Updated: Dec 20, 2020
Having a regular period is one of the most wonderful parts of being female. It encompasses your womanhood and it typically indicates that you are fertile and you will be able to conceive a baby when you are old enough and ready. However, for some girls and women, their monthly menstrual cycle can be a time of confusion, annoyance, frustration and even pain. It needn’t be – as a doctor who specialises in fertility and gynaecology, I am here to help. In this month’s column, I answer some reader’s questions about your monthly period.
Q: Is it bad to skip your period multiple times whilst on the pill?
A: Skipping a period when you’re on the pill means you take the ‘active’ medication in the pack consistently without a break, which effectively stops menstrual bleeding that month. So, instead of taking the seven days of inactive medication, which is the time you would typically menstruate, you leave them and continue with the active pills. This has the effect of causing you to skip a period. A lot of women do this, for many different reasons. They may have a special event, a holiday, or it could be to help control mood swings, stop painful menstrual cramps, ease migraines, calm hormone-related acne and more. Generally, we do say it’s safe to do this. However, we do advise you speak to your doctor before you do this, especially if you have other medical conditions. Q: I'm having trouble with tampons. I feel like they're not working properly. What do I do?
A: Tampons can be tricky to manage when you first begin using them, from getting the hang of inserting them properly, to knowing which size is best for your flow, and even how frequently to change them. Firstly, let’s talk about which size to choose. Typically, tampons come in Super, Regular and Mini sizes, with the Super being designed for heavier flow in the first days of your period and the mini designed for use at the end when flow is very light.
Remember to always change your tampon every three to four hours, or more if your period is heavier. Tampons have been associated with a rare bacterial infection called Toxic Shock Syndrome, so it is very important to wash your hands thoroughly before inserting a tampon, and alternating between tampons and pads where possible.
Q: My periods are so painful each month. Sometimes the cramping is so bad I need to stay at home. What can I do about it? Could there be something wrong? A: Many women naturally experience painful periods, a condition medically known as dysmenorrhoea. Primary Period Pain is the most common and it is when hormones cause the uterus to contract more than usual during your period. There are over the counter medications available at pharmacies that can ease this kind of cramping, and of course things like a hot water bottle and/or a hot bath can be extremely useful. You may not feel like exercising, however, sometimes gentle stretching in a yoga class can help ease the cramping, too. If the pain is prolonged and very strong, ask your GP to explore any medical conditions that may be causing the cramping, which is what we refer to as Secondary Period Pain. Secondary period pain is when the pain is symptomatic of an underlying medical condition like endometriosis or another medical condition. Your doctor can refer you to a gynaecologist who can diagnose the condition and work out an appropriate treatment protocol.
Q: My period is so heavy that I go through a tampon or pad almost every hour or two. What can I do?
A: Heavy periods can be associated with medical conditions like fibroids or polyps, so I recommend seeing your doctor to rule these conditions out. If you receive a positive diagnosis to these or other medical conditions associated with heavy periods, your doctor can refer you to a specialist who can then treat the condition accordingly. If medical conditions are ruled out, and it turns out that you simply have a heavier flow than most, you may wish to consider taking the contraceptive pill, which can be a great way of minimising a heavy blood flow with each period.
Q: What does the colour of my period mean?
A: The colour of your menstrual flow can vary from black, to dark brown, dark red, bright red, orange, or pink. It is all related to how fast or slow your flow is. Typically, the darker the blood, the slower your menstrual flow is, as the darker colour indicates older blood that has been sitting in the uterus for longer.
Sometimes dark red blood can be associated with the start of your period, or it might be that colour first thing in the morning, after you’ve been lying down all night. It indicates the blood has been sitting in your uterus for a while but hasn’t yet oxidised to the point of turning brown. Occasionally, this colour is evident towards the end of your period, too, although as you near the end of your period, it’s likely the blood will be a lighter pink. If your period appears grey in colour, it may indicate infection, in which case you should see your doctor immediately, especially if it’s accompanied by fever, itching, pain or an unusual odour. Q: Is PMS still relevant when you're in your 20s? A: PMS, or Pre-Menstrual Syndrome, is a collection of signs that you are ovulating, and it can affect women at any age. These include cramping, tender breasts, bloating, mood swings, hormonal acne and tension headaches. Typically, these symptoms are most prominent from your mid-to-late twenties to early thirties, however they can be present from the onset of puberty right through to menopause. Over-the-counter medications can help ease cramping, while gentle exercise like swimming and yoga can improve your mood and help ease bloating and headaches. If the symptoms become unbearable, please seek advice from your doctor.
Q: Can I get pregnant whilst on my period?
A: While the chances may be low, it is possible. Your ovum (egg) survives for only 12 to 24 hours after being released, however sperm can live inside your body for up to five days. So, if you have unprotected sex whilst on our period and the timing aligns, there is a chance you may conceive.
Q: My period lasts three days... is that normal?
A: The length of a period can vary between three to four days and sometimes up to seven tor even 10 days. Some women experience quite long menstrual bleeds of seven or more days, while others have quite short periods. However, the average period is approximately five days, with a heavier flow during the first few days, which then typically lightens considerably. It is not unusual for someone to experience a three-day period, however if it is shorter than two days, it could indicate a fertility issue and if longer than seven days you may be prone to getting anaemia and it would be wise to ask your doctor for further investigation.
Q: Is it true women are seen as less desirable when on our periods, because we let off an odour?
A: Anyone who tells you that you’re less desirable because you are experiencing a natural, beautiful female function is not really a good friend and definitely not good boyfriend/husband material! Your period does not cause you to ‘let off an odour’. However, a healthy period may have a slight smell of blood, which can be metallic due to the iron levels. This is typically not noticeable to anyone except you. Showering daily and practising proper hygiene will also help keep any odours at bay. If you notice a fishy or sour smell at any time (whether you have your period or not), it may indicate a bacterial imbalance or infection, so it would be wise to see your doctor to investigate further.