being underweight can be just as bad.

Engage in a healthy rate of exercise that you enjoy and avoid vigorous exercise. Keeping active will also reduce stress levels, which can adversely affect your cycle.

11 Teenage girls and periods

Between the ages of eight and 13, a girl will normally go through puberty. Generally speaking, about two years after a girl's breasts develop, she should experience her first period. The medical term for this is menarche; when all parts of the girl's reproductive system have matured and are working together.

Around six months before a girl gets her first period, she may notice a clear vaginal discharge. This is normal and should not cause worry, unless it is causing itchiness or has a strong odour. Normally, a first period should not last longer than seven days. If it does, or if dizziness or a racing pulse is experienced, medical advice should be sought.

12 Menopause

This is a normal condition that all women experience over the age of 40 and usually at around age 51. As every woman is born with a finite number of eggs, a woman eventually stops ovulating and, therefore, menstruating.

Perimenopause begins a number of years before menopause, and in the final one to two years, women will experience menopausal symptoms such as hot flushes, mood swings, insomnia and fatigue. Once the period stops for 12 months, the woman enters the postmenopausal stage and the symptoms should cease.

13 Early menopause

Around one-in-100 women will experience early menopause - before the age of 40. The symptoms are very similar to menopausal symptoms: hot flushes, night sweats, mood swings and low libido. Early menopause can be genetic, so it's a good idea to chat to your mum about her history. There are also lifestyle factors such as smoking or being very underweight, and other factors including chromosome defects or autoimmune diseases.

14 Clues to cervical cancer symptoms

There are a number of symptoms of cervical cancer that can become apparent if you are tuned in to your menstrual cycle. For example, irregular bleeding in between your periods or a discharge that is streaked with blood. If a woman who has gone through menopause notices this type of bleeding, it is never normal and they should consult a GP. Any unusual vaginal discharge should also be taken note of, especially discharge that is white, watery, brown, or smells. If this persists, medical advice should be sought.

15 When to expect a period after having a baby

A woman's period will typically return about six to eight weeks after giving birth, if she is not breastfeeding. If she does breastfeed, the time it takes for a period to return can vary. Some women might not have a period the entire time they breastfeed. But for others, it might return after a couple of months. If you are not breastfeeding and do not get your period after three months, you should speak to your GP.

* Mary McAuliffe is a fertility nurse specialist and head of clinical services at Cork Fertility Centre

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