Today is International Menstrual Hygiene Day (28 May). The day was created to break taboos surrounding menstruation, and take action towards a world where women and girls are no longer limited because of their periods. We asked Dr June Tan Sheren all about the monthly cycle that is with girls and women from their tween years to their 50’s.
What exactly is a period?
The menstrual period is a woman’s monthly bleeding, when the build-up of the lining of the uterus (womb) is shed. This is brought about by hormones in the body. Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina.
Talk to your daughter about starting her periods
Most girls experience menarche (the start of periods) between the ages of 10 and 16 years. Changes of puberty in the body usually occur before the periods start. The age at which menarche occurs is affected by genetic and environmental factors. Menarche can be delayed by poor nutrition, high levels of exercise (in athletes and dancers) and less often, certain medical conditions.
Your daughter will probably be asking you questions about menstruation before you know it! Aim to have this conversation before she actually starts having periods so there are no surprises. It is important to reassure your child that it is a perfectly normal and natural process of growth and development – one of the changes that she and all her girlfriends will experience as they go through puberty. Explain to her that girls should not feel afraid or ashamed about menstruation.
I highly recommend talking about menstruation to your sons as well when you feel the time is appropriate. They may or may not have learnt about it in school and it is always good as a parent to be able to check their knowledge and understanding, and clarify doubts and misconceptions.
I recommend these resources to my patients:
About your first period – American College of Obstetricians and Gynaecologists
Raising Children – an Australian parenting website
Period pain – treatments and why it happens
The medical term for period pain or menstrual cramps is Dysmenorhoea. More than half of women who menstruate have some pain for 1 to 2 days each month. Pain occurs during menstruation as the uterus contracts to expel the lining that is shed. This is a normal process. Common treatments that work well for mild to moderate pain include relaxation exercises, use of a hot water bottle, and pain relief medications including paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs, like ibuprofen and naproxen, reduce hormone-like substances (prostaglandins) in the body that trigger the uterine contractions, thereby reducing cramps. Hormonal birth control methods (contraceptives) are also good methods of preventing menstrual pain.
Sometimes, more severe and/or prolonged period pains may require further testing to check for other causes, such as:
- Endometriosis—Endometriosis happens when tissue similar to the lining of the uterus grows in other areas of the body, such as on the ovaries and fallopian tubes, behind the uterus, and on the bladder. Like the lining of the uterus, this tissue breaks down and bleeds in response to changes in hormones. This bleeding can cause pain, especially around the time of a period. Scar tissue called adhesions may form inside the pelvis where the bleeding occurs. Adhesions can cause organs to stick together, also causing pain.
- Fibroids—Fibroids are growths that form on the outside, on the inside, or in the walls of the uterus. Fibroids located in the wall of the uterus can cause pain. Small fibroids usually do not cause pain. This is commonly diagnosed in the pre- and peri-menopausal age groups, causing heavier menstruation as well.
- Adenomyosis—Adenomyosis develops when tissue that normally lines the uterus begins to grow in the muscle wall of the uterus. This condition is more common in older women who have had children.
Many different treatment options are available depending on the condition and the severity of it.
Finishing your periods
The extent of menstrual pain and flow often varies at different stages of a woman’s life, from adolescence into adulthood, before and after pregnancy and delivery, and when a woman enters the perimenopause before menstruation completely ends at menopause (defined as 12 months without a period). It is good to be aware of changes, and if there are unexpected changes or changes that you have difficulty coping with, to see your doctor for a check. Here is another article I wrote on Menopause that may explain some of the changes.
Dr June Tan Sheren is a family physician who sees girls and women at all stages of their life. She is known for her kind and measured approach and is a trusted women’s health professional with many years experience.
If you wish to book an appointment with Dr June please book here.